Curators of the University of Missouri
Curators of the University of Missouri in Columbia, MO publishes cash prices for 458 common procedures listed here, from its own machine-readable price file updated Dec 15, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 221 of 436 procedures and below it for 204. By typical cash price it ranks #33 of 67 Missouri hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
One Hospital Drive, Columbia, MO 65212 Collected Sep 22, 2026 Source price file Check a bill from this hospital (573) 882-4141
Acute care hospital Government-owned hospital Emergency department CMS star rating 3 of 5 CCN 260141 · CMS hospital register NPI 1699769901
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Curators of the University of Missouri 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 Missouri | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WOW CONTRAST-AM | $1,650.00 | $2,750.00 | $169.27–$175.84 | 15% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WOW CONTRAST-MOC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 15% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WOW CONTRAST-JCT | $1,650.00 | $2,750.00 | $169.27–$175.84 | 15% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WOW CONTRAST-XS | $1,650.00 | $2,750.00 | $169.27–$175.84 | 15% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WOW CONTRAST-CM | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 15% below | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-MOC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-DIJR | $1,650.00 | $2,750.00 | $748.00–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-XS | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-AM | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-CM | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-JCTG | $1,650.00 | $2,750.00 | $748.00–$2,420.00 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WOW CONTRAST-JCT | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY ABDOMEN 2 VIEWS-JDI | $336.60 | $561.00 | $101.11–$105.04 | 14% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XO | $336.60 | $561.00 | $196.35–$493.68 | 14% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XS | $336.60 | $561.00 | $101.11–$105.04 | 14% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XM | $336.60 | $561.00 | $196.35–$493.68 | 14% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-FAY | $336.60 | $561.00 | $196.35–$493.68 | 14% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY; ABDOMEN; 2 VIEWS-JUTR | $403.80 | $673.00 | $101.11–$105.04 | 36% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY ABDOMEN 2 VIEWS-MUCX | $403.80 | $673.00 | $235.55–$592.24 | 36% above | 40% |
| Abdominal X-ray, 2 views CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-MUC | $403.80 | $673.00 | $235.55–$592.24 | 36% above | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS-JFMC | $336.60 | $561.00 | $152.59–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XS | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS-DIJR | $336.60 | $561.00 | $152.59–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS-JDI | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XO | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-FAY | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY; ABDOMEN; 2 VIEWS-JFMV | $336.60 | $561.00 | $152.59–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS-FFH | $336.60 | $561.00 | $152.59–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-BAMB | $336.60 | $561.00 | $152.59–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-XM | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS-MUCX | $403.80 | $673.00 | $235.55–$592.24 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY; ABDOMEN; 2 VIEWS-JUTR | $403.80 | $673.00 | $235.55–$592.24 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY, ABDOMEN, 2 VIEWS-MUC | $403.80 | $673.00 | $235.55–$592.24 | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-XS | $314.40 | $524.00 | $183.40–$461.12 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-XM | $314.40 | $524.00 | $83.72–$86.97 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE COMP-FAY | $314.40 | $524.00 | $183.40–$461.12 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE OC | $314.40 | $524.00 | $183.40–$461.12 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE MIN 3 VIEWS-XO | $314.40 | $524.00 | $83.72–$86.97 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-JDI | $314.40 | $524.00 | $83.72–$86.97 | 9% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-MUCX | $378.00 | $630.00 | $220.50–$554.40 | 31% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-JUTR | $378.00 | $630.00 | $220.50–$554.40 | 31% above | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE COMPLETE-MUC | $378.00 | $630.00 | $220.50–$554.40 | 31% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE MINIMUM 3 VIEWS-JFMC | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY, ANKLE, COMPLETE, MINIMUM 3 VIEWS-BAMB | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-XS | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE-DIJR | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-XM | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE OC | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-FFH | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE MIN 3 VIEWS-XO | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-JDI | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE MINIMUM 3 VIEWS-JFME | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE MINIMUM 3 VIEWS-JFML | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE MINIMUM 3 VIEWS-JFMO | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE COMPLETE MINIMUM 3 VIEWS-JFMV | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RAD EXAM ANKLE COMP-FAY | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-MUC | $378.00 | $630.00 | $220.50–$554.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-JUTR | $378.00 | $630.00 | $220.50–$554.40 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE COMPLETE-MUCX | $378.00 | $630.00 | $220.50–$554.40 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON-INVASV PHYSIOLOGIC STUDY UPR/LWR EXTR ARTER 2 LVLS-CTST | $377.40 | $629.00 | $122.56–$127.32 | 21% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ARTERIAL DOPPLER ABI UM | $377.40 | $629.00 | $122.56–$127.32 | 21% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ARTERIAL DOPPLER ABI-XS | $377.40 | $629.00 | $122.56–$127.32 | 21% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ARTERIAL DOPPLER ABI-JUC | $377.40 | $629.00 | $220.15–$553.52 | 21% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ARTERIAL DOPPLER ABI-XO | $377.40 | $629.00 | $220.15–$553.52 | 21% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON-INVASV PHYSIOLOGIC STUDY UPR/LWR EXTR ARTER 2 LVLS-CTST | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ARTERIAL DOPPLER ABI-XS | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ARTERIAL DOPPLER ABI-JUC | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ARTERIAL DOPPLER ABI-CCDJ | $377.40 | $629.00 | $171.09–$553.52 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ARTERIAL DOPPLER ABI-XO | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ARTERIAL DOPPLER ABI UM | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WO CONTRAST-XS | $949.80 | $1,583.00 | $101.11–$105.04 | 21% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WO CONTRAST-CM | $949.80 | $1,583.00 | $554.05–$1,393.04 | 21% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WO CONTRAST-JCT | $949.80 | $1,583.00 | $554.05–$1,393.04 | 21% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WO CONTRAST-MOC | $949.80 | $1,583.00 | $101.11–$105.04 | 21% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-CM | $949.80 | $1,583.00 | $554.05–$1,393.04 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-XS | $949.80 | $1,583.00 | $554.05–$1,393.04 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-MOC | $949.80 | $1,583.00 | $554.05–$1,393.04 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-JCTG | $949.80 | $1,583.00 | $430.58–$1,393.04 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-JCT | $949.80 | $1,583.00 | $554.05–$1,393.04 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WO CONTRAST-DIJR | $949.80 | $1,583.00 | $430.58–$1,393.04 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-XO | $435.60 | $726.00 | $169.27–$175.84 | at median | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-XM | $435.60 | $726.00 | $254.10–$638.88 | at median | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-JDI | $435.60 | $726.00 | $254.10–$638.88 | at median | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-XM | $435.60 | $726.00 | $254.10–$638.88 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-JDI | $435.60 | $726.00 | $254.10–$638.88 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY, ESOPHAGUS, INCLD CHEST, SINGLE CONTRAST STUDY-BAMB | $435.60 | $726.00 | $197.47–$638.88 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XRAY ESOPHAGUS; SINGLE CONTRAST STUDY-XO | $435.60 | $726.00 | $254.10–$638.88 | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY-JNM | $1,452.00 | $2,420.00 | $382.07–$396.91 | 2% above | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY-NM | $1,452.00 | $2,420.00 | $382.07–$396.91 | 2% above | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY-DINP | $1,452.00 | $2,420.00 | $382.07–$396.91 | 2% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY-DINP | $1,452.00 | $2,420.00 | $847.00–$2,129.60 | — | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE IMAGING WHOLE BODY-NM | $1,452.00 | $2,420.00 | $847.00–$2,129.60 | — | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE IMAGING WHOLE BODY-JNM | $1,452.00 | $2,420.00 | $847.00–$2,129.60 | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-BI | $527.40 | $879.00 | $101.11–$105.04 | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT INCLUDING AXILLA COMP-JUC | $527.40 | $879.00 | $307.65–$773.52 | 24% above | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-UM | $527.40 | $879.00 | $101.11–$105.04 | 24% above | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-FAY | $527.40 | $879.00 | $307.65–$773.52 | 24% above | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-BI | $527.40 | $879.00 | $307.65–$773.52 | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-UM | $527.40 | $879.00 | $307.65–$773.52 | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST, UNILAT, INCLUDING AXILLA COMP-FAY | $527.40 | $879.00 | $307.65–$773.52 | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT INCLUDING AXILLA COMP-JUC | $527.40 | $879.00 | $307.65–$773.52 | — | 40% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST, UNILAT, INCLUDING AXILLA LIMITED-BI | $345.00 | $575.00 | $83.72–$86.97 | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-SPFM | $345.00 | $575.00 | $201.25–$506.00 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-NFM | $345.00 | $575.00 | $83.72–$86.97 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FUL | $345.00 | $575.00 | $83.72–$86.97 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FAY | $345.00 | $575.00 | $201.25–$506.00 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCLD AXILLA WHN PERF LIMITED-EC | $414.60 | $691.00 | $83.72–$86.97 | 19% above | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST UNILATERL INCLD AXILLA WHN PERF LIMITD-JER | $414.60 | $691.00 | $83.72–$86.97 | 19% above | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-XS | $345.00 | $575.00 | $83.72–$86.97 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-JUC | $345.00 | $575.00 | $201.25–$506.00 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST UNILAT REAL TIME WITH IMAGE LIMITED-EF | $345.00 | $575.00 | $201.25–$506.00 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST, UNILAT, INCLUDING AXILLA LIMITED-UM | $345.00 | $575.00 | $83.72–$86.97 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-XO | $345.00 | $575.00 | $83.72–$86.97 | 1% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST, UNILAT, INCLUDING AXILLA LIMITED-BI | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-SPFM | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-AFM | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FFH | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FUL | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FAY | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FMCK | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-MFMC | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-FMCJ | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-BAMB | $345.00 | $575.00 | $156.40–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCL AXILLA WHN PERF LIMITD-NFM | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCLD AXILLA WHN PERF LIMITED-EC | $414.60 | $691.00 | $241.85–$608.08 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST UNILATERL INCLD AXILLA WHN PERF LIMITD-JER | $414.60 | $691.00 | $241.85–$608.08 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST UNILAT REAL TIME WITH IMAGE LIMITED-EF | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST, UNILAT, INCLUDING AXILLA LIMITED-UM | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-XS | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-XO | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT INCLUDING AXILLA LIMITED-JUC | $345.00 | $575.00 | $201.25–$506.00 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST AM | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | 7% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-MOC | $2,301.00 | $3,835.00 | $339.57–$352.76 | 7% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-XS | $2,301.00 | $3,835.00 | $339.57–$352.76 | 7% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-JCT | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | 7% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-JCT | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-XS | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-MOC | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST-JCTG | $2,301.00 | $3,835.00 | $1,043.12–$3,374.80 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD AND PELVIS W/WO CONTRAST AM | $2,301.00 | $3,835.00 | $1,342.25–$3,374.80 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ABD AND PELVIS W/WO CONTRAST-DIJR | $2,301.00 | $3,835.00 | $1,043.12–$3,374.80 | — | 40% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-XS | $1,764.00 | $2,940.00 | $169.27–$175.84 | 10% below | 40% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-JCT | $1,764.00 | $2,940.00 | $1,029.00–$2,587.20 | 10% below | 40% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-CM | $1,764.00 | $2,940.00 | $169.27–$175.84 | 10% below | 40% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-MOC | $1,764.00 | $2,940.00 | $169.27–$175.84 | 10% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-JCTG | $1,764.00 | $2,940.00 | $799.68–$2,587.20 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-CM | $1,764.00 | $2,940.00 | $1,029.00–$2,587.20 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-XS | $1,764.00 | $2,940.00 | $1,029.00–$2,587.20 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-MOC | $1,764.00 | $2,940.00 | $1,029.00–$2,587.20 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-DIJR | $1,764.00 | $2,940.00 | $799.68–$2,587.20 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD WOW CONTRAST-JCT | $1,764.00 | $2,940.00 | $1,029.00–$2,587.20 | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-XS | $1,521.00 | $2,535.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-CM | $1,521.00 | $2,535.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-JCT | $1,521.00 | $2,535.00 | $887.25–$2,230.80 | 24% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-MOC | $1,521.00 | $2,535.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-DIJR | $1,521.00 | $2,535.00 | $689.52–$2,230.80 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-MOC | $1,521.00 | $2,535.00 | $887.25–$2,230.80 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-XS | $1,521.00 | $2,535.00 | $887.25–$2,230.80 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-CM | $1,521.00 | $2,535.00 | $887.25–$2,230.80 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-JCTG | $1,521.00 | $2,535.00 | $689.52–$2,230.80 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK WOW CONTRAST-JCT | $1,521.00 | $2,535.00 | $887.25–$2,230.80 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-CM | $1,468.80 | $2,448.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-MOC | $1,468.80 | $2,448.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-XS | $1,468.80 | $2,448.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-JCT | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-AM | $1,468.80 | $2,448.00 | $169.27–$175.84 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-JCT | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-CM | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-XS | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-JCTG | $1,468.80 | $2,448.00 | $665.86–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-MOC | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-AM | $1,468.80 | $2,448.00 | $856.80–$2,154.24 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOW CONTRAST-DIJR | $1,468.80 | $2,448.00 | $665.86–$2,154.24 | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HEART CORONRY ARTERIES/BYPASS GRAFTS W/CONTRAST-CM | $1,233.60 | $2,056.00 | $719.60–$1,809.28 | 3% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HEART CORONRY ARTERIES/BYPASS GRAFTS W/CONTRAST-JCT | $1,233.60 | $2,056.00 | $719.60–$1,809.28 | 3% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HEART CORONRY ARTERIES/BYPASS GRAFTS W/CONTRAST-JCT | $1,233.60 | $2,056.00 | $719.60–$1,809.28 | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HEART CORONRY ARTERIES/BYPASS GRAFTS W/CONTRAST-CM | $1,233.60 | $2,056.00 | $719.60–$1,809.28 | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CONTRAST W/QUANT EVAL OF CORONARY CALCIUM-CM | $229.20 | $382.00 | $133.70–$336.16 | 195% above | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CONTRST W/QUANT EVAL OF CORONARY CALCIUM-CM | $229.20 | $382.00 | $133.70–$336.16 | 195% above | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CONTRST W/QUANT EVAL OF CORONARY CALCIUM-CM | $229.20 | $382.00 | $133.70–$336.16 | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CONTRAST W/QUANT EVAL OF CORONARY CALCIUM-CM | $229.20 | $382.00 | $133.70–$336.16 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST CM | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | 37% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST-MOC | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | 37% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST-AM | $1,357.20 | $2,262.00 | $229.84–$238.76 | 37% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST-JCT | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | 37% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST-XS | $1,357.20 | $2,262.00 | $229.84–$238.76 | 37% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-XS | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-MOC | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-DIJR | $1,357.20 | $2,262.00 | $615.26–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-JCTG | $1,357.20 | $2,262.00 | $615.26–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-JCT | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST CM | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST-AM | $1,357.20 | $2,262.00 | $791.70–$1,990.56 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-JCT | $2,218.20 | $3,697.00 | $1,293.95–$3,253.36 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-MOC | $2,218.20 | $3,697.00 | $339.57–$352.76 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-XS | $2,218.20 | $3,697.00 | $339.57–$352.76 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-AM | $2,218.20 | $3,697.00 | $339.57–$352.76 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST CM | $2,218.20 | $3,697.00 | $1,293.95–$3,253.36 | 16% below | 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 | $1,005.58–$3,253.36 | — | 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 | $1,005.58–$3,253.36 | — | 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 | $1,293.95–$3,253.36 | — | 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 | $1,293.95–$3,253.36 | — | 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 | $1,293.95–$3,253.36 | — | 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 | $1,293.95–$3,253.36 | — | 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 | $1,293.95–$3,253.36 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-MOC | $2,416.80 | $4,028.00 | $339.57–$352.76 | 24% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-XS | $2,416.80 | $4,028.00 | $339.57–$352.76 | 24% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT CM | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | 24% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-AM | $2,416.80 | $4,028.00 | $339.57–$352.76 | 24% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-JCT | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | 24% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT CM | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-DIJR | $2,416.80 | $4,028.00 | $1,095.62–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-AM | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-MOC | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-JCT | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-JCTG | $2,416.80 | $4,028.00 | $1,095.62–$3,544.64 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT A/P W/O ONE OR BOTH BDY RGN FL BY/CNT-XS | $2,416.80 | $4,028.00 | $1,409.80–$3,544.64 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST-JCT | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | 15% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST-CM | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | 15% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST-MOC | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | 15% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST-XS | $1,446.00 | $2,410.00 | $169.27–$175.84 | 15% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-CM | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-JCTG | $1,446.00 | $2,410.00 | $655.52–$2,120.80 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-XS | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-DIJR | $1,446.00 | $2,410.00 | $655.52–$2,120.80 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-MOC | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST-JCT | $1,446.00 | $2,410.00 | $843.50–$2,120.80 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST-JCT | $1,018.80 | $1,698.00 | $101.11–$105.04 | 13% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST-MOC | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | 13% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST-CM | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | 13% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST-XS | $1,018.80 | $1,698.00 | $101.11–$105.04 | 13% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-JCT | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-CM | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-XS | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-DIJR | $1,018.80 | $1,698.00 | $461.86–$1,494.24 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-JCTG | $1,018.80 | $1,698.00 | $461.86–$1,494.24 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST-MOC | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE/SINUS WO CONTRAST-JCT | $674.40 | $1,124.00 | $393.40–$989.12 | 41% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE/SINUS WO CONTRAST-CM | $674.40 | $1,124.00 | $101.11–$105.04 | 41% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE/SINUS WO CONTRAST-XS | $674.40 | $1,124.00 | $101.11–$105.04 | 41% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE/SINUS WO CONTRAST-MOC | $674.40 | $1,124.00 | $393.40–$989.12 | 41% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-DIJR | $674.40 | $1,124.00 | $305.73–$989.12 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-JCT | $674.40 | $1,124.00 | $393.40–$989.12 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-JCTG | $674.40 | $1,124.00 | $305.73–$989.12 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-CM | $674.40 | $1,124.00 | $393.40–$989.12 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-XS | $674.40 | $1,124.00 | $393.40–$989.12 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE/SINUS WO CONTRAST-MOC | $674.40 | $1,124.00 | $393.40–$989.12 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-AM | $699.00 | $1,165.00 | $101.11–$105.04 | 44% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-CM | $699.00 | $1,165.00 | $407.75–$1,025.20 | 44% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-XS | $699.00 | $1,165.00 | $101.11–$105.04 | 44% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-JCT | $699.00 | $1,165.00 | $407.75–$1,025.20 | 44% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-MOC | $699.00 | $1,165.00 | $407.75–$1,025.20 | 44% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-AM | $699.00 | $1,165.00 | $407.75–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-XS | $699.00 | $1,165.00 | $407.75–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-MOC | $699.00 | $1,165.00 | $407.75–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-DIJR | $699.00 | $1,165.00 | $316.88–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-JCT | $699.00 | $1,165.00 | $407.75–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-JCTG | $699.00 | $1,165.00 | $316.88–$1,025.20 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-CM | $699.00 | $1,165.00 | $407.75–$1,025.20 | — | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST-JCT | $1,106.40 | $1,844.00 | $169.27–$175.84 | 23% below | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST-XS | $1,106.40 | $1,844.00 | $169.27–$175.84 | 23% below | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST-CM | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | 23% below | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST-MOC | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | 23% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-JCTG | $1,106.40 | $1,844.00 | $501.57–$1,622.72 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-JCT | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-DIJR | $1,106.40 | $1,844.00 | $501.57–$1,622.72 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-MOC | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-XS | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST-CM | $1,106.40 | $1,844.00 | $645.40–$1,622.72 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONTRAST-JCT | $1,205.40 | $2,009.00 | $169.27–$175.84 | 32% below | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONTRAST-MOC | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | 32% below | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONTRAST-XS | $1,205.40 | $2,009.00 | $169.27–$175.84 | 32% below | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONTRAST-CM | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | 32% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-JCTG | $1,205.40 | $2,009.00 | $546.45–$1,767.92 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-JCT | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-CM | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-DIJR | $1,205.40 | $2,009.00 | $546.45–$1,767.92 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-MOC | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONTRAST-XS | $1,205.40 | $2,009.00 | $703.15–$1,767.92 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST-MOC | $1,096.80 | $1,828.00 | $135.99–$1,500.00 | 23% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST-XS | $1,096.80 | $1,828.00 | $101.11–$105.04 | 23% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST-CM | $1,096.80 | $1,828.00 | $101.11–$105.04 | 23% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONTRAST-JCT | $1,096.80 | $1,828.00 | $639.80–$1,608.64 | 23% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-CM | $1,096.80 | $1,828.00 | $639.80–$1,608.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-XS | $1,096.80 | $1,828.00 | $639.80–$1,608.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-JCTG | $1,096.80 | $1,828.00 | $497.22–$1,608.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-DIJR | $1,096.80 | $1,828.00 | $497.22–$1,608.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-JCT | $1,096.80 | $1,828.00 | $639.80–$1,608.64 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONTRAST-MOC | $1,096.80 | $1,828.00 | $639.80–$1,608.64 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST-CM | $874.20 | $1,457.00 | $101.11–$105.04 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST-MOC | $874.20 | $1,457.00 | $101.11–$105.04 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST-JCT | $874.20 | $1,457.00 | $101.11–$105.04 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONTRAST-XS | $874.20 | $1,457.00 | $101.11–$105.04 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O CONTRAST-AM | $874.20 | $1,457.00 | $101.11–$105.04 | 45% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-MOC | $874.20 | $1,457.00 | $509.95–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-JCT | $874.20 | $1,457.00 | $509.95–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-CM | $874.20 | $1,457.00 | $509.95–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-XS | $874.20 | $1,457.00 | $509.95–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-JCTG | $874.20 | $1,457.00 | $396.30–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL W/O CONTRAST-AM | $874.20 | $1,457.00 | $509.95–$1,282.16 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONTRAST-DIJR | $874.20 | $1,457.00 | $396.30–$1,282.16 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-MOC | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | 19% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-CM | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | 19% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-JCT | $1,329.00 | $2,215.00 | $169.27–$175.84 | 19% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-XS | $1,329.00 | $2,215.00 | $169.27–$175.84 | 19% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-JCT | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-JCTG | $1,329.00 | $2,215.00 | $602.48–$1,949.20 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-CM | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-XS | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-MOC | $1,329.00 | $2,215.00 | $775.25–$1,949.20 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-DIJR | $1,329.00 | $2,215.00 | $602.48–$1,949.20 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL-XS | $1,003.80 | $1,673.00 | $229.84–$238.76 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL XO | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX SCAN BILATERAL-CTST | $1,003.80 | $1,673.00 | $229.84–$238.76 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL-JUC | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL UM | $1,003.80 | $1,673.00 | $229.84–$238.76 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL-XS | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL-CCDJ | $1,003.80 | $1,673.00 | $455.06–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX SCAN BILATERAL-CTST | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL UM | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL-JUC | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL XO | $1,003.80 | $1,673.00 | $585.55–$1,472.24 | — | 40% |
| Chest CT scan without and with contrast CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-XS | $1,358.40 | $2,264.00 | $169.27–$175.84 | 27% below | 40% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST DIAGNOSTIC; WOW CONTRAST-JCT | $1,358.40 | $2,264.00 | $169.27–$175.84 | 27% below | 40% |
| Chest CT scan without and with contrast CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-CM | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | 27% below | 40% |
| Chest CT scan without and with contrast CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-MOC | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | 27% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-MOC | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST DIAGNOSTIC; WOW CONTRAST-JCT | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST DIAGNOSTIC; WOW CONTRAST-JCTG | $1,358.40 | $2,264.00 | $615.81–$1,992.32 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-CM | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT, CHEST, DIAGNOSTIC; WOW CONTRAST-XS | $1,358.40 | $2,264.00 | $792.40–$1,992.32 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST DIAGNOSTIC; WOW CONTRAST-DIJR | $1,358.40 | $2,264.00 | $615.81–$1,992.32 | — | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY CHEST 2 VIEWS-JDI | $284.40 | $474.00 | $83.72–$86.97 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY, CHEST, 2 VIEWS-FAY | $284.40 | $474.00 | $83.72–$86.97 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY CHEST 2 VIEWS-XO | $284.40 | $474.00 | $165.90–$417.12 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY, CHEST, 2 VIEWS-XM | $284.40 | $474.00 | $165.90–$417.12 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY, CHEST, 2 VIEWS-OC | $284.40 | $474.00 | $83.72–$86.97 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY, CHEST, 2 VIEWS-XS | $284.40 | $474.00 | $83.72–$86.97 | 15% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY; CHEST; 2 VIEWS-JUTR | $341.40 | $569.00 | $199.15–$500.72 | 38% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY CHEST 2 VIEWS-MUCX | $341.40 | $569.00 | $199.15–$500.72 | 38% above | 40% |
| Chest X-ray, 2 views CPT 71046 X-RAY, CHEST, 2 VIEWS-MUC | $341.40 | $569.00 | $83.72–$86.97 | 38% above | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-JDI | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-XM | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-XO | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-XS | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-DIJR | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-OC | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-FAY | $284.40 | $474.00 | $165.90–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY; CHEST; 2 VIEWS-JFMV | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-JFMO | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY; CHEST; 2 VIEWS-JFML | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY; CHEST; 2 VIEWS-JFMB | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-JFME | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-JFMC | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-BAMB | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-FFH | $284.40 | $474.00 | $128.93–$417.12 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY, CHEST, 2 VIEWS-MUC | $341.40 | $569.00 | $199.15–$500.72 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS-MUCX | $341.40 | $569.00 | $199.15–$500.72 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 X-RAY; CHEST; 2 VIEWS-JUTR | $341.40 | $569.00 | $199.15–$500.72 | — | 40% |
| Chest X-ray, single view CPT 71045 X-RAY, CHEST, SINGLE VIEW-FAY | $226.80 | $378.00 | $83.72–$86.97 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY, CHEST, SINGLE VIEW-XM | $226.80 | $378.00 | $132.30–$332.64 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY CHEST SINGLE VIEW-XO | $226.80 | $378.00 | $132.30–$332.64 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY, CHEST, SINGLE VIEW-OC | $226.80 | $378.00 | $83.72–$86.97 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY, CHEST, SINGLE VIEW-XS | $226.80 | $378.00 | $83.72–$86.97 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY CHEST SINGLE VIEW-JDI | $226.80 | $378.00 | $83.72–$86.97 | 19% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY CHEST SINGLE VIEW-MUCX | $271.80 | $453.00 | $158.55–$398.64 | 42% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY; CHEST; SINGLE VIEW-JUTR | $271.80 | $453.00 | $158.55–$398.64 | 42% above | 40% |
| Chest X-ray, single view CPT 71045 X-RAY, CHEST, SINGLE VIEW-MUC | $271.80 | $453.00 | $158.55–$398.64 | 42% above | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-XO | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-FFH | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, 1 VIEW-BAMB | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY; CHEST; SINGLE VIEW-JFME | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY; CHEST; SINGLE VIEW-JFML | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-JFMO | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, SINGLE VIEW-FAY | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-JDI | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, SINGLE VIEW-XM | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, SINGLE VIEW-XS | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-DIJR | $226.80 | $378.00 | $102.82–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, SINGLE VIEW-OC | $226.80 | $378.00 | $132.30–$332.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY; CHEST; SINGLE VIEW-JUTR | $271.80 | $453.00 | $158.55–$398.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY, CHEST, SINGLE VIEW-MUC | $271.80 | $453.00 | $158.55–$398.64 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW-MUCX | $271.80 | $453.00 | $158.55–$398.64 | — | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE OC | $261.00 | $435.00 | $152.25–$382.80 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 RAD EXAM COLLARBONE-FAY | $261.00 | $435.00 | $152.25–$382.80 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE -XO | $261.00 | $435.00 | $83.72–$86.97 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-JDI | $261.00 | $435.00 | $83.72–$86.97 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-XM | $261.00 | $435.00 | $83.72–$86.97 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-XS | $261.00 | $435.00 | $152.25–$382.80 | 8% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-MUC | $313.20 | $522.00 | $182.70–$459.36 | 30% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-JUTR | $313.20 | $522.00 | $83.72–$86.97 | 30% above | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE-MUCX | $313.20 | $522.00 | $83.72–$86.97 | 30% above | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE -XO | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-XM | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-JDI | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY, CLAVICLE, COMPLETE-BAMB | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY CLAVICLE COMPLETE-JFME | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY CLAVICLE; COMPLETE-JFML | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY CLAVICLE COMPLETE-JFMO | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY, CLAVICLE, COMPLETE-JFMV | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD EXAM COLLARBONE-FAY | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-FFH | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE OC | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY CLAVICLE-DIJR | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-XS | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-JUTR | $313.20 | $522.00 | $182.70–$459.36 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-MUCX | $313.20 | $522.00 | $182.70–$459.36 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE-MUC | $313.20 | $522.00 | $182.70–$459.36 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE-XS | $621.00 | $1,035.00 | $101.11–$105.04 | at median | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE-JUC | $621.00 | $1,035.00 | $101.11–$105.04 | at median | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE-UM | $621.00 | $1,035.00 | $362.25–$910.80 | at median | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE-XO | $621.00 | $1,035.00 | $362.25–$910.80 | at median | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE-UM | $621.00 | $1,035.00 | $362.25–$910.80 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE-XS | $621.00 | $1,035.00 | $362.25–$910.80 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE-XO | $621.00 | $1,035.00 | $362.25–$910.80 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE-JUC | $621.00 | $1,035.00 | $362.25–$910.80 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine both sides CPT 77080 DEXA BONE DENSITY STUDY, 1/MORE SITES; AXIAL SKELETON-BI | $296.40 | $494.00 | $101.11–$105.04 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA SPINE AND HIP-JDXA | $296.40 | $494.00 | $101.11–$105.04 | 7% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA SPINE AND HIP-XO | $296.40 | $494.00 | $101.11–$105.04 | 7% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient both sides CPT 77080 DEXA BONE DENSITY STUDY, 1/MORE SITES; AXIAL SKELETON-BI | $296.40 | $494.00 | $172.90–$434.72 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA SPINE AND HIP-JDXA | $296.40 | $494.00 | $172.90–$434.72 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA, BONE DENSITY STUDY,1/MR SITES, AXIAL SKELETON-BAMB | $296.40 | $494.00 | $134.37–$434.72 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA SPINE AND HIP-XO | $296.40 | $494.00 | $172.90–$434.72 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) both sides CPT 77081 XR DEXA FOREARM-BI | $196.20 | $327.00 | $83.72–$86.97 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA FOREARM -JDXA | $196.20 | $327.00 | $83.72–$86.97 | 5% above | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA FOREARM -XM | $196.20 | $327.00 | $114.45–$287.76 | 5% above | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA FOREARM -XO | $196.20 | $327.00 | $83.72–$86.97 | 5% above | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient both sides CPT 77081 XR DEXA FOREARM-BI | $196.20 | $327.00 | $114.45–$287.76 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA FOREARM -JDXA | $196.20 | $327.00 | $114.45–$287.76 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA FOREARM -XO | $196.20 | $327.00 | $114.45–$287.76 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA FOREARM -XM | $196.20 | $327.00 | $114.45–$287.76 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA,BONE DENSITY STUDY,1/MR SITES,APPENDICULAR SKELETON-BAMB | $196.20 | $327.00 | $88.94–$287.76 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREGNANCY COMPLETE W DETAIL-UM | $672.60 | $1,121.00 | $392.35–$986.48 | 1% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND PREG UTER DTL FETAL ANAT EXM;SINGLE/1ST GEST-IVF | $672.60 | $1,121.00 | $229.84–$238.76 | 1% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTER +DTLD FETAL EXAM TRABD APP 1ST GEST -NSOB | $672.60 | $1,121.00 | $392.35–$986.48 | 1% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION-OBC | $672.60 | $1,121.00 | $392.35–$986.48 | 1% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND PREG UTER DTL FETAL ANAT EXM;SINGLE/1ST GEST-MFCC | $672.60 | $1,121.00 | $229.84–$238.76 | 1% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREGNANCY COMPLETE W DETAIL-UM | $672.60 | $1,121.00 | $392.35–$986.48 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 ULTRASOUND PREG UTER DTL FETAL ANAT EXM;SINGLE/1ST GEST-IVF | $672.60 | $1,121.00 | $392.35–$986.48 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 ULTRASOUND,PREG UTER,DTL FETAL ANAT EXM;SINGLE/1ST GEST-BAMB | $672.60 | $1,121.00 | $304.91–$986.48 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 ULTRASOUND PREG UTER DTL FETAL ANAT EXM;SINGLE/1ST GEST-MFCC | $672.60 | $1,121.00 | $392.35–$986.48 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION-OBC | $672.60 | $1,121.00 | $392.35–$986.48 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTER +DTLD FETAL EXAM TRABD APP 1ST GEST -NSOB | $672.60 | $1,121.00 | $392.35–$986.48 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-AM | $782.40 | $1,304.00 | $101.11–$105.04 | 40% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-XS | $782.40 | $1,304.00 | $101.11–$105.04 | 40% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-CM | $782.40 | $1,304.00 | $456.40–$1,147.52 | 40% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-JCT | $782.40 | $1,304.00 | $101.11–$105.04 | 40% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-MOC | $782.40 | $1,304.00 | $456.40–$1,147.52 | 40% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-DIJR | $782.40 | $1,304.00 | $354.69–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-JCT | $782.40 | $1,304.00 | $456.40–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-JCTG | $782.40 | $1,304.00 | $354.69–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-CM | $782.40 | $1,304.00 | $456.40–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST DIAGNOSTIC; W/O CONTRAST-AM | $782.40 | $1,304.00 | $456.40–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-XS | $782.40 | $1,304.00 | $456.40–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT, CHEST, DIAGNOSTIC; W/O CONTRAST-MOC | $782.40 | $1,304.00 | $456.40–$1,147.52 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-MOC | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | 27% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST DIAGNOSTIC; W/ CONTRAST-JCT | $1,192.20 | $1,987.00 | $169.27–$175.84 | 27% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-CM | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | 27% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-XS | $1,192.20 | $1,987.00 | $169.27–$175.84 | 27% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST DIAGNOSTIC; W/ CONTRAST-DIJR | $1,192.20 | $1,987.00 | $540.46–$1,748.56 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-MOC | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-XS | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT, CHEST, DIAGNOSTIC; W/ CONTRAST-CM | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST DIAGNOSTIC; W/ CONTRAST-JCTG | $1,192.20 | $1,987.00 | $540.46–$1,748.56 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST DIAGNOSTIC; W/ CONTRAST-JCT | $1,192.20 | $1,987.00 | $695.45–$1,748.56 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-JMAM | $300.60 | $501.00 | $136.27–$440.88 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-BE | $300.60 | $501.00 | $136.27–$440.88 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-BE | $300.60 | $501.00 | $136.27–$440.88 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-JMAM | $300.60 | $501.00 | $136.27–$440.88 | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-JMAM | $232.80 | $388.00 | $105.54–$341.44 | at median | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-BE | $232.80 | $388.00 | $105.54–$341.44 | at median | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-JMAM | $232.80 | $388.00 | $105.54–$341.44 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-BE | $232.80 | $388.00 | $105.54–$341.44 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN LWR EXTR ARTERIES/BYPASS GRAFTS BILATERAL-CTST | $963.60 | $1,606.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL-JUC | $963.60 | $1,606.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL-XS | $963.60 | $1,606.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL UM | $963.60 | $1,606.00 | $562.10–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX SCAN LWR EXTR ARTERIES/BYPASS GRAFTS BILATERAL-CTST | $963.60 | $1,606.00 | $562.10–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL-XS | $963.60 | $1,606.00 | $562.10–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL UM | $963.60 | $1,606.00 | $562.10–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL-CCDJ | $963.60 | $1,606.00 | $436.83–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LE ARTERIAL DUPLEX BILATERAL-JUC | $963.60 | $1,606.00 | $562.10–$1,413.28 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL-JUC | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL-XS | $1,133.40 | $1,889.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL UM | $1,133.40 | $1,889.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL-CTST | $1,133.40 | $1,889.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL-JVC | $1,133.40 | $1,889.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DUPLEX BILATERAL-XO | $1,133.40 | $1,889.00 | $229.84–$238.76 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-JUC | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-XO | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-XS | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL UM | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-CCDJ | $1,133.40 | $1,889.00 | $513.81–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-CTST | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DUPLEX BILATERAL-JVC | $1,133.40 | $1,889.00 | $661.15–$1,662.32 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE 2D W/DOPPLER COMPLETE-CSC | $2,171.40 | $3,619.00 | $1,266.65–$3,184.72 | 29% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D & M-MODE COMPLETE WITH DOPPLER-CTST | $2,171.40 | $3,619.00 | $521.34–$541.59 | 29% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D & M-MODE COMPLETE WITH DOPPLER-JCRD | $2,171.40 | $3,619.00 | $1,266.65–$3,184.72 | 29% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D & M-MODE COMPLETE WITH DOPPLER-CTST | $2,171.40 | $3,619.00 | $1,266.65–$3,184.72 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D & M-MODE COMPLETE WITH DOPPLER-JCRD | $2,171.40 | $3,619.00 | $1,266.65–$3,184.72 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D & M-MODE COMPLETE WITH DOPPLER-CCDJ | $2,171.40 | $3,619.00 | $984.37–$3,184.72 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE 2D W/DOPPLER COMPLETE-CSC | $2,171.40 | $3,619.00 | $1,266.65–$3,184.72 | — | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-XM | $243.00 | $405.00 | $141.75–$356.40 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS -XO | $243.00 | $405.00 | $141.75–$356.40 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 RAD EXAM ELBOW-FAY | $243.00 | $405.00 | $141.75–$356.40 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS OC | $243.00 | $405.00 | $141.75–$356.40 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 1 VIEW-XO | $243.00 | $405.00 | $83.72–$86.97 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-XS | $243.00 | $405.00 | $83.72–$86.97 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-JDI | $243.00 | $405.00 | $141.75–$356.40 | 16% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-JUTR | $291.60 | $486.00 | $83.72–$86.97 | 39% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-MUC | $291.60 | $486.00 | $170.10–$427.68 | 39% above | 40% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW 2 VIEWS-MUCX | $291.60 | $486.00 | $83.72–$86.97 | 39% above | 40% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-MUCX | $291.60 | $486.00 | $83.72–$86.97 | 39% above | 40% |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-JUTR | $291.60 | $486.00 | $170.10–$427.68 | 39% above | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-XM | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VIEWS-JFMO | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VIEWS-JFMV | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS OC | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VIEWS-DIJR | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-FFH | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY, ELBOW, 2 VIEWS-BAMB | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-XS | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-JDI | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VIEWS-JFMC | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VIEWS-JFME | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-JFML | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 1 VIEW-XO | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS -XO | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 RAD EXAM ELBOW-FAY | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-MUCX | $291.60 | $486.00 | $170.10–$427.68 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-MUC | $291.60 | $486.00 | $170.10–$427.68 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEWS-JUTR | $291.60 | $486.00 | $170.10–$427.68 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY ELBOW 1 VIEW RT OR LT-DIJR | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-FFH | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW-RT OR LT | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW RT OR LEFT | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-XS | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-JUTR | $291.60 | $486.00 | $170.10–$427.68 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 1 VIEW RIGHT/LEFT-MUCX | $291.60 | $486.00 | $170.10–$427.68 | — | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 RAD EXAM ELBOW,3 OR MORE VIEWS-FAY | $303.60 | $506.00 | $177.10–$445.28 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE OC | $303.60 | $506.00 | $177.10–$445.28 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-XS | $303.60 | $506.00 | $177.10–$445.28 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-XM | $303.60 | $506.00 | $83.72–$86.97 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-JDI | $303.60 | $506.00 | $83.72–$86.97 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE MIN 3 VIEWS-XO | $303.60 | $506.00 | $83.72–$86.97 | 9% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-JUTR | $364.20 | $607.00 | $83.72–$86.97 | 31% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-MUC | $364.20 | $607.00 | $212.45–$534.16 | 31% above | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW COMPLETE-MUCX | $364.20 | $607.00 | $83.72–$86.97 | 31% above | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-XS | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-FFH | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY, ELBOW, COMPLETE, MINIMUM 3 VIEWS-BAMB | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW COMPLETE MINIMUM 3 VIEWS-JFMC | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW COMPLETE MINIMUM 3 VIEWS-JFME | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW COMPLETE MINIMUM 3 VIEWS-JFMO | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW COMPLETE MINIMUM 3 VIEWS-JFMV | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RAD EXAM ELBOW,3 OR MORE VIEWS-FAY | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE MIN 3 VIEWS-XO | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-JDI | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-XM | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW COMPLETE-DIJR | $303.60 | $506.00 | $137.63–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE OC | $303.60 | $506.00 | $177.10–$445.28 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-MUC | $364.20 | $607.00 | $212.45–$534.16 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-JUTR | $364.20 | $607.00 | $212.45–$534.16 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW COMPLETE-MUCX | $364.20 | $607.00 | $212.45–$534.16 | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-JCT | $701.40 | $1,169.00 | $409.15–$1,028.72 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-MOC | $701.40 | $1,169.00 | $409.15–$1,028.72 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA ETC WO CONTRAST-XS | $701.40 | $1,169.00 | $101.11–$105.04 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-CM | $701.40 | $1,169.00 | $409.15–$1,028.72 | 45% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC WO CONTRAST-XS | $701.40 | $1,169.00 | $409.15–$1,028.72 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-JCTG | $701.40 | $1,169.00 | $317.97–$1,028.72 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-JCT | $701.40 | $1,169.00 | $409.15–$1,028.72 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-MOC | $701.40 | $1,169.00 | $409.15–$1,028.72 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC WO CONTRAST-DIJR | $701.40 | $1,169.00 | $317.97–$1,028.72 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA ETC. WO CONTRAST-CM | $701.40 | $1,169.00 | $409.15–$1,028.72 | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-XM | $335.40 | $559.00 | $195.65–$491.92 | 13% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-JDI | $335.40 | $559.00 | $101.11–$105.04 | 13% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINMUM 3 VIEWS-XO | $335.40 | $559.00 | $101.11–$105.04 | 13% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 RAD EXAM FACIAL BONES 3 OR MORE VIEWS-FAY | $335.40 | $559.00 | $101.11–$105.04 | 13% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-XS | $335.40 | $559.00 | $101.11–$105.04 | 13% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-MUC | $402.60 | $671.00 | $234.85–$590.48 | 35% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-MUCX | $402.60 | $671.00 | $234.85–$590.48 | 35% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-JUTR | $402.60 | $671.00 | $234.85–$590.48 | 35% above | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY FACIAL BONES MINIMUM 3 VIEWS-DIJR | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RAD EXAM FACIAL BONES 3 OR MORE VIEWS-FAY | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-XS | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-XM | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-JDI | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINMUM 3 VIEWS-XO | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-FFH | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-JUTR | $402.60 | $671.00 | $234.85–$590.48 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-MUCX | $402.60 | $671.00 | $234.85–$590.48 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MINIMUM 3 VIEWS-MUC | $402.60 | $671.00 | $234.85–$590.48 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS -XO | $273.60 | $456.00 | $159.60–$401.28 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-XS | $273.60 | $456.00 | $159.60–$401.28 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 RAD EXAM FOREARM-FAY | $273.60 | $456.00 | $159.60–$401.28 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-JDI | $273.60 | $456.00 | $83.72–$86.97 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-XM | $273.60 | $456.00 | $83.72–$86.97 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS OC | $273.60 | $456.00 | $159.60–$401.28 | 31% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-JUTR | $328.20 | $547.00 | $83.72–$86.97 | 57% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-MUC | $328.20 | $547.00 | $191.45–$481.36 | 57% above | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 2 VIEWS-MUCX | $328.20 | $547.00 | $191.45–$481.36 | 57% above | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-DIJR | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS OC | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-XS | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-FFH | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY, FOREARM, 2 VIEWS-BAMB | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-JFMC | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-JFME | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-XM | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-JDI | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS -XO | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RAD EXAM FOREARM-FAY | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-JFML | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-JFMO | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VIEWS-JFMV | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-JUTR | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-MUCX | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEWS-MUC | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATO SYS IMAG INCL GALLBLADDER NM | $1,258.20 | $2,097.00 | $733.95–$1,845.36 | 1% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATO SYS IMAG INCL GALLBLADDER-DINP | $1,258.20 | $2,097.00 | $382.07–$396.91 | 1% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATO SYS IMAG INCL GALLBLADDER-JNM | $1,258.20 | $2,097.00 | $733.95–$1,845.36 | 1% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATO SYS IMAG INCL GALLBLADDER-DINP | $1,258.20 | $2,097.00 | $733.95–$1,845.36 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATO SYS IMAG INCL GALLBLADDER-JNM | $1,258.20 | $2,097.00 | $733.95–$1,845.36 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATO SYS IMAG INCL GALLBLADDER NM | $1,258.20 | $2,097.00 | $733.95–$1,845.36 | — | 40% |
| Hand X-ray, 2 views CPT 73120 RAD EXAM HAND TWO VIEWS-FAY | $323.40 | $539.00 | $188.65–$474.32 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-JDI | $323.40 | $539.00 | $101.11–$105.04 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-XS | $323.40 | $539.00 | $188.65–$474.32 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-XM | $323.40 | $539.00 | $101.11–$105.04 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 1 VIEW-XO | $323.40 | $539.00 | $101.11–$105.04 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS -XO | $323.40 | $539.00 | $101.11–$105.04 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS OC | $323.40 | $539.00 | $188.65–$474.32 | 70% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-JUTR | $388.20 | $647.00 | $226.45–$569.36 | 105% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-MUCX | $388.20 | $647.00 | $101.11–$105.04 | 105% above | 40% |
| Hand X-ray, 2 views CPT 73120 XR HAND 2 VIEWS-MUC | $388.20 | $647.00 | $226.45–$569.36 | 105% above | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-JUTR | $388.20 | $647.00 | $226.45–$569.36 | 105% above | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-MUCX | $388.20 | $647.00 | $101.11–$105.04 | 105% above | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-JFML | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-JFMO | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-JFMV | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-XM | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-JFME | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY, HAND, 2 VIEWS-BAMB | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-FFH | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 RAD EXAM HAND TWO VIEWS-FAY | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-JDI | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS -XO | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS OC | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-DIJR | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-XS | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 1 VIEW-XO | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VIEWS-JFMC | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-JUTR | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-MUC | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEWS-MUCX | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY HAND 1 VIEW RT OR LT-DIJR | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW-RT OR LT | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW RT OR LT | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-FFH | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-XS | $323.40 | $539.00 | $146.61–$474.32 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-MUCX | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW RIGHT/LEFT-JUTR | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEUS 1 VIEW-XO | $205.80 | $343.00 | $83.72–$86.97 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-XM | $205.80 | $343.00 | $83.72–$86.97 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-JDI | $205.80 | $343.00 | $83.72–$86.97 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEUS-XO | $205.80 | $343.00 | $83.72–$86.97 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RAD EXAM HEEL 2 OR MORE VIEWS-FAY | $205.80 | $343.00 | $120.05–$301.84 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-XS | $205.80 | $343.00 | $120.05–$301.84 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS OC | $205.80 | $343.00 | $120.05–$301.84 | 5% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-MUC | $246.60 | $411.00 | $143.85–$361.68 | 25% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-JUTR | $246.60 | $411.00 | $83.72–$86.97 | 25% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEOUS-MUCX | $246.60 | $411.00 | $143.85–$361.68 | 25% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RAD EXAM HEEL 2 OR MORE VIEWS-JFMO | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RAD EXAM HEEL 2 OR MORE VIEWS-FAY | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY CALCANEOUS-DIJR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-JFME | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RAD EXAM HEEL 2 OR MORE VIEWS-JFML | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY, CALCANEOUS, MINIMUM 2 VIEWS-BAMB | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS OC | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-FFH | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEUS-XO | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-XM | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEUS 1 VIEW-XO | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-JDI | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-XS | $205.80 | $343.00 | $120.05–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-JUTR | $246.60 | $411.00 | $143.85–$361.68 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-MUC | $246.60 | $411.00 | $143.85–$361.68 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEOUS-MUCX | $246.60 | $411.00 | $143.85–$361.68 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS 1 VIEW RT OR LT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEOUS 1 VIEW-RT OR LT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen one side CPT 95806 SLEEP STUDY HRT RT/02/RT FLOW/RT EFFORT UNATTENDED-JSDC | $700.20 | $1,167.00 | $408.45–$1,026.96 | 9% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient one side CPT 95806 SLEEP STUDY HRT RT/02/RT FLOW/RT EFFORT UNATTENDED-JSDC | $700.20 | $1,167.00 | $408.45–$1,026.96 | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient one side CPT 95806 SLEEP STUDY VENT/RT/EKG/O2; UNATTENDED-SDRC | $700.20 | $1,167.00 | $317.42–$1,026.96 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY 4+ PARAMETERS +CPAP 6YO OR OLDER-JSDC | $3,349.80 | $5,583.00 | $1,954.05–$4,913.04 | 28% above | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMN 4+ PARAMETERS +CPAP, AGES 6 YEARS OR OLDER-SDRC | $3,349.80 | $5,583.00 | $1,518.58–$4,913.04 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY 4+ PARAMETERS +CPAP 6YO OR OLDER-JSDC | $3,349.80 | $5,583.00 | $1,954.05–$4,913.04 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY 4+ PARAMETERS +CPAP, 6YO OR OLDER-SDCP | $3,349.80 | $5,583.00 | $1,518.58–$4,913.04 | — | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS OC | $270.00 | $450.00 | $157.50–$396.00 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS -XO | $270.00 | $450.00 | $157.50–$396.00 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-FAY | $270.00 | $450.00 | $157.50–$396.00 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-XS | $270.00 | $450.00 | $83.72–$86.97 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-XM | $270.00 | $450.00 | $157.50–$396.00 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-JDI | $270.00 | $450.00 | $157.50–$396.00 | at median | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-JUTR | $323.40 | $539.00 | $188.65–$474.32 | 20% above | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-MUCX | $323.40 | $539.00 | $188.65–$474.32 | 20% above | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE 3 VIEWS-MUC | $323.40 | $539.00 | $188.65–$474.32 | 20% above | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-JFME | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-JFMC | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 X-RAY KNEE 3 VIEWS-DIJR | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-XM | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-XS | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-JDI | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS -XO | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-JFMV | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-FAY | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-JFMO | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 X-RAY, KNEE, 3 VIEWS-BAMB | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 OR MORE VIEWS-JFML | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-FFH | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS OC | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-MUCX | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-MUC | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS-JUTR | $323.40 | $539.00 | $188.65–$474.32 | — | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-XM | $335.40 | $559.00 | $101.11–$105.04 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-JDI | $335.40 | $559.00 | $101.11–$105.04 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE MIN 4 VIEWS-XO | $335.40 | $559.00 | $101.11–$105.04 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE OC | $335.40 | $559.00 | $195.65–$491.92 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-FAY | $335.40 | $559.00 | $195.65–$491.92 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-XS | $335.40 | $559.00 | $195.65–$491.92 | 2% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-JUTR | $402.00 | $670.00 | $234.50–$589.60 | 22% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-MUC | $402.00 | $670.00 | $234.50–$589.60 | 22% above | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE COMPLETE-MUCX | $402.00 | $670.00 | $234.50–$589.60 | 22% above | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE MIN 4 VIEWS-XO | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-XS | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-XM | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE OC | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY KNEE COMPLETE-DIJR | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-JDI | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-FFH | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY, KNEE, COMPLETE, 4 OR MORE VIEWS-BAMB | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-JFME | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-JFMV | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-FAY | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-JUTR | $402.00 | $670.00 | $234.50–$589.60 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-MUC | $402.00 | $670.00 | $234.50–$589.60 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE COMPLETE-MUCX | $402.00 | $670.00 | $234.50–$589.60 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO CONTRAST-XS | $855.00 | $1,425.00 | $101.11–$105.04 | 32% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO CONTRAST-CM | $855.00 | $1,425.00 | $101.11–$105.04 | 32% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO CONTRAST-AM | $855.00 | $1,425.00 | $101.11–$105.04 | 32% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO CONTRAST-JCT | $855.00 | $1,425.00 | $498.75–$1,254.00 | 32% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WO CONTRAST-MOC | $855.00 | $1,425.00 | $101.11–$105.04 | 32% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-DIJR | $855.00 | $1,425.00 | $387.60–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-JCTG | $855.00 | $1,425.00 | $387.60–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-CM | $855.00 | $1,425.00 | $498.75–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-XS | $855.00 | $1,425.00 | $498.75–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-MOC | $855.00 | $1,425.00 | $498.75–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-AM | $855.00 | $1,425.00 | $498.75–$1,254.00 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WO CONTRAST-JCT | $855.00 | $1,425.00 | $498.75–$1,254.00 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-JUC | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-SPFM | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-PESC | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND, ABDOMINAL, REAL TIME W/IMAGE DOCMT, LIMITED-PMR | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-XS | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-UM | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-NFM | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FAY | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-TSBW | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-XO | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-SC | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-AM | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FUL | $559.20 | $932.00 | $101.11–$105.04 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL LIMITED EF | $559.20 | $932.00 | $326.20–$820.16 | 13% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-EC | $670.80 | $1,118.00 | $101.11–$105.04 | 36% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED-JER | $670.80 | $1,118.00 | $101.11–$105.04 | 36% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-SPFM | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND, ABDOMINAL, REAL TIME W/IMAGE DOCMT, LIMITED-PMR | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL LIMITED EF | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-XO | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-JUC | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-AM | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-XS | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FAY | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FUL | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-SC | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-NFM | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-PESC | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-JFMM | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FMCK | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-MFMC | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FMCJ | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-BAMB | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-FFH | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOCMTN LIMITED-AFM | $559.20 | $932.00 | $253.50–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL REAL TIME W/IMAGE DOC; LIMITED-TSBW | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-UM | $559.20 | $932.00 | $326.20–$820.16 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-JER | $670.80 | $1,118.00 | $391.30–$983.84 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED-EC | $670.80 | $1,118.00 | $391.30–$983.84 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-OCJC | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-CSJC | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JMOI | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-BE | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-TSBW | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-MCLN | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-PMR | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FUL | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JUC | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FAY | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-EFC | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-XO | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-SPFM | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-NFM | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-AM | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-UM | $452.40 | $754.00 | $263.90–$663.52 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-XS | $452.40 | $754.00 | $101.11–$105.04 | 28% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-EC | $543.60 | $906.00 | $317.10–$797.28 | 54% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JER | $543.60 | $906.00 | $101.11–$105.04 | 54% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FMCK | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FMCJ | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-MFMC | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-SPFM | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JMOI | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-OCJC | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-CSJC | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-BAMB | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FFH | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-AFM | $452.40 | $754.00 | $205.09–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-EFC | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-XO | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-TSBW | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FUL | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-BE | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-MCLN | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-FAY | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JUC | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-AM | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-XS | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-UM | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-PMR | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-NFM | $452.40 | $754.00 | $263.90–$663.52 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-JER | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LMTD JNT/OTHR NONVASC XTRMTY REAL-TIME W/IMG-EC | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-CM | $335.40 | $559.00 | $101.11–$105.04 | 26% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-XS | $335.40 | $559.00 | $101.11–$105.04 | 26% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LOW DOSE CANCER SCREENING-JCT | $335.40 | $559.00 | $195.65–$491.92 | 26% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-MOC | $335.40 | $559.00 | $101.11–$105.04 | 26% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LOW DOSE CANCER SCREENING-JCT | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-CM | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LOW DOSE CANCER SCREENING-JCTG | $335.40 | $559.00 | $152.05–$491.92 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-XS | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY, THORAX, LOW DOSE CANCER SCREENING-MOC | $335.40 | $559.00 | $195.65–$491.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA OC | $275.40 | $459.00 | $160.65–$403.92 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA/FIBULA-XO | $275.40 | $459.00 | $83.72–$86.97 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA-XS | $275.40 | $459.00 | $83.72–$86.97 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD EXAM LOWER LEG-FAY | $275.40 | $459.00 | $160.65–$403.92 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA XM | $275.40 | $459.00 | $160.65–$403.92 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA/FIBULA 1 VIEW-XO | $275.40 | $459.00 | $83.72–$86.97 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA-JDI | $275.40 | $459.00 | $160.65–$403.92 | 14% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA-MUCX | $331.20 | $552.00 | $193.20–$485.76 | 37% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA-MUC | $331.20 | $552.00 | $193.20–$485.76 | 37% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA-JUTR | $331.20 | $552.00 | $193.20–$485.76 | 37% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-JUTR | $331.20 | $552.00 | $193.20–$485.76 | 37% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-MUCX | $331.20 | $552.00 | $83.72–$86.97 | 37% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA FIBULA-DIJR | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD EXAM LOWER LEG-FAY | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA/FIBULA-XO | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA/FIBULA 1 VIEW-XO | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-JDI | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA XM | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-XS | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA OC | $275.40 | $459.00 | $160.65–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA & FIBULA 2 VIEWS-JFMV | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA & FIBULA 2 VIEWS-JFMO | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA & FIBULA 2 VIEWS-JFML | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA & FIBULA 2 VIEWS-JFME | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIBIA & FIBULA 2 VIEWS-JFMC | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY, TIBIA & FIBULA, 2 VIEWS-BAMB | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-FFH | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-MUC | $331.20 | $552.00 | $193.20–$485.76 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-JUTR | $331.20 | $552.00 | $193.20–$485.76 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA-MUCX | $331.20 | $552.00 | $193.20–$485.76 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-FFH | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY TIBIA/FIBULA 1 VIEW RT OR LT-DIJR | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-XS | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RT OR LT | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW-RT OR LT | $275.40 | $459.00 | $124.85–$403.92 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-JUTR | $331.20 | $552.00 | $193.20–$485.76 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 1 VIEW RIGHT/LEFT-MUCX | $331.20 | $552.00 | $193.20–$485.76 | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST-MOI | $1,459.20 | $2,432.00 | $229.84–$238.76 | 5% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST-JMRI | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | 5% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST-XS | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | 5% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST-MM | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | 5% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST-DINM | $1,459.20 | $2,432.00 | $229.84–$238.76 | 5% below | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-DINM | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-XS | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-MM | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-JMRI | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-MOI | $1,459.20 | $2,432.00 | $851.20–$2,140.16 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST-JMCC | $1,459.20 | $2,432.00 | $661.50–$2,140.16 | — | 40% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST WO/W CONTRAST;INCL CAD WHEN PERFMD; BILATRAL-DINM | $1,531.20 | $2,552.00 | $694.14–$2,245.76 | 14% below | 40% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI,BREAST WO/W CONTRAST;INCL CAD WHEN PERFMD; BILATRAL-MM | $1,531.20 | $2,552.00 | $694.14–$2,245.76 | 14% below | 40% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST WO/W CONTRAST;INCL CAD WHEN PERFMD; BILATRAL-DINM | $1,531.20 | $2,552.00 | $694.14–$2,245.76 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST WO/W CONTRAST;INCL CAD WHEN PERFMD; BILATRAL-JMCC | $1,531.20 | $2,552.00 | $694.14–$2,245.76 | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI,BREAST WO/W CONTRAST;INCL CAD WHEN PERFMD; BILATRAL-MM | $1,531.20 | $2,552.00 | $694.14–$2,245.76 | — | 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 | $229.84–$238.76 | 18% below | 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 | $229.84–$238.76 | 18% below | 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 | $838.60–$2,108.48 | 18% below | 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 | $229.84–$238.76 | 18% below | 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 | $229.84–$238.76 | 18% below | 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 | $838.60–$2,108.48 | — | 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 | $838.60–$2,108.48 | — | 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 | $838.60–$2,108.48 | — | 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 | $838.60–$2,108.48 | — | 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 | $651.71–$2,108.48 | — | 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 | $838.60–$2,108.48 | — | 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 | $339.57–$352.76 | 2% below | 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 | $1,306.90–$3,285.92 | 2% below | 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 | $339.57–$352.76 | 2% below | 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 | $339.57–$352.76 | 2% below | 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 | $1,306.90–$3,285.92 | 2% below | 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 | $1,306.90–$3,285.92 | — | 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 | $1,306.90–$3,285.92 | — | 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 | $1,306.90–$3,285.92 | — | 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 | $1,306.90–$3,285.92 | — | 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 | $1,015.65–$3,285.92 | — | 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 | $1,306.90–$3,285.92 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST-XS | $1,659.00 | $2,765.00 | $229.84–$238.76 | at median | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST-MM | $1,659.00 | $2,765.00 | $229.84–$238.76 | at median | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST-JMRI | $1,659.00 | $2,765.00 | $229.84–$238.76 | at median | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST-MO | $1,659.00 | $2,765.00 | $229.84–$238.76 | at median | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST-DINM | $1,659.00 | $2,765.00 | $229.84–$238.76 | at median | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-DINM | $1,659.00 | $2,765.00 | $967.75–$2,433.20 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-XS | $1,659.00 | $2,765.00 | $967.75–$2,433.20 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-MM | $1,659.00 | $2,765.00 | $967.75–$2,433.20 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-JMCC | $1,659.00 | $2,765.00 | $752.08–$2,433.20 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-JMRI | $1,659.00 | $2,765.00 | $967.75–$2,433.20 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST-MO | $1,659.00 | $2,765.00 | $967.75–$2,433.20 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST-XS | $2,971.80 | $4,953.00 | $339.57–$352.76 | 23% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST-JMRI | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | 23% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST-DINM | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | 23% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST-MM | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | 23% above | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST-MOI | $2,971.80 | $4,953.00 | $339.57–$352.76 | 23% above | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-DINM | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-MM | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-JMCC | $2,971.80 | $4,953.00 | $1,347.22–$4,358.64 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-JMRI | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-MOI | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST-XS | $2,971.80 | $4,953.00 | $1,733.55–$4,358.64 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-JMRI | $1,240.80 | $2,068.00 | $229.84–$238.76 | 20% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-DINM | $1,240.80 | $2,068.00 | $229.84–$238.76 | 20% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-XS | $1,240.80 | $2,068.00 | $229.84–$238.76 | 20% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN IMAGES FOR CRANIOTOMY-MO | $1,240.80 | $2,068.00 | $229.84–$238.76 | 20% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-MM | $1,240.80 | $2,068.00 | $229.84–$238.76 | 20% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-JMCC | $1,240.80 | $2,068.00 | $562.50–$1,819.84 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-MM | $1,240.80 | $2,068.00 | $723.80–$1,819.84 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-XS | $1,240.80 | $2,068.00 | $723.80–$1,819.84 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-DINM | $1,240.80 | $2,068.00 | $723.80–$1,819.84 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN IMAGES FOR CRANIOTOMY-MO | $1,240.80 | $2,068.00 | $723.80–$1,819.84 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-JMRI | $1,240.80 | $2,068.00 | $723.80–$1,819.84 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-MM | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | 7% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-MOI | $2,646.00 | $4,410.00 | $339.57–$352.76 | 7% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-DINM | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | 7% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-XS | $2,646.00 | $4,410.00 | $339.57–$352.76 | 7% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-JMRI | $2,646.00 | $4,410.00 | $339.57–$352.76 | 7% above | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-XS | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-JMRI | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-JMCC | $2,646.00 | $4,410.00 | $1,199.52–$3,880.80 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-MOI | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-DINM | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-MM | $2,646.00 | $4,410.00 | $1,543.50–$3,880.80 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-XS | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMCC | $1,464.00 | $2,440.00 | $663.68–$2,147.20 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-XS | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-JMRI | $2,716.80 | $4,528.00 | $339.57–$352.76 | 10% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-XS | $2,716.80 | $4,528.00 | $339.57–$352.76 | 10% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-DINM | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | 10% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-MM | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | 10% above | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-MOI | $2,716.80 | $4,528.00 | $339.57–$352.76 | 10% above | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-DINM | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-MM | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-MOI | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-XS | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-JMRI | $2,716.80 | $4,528.00 | $1,584.80–$3,984.64 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WOW CONTRAST-JMCC | $2,716.80 | $4,528.00 | $1,231.62–$3,984.64 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $229.84–$238.76 | 17% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST-MM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 17% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | 17% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 17% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST-XS | $1,464.00 | $2,440.00 | $229.84–$238.76 | 17% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-XS | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-MM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-JMCC | $1,464.00 | $2,440.00 | $663.68–$2,147.20 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-MOI | $2,368.80 | $3,948.00 | $339.57–$352.76 | 4% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-XS | $2,368.80 | $3,948.00 | $339.57–$352.76 | 4% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-JMRI | $2,368.80 | $3,948.00 | $339.57–$352.76 | 4% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-DINM | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | 4% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-MM | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | 4% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-JMCC | $2,368.80 | $3,948.00 | $1,073.86–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-JMRI | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-DINM | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-MOI | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-XS | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WOW CONTRAST-MM | $2,368.80 | $3,948.00 | $1,381.80–$3,474.24 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST-MOI | $1,437.60 | $2,396.00 | $229.84–$238.76 | 27% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST-MM | $1,437.60 | $2,396.00 | $229.84–$238.76 | 27% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST-JMRI | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | 27% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST-XS | $1,437.60 | $2,396.00 | $229.84–$238.76 | 27% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST-DINM | $1,437.60 | $2,396.00 | $229.84–$238.76 | 27% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-DINM | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-MOI | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-JMRI | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-JMCC | $1,437.60 | $2,396.00 | $651.71–$2,108.48 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-MM | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST-XS | $1,437.60 | $2,396.00 | $838.60–$2,108.48 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST-MM | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | 12% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST-JMRI | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | 12% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST-DINM | $2,773.20 | $4,622.00 | $339.57–$352.76 | 12% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST-MOI | $2,773.20 | $4,622.00 | $339.57–$352.76 | 12% above | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST-XS | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | 12% above | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-JMRI | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-MOI | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-DINM | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-XS | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-MM | $2,773.20 | $4,622.00 | $1,617.70–$4,067.36 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST-JMCC | $2,773.20 | $4,622.00 | $1,257.18–$4,067.36 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST-DINM | $1,553.40 | $2,589.00 | $229.84–$238.76 | 16% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST-MOI | $1,553.40 | $2,589.00 | $229.84–$238.76 | 16% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST-XS | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | 16% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST-MM | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | 16% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST-JMRI | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | 16% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST-XS | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST-MOI | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST-JMCC | $1,553.40 | $2,589.00 | $704.21–$2,278.32 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST-DINM | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST-JMRI | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST-MM | $1,553.40 | $2,589.00 | $906.15–$2,278.32 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST MM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST-XS | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UE JOINT WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $229.84–$238.76 | 21% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST MM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST-JMCC | $1,464.00 | $2,440.00 | $663.68–$2,147.20 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST-DINM | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST-MOI | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UE JOINT WO CONTRAST-XS | $1,464.00 | $2,440.00 | $854.00–$2,147.20 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-XS | $463.80 | $773.00 | $101.11–$105.04 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINMUM 4 VIEWS-XO | $463.80 | $773.00 | $101.11–$105.04 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-XM | $463.80 | $773.00 | $270.55–$680.24 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-JDI | $463.80 | $773.00 | $270.55–$680.24 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS OC | $463.80 | $773.00 | $101.11–$105.04 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RAD EXAM NECK SPINE 4 OR MORE VIEWS-FAY | $463.80 | $773.00 | $101.11–$105.04 | 12% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-MUC | $556.80 | $928.00 | $101.11–$105.04 | 34% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-MUCX | $556.80 | $928.00 | $324.80–$816.64 | 34% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-JUTR | $556.80 | $928.00 | $101.11–$105.04 | 34% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY, SPINE, CERVICAL, 4 OR 5 VIEWS-BAMB | $463.80 | $773.00 | $210.26–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RAD EXAM NECK SPINE 4 OR MORE VIEWS-FAY | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINMUM 4 VIEWS-XO | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-JDI | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-XM | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-XS | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY SPINE CERVICAL MINIMUM 4 VIEWS-DIJR | $463.80 | $773.00 | $210.26–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS OC | $463.80 | $773.00 | $270.55–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-FFH | $463.80 | $773.00 | $210.26–$680.24 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-MUC | $556.80 | $928.00 | $324.80–$816.64 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-MUCX | $556.80 | $928.00 | $324.80–$816.64 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MINIMUM 4 VIEWS-JUTR | $556.80 | $928.00 | $324.80–$816.64 | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST-XS | $1,226.40 | $2,044.00 | $169.27–$175.84 | 15% below | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST-CM | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | 15% below | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST-JCT | $1,226.40 | $2,044.00 | $169.27–$175.84 | 15% below | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST-MOC | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | 15% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-XS | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-DIJR | $1,226.40 | $2,044.00 | $555.97–$1,798.72 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-MOC | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-CM | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-JCTG | $1,226.40 | $2,044.00 | $555.97–$1,798.72 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST-JCT | $1,226.40 | $2,044.00 | $715.40–$1,798.72 | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-XS | $969.00 | $1,615.00 | $101.11–$105.04 | 17% below | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-MOC | $969.00 | $1,615.00 | $565.25–$1,421.20 | 17% below | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-AM | $969.00 | $1,615.00 | $101.11–$105.04 | 17% below | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-CM | $969.00 | $1,615.00 | $565.25–$1,421.20 | 17% below | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-JCT | $969.00 | $1,615.00 | $101.11–$105.04 | 17% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-JCT | $969.00 | $1,615.00 | $565.25–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-DIJR | $969.00 | $1,615.00 | $439.28–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-MOC | $969.00 | $1,615.00 | $565.25–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-XS | $969.00 | $1,615.00 | $565.25–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-AM | $969.00 | $1,615.00 | $565.25–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-CM | $969.00 | $1,615.00 | $565.25–$1,421.20 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CONTRAST-JCTG | $969.00 | $1,615.00 | $439.28–$1,421.20 | — | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE -XO | $235.80 | $393.00 | $83.72–$86.97 | 3% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-XM | $235.80 | $393.00 | $137.55–$345.84 | 3% above | 40% |
| Neck soft tissue X-ray CPT 70360 RAD EXAM NECK SOFT TISSUE-FAY | $235.80 | $393.00 | $83.72–$86.97 | 3% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-XS | $235.80 | $393.00 | $83.72–$86.97 | 3% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-JDI | $235.80 | $393.00 | $83.72–$86.97 | 3% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-MUCX | $282.60 | $471.00 | $164.85–$414.48 | 24% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-JUTR | $282.60 | $471.00 | $164.85–$414.48 | 24% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE-MUC | $282.60 | $471.00 | $164.85–$414.48 | 24% above | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-BAMB | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-FFH | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 X-RAY NECK SOFT TISSUE-DIJR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-XS | $235.80 | $393.00 | $137.55–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-XM | $235.80 | $393.00 | $137.55–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-JDI | $235.80 | $393.00 | $137.55–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE -XO | $235.80 | $393.00 | $137.55–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 RAD EXAM NECK SOFT TISSUE-FAY | $235.80 | $393.00 | $137.55–$345.84 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-MUC | $282.60 | $471.00 | $164.85–$414.48 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-JUTR | $282.60 | $471.00 | $164.85–$414.48 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE-MUCX | $282.60 | $471.00 | $164.85–$414.48 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-NM | $3,840.00 | $6,400.00 | $2,240.00–$5,632.00 | 8% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-DINP | $3,840.00 | $6,400.00 | $1,241.30–$1,289.50 | 8% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-JNM | $3,840.00 | $6,400.00 | $2,240.00–$5,632.00 | 8% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-CCDJ | $3,840.00 | $6,400.00 | $1,740.80–$5,632.00 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-JNM | $3,840.00 | $6,400.00 | $2,240.00–$5,632.00 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-NM | $3,840.00 | $6,400.00 | $2,240.00–$5,632.00 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF IMAGING SPECT MULTIPLE AT REST/STRESS-DINP | $3,840.00 | $6,400.00 | $2,240.00–$5,632.00 | — | 40% |
| OCT scan of the retina (optical coherence tomography) both sides CPT 92134 COMPUTERZD OPH DIAG IMG POST SEG W/INT RPT UNI/BI RETINA-MEE | $76.80 | $128.00 | $56.48–$58.67 | — | 40% |
| OCT scan of the retina (optical coherence tomography) both sides CPT 92134 COMPUTERZD OPH DIAG IMG POST SEG W/INT RPT UNI/BI RETINA-OPH | $76.80 | $128.00 | $44.80–$112.64 | — | 40% |
| OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 COMPUTERZD OPH DIAG IMG POST SEG W/INT RPT UNI/BI RETINA-MEE | $76.80 | $128.00 | $44.80–$112.64 | — | 40% |
| OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 COMPUTERZD OPH DIAG IMG POST SEG W/INT RPT UNI/BI RETINA-OPH | $76.80 | $128.00 | $44.80–$112.64 | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL BASE TO MID THIGH-DINP | $4,592.40 | $7,654.00 | $1,386.88–$1,440.74 | 8% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT, SKULL BASE TO MID THIGH-NM | $4,592.40 | $7,654.00 | $1,386.88–$1,440.74 | 8% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL BASE TO MID THIGH-DINP | $4,592.40 | $7,654.00 | $2,678.90–$6,735.52 | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT, SKULL BASE TO MID THIGH-NM | $4,592.40 | $7,654.00 | $2,678.90–$6,735.52 | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL BASE TO MID THIGH-JPET | $4,592.40 | $7,654.00 | $2,081.89–$6,735.52 | — | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST-JCT | $1,018.80 | $1,698.00 | $101.11–$105.04 | 27% below | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST-MOC | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | 27% below | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST-XS | $1,018.80 | $1,698.00 | $101.11–$105.04 | 27% below | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST-CM | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | 27% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-XS | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-JCTG | $1,018.80 | $1,698.00 | $461.86–$1,494.24 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-JCT | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-DIJR | $1,018.80 | $1,698.00 | $461.86–$1,494.24 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-MOC | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST-CM | $1,018.80 | $1,698.00 | $594.30–$1,494.24 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FUL | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-IVF | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-JOB | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-MFCC | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-OBC | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED OR F/U FOLLICLE SCAN-OBTR | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-NFM | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC B SCAN W/LMTD RPT F/U FOLLICLE SCAN -NSOB | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FAY | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-SPFM | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-EF | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-XO | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-JUC | $415.20 | $692.00 | $242.20–$608.96 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-XS | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-UM | $415.20 | $692.00 | $101.11–$105.04 | 16% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-EC | $498.00 | $830.00 | $290.50–$730.40 | 39% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS NON-OB LIMITED-JER | $498.00 | $830.00 | $101.11–$105.04 | 39% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC B SCAN W/LMTD RPT F/U FOLLICLE SCAN -NSOB | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-NFM | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED OR F/U FOLLICLE SCAN-OBTR | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-OBC | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-MFCC | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-JUC | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FUL | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-JOB | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-XO | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-XS | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-UM | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FMCK | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-MFMC | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FMCJ | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-BAMB | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FFH | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-AFM | $415.20 | $692.00 | $188.22–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-SPFM | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-FAY | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC NON-OBSTETRICAL LIMITED/FOLLOW-UP-IVF | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND, PELVIC, NON-OBSTETRICAL, LIMITED/FOLLOW-UP-EF | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-JER | $498.00 | $830.00 | $290.50–$730.40 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS NON-OB LIMITED-EC | $498.00 | $830.00 | $290.50–$730.40 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON-OB COMPLETE-JUC | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-IVF | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-JOB | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON-OB COMPLETE-XO | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC COMPLETE EF | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-SC | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ECHO PELVIC B SCAN W IMAGE -NSOB | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-OBC | $706.20 | $1,177.00 | $411.95–$1,035.76 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-PESC | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-MFCC | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON-OB COMPLETE-UM | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS NON-OB COMPLETE-XS | $706.20 | $1,177.00 | $101.11–$105.04 | 12% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON-OB COMPLETE-UM | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-MFCC | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON-OB COMPLETE-XS | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND, PELVIC, NON-OBSTETRICAL, COMPLETE-BAMB | $706.20 | $1,177.00 | $320.14–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON-OB COMPLETE-XO | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-OBC | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-PESC | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC COMPLETE EF | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-SC | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS NON-OB COMPLETE-JUC | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ECHO PELVIC B SCAN W IMAGE -NSOB | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-JOB | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIC NON-OBSTETRICAL COMPLETE-IVF | $706.20 | $1,177.00 | $411.95–$1,035.76 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY GT 14 WEEKS-JUC | $570.60 | $951.00 | $332.85–$836.88 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-LAD | $570.60 | $951.00 | $332.85–$836.88 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-JOB | $570.60 | $951.00 | $332.85–$836.88 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-MFCC | $570.60 | $951.00 | $101.11–$105.04 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-OBC | $570.60 | $951.00 | $332.85–$836.88 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUNDAFTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBTR | $570.60 | $951.00 | $101.11–$105.04 | 7% above | 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 | $332.85–$836.88 | 7% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY GT 14 WEEKS-UM | $570.60 | $951.00 | $101.11–$105.04 | 7% above | 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 | $332.85–$836.88 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY GT 14 WEEKS-UM | $570.60 | $951.00 | $332.85–$836.88 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY GT 14 WEEKS-JUC | $570.60 | $951.00 | $332.85–$836.88 | — | 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 | $332.85–$836.88 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUNDAFTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBTR | $570.60 | $951.00 | $332.85–$836.88 | — | 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 | $332.85–$836.88 | — | 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 | $332.85–$836.88 | — | 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 | $258.67–$836.88 | — | 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 | $332.85–$836.88 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBC | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-LAD | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-IVF | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-NFM | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANCY < 14 WEEKS-UM | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-MFCC | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANCY < 14 WEEKS-XS | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANCY < 14 WEEKS-JUC | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-SPFM | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FAY | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FUL | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRIM TRABD APP 1ST TRIMSTR -NSOB | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND1ST TRIMESTER; SINGLE/1ST GESTATION-OBTR | $538.20 | $897.00 | $101.11–$105.04 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-JOB | $538.20 | $897.00 | $313.95–$789.36 | 5% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBC | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-NFM | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-JOB | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-LAD | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FMCK | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-MFMC | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FMCJ | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND,PREG UTER,1ST TRIMESTER;SINGLE/1ST GESTATION-BAMB | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FFH | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-AFM | $538.20 | $897.00 | $243.98–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-IVF | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-MFCC | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTER 1ST TRIM TRABD APP 1ST TRIMSTR -NSOB | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FUL | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-FAY | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND PREG UTER 1ST TRIMESTER;SINGLE/1ST GESTATION-SPFM | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANCY < 14 WEEKS-JUC | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANCY < 14 WEEKS-XS | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANCY < 14 WEEKS-UM | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 ULTRASOUND1ST TRIMESTER; SINGLE/1ST GESTATION-OBTR | $538.20 | $897.00 | $313.95–$789.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED-UM | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-JOB | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-MNU | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-OBTR | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-OBC | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND, PREG UTER, LIMITED, 1/MORE FETUSES-IVF | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-SPFM | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTER LIMTD 1/MORE FETUSES -NSOB | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-LAD | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FAY | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-MFCC | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FUL | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-NFM | $388.20 | $647.00 | $101.11–$105.04 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND LTD FETAL POSITION-EF | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LDU ULTRASOUND LIMITED FETAL POSITION-LAD | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED-JUC | $388.20 | $647.00 | $226.45–$569.36 | 8% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED-EC | $466.20 | $777.00 | $271.95–$683.76 | 30% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED-JER | $466.20 | $777.00 | $101.11–$105.04 | 30% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND LTD FETAL POSITION-EF | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-BAMB | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FMCJ | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-MFMC | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED-JUC | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FMCK | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-SPFM | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FAY | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FUL | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTER LIMTD 1/MORE FETUSES -NSOB | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-NFM | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-OBTR | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-OBC | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-MFCC | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-MNU | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED-UM | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-JOB | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-JFMV | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 LDU ULTRASOUND LIMITED FETAL POSITION-LAD | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND, PREG UTER, LIMITED, 1/MORE FETUSES-IVF | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-AFM | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND PREG UTER LIMITED 1/MORE FETUSES-LAD | $388.20 | $647.00 | $226.45–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRASOUND,PREG UTER, LIMITED, 1/MORE FETUSES-FFH | $388.20 | $647.00 | $175.98–$569.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED-EC | $466.20 | $777.00 | $271.95–$683.76 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED-JER | $466.20 | $777.00 | $271.95–$683.76 | — | 40% |
| Rib X-ray, one side, 2 views CPT 71100 XR RIBS 2 VIEWS-XO | $246.00 | $410.00 | $143.50–$360.80 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL XM | $246.00 | $410.00 | $143.50–$360.80 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 RAD EXAM RIBS UNILATERAL TWO VIEWS-FAY | $246.00 | $410.00 | $83.72–$86.97 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-JDI | $246.00 | $410.00 | $83.72–$86.97 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL OC | $246.00 | $410.00 | $143.50–$360.80 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-XS | $246.00 | $410.00 | $143.50–$360.80 | 4% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-MUCX | $295.20 | $492.00 | $172.20–$432.96 | 25% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-JUTR | $295.20 | $492.00 | $172.20–$432.96 | 25% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-MUC | $295.20 | $492.00 | $83.72–$86.97 | 25% above | 40% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 XR RIBS 2 VIEWS-XO | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-FFH | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-JDI | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD EXAM RIBS UNILATERAL TWO VIEWS-FAY | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VIEWS UNILATERAL-JFMV | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VIEWS UNILATERAL-JFMO | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-JFML | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VIEWS UNILATERAL-JFME | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VIEWS UNILATERAL-BAMB | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL OC | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL XM | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-XS | $246.00 | $410.00 | $143.50–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VIEWS UNILATERAL-DIJR | $246.00 | $410.00 | $111.52–$360.80 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-MUCX | $295.20 | $492.00 | $172.20–$432.96 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-JUTR | $295.20 | $492.00 | $172.20–$432.96 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS UNILATERAL-MUC | $295.20 | $492.00 | $172.20–$432.96 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS W/ PA CHEST-XO | $372.60 | $621.00 | $101.11–$105.04 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RAD EXAM,RIBS,UNLAT.INC POST/ANT CHEST,MIN THREE VIEW-FAY | $372.60 | $621.00 | $101.11–$105.04 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-XS | $372.60 | $621.00 | $217.35–$546.48 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-OC | $372.60 | $621.00 | $217.35–$546.48 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL XM | $372.60 | $621.00 | $101.11–$105.04 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-JDI | $372.60 | $621.00 | $101.11–$105.04 | 36% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-JUTR | $448.20 | $747.00 | $261.45–$657.36 | 63% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-MUCX | $448.20 | $747.00 | $261.45–$657.36 | 63% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-MUC | $448.20 | $747.00 | $101.11–$105.04 | 63% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS W/ PA CHEST-XO | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RAD EXAM,RIBS,UNLAT.INC POST/ANT CHEST,MIN THREE VIEW-FAY | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-OC | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS W PA CHEST UNILATERAL-DIJR | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-XS | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL XM | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-JDI | $372.60 | $621.00 | $217.35–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS INCLD POST ANTR CHEST UNILATERAL MIN 3 VIEWS-JFMV | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS INCLD POST ANTR CHEST UNILATERAL MIN 3 VIEWS-JFMO | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS INCLD POST ANTR CHEST UNILATERAL MIN 3 VIEWS-JFME | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS INCLD POST ANTR CHEST UNILATERAL MIN 3 VIEWS-JFMC | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-FFH | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY RIBS INCLD POST ANTR CHEST,UNILATERAL,MIN 3 VIEWS-BAMB | $372.60 | $621.00 | $168.91–$546.48 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-MUC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-MUCX | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST UNILATERAL-JUTR | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-JMAM | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BE | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BV | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BV | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BE | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-JMAM | $229.20 | $382.00 | $103.90–$336.16 | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-XS | $297.60 | $496.00 | $173.60–$436.48 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER 2 OR MORE VIEWS-FAY | $297.60 | $496.00 | $173.60–$436.48 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-JDI | $297.60 | $496.00 | $83.72–$86.97 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-XM | $297.60 | $496.00 | $83.72–$86.97 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE OC | $297.60 | $496.00 | $173.60–$436.48 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE MIN 2 VWS-XO | $297.60 | $496.00 | $83.72–$86.97 | 12% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-MUCX | $357.60 | $596.00 | $83.72–$86.97 | 35% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-MUC | $357.60 | $596.00 | $208.60–$524.48 | 35% above | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER COMPLETE-JUTR | $357.60 | $596.00 | $83.72–$86.97 | 35% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-XS | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE OC | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE-DIJR | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-XM | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-JDI | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE MIN 2 VWS-XO | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD EXAM SHOULDER 2 OR MORE VIEWS-FAY | $297.60 | $496.00 | $173.60–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE MINIMUM 2 VIEWS-JFMV | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE MINIMUM 2 VIEWS-JFMO | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE MINIMUM 2 VIEWS-JFML | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE MINIMUM 2 VIEWS-JFME | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER COMPLETE MINIMUM 2 VIEWS-JFMC | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY, SHOULDER, COMPLETE, MINIMUM 2 VIEWS-BAMB | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-FFH | $297.60 | $496.00 | $134.91–$436.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-MUCX | $357.60 | $596.00 | $208.60–$524.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-MUC | $357.60 | $596.00 | $208.60–$524.48 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER COMPLETE-JUTR | $357.60 | $596.00 | $208.60–$524.48 | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-XM | $387.00 | $645.00 | $225.75–$567.60 | 30% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-JDI | $387.00 | $645.00 | $83.72–$86.97 | 30% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-XS | $387.00 | $645.00 | $83.72–$86.97 | 30% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-JUTR | $464.40 | $774.00 | $270.90–$681.12 | 56% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-MUCX | $464.40 | $774.00 | $270.90–$681.12 | 56% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE-MUC | $464.40 | $774.00 | $270.90–$681.12 | 56% above | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-JDI | $387.00 | $645.00 | $225.75–$567.60 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-XS | $387.00 | $645.00 | $225.75–$567.60 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-FFH | $387.00 | $645.00 | $175.44–$567.60 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-XM | $387.00 | $645.00 | $225.75–$567.60 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY SINUSES PARANASAL COMPLETE-DIJR | $387.00 | $645.00 | $175.44–$567.60 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-MUCX | $464.40 | $774.00 | $270.90–$681.12 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-MUC | $464.40 | $774.00 | $270.90–$681.12 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE-JUTR | $464.40 | $774.00 | $270.90–$681.12 | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 RAD EXAM SKULL LESS THAN FOUR VIEWS-OC | $314.40 | $524.00 | $101.11–$105.04 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 RAD EXAM SKULL LESS THAN FOUR VIEWS-FAY | $314.40 | $524.00 | $101.11–$105.04 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LESS THAN 4 VIEWS-XO | $314.40 | $524.00 | $101.11–$105.04 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-JDI | $314.40 | $524.00 | $101.11–$105.04 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-XM | $314.40 | $524.00 | $183.40–$461.12 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-XS | $314.40 | $524.00 | $101.11–$105.04 | 22% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-JUTR | $377.40 | $629.00 | $220.15–$553.52 | 47% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-MUCX | $377.40 | $629.00 | $220.15–$553.52 | 47% above | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS-MUC | $377.40 | $629.00 | $220.15–$553.52 | 47% above | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY SKULL < 4 VIEWS-DIJR | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-JDI | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-XM | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD EXAM SKULL LESS THAN FOUR VIEWS-OC | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD EXAM SKULL LESS THAN FOUR VIEWS-BAMB | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-XS | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD EXAM SKULL LESS THAN FOUR VIEWS-FAY | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-FFH | $314.40 | $524.00 | $142.53–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LESS THAN 4 VIEWS-XO | $314.40 | $524.00 | $183.40–$461.12 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-MUC | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-JUTR | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS-MUCX | $377.40 | $629.00 | $220.15–$553.52 | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | $1,837.85–$4,620.88 | 34% above | 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 | $1,428.27–$4,620.88 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 ABORTED POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | $1,428.27–$4,620.88 | — | 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 | $1,428.27–$4,620.88 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | $1,837.85–$4,620.88 | — | 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 | $1,428.27–$4,620.88 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 ABORTED POLYSOMNOGRAPHY 4+ PARAMETERS, 6YO OR OLDER-SDCP | $3,150.60 | $5,251.00 | $1,428.27–$4,620.88 | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO, TRANSTH, REAL-TIME IMGE, STRESS TST, CONT ECG MON-CTST | $1,486.20 | $2,477.00 | $521.34–$541.59 | 14% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO, TRANSTH, REAL-TIME IMGE, STRESS TST, CONT ECG MON-CTST | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XRAY SWALLOWING FUNCTION, W/ VIDEO, SINGLE CONTRAST STUDY-XM | $471.60 | $786.00 | $275.10–$691.68 | 6% above | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XRAY SWALLOWING FUNCTION, W/ VIDEO, SINGLE CONTRAST STUDY-XO | $471.60 | $786.00 | $275.10–$691.68 | 6% above | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XRAY SWALLOWING FUNCTION W/VIDEO SINGLE CONTRAST STUDY-JDI | $471.60 | $786.00 | $169.27–$175.84 | 6% above | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XRAY SWALLOWING FUNCTION, W/ VIDEO, SINGLE CONTRAST STUDY-XO | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XRAY SWALLOWING FUNCTION W/VIDEO SINGLE CONTRAST STUDY-JDI | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XRAY SWALLOWING FUNCTION, W/ VIDEO, SINGLE CONTRAST STUDY-XM | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY,SWALLOWING FUNCTION,W/VIDEO,SINGLE CONTRAST STUDY-BAMB | $471.60 | $786.00 | $213.79–$691.68 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-XS | $297.00 | $495.00 | $173.25–$435.60 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-XO | $297.00 | $495.00 | $173.25–$435.60 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-FAY | $297.00 | $495.00 | $173.25–$435.60 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-JDI | $297.00 | $495.00 | $83.72–$86.97 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-OC | $297.00 | $495.00 | $173.25–$435.60 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-XM | $297.00 | $495.00 | $173.25–$435.60 | 15% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-JUTR | $356.40 | $594.00 | $207.90–$522.72 | 38% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-MUC | $356.40 | $594.00 | $207.90–$522.72 | 38% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR 2 VIEW-MUCX | $356.40 | $594.00 | $83.72–$86.97 | 38% above | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JDI | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-XM | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-XS | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-FFH | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY, FEMUR, 2 VIEWS-BAMB | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY FEMUR 2 VIEW-DIJR | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-FAY | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JFME | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JFML | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JFMO | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JFMV | $297.00 | $495.00 | $134.64–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-OC | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-XO | $297.00 | $495.00 | $173.25–$435.60 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-MUCX | $356.40 | $594.00 | $207.90–$522.72 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-JUTR | $356.40 | $594.00 | $207.90–$522.72 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR 2 VIEW-MUC | $356.40 | $594.00 | $207.90–$522.72 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO CONTRAST-CM | $765.60 | $1,276.00 | $101.11–$105.04 | 42% below | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO CONTRAST-MOC | $765.60 | $1,276.00 | $101.11–$105.04 | 42% below | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W/O CONTRAST-AM | $765.60 | $1,276.00 | $101.11–$105.04 | 42% below | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO CONTRAST-XS | $765.60 | $1,276.00 | $101.11–$105.04 | 42% below | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO CONTRAST-JCT | $765.60 | $1,276.00 | $101.11–$105.04 | 42% below | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-XS | $765.60 | $1,276.00 | $446.60–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-JCTG | $765.60 | $1,276.00 | $347.07–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-CM | $765.60 | $1,276.00 | $446.60–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC W/O CONTRAST-AM | $765.60 | $1,276.00 | $446.60–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-MOC | $765.60 | $1,276.00 | $446.60–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-JCT | $765.60 | $1,276.00 | $446.60–$1,122.88 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONTRAST-DIJR | $765.60 | $1,276.00 | $347.07–$1,122.88 | — | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-XS | $219.60 | $366.00 | $128.10–$322.08 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-FAY | $219.60 | $366.00 | $128.10–$322.08 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES -XO | $219.60 | $366.00 | $83.72–$86.97 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-JDI | $219.60 | $366.00 | $83.72–$86.97 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-XM | $219.60 | $366.00 | $83.72–$86.97 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES OC | $219.60 | $366.00 | $128.10–$322.08 | 10% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-JUTR | $263.40 | $439.00 | $83.72–$86.97 | 32% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-MUCX | $263.40 | $439.00 | $153.65–$386.32 | 32% above | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES-MUC | $263.40 | $439.00 | $153.65–$386.32 | 32% above | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-XS | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-XM | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-FFH | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY, TOES, 2 VIEWS-BAMB | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-JDI | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-JFME | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-JFML | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-JFMO | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-JFMV | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES -XO | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-FAY | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOE 2 OR MORE VIEWS-JFMC | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES OC | $219.60 | $366.00 | $128.10–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY TOES-DIJR | $219.60 | $366.00 | $99.55–$322.08 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-MUCX | $263.40 | $439.00 | $153.65–$386.32 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-MUC | $263.40 | $439.00 | $153.65–$386.32 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES-JUTR | $263.40 | $439.00 | $153.65–$386.32 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBC | $517.80 | $863.00 | $302.05–$759.44 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBTR | $517.80 | $863.00 | $101.11–$105.04 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ECHO -NSOB | $517.80 | $863.00 | $302.05–$759.44 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ECHO EF | $517.80 | $863.00 | $302.05–$759.44 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-JUC | $517.80 | $863.00 | $101.11–$105.04 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-XS | $517.80 | $863.00 | $101.11–$105.04 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-IVF | $517.80 | $863.00 | $101.11–$105.04 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-UM | $517.80 | $863.00 | $302.05–$759.44 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-JOB | $517.80 | $863.00 | $302.05–$759.44 | at median | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-MFCC | $517.80 | $863.00 | $101.11–$105.04 | at median | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-UM | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-IVF | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL, NON-OBSTETRICAL-BAMB | $517.80 | $863.00 | $234.74–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-JOB | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-MFCC | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBC | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBTR | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ECHO -NSOB | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ECHO EF | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-JUC | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-XS | $517.80 | $863.00 | $302.05–$759.44 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-JOB | $407.40 | $679.00 | $237.65–$597.52 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-MFCC | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-OBTR | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-OBC | $407.40 | $679.00 | $237.65–$597.52 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-LAD | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL-JUC | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL-XS | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-IVF | $407.40 | $679.00 | $101.11–$105.04 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL-EF | $407.40 | $679.00 | $237.65–$597.52 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTER TRANSVAGINAL APPROACH -NSOB | $407.40 | $679.00 | $237.65–$597.52 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL UM | $407.40 | $679.00 | $237.65–$597.52 | 5% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL-EC | $489.00 | $815.00 | $285.25–$717.20 | 14% above | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL-JER | $489.00 | $815.00 | $101.11–$105.04 | 14% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL-EF | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL-JUC | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL-XS | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL UM | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-JOB | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-LAD | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-MFCC | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-OBC | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-IVF | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND, PREG UTER, TRANSVAGINAL-BAMB | $407.40 | $679.00 | $184.69–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 ULTRASOUND PREG UTER TRANSVAGINAL-OBTR | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTER TRANSVAGINAL APPROACH -NSOB | $407.40 | $679.00 | $237.65–$597.52 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL-JER | $489.00 | $815.00 | $285.25–$717.20 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL-EC | $489.00 | $815.00 | $285.25–$717.20 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-UM | $636.60 | $1,061.00 | $101.11–$105.04 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-PESC | $636.60 | $1,061.00 | $101.11–$105.04 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-JUC | $636.60 | $1,061.00 | $371.35–$933.68 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-XO | $636.60 | $1,061.00 | $101.11–$105.04 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-SC | $636.60 | $1,061.00 | $371.35–$933.68 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-XS | $636.60 | $1,061.00 | $101.11–$105.04 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL ULTRASOUND EF | $636.60 | $1,061.00 | $371.35–$933.68 | 20% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-JUTR | $764.40 | $1,274.00 | $445.90–$1,121.12 | 4% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-XO | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-JUC | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-SC | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-PESC | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL ULTRASOUND EF | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-XS | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-UM | $636.60 | $1,061.00 | $371.35–$933.68 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-JUTR | $764.40 | $1,274.00 | $445.90–$1,121.12 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-JUC | $648.00 | $1,080.00 | $378.00–$950.40 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-PESC | $648.00 | $1,080.00 | $101.11–$105.04 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-SC | $648.00 | $1,080.00 | $378.00–$950.40 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-UM | $648.00 | $1,080.00 | $101.11–$105.04 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-XS | $648.00 | $1,080.00 | $101.11–$105.04 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-XO | $648.00 | $1,080.00 | $378.00–$950.40 | 14% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-EC | $777.60 | $1,296.00 | $453.60–$1,140.48 | 36% above | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM (CONTENTS)-JER | $777.60 | $1,296.00 | $101.11–$105.04 | 36% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-XS | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-SC | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-PESC | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-XO | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-UM | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-JUC | $648.00 | $1,080.00 | $378.00–$950.40 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-JER | $777.60 | $1,296.00 | $453.60–$1,140.48 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM (CONTENTS)-EC | $777.60 | $1,296.00 | $453.60–$1,140.48 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-FUL | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-CIDE | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-UM | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-XS | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-AM | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-JUC | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-XO | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-EF | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-SPFM | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-FAY | $598.80 | $998.00 | $349.30–$878.24 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-NFM | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-JIMC | $598.80 | $998.00 | $101.11–$105.04 | 4% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-JER | $718.80 | $1,198.00 | $101.11–$105.04 | 25% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK SOFT TISSUE-EC | $718.80 | $1,198.00 | $101.11–$105.04 | 25% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-CIDE | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-FMCK | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-MFMC | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-NFM | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-FUL | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-FAY | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-SPFM | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-EF | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-AFM | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-JUC | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-UM | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-XS | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-BAMB | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-FFH | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-AM | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-FMCJ | $598.80 | $998.00 | $271.46–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-XO | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUES OF HEAD AND NECK-JIMC | $598.80 | $998.00 | $349.30–$878.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-JER | $718.80 | $1,198.00 | $419.30–$1,054.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK SOFT TISSUE-EC | $718.80 | $1,198.00 | $419.30–$1,054.24 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY UPPER GI; SINGLE CONTRAST STUDY-JDI | $563.40 | $939.00 | $169.27–$175.84 | 3% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XRAY UPPER GI; SINGLE CONTRAST STUDY-XM | $563.40 | $939.00 | $328.65–$826.32 | 3% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY UPPER GI; SINGLE CONTRAST STUDY-JDI | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XRAY UPPER GI; SINGLE CONTRAST STUDY-XM | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY, UPPER GI, INCLD ABDOMINAL, SINGLE CONTRAST STUDY-BAMB | $563.40 | $939.00 | $255.41–$826.32 | — | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-JDI | $273.60 | $456.00 | $83.72–$86.97 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS -XO | $273.60 | $456.00 | $159.60–$401.28 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS OC | $273.60 | $456.00 | $159.60–$401.28 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-XS | $273.60 | $456.00 | $159.60–$401.28 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 RAD EXAM HUMERUS 2 VIEWS OR MORE-FAY | $273.60 | $456.00 | $159.60–$401.28 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-XM | $273.60 | $456.00 | $159.60–$401.28 | 14% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-JUTR | $328.20 | $547.00 | $83.72–$86.97 | 36% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-MUC | $328.20 | $547.00 | $191.45–$481.36 | 36% above | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS-MUCX | $328.20 | $547.00 | $83.72–$86.97 | 36% above | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MINIMUM 2 VIEWS-JFMC | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RAD EXAM HUMERUS 2 VIEWS OR MORE-FAY | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS -XO | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-JDI | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-XM | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-XS | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS-DIJR | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS OC | $273.60 | $456.00 | $159.60–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY, HUMERUS, MINIMUM 2 VIEWS-BAMB | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-FFH | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MINIMUM 2 VIEWS-JFMO | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MINIMUM 2 VIEWS-JFML | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MINIMUM 2 VIEWS-JFME | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MINIMUM 2 VIEWS-JFMV | $273.60 | $456.00 | $124.03–$401.28 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-MUCX | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-MUC | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS-JUTR | $328.20 | $547.00 | $191.45–$481.36 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILAT-JUC | $612.00 | $1,020.00 | $357.00–$897.60 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILAT UM | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILAT-XS | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-JSCM | $612.00 | $1,020.00 | $357.00–$897.60 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-FUL | $612.00 | $1,020.00 | $357.00–$897.60 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILAT XO | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-CTST | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-FAY | $612.00 | $1,020.00 | $357.00–$897.60 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-NFM | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-JVC | $612.00 | $1,020.00 | $101.11–$105.04 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL-SPFM | $612.00 | $1,020.00 | $357.00–$897.60 | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-EC | $734.40 | $1,224.00 | $428.40–$1,077.12 | 20% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-JER | $734.40 | $1,224.00 | $101.11–$105.04 | 20% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-JSCM | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILAT UM | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-JVC | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILAT-XS | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILAT XO | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-CTST | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILAT-JUC | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-NFM | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-FMCJ | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-FUL | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-MFMC | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-FMCK | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-BAMB | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-JFMC | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILAT-CCDJ | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-FFH | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-AFM | $612.00 | $1,020.00 | $277.44–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-SPFM | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL-FAY | $612.00 | $1,020.00 | $357.00–$897.60 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-EC | $734.40 | $1,224.00 | $428.40–$1,077.12 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DUPLEX UNILATERAL/LIMTED-JER | $734.40 | $1,224.00 | $428.40–$1,077.12 | — | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-XM | $231.00 | $385.00 | $134.75–$338.80 | 12% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS -XO | $231.00 | $385.00 | $134.75–$338.80 | 12% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-JDI | $231.00 | $385.00 | $134.75–$338.80 | 12% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS OC | $231.00 | $385.00 | $134.75–$338.80 | 12% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-XS | $231.00 | $385.00 | $83.72–$86.97 | 12% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-MUC | $277.20 | $462.00 | $161.70–$406.56 | 35% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-MUCX | $277.20 | $462.00 | $83.72–$86.97 | 35% above | 40% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST 2 VIEWS-JUTR | $277.20 | $462.00 | $83.72–$86.97 | 35% above | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS OC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JDI | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS -XO | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 X-RAY, WRIST, 2 VIEWS-BAMB | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 X-RAY, WRIST, 2 VIEWS-JFME | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JFMB | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JFML | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JFMC | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-FFH | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JFMO | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JFMV | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 X-RAY WRIST 2 VIEWS-DIJR | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-XS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-XM | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-MUCX | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-MUC | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEWS-JUTR | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE OC | $298.80 | $498.00 | $174.30–$438.24 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE MIN 3 VIEWS-XO | $298.80 | $498.00 | $83.72–$86.97 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST 3 OR MORE VIEWS-FAY | $298.80 | $498.00 | $174.30–$438.24 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-XS | $298.80 | $498.00 | $174.30–$438.24 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-XM | $298.80 | $498.00 | $83.72–$86.97 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-JDI | $298.80 | $498.00 | $83.72–$86.97 | 14% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-MUCX | $358.80 | $598.00 | $83.72–$86.97 | 36% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-MUC | $358.80 | $598.00 | $209.30–$526.24 | 36% above | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST COMPLETE-JUTR | $358.80 | $598.00 | $83.72–$86.97 | 36% above | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RAD EXAM WRIST 3 OR MORE VIEWS-FAY | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE MINIMUM 3 VIEWS-JFMC | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE MINIMUM 3 VIEWS-JFME | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE MIN 3 VIEWS-XO | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-JDI | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-XM | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-XS | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE MINIMUM 3 VIEWS-JFML | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE-DIJR | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-FFH | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE OC | $298.80 | $498.00 | $174.30–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE MINIMUM 3 VIEWS-JFMV | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST COMPLETE MINIMUM 3 VIEWS-JFMO | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY, WRIST, COMPLETE, MINIMUM 3 VIEWS-BAMB | $298.80 | $498.00 | $135.46–$438.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-MUCX | $358.80 | $598.00 | $209.30–$526.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-JUTR | $358.80 | $598.00 | $209.30–$526.24 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST COMPLETE-MUC | $358.80 | $598.00 | $209.30–$526.24 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-FAY | $287.40 | $479.00 | $167.65–$421.52 | 21% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XM | $287.40 | $479.00 | $167.65–$421.52 | 21% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XO | $287.40 | $479.00 | $167.65–$421.52 | 21% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XS | $287.40 | $479.00 | $83.72–$86.97 | 21% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-JDI | $287.40 | $479.00 | $83.72–$86.97 | 21% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-MUC | $344.40 | $574.00 | $200.90–$505.12 | 45% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-JUTR | $344.40 | $574.00 | $200.90–$505.12 | 45% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-MUCX | $344.40 | $574.00 | $83.72–$86.97 | 45% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XO | $287.40 | $479.00 | $167.65–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-FFH | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-FAY | $287.40 | $479.00 | $167.65–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-JDI | $287.40 | $479.00 | $167.65–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XM | $287.40 | $479.00 | $167.65–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-XS | $287.40 | $479.00 | $167.65–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY HIP UNIL W PELVIS 2-3 VIEW-DIJR | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-MUCX | $344.40 | $574.00 | $200.90–$505.12 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-JUTR | $344.40 | $574.00 | $200.90–$505.12 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP UNIL W PELVIS 2-3 VIEW-MUC | $344.40 | $574.00 | $200.90–$505.12 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY, HIP, UNILATERAL, W/PELVIS, 2-3 VIEWS-BAMB | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL W/PELVIS 2-3 VIEWS-JFMO | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL W/PELVIS 2-3 VIEWS-JFME | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL W/PELVIS 2-3 VIEWS-JFMC | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL W/PELVIS 2-3 VIEWS-JFMV | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY HIP UNILATERAL W/PELVIS 2-3 VIEWS-JFML | $287.40 | $479.00 | $130.29–$421.52 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY, ABDOMEN, 1 VIEW-XM | $259.20 | $432.00 | $151.20–$380.16 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY, ABDOMEN, 1 VIEW-FAY | $259.20 | $432.00 | $151.20–$380.16 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY ABDOMEN 1 VIEW-AM | $259.20 | $432.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY, ABDOMEN, 1 VIEW-OC | $259.20 | $432.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY ABDOMEN 1 VIEW-JDI | $259.20 | $432.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY ABDOMEN 1 VIEW-XO | $259.20 | $432.00 | $151.20–$380.16 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY, ABDOMEN, 1 VIEW-XS | $259.20 | $432.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY; ABDOMEN; 1 VIEW-JUTR | $311.40 | $519.00 | $83.72–$86.97 | 50% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY ABDOMEN 1 VIEW-MUCX | $311.40 | $519.00 | $181.65–$456.72 | 50% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 X-RAY, ABDOMEN, 1 VIEW-MUC | $311.40 | $519.00 | $181.65–$456.72 | 50% above | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-JDI | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-OC | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-DIJR | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-XS | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-AM | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-FFH | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-BAMB | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-JFMC | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-JFME | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-XM | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY; ABDOMEN; 1 VIEW-JFML | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-JFMO | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY; ABDOMEN; 1 VIEW-JFMV | $259.20 | $432.00 | $117.50–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-FAY | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-XO | $259.20 | $432.00 | $151.20–$380.16 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY; ABDOMEN; 1 VIEW-JUTR | $311.40 | $519.00 | $181.65–$456.72 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY, ABDOMEN, 1 VIEW-MUC | $311.40 | $519.00 | $181.65–$456.72 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY ABDOMEN 1 VIEW-MUCX | $311.40 | $519.00 | $181.65–$456.72 | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-JDI | $250.20 | $417.00 | $83.72–$86.97 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE-FAY | $250.20 | $417.00 | $145.95–$366.96 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS OC | $250.20 | $417.00 | $145.95–$366.96 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 1 VIEW-XO | $250.20 | $417.00 | $83.72–$86.97 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-XM | $250.20 | $417.00 | $83.72–$86.97 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-XS | $250.20 | $417.00 | $145.95–$366.96 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS -XO | $250.20 | $417.00 | $83.72–$86.97 | 27% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-MUCX | $300.60 | $501.00 | $175.35–$440.88 | 52% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-JUTR | $300.60 | $501.00 | $175.35–$440.88 | 52% above | 40% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEWS-MUC | $300.60 | $501.00 | $175.35–$440.88 | 52% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-JUTR | $300.60 | $501.00 | $175.35–$440.88 | 52% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-MUCX | $300.60 | $501.00 | $83.72–$86.97 | 52% above | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE-JFME | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE-FAY | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE-JFMV | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE-JFMO | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS OC | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE-JFML | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY ANKLE 2 VIEWS-DIJR | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-XS | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-XM | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-JDI | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 1 VIEW-XO | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS -XO | $250.20 | $417.00 | $145.95–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-FFH | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY, ANKLE , 2 VIEWS-BAMB | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-MUC | $300.60 | $501.00 | $175.35–$440.88 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-JUTR | $300.60 | $501.00 | $175.35–$440.88 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEWS-MUCX | $300.60 | $501.00 | $175.35–$440.88 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW-RT OR LT | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RT OR LT | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY ANKLE 1 VIEW RT OR LT-DIJR | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-XS | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-FFH | $250.20 | $417.00 | $113.42–$366.96 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-JUTR | $300.60 | $501.00 | $175.35–$440.88 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT/LEFT-MUCX | $300.60 | $501.00 | $175.35–$440.88 | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-FAY | $213.60 | $356.00 | $124.60–$313.28 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-JDI | $213.60 | $356.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-XS | $213.60 | $356.00 | $124.60–$313.28 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER -XO | $213.60 | $356.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-XM | $213.60 | $356.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER OC | $213.60 | $356.00 | $124.60–$313.28 | 4% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-JUTR | $256.80 | $428.00 | $149.80–$376.64 | 25% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-MUCX | $256.80 | $428.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER-MUC | $256.80 | $428.00 | $149.80–$376.64 | 25% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-JDI | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY, FINGER, MINIMUM 2 VIEWS-BAMB | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-XM | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-XS | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY FINGER-DIJR | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER -XO | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-JFMO | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-JFMV | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER OC | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-FAY | $213.60 | $356.00 | $124.60–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-FFH | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-JFML | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-JFME | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MINIMUM OF TWO VIEWS-JFMC | $213.60 | $356.00 | $96.83–$313.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-MUC | $256.80 | $428.00 | $149.80–$376.64 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-MUCX | $256.80 | $428.00 | $149.80–$376.64 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER-JUTR | $256.80 | $428.00 | $149.80–$376.64 | — | 40% |
| X-ray of the foot, 2 views CPT 73620 X-RAY, FOOT, 2 VIEWS-FAY | $231.00 | $385.00 | $134.75–$338.80 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS OC | $231.00 | $385.00 | $134.75–$338.80 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-XS | $231.00 | $385.00 | $134.75–$338.80 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-JDI | $231.00 | $385.00 | $83.72–$86.97 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-XM | $231.00 | $385.00 | $83.72–$86.97 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS -XO | $231.00 | $385.00 | $83.72–$86.97 | 10% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-MUC | $277.20 | $462.00 | $161.70–$406.56 | 32% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-JUTR | $277.20 | $462.00 | $83.72–$86.97 | 32% above | 40% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS-MUCX | $277.20 | $462.00 | $161.70–$406.56 | 32% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-MUCX | $277.20 | $462.00 | $83.72–$86.97 | 32% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-JUTR | $277.20 | $462.00 | $161.70–$406.56 | 32% above | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VIEWS-JFME | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS -XO | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-XM | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY; FOOT; 2 VIEWS-JFMV | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY, FOOT, 2 VIEWS-FAY | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VIEWS-JFMO | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-JDI | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 1 VIEW-XO | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VIEWS-JFMC | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS OC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VIEWS-DIJR | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY; FOOT; 2 VIEWS-JFML | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 X-RAY, FOOT, 2 VIEWS-BAMB | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-FFH | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-XS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-JUTR | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-MUC | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEWS-MUCX | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-FFH | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW RT OR LT | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-XS | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY FOOT 1 VIEW RT OR LT-DIJR | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW-RT OR LT | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-MUCX | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 VIEW RIGHT/LEFT-JUTR | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-JDI | $280.20 | $467.00 | $163.45–$410.96 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-XS | $280.20 | $467.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-XM | $280.20 | $467.00 | $163.45–$410.96 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT COMP-FAY | $280.20 | $467.00 | $163.45–$410.96 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE MIN 3 VIEWS-XO | $280.20 | $467.00 | $163.45–$410.96 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE OC | $280.20 | $467.00 | $163.45–$410.96 | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-JUTR | $336.60 | $561.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-MUCX | $336.60 | $561.00 | $196.35–$493.68 | 25% above | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT COMPLETE-MUC | $336.60 | $561.00 | $196.35–$493.68 | 25% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-XM | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-FFH | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY, FOOT, COMPLETE, MINIMUM 3 VIEWS-BAMB | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFMC | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFME | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFMB | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFML | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFMO | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE MINIMUM 3 VIEWS-JFMV | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD EXAM FOOT COMP-FAY | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE MIN 3 VIEWS-XO | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-JDI | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-XS | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT COMPLETE-DIJR | $280.20 | $467.00 | $127.02–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE OC | $280.20 | $467.00 | $163.45–$410.96 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-MUCX | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-MUC | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT COMPLETE-JUTR | $336.60 | $561.00 | $196.35–$493.68 | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-XS | $285.60 | $476.00 | $166.60–$418.88 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE OC | $285.60 | $476.00 | $166.60–$418.88 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-JDI | $285.60 | $476.00 | $83.72–$86.97 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MINIMUM OF THREE VIEWS-FAY | $285.60 | $476.00 | $166.60–$418.88 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-XM | $285.60 | $476.00 | $166.60–$418.88 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE MIN 3 VIEWS-XO | $285.60 | $476.00 | $166.60–$418.88 | 10% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-JUTR | $343.20 | $572.00 | $200.20–$503.36 | 32% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-MUCX | $343.20 | $572.00 | $83.72–$86.97 | 32% above | 40% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND COMPLETE-MUC | $343.20 | $572.00 | $200.20–$503.36 | 32% above | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-JDI | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE OC | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND COMPLETE-DIJR | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-XS | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 RAD EXAM HAND MINIMUM OF THREE VIEWS-FAY | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND MINIMUM 3 VIEWS-JFMV | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND MINIMUM 3 VIEWS-JFMO | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND MINIMUM 3 VIEWS-JFML | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND MINIMUM 3 VIEWS-JFME | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-XM | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND MINIMUM 3 VIEWS-JFMC | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE MIN 3 VIEWS-XO | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY, HAND, MINIMUM 3 VIEWS-BAMB | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-FFH | $285.60 | $476.00 | $129.47–$418.88 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-JUTR | $343.20 | $572.00 | $200.20–$503.36 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-MUC | $343.20 | $572.00 | $200.20–$503.36 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND COMPLETE-MUCX | $343.20 | $572.00 | $200.20–$503.36 | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-XS | $238.20 | $397.00 | $138.95–$349.36 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS -XO | $238.20 | $397.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-XM | $238.20 | $397.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE-FAY | $238.20 | $397.00 | $138.95–$349.36 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS OC | $238.20 | $397.00 | $138.95–$349.36 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-JDI | $238.20 | $397.00 | $83.72–$86.97 | 4% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-MUCX | $285.60 | $476.00 | $83.72–$86.97 | 25% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-JUTR | $285.60 | $476.00 | $166.60–$418.88 | 25% above | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE ONE OR TWO VIEWS-MUC | $285.60 | $476.00 | $166.60–$418.88 | 25% above | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-XM | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY, KNEE, 1 OR 2 VIEWS-BAMB | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS OC | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-FFH | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS -XO | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-JDI | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-XS | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE ONE OR TWO VIEWS-DIJR | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM KNEE-FAY | $238.20 | $397.00 | $138.95–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFMV | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFMO | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFML | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFMB | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFME | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEWS-JFMC | $238.20 | $397.00 | $107.98–$349.36 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-MUC | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-MUCX | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE ONE OR TWO VIEWS-JUTR | $285.60 | $476.00 | $166.60–$418.88 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-XS | $354.60 | $591.00 | $101.11–$105.04 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-JDI | $354.60 | $591.00 | $101.11–$105.04 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS OC | $354.60 | $591.00 | $206.85–$520.08 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-XM | $354.60 | $591.00 | $206.85–$520.08 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS -XO | $354.60 | $591.00 | $206.85–$520.08 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM LOWER SPINE-FAY | $354.60 | $591.00 | $206.85–$520.08 | 22% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-MUCX | $425.40 | $709.00 | $101.11–$105.04 | 46% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-MUC | $425.40 | $709.00 | $101.11–$105.04 | 46% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-JUTR | $425.40 | $709.00 | $101.11–$105.04 | 46% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-JFMO | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS OC | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-DIJR | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-XS | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-XM | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-JDI | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS -XO | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD EXAM LOWER SPINE-FAY | $354.60 | $591.00 | $206.85–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-JFMV | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-JFML | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-JFME | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY SPINE LUMBOSACRAL 2 OR 3 VIEWS-JFMC | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY, SPINE, LUMBOSACRAL 2 OR 3 VIEWS-BAMB | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-FFH | $354.60 | $591.00 | $160.75–$520.08 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-JUTR | $425.40 | $709.00 | $248.15–$623.92 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-MUCX | $425.40 | $709.00 | $248.15–$623.92 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS-MUC | $425.40 | $709.00 | $248.15–$623.92 | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JDI | $477.60 | $796.00 | $101.11–$105.04 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS -XO | $477.60 | $796.00 | $278.60–$700.48 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XM | $477.60 | $796.00 | $278.60–$700.48 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XS | $477.60 | $796.00 | $278.60–$700.48 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS OC | $477.60 | $796.00 | $278.60–$700.48 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM LOWER SPINE COMP-FAY | $477.60 | $796.00 | $278.60–$700.48 | 12% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-MUCX | $573.60 | $956.00 | $101.11–$105.04 | 35% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JUTR | $573.60 | $956.00 | $101.11–$105.04 | 35% above | 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 | $278.60–$700.48 | — | 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 | $278.60–$700.48 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM LOWER SPINE COMP-FAY | $477.60 | $796.00 | $278.60–$700.48 | — | 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 | $278.60–$700.48 | — | 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 | $216.51–$700.48 | — | 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 | $216.51–$700.48 | — | 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 | $278.60–$700.48 | — | 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 | $216.51–$700.48 | — | 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 | $216.51–$700.48 | — | 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 | $278.60–$700.48 | — | 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 | $334.60–$841.28 | — | 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 | $334.60–$841.28 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS -XO | $324.00 | $540.00 | $189.00–$475.20 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM THORAX SPINE-FAY | $324.00 | $540.00 | $101.11–$105.04 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS OC | $324.00 | $540.00 | $189.00–$475.20 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-JDI | $324.00 | $540.00 | $101.11–$105.04 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-XM | $324.00 | $540.00 | $189.00–$475.20 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-XS | $324.00 | $540.00 | $101.11–$105.04 | 29% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-JUTR | $388.80 | $648.00 | $101.11–$105.04 | 54% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-MUC | $388.80 | $648.00 | $101.11–$105.04 | 54% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS-MUCX | $388.80 | $648.00 | $226.80–$570.24 | 54% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS OC | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-DIJR | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-XS | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-JFML | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-JFME | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-JFMC | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY, SPINE, THORACIC, 2 VIEWS-BAMB | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-FFH | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-XM | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS -XO | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-JFMV | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY SPINE THORACIC 2 VIEWS-JFMO | $324.00 | $540.00 | $146.88–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD EXAM THORAX SPINE-FAY | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-JDI | $324.00 | $540.00 | $189.00–$475.20 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-MUCX | $388.80 | $648.00 | $226.80–$570.24 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-MUC | $388.80 | $648.00 | $226.80–$570.24 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS-JUTR | $388.80 | $648.00 | $226.80–$570.24 | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY NASAL BONES COMPLETE MINIMUM 3 VIEWS-FAY | $243.00 | $405.00 | $83.72–$86.97 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINMUM 3 VIEWS-XO | $243.00 | $405.00 | $83.72–$86.97 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-JDI | $243.00 | $405.00 | $141.75–$356.40 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-XM | $243.00 | $405.00 | $141.75–$356.40 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-XS | $243.00 | $405.00 | $83.72–$86.97 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINMUM 3 VIEWS-OC | $243.00 | $405.00 | $141.75–$356.40 | 2% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-MUC | $292.20 | $487.00 | $170.45–$428.56 | 17% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-MUCX | $292.20 | $487.00 | $170.45–$428.56 | 17% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-JUTR | $292.20 | $487.00 | $170.45–$428.56 | 17% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-BAMB | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-FFH | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY NASAL BONES COMPLETE MINIMUM 3 VIEWS-FAY | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINMUM 3 VIEWS-XO | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-JDI | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-XM | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-XS | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY NASAL BONES MINIMUM 3 VIEWS-DIJR | $243.00 | $405.00 | $110.16–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINMUM 3 VIEWS-OC | $243.00 | $405.00 | $141.75–$356.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-MUC | $292.20 | $487.00 | $170.45–$428.56 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-MUCX | $292.20 | $487.00 | $170.45–$428.56 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MINIMUM 3 VIEWS-JUTR | $292.20 | $487.00 | $170.45–$428.56 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-XS | $294.60 | $491.00 | $171.85–$432.08 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-JDI | $294.60 | $491.00 | $83.72–$86.97 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-XM | $294.60 | $491.00 | $171.85–$432.08 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM NECK SPINE-FAY | $294.60 | $491.00 | $83.72–$86.97 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS OC | $294.60 | $491.00 | $171.85–$432.08 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS -XO | $294.60 | $491.00 | $83.72–$86.97 | 1% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-MUC | $354.00 | $590.00 | $83.72–$86.97 | 21% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-JUTR | $354.00 | $590.00 | $83.72–$86.97 | 21% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-MUCX | $354.00 | $590.00 | $206.50–$519.20 | 21% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY SPINE CERVICAL 2 OR 3 VIEWS-DIJR | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS OC | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY, SPINE, CERVICAL, 2 OR 3 VIEWS-BAMB | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-FFH | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-JFMC | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY SPINE CERVICAL 2 OR 3 VIEWS-JFME | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY SPINE CERVICAL 2 OR 3 VIEWS-JFML | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY SPINE CERVICAL 2 OR 3 VIEWS-JFMO | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY SPINE CERVICAL 2 OR 3 VIEWS-JFMV | $294.60 | $491.00 | $133.55–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD EXAM NECK SPINE-FAY | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS -XO | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-JDI | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-XS | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-XM | $294.60 | $491.00 | $171.85–$432.08 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-MUC | $354.00 | $590.00 | $206.50–$519.20 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-JUTR | $354.00 | $590.00 | $206.50–$519.20 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS-MUCX | $354.00 | $590.00 | $206.50–$519.20 | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-XS | $333.60 | $556.00 | $194.60–$489.28 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS ANTEROPOSTERIOR-FAY | $333.60 | $556.00 | $194.60–$489.28 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS -XO | $333.60 | $556.00 | $101.11–$105.04 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-JDI | $333.60 | $556.00 | $101.11–$105.04 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-XM | $333.60 | $556.00 | $101.11–$105.04 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS OC | $333.60 | $556.00 | $194.60–$489.28 | 51% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-MUC | $400.20 | $667.00 | $101.11–$105.04 | 81% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-MUCX | $400.20 | $667.00 | $101.11–$105.04 | 81% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS-JUTR | $400.20 | $667.00 | $101.11–$105.04 | 81% above | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-FFH | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS ANTEROPOSTERIOR-JFMO | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-XM | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-XS | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS -XO | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS OC | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS ANTEROPOSTERIOR-JFML | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-JFME | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-BAMB | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY PELVIS 1 OR 2 VIEWS-DIJR | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS ANTEROPOSTERIOR-FAY | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-JDI | $333.60 | $556.00 | $194.60–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS ANTEROPOSTERIOR-JFMV | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-JFMC | $333.60 | $556.00 | $151.23–$489.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-MUC | $400.20 | $667.00 | $233.45–$586.96 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-JUTR | $400.20 | $667.00 | $233.45–$586.96 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS-MUCX | $400.20 | $667.00 | $233.45–$586.96 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-XS | $279.00 | $465.00 | $83.72–$86.97 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SPINE SACRUM/COCCYX MIN OF TWO VIEWS-XO | $279.00 | $465.00 | $83.72–$86.97 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-XM | $279.00 | $465.00 | $162.75–$409.20 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM TAILBONE 2 VIEWS OR MORE-FAY | $279.00 | $465.00 | $162.75–$409.20 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-JDI | $279.00 | $465.00 | $162.75–$409.20 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS OC | $279.00 | $465.00 | $83.72–$86.97 | 9% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-MUCX | $334.80 | $558.00 | $83.72–$86.97 | 31% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-MUC | $334.80 | $558.00 | $195.30–$491.04 | 31% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-JUTR | $334.80 | $558.00 | $83.72–$86.97 | 31% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY SACRUM/COCCYX MINIMUM 2 VIEWS-JFMV | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-FFH | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY, SACRUM/COCCYX, MINIMUM 2 VIEWS-BAMB | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY SACRUM/COCCYX MINIMUM 2 VIEWS-JFME | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY SACRUM/COCCYX MINIMUM 2 VIEWS-JFMO | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD EXAM TAILBONE 2 VIEWS OR MORE-FAY | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SPINE SACRUM/COCCYX MIN OF TWO VIEWS-XO | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-JDI | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-XM | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-XS | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY SACRUM/COCCYX MINIMUM 2 VIEWS-DIJR | $279.00 | $465.00 | $126.48–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS OC | $279.00 | $465.00 | $162.75–$409.20 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-MUC | $334.80 | $558.00 | $195.30–$491.04 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-MUCX | $334.80 | $558.00 | $195.30–$491.04 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX MINIMUM 2 VIEWS-JUTR | $334.80 | $558.00 | $195.30–$491.04 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE PLASMA (ACTH) P28632154 | $222.48 | $370.80 | $100.86–$326.30 | 30% above | 40% |
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE PLASMA (ACTH) P31032154 | $222.48 | $370.80 | $100.86–$326.30 | 30% above | 40% |
| ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE PLASMA (ACTH) P31032154 | $222.48 | $370.80 | $100.86–$326.30 | — | 40% |
| ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE PLASMA (ACTH) P28632154 | $222.48 | $370.80 | $100.86–$326.30 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE P31020060 | $21.81 | $36.35 | $9.89–$31.99 | 55% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE P28620060 | $21.81 | $36.35 | $9.89–$31.99 | 55% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE P31020060 | $21.81 | $36.35 | $9.89–$31.99 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE P28620060 | $21.81 | $36.35 | $9.89–$31.99 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE P31020193 | $21.93 | $36.55 | $9.94–$32.16 | 53% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE P28620193 | $21.93 | $36.55 | $9.94–$32.16 | 53% below | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE P28620193 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE P31020193 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL P31025254 | $233.67 | $389.45 | $105.93–$342.72 | 3% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL P28625254 | $233.67 | $389.45 | $105.93–$342.72 | 3% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL P31025254 | $233.67 | $389.45 | $105.93–$342.72 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL P28625254 | $233.67 | $389.45 | $105.93–$342.72 | — | 40% |
| Albumin blood test CPT 82040 ALBUMIN LEVEL P28620053 | $21.99 | $36.65 | $9.97–$32.25 | 32% below | 40% |
| Albumin blood test CPT 82040 ALBUMIN LEVEL P31020053 | $21.99 | $36.65 | $9.97–$32.25 | 32% below | 40% |
| Albumin blood test CPT 82040 ALBUMIN; SERUM PLASMA OR WHOLE BLOOK P31030548 | $28.83 | $48.05 | $13.07–$42.28 | 10% below | 40% |
| Albumin blood test CPT 82040 ALBUMIN; SERUM PLASMA OR WHOLE BLOOD P28630548 | $28.83 | $48.05 | $13.07–$42.28 | 10% below | 40% |
| Albumin blood test CPT 82040 LYME IGG AB INDEX; SERUM ALBUMIN (LNBAI) 1/4 P31032972 | $30.24 | $50.40 | $13.71–$44.35 | 6% below | 40% |
| Albumin blood test CPT 82040 LYME IGG AB INDEX; SERUM ALBUMIN (LNBAI) 1/4 P28632972 | $30.24 | $50.40 | $13.71–$44.35 | 6% below | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN LEVEL P28620053 | $21.99 | $36.65 | $9.97–$32.25 | — | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN LEVEL P31020053 | $21.99 | $36.65 | $9.97–$32.25 | — | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN; SERUM PLASMA OR WHOLE BLOOD P28630548 | $28.83 | $48.05 | $13.07–$42.28 | — | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN; SERUM PLASMA OR WHOLE BLOOK P31030548 | $28.83 | $48.05 | $13.07–$42.28 | — | 40% |
| Albumin blood test inpatient CPT 82040 LYME IGG AB INDEX; SERUM ALBUMIN (LNBAI) 1/4 P28632972 | $30.24 | $50.40 | $13.71–$44.35 | — | 40% |
| Albumin blood test inpatient CPT 82040 LYME IGG AB INDEX; SERUM ALBUMIN (LNBAI) 1/4 P31032972 | $30.24 | $50.40 | $13.71–$44.35 | — | 40% |
| Aldosterone blood test CPT 82088 ALDOSTERONE P28632153 | $234.72 | $391.20 | $106.41–$344.26 | 45% above | 40% |
| Aldosterone blood test CPT 82088 ALDOSTERONE P31032153 | $234.72 | $391.20 | $106.41–$344.26 | 45% above | 40% |
| Aldosterone blood test CPT 82088 ALDOSTERONE P28631479 | $234.72 | $391.20 | $106.41–$344.26 | 45% above | 40% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P28632153 | $234.72 | $391.20 | $106.41–$344.26 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P28631479 | $234.72 | $391.20 | $106.41–$344.26 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE P31032153 | $234.72 | $391.20 | $106.41–$344.26 | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE P28620056 | $23.01 | $38.35 | $10.43–$33.75 | 55% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE P31020056 | $23.01 | $38.35 | $10.43–$33.75 | 55% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE SERUM P28632221 | $30.75 | $51.25 | $13.94–$45.10 | 40% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE P28634199 | $30.75 | $51.25 | $13.94–$45.10 | 40% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE SERUM P31032221 | $30.75 | $51.25 | $13.94–$45.10 | 40% below | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE P31020056 | $23.01 | $38.35 | $10.43–$33.75 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE P28620056 | $23.01 | $38.35 | $10.43–$33.75 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE SERUM P31032221 | $30.75 | $51.25 | $13.94–$45.10 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE SERUM P28632221 | $30.75 | $51.25 | $13.94–$45.10 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE P28634199 | $30.75 | $51.25 | $13.94–$45.10 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANT OR SEMI-QUANT EACH P31030166 | $30.09 | $50.15 | $13.64–$44.13 | 40% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE (ASP) P31032457 | $30.09 | $50.15 | $13.64–$44.13 | 40% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE (ASP) P28632457 | $30.09 | $50.15 | $13.64–$44.13 | 40% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANT OR SEMI-QUANT EACH P28630166 | $30.09 | $50.15 | $13.64–$44.13 | 40% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DUCK MEAT IGE - (FDME) P28634411 | $103.62 | $172.70 | $46.97–$151.98 | 381% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 VENISON IGE - (FVENE) P28634413 | $108.78 | $181.30 | $49.31–$159.54 | 405% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TAPIOCA IGE (FIOCA) P28634458 | $108.78 | $181.30 | $49.31–$159.54 | 405% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SMUT CORN (USTILAGO MAYDIS) IGE (FCRNS) P28637221 | $118.20 | $197.00 | $53.58–$173.36 | 449% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SMUT CORN (USTILAGO MAYDIS) IGE (FCRNS) P31037221 | $118.20 | $197.00 | $53.58–$173.36 | 449% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NECTARINE IGE (FNECT) P28637160 | $118.74 | $197.90 | $53.83–$174.15 | 451% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NECTARINE IGE (FNECT) P31037160 | $118.74 | $197.90 | $53.83–$174.15 | 451% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MINT (MENTA PIPERITA) IGE - (FMINT) P28634956 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITEFISH IGE FWHFE P28634933 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUM CARAGEENAN IGE (FCGUM) P31037073 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUM CARAGEENAN IGE (FCGUM) P28637073 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHUBARB (RHEUM RHAPONTICUM) IGE (FRUB) P28637007 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEAN LIMA (PHASEOLUS LIMENSIS) IGE - (FBLME) P28634961 | $124.68 | $207.80 | $56.52–$182.86 | 479% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SAGE (ARTEMISIA SPP.) IGE (FSAG) P28634752 | $130.92 | $218.20 | $59.35–$192.02 | 508% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS CHARTARUM/ATRA IGE (FSTAB) P28634638 | $130.92 | $218.20 | $59.35–$192.02 | 508% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEAN BLACK (PHASEOLUS SPP) IGE (FBEBE) P28634701 | $130.92 | $218.20 | $59.35–$192.02 | 508% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TURMERIC (CURCUMA LONGA) IGE (FCTUR) P28634680 | $130.92 | $218.20 | $59.35–$192.02 | 508% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARMINE/RED COCHINEAL(DACTYLOPIUS COCS) IGE(FCRDE) P28634375 | $140.10 | $233.50 | $63.51–$205.48 | 550% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COFFEE SPP IGE MAYO P28634940 | $149.04 | $248.40 | $67.56–$218.59 | 592% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE-ALPHA-1 3-GALACTOSE IGE SERUM(ALGAL) P28634436 | $156.51 | $260.85 | $70.95–$229.55 | 627% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 QUINOA (CHENOPODIUM QUINOA) IGE (FQUIN) P28634906 | $156.51 | $260.85 | $70.95–$229.55 | 627% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKROACH P86525102 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HORSE DANDER P86520004 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 INDIVIDUAL ALLERGEN SCREEN P86520872 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BAKERS YEAST P86520876 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE P86520877 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK P86520878 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CODFISH P86520879 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT P86520880 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RYE P86520881 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAT P86520882 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN/MAIZE P86520883 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT P86520884 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN P86520885 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ORANGE P86520886 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF P86520887 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COW DANDER P86520888 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GUINEA PIG EPITHELIUM P86520889 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOOSE FEATHERS P86520890 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOUSE EPITHELIUM P86520891 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RAT EPITHELIUM P86520892 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOAT EPITHELIUM P86520893 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHEEP EPITHELIUM P86520894 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RABBIT EPITHELIUM P86520895 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAMSTER EPITHELIUM P86520896 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN FEATHERS P86520897 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DUCK FEATHERS P86520898 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ELM P86520905 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE OAK P86520906 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PERRENNIAL RYE P86520907 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JUNE (KENTUCKY BLUE) P86520908 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON RAGWEED SHORT P86520909 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LAMB'S QUARTERS P86520910 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLADOSPORIUM HERBARUM (HORMODENDRUM) P86520911 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN D. FARINAE P86520912 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALTERNARIA ALTERNATA P86520913 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN D. PTERONYSSINUS P86520916 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKROACH P86520917 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FEATHER MIX P86520918 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN P86520919 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BAKERS YEAST P86520920 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE P86520921 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK P86520922 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CODFISH P86520923 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT P86520924 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RYE P86520925 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BARLEY P86520926 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OAT P86520927 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN/MAIZE P86520928 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT P86520929 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN P86520930 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TOMATO P86520931 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PORK P86520932 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ORANGE P86520933 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN POTATO P86520934 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LETTUCE P86520935 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BEEF P86520936 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MALT P86520937 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHOCOLATE P86520938 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIUM NOTATUM P86520942 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ASPERGILLUS FUMIGATUS P86520943 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUCOR RACEMOSUS P86520944 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CANDIDA ALBICANS (YEAST) P86520945 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HELMINTHOSPORIUM HALODES P86520946 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FUSARIUM MONILIFORME P86520947 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RHIZOPUS NIGRICANS P86520948 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AUREOBASIDIUM PULLULANS P86520949 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PHOMA BETAE P86520950 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EPICOCCUM PURPURASCENS P86520951 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CEPHALOSPORIUM ACREMONIUM P86520952 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLADOSPORIUM HERBARUM (HORMODENDRUM) P86520962 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT P86520970 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HAZELNUT P86520971 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BRAZILNUT P86520972 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALMOND P86520973 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN P86520974 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CASHEW P86520975 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PISTACHIO P86520976 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT P86520977 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHESTNUT P86520978 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CARAWAY P86520979 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MACADAMIA NUT P86520980 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MAPLE BOX ELDER P86520993 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON SILVER BIRCH TREE P86520994 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WALNUT TREE P86520995 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COTTONWOOD TREE P86520996 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE ASH TREE P86520997 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE PINE TREE P86520998 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PECAN HICKORY TREE P86520999 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MULBERRY TREE P86521000 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MUGWORT P86521005 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PLANTAIN (ENGLISH) RIBWORT P86521006 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SALTWORT RUSSIAN THISTLE P86521007 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GOLDEN ROD P86521008 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COMMON PIGWEED P86521009 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHEEP SORREL P86521010 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN AMPICILLIN IGE P86525059 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK (COW) P86525090 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ALTERNARIA ALTERNATA P86525099 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLADOSPORIUM HERBARUM (HORMODENDRUM) P86525101 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN MAIZE P86525103 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DUST MITE DERMATOPHAGOIDES FARINAE P86525105 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DUST MITE D. PTERONYSSINUS P86525106 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE P86525107 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MILK (COW) P86525108 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN P86525109 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT P86525110 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BLUE MUSSEL P86525118 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CLAM P86525119 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CRAB P86525120 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CRAYFISH P86525121 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LOBSTER P86525122 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OYSTER P86525123 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SCALLOP P86525124 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SHRIMP P86525125 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YELLOW-FACED HORNET P86525973 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHITE-FACED HORNET P86525972 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HONEYBEE P86525971 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PAPER WASP P86525970 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN YELLOW JACKET P86525969 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SESAME SEED P86525870 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SNAIL P86525126 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRASS POLLEN ALLERGEN PANEL P86525220 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BERMUDA GRASS PANEL P86525221 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TIMOTHY GRASS PANEL P86525222 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DOG DANDER P86525241 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EASTERN RED CEDAR P86525312 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SWEET GUM TREE P86525313 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PRIVET TREE P86525314 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OLIVE TREE P86525315 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ACACIA TREE P86525316 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MESQUITE TREE P86525317 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN GRAIN SMUT (USTILSGO TRITICI) P86525318 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN LUPIN P86525319 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAT EPITHELIUM AND DANDER P86525320 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COCKROACH GERMAN P86525321 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN JOHNSON GRASS P86525837 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MAPLE LEAF SYCAMORE TREE P86525838 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIUM CHRYSOQENUM P86525839 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SALMON P86525866 | $21.93 | $36.55 | $9.94–$32.16 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANT OR SEMI-QUANT EACH P28630166 | $30.09 | $50.15 | $13.64–$44.13 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANT OR SEMI-QUANT EACH P31030166 | $30.09 | $50.15 | $13.64–$44.13 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE (ASP) P31032457 | $30.09 | $50.15 | $13.64–$44.13 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE (ASP) P28632457 | $30.09 | $50.15 | $13.64–$44.13 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK MEAT IGE - (FDME) P28634411 | $103.62 | $172.70 | $46.97–$151.98 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TAPIOCA IGE (FIOCA) P28634458 | $108.78 | $181.30 | $49.31–$159.54 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 VENISON IGE - (FVENE) P28634413 | $108.78 | $181.30 | $49.31–$159.54 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SMUT CORN (USTILAGO MAYDIS) IGE (FCRNS) P28637221 | $118.20 | $197.00 | $53.58–$173.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SMUT CORN (USTILAGO MAYDIS) IGE (FCRNS) P31037221 | $118.20 | $197.00 | $53.58–$173.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NECTARINE IGE (FNECT) P31037160 | $118.74 | $197.90 | $53.83–$174.15 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NECTARINE IGE (FNECT) P28637160 | $118.74 | $197.90 | $53.83–$174.15 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MINT (MENTA PIPERITA) IGE - (FMINT) P28634956 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEAN LIMA (PHASEOLUS LIMENSIS) IGE - (FBLME) P28634961 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUM CARAGEENAN IGE (FCGUM) P31037073 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITEFISH IGE FWHFE P28634933 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUM CARAGEENAN IGE (FCGUM) P28637073 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHUBARB (RHEUM RHAPONTICUM) IGE (FRUB) P28637007 | $124.68 | $207.80 | $56.52–$182.86 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS CHARTARUM/ATRA IGE (FSTAB) P28634638 | $130.92 | $218.20 | $59.35–$192.02 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SAGE (ARTEMISIA SPP.) IGE (FSAG) P28634752 | $130.92 | $218.20 | $59.35–$192.02 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURMERIC (CURCUMA LONGA) IGE (FCTUR) P28634680 | $130.92 | $218.20 | $59.35–$192.02 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEAN BLACK (PHASEOLUS SPP) IGE (FBEBE) P28634701 | $130.92 | $218.20 | $59.35–$192.02 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARMINE/RED COCHINEAL(DACTYLOPIUS COCS) IGE(FCRDE) P28634375 | $140.10 | $233.50 | $63.51–$205.48 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COFFEE SPP IGE MAYO P28634940 | $149.04 | $248.40 | $67.56–$218.59 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE-ALPHA-1 3-GALACTOSE IGE SERUM(ALGAL) P28634436 | $156.51 | $260.85 | $70.95–$229.55 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 QUINOA (CHENOPODIUM QUINOA) IGE (FQUIN) P28634906 | $156.51 | $260.85 | $70.95–$229.55 | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER P28620058 | $97.08 | $161.80 | $44.01–$142.38 | 1% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SINGLE MARKER SCREEN MATERNAL SERUM (MAFP) P28632962 | $102.39 | $170.65 | $46.42–$150.17 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SINGLE MARKER SCREEN MATERNAL SERUM (MAFP) P31032962 | $102.39 | $170.65 | $46.42–$150.17 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER (AFP) P31032628 | $102.39 | $170.65 | $46.42–$150.17 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER P28620058 | $97.08 | $161.80 | $44.01–$142.38 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER (AFP) P31032628 | $102.39 | $170.65 | $46.42–$150.17 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SINGLE MARKER SCREEN MATERNAL SERUM (MAFP) P28632962 | $102.39 | $170.65 | $46.42–$150.17 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SINGLE MARKER SCREEN MATERNAL SERUM (MAFP) P31032962 | $102.39 | $170.65 | $46.42–$150.17 | — | 40% |
| Ammonia blood test CPT 82140 AMMONIA LEVEL P28620064 | $84.33 | $140.55 | $38.23–$123.68 | 10% above | 40% |
| Ammonia blood test CPT 82140 AMMONIA LEVEL P31020064 | $84.33 | $140.55 | $38.23–$123.68 | 10% above | 40% |
| Ammonia blood test CPT 82140 AMMONIA P28631226 | $86.46 | $144.10 | $39.20–$126.81 | 13% above | 40% |
| Ammonia blood test CPT 82140 AMMONIUM, 24 HR, U (AMMO) P28637085 | $300.12 | $500.20 | $136.05–$440.18 | 292% above | 40% |
| Ammonia blood test CPT 82140 AMMONIUM, 24 HR, U (AMMO) P31037085 | $300.12 | $500.20 | $136.05–$440.18 | 292% above | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIA LEVEL P28620064 | $84.33 | $140.55 | $38.23–$123.68 | — | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIA LEVEL P31020064 | $84.33 | $140.55 | $38.23–$123.68 | — | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIA P28631226 | $86.46 | $144.10 | $39.20–$126.81 | — | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIUM, 24 HR, U (AMMO) P28637085 | $300.12 | $500.20 | $136.05–$440.18 | — | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIUM, 24 HR, U (AMMO) P31037085 | $300.12 | $500.20 | $136.05–$440.18 | — | 40% |
| Amylase blood test CPT 82150 AMLYASE FLUID TYPE P28620066 | $29.31 | $48.85 | $13.29–$42.99 | 49% below | 40% |
| Amylase blood test CPT 82150 AMYLASE LEVEL P31020065 | $29.31 | $48.85 | $13.29–$42.99 | 49% below | 40% |
| Amylase blood test CPT 82150 AMYLASE LEVEL P28620065 | $29.31 | $48.85 | $13.29–$42.99 | 49% below | 40% |
| Amylase blood test CPT 82150 AMLYASE FLUID TYPE P31020066 | $29.31 | $48.85 | $13.29–$42.99 | 49% below | 40% |
| Amylase blood test inpatient CPT 82150 AMLYASE FLUID TYPE P28620066 | $29.31 | $48.85 | $13.29–$42.99 | — | 40% |
| Amylase blood test inpatient CPT 82150 AMLYASE FLUID TYPE P31020066 | $29.31 | $48.85 | $13.29–$42.99 | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE LEVEL P31020065 | $29.31 | $48.85 | $13.29–$42.99 | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE LEVEL P28620065 | $29.31 | $48.85 | $13.29–$42.99 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY P28633078 | $74.61 | $124.35 | $33.82–$109.43 | 7% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATD PEPTIDE (CCP) ANTIBODY P31031239 | $74.61 | $124.35 | $33.82–$109.43 | 7% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY P31033078 | $74.61 | $124.35 | $33.82–$109.43 | 7% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATD PEPTIDE (CCP) ANTIBODY P28631239 | $74.61 | $124.35 | $33.82–$109.43 | 7% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULINATED PEPTIDE IGG P86520836 | $72.84 | $121.40 | $33.02–$106.83 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY P28633078 | $74.61 | $124.35 | $33.82–$109.43 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATD PEPTIDE (CCP) ANTIBODY P28631239 | $74.61 | $124.35 | $33.82–$109.43 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATD PEPTIDE (CCP) ANTIBODY P31031239 | $74.61 | $124.35 | $33.82–$109.43 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY P31033078 | $74.61 | $124.35 | $33.82–$109.43 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 FANA P28620844 | $71.31 | $118.85 | $32.33–$104.59 | 7% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA P28630224 | $73.83 | $123.05 | $33.47–$108.28 | 11% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA P31030224 | $73.83 | $123.05 | $33.47–$108.28 | 11% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P28633054 | $73.83 | $123.05 | $33.47–$108.28 | 11% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES P31033054 | $73.83 | $123.05 | $33.47–$108.28 | 11% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA P86520844 | $71.31 | $118.85 | $32.33–$104.59 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 FANA P28620844 | $71.31 | $118.85 | $32.33–$104.59 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA P31030224 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA P28630224 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P31033054 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES P28633054 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE P31020740 | $214.38 | $357.30 | $97.19–$314.42 | 73% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP NATRIURETIC PEPTIDE P28620740 | $214.38 | $357.30 | $97.19–$314.42 | 73% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE P31033126 | $226.14 | $376.90 | $102.52–$331.67 | 82% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE P28637056 | $226.14 | $376.90 | $102.52–$331.67 | 82% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE P31037056 | $226.14 | $376.90 | $102.52–$331.67 | 82% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP NATRIURETIC PEPTIDE P28620740 | $214.38 | $357.30 | $97.19–$314.42 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE P31020740 | $214.38 | $357.30 | $97.19–$314.42 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE P28637056 | $226.14 | $376.90 | $102.52–$331.67 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE P31037056 | $226.14 | $376.90 | $102.52–$331.67 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE P31033126 | $226.14 | $376.90 | $102.52–$331.67 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL P31022026 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE P31022042 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND P31022045 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR P31022021 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE P31022022 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE FLUID P31022023 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY P31022037 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF P31022020 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BONE MARROW P31022018 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF P28622020 | $51.78 | $86.30 | $23.47–$75.94 | 24% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE P31022022 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL P31022026 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE FLUID P31022023 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR P31022021 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF P31022020 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BONE MARROW P31022018 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF P28622020 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE RESPIRATORY P31022037 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TISSUE P31022042 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND P31022045 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BONE MARROW P86522018 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF P86522020 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR P86522021 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE P86522022 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE FLUID P86522023 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL P86522026 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE MISCELLANEOUS P86522031 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE RESPIRATORY P86522037 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TISSUE P86522042 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND P86522045 | $51.78 | $86.30 | $23.47–$75.94 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL P31020007 | $77.22 | $128.70 | $35.01–$113.26 | 31% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL P28620007 | $77.22 | $128.70 | $35.01–$113.26 | 31% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL P28620007 | $77.22 | $128.70 | $35.01–$113.26 | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL P31020007 | $77.22 | $128.70 | $35.01–$113.26 | — | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P28620199 | $29.07 | $48.45 | $13.18–$42.64 | 41% below | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL P31020199 | $29.07 | $48.45 | $13.18–$42.64 | 41% below | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, BODY FLUID (BFBL) P28637138 | $140.13 | $233.55 | $63.53–$205.52 | 183% above | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, BODY FLUID (BFBL) P31037138 | $140.13 | $233.55 | $63.53–$205.52 | 183% above | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P28620199 | $29.07 | $48.45 | $13.18–$42.64 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL P31020199 | $29.07 | $48.45 | $13.18–$42.64 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, BODY FLUID (BFBL) P28637138 | $140.13 | $233.55 | $63.53–$205.52 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, BODY FLUID (BFBL) P31037138 | $140.13 | $233.55 | $63.53–$205.52 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATHOLOGY P31030236 | $344.07 | $573.45 | $200.71–$504.64 | 74% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATHOLOGY P28630236 | $344.07 | $573.45 | $200.71–$504.64 | 74% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 NERVEPATH LEVEL IV WET TS (NPWT) P31032773 | $361.26 | $602.10 | $210.74–$529.85 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 ASPIRATE CLOT SECTION PROCESSING P30325216 | $361.26 | $602.10 | $210.74–$529.85 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 NERVEPATH LEVEL IV WET TS (NPWT) P28632773 | $361.26 | $602.10 | $210.74–$529.85 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEV IV P30350321 | $361.26 | $602.10 | $210.74–$529.85 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEV IV P31088305 | $361.26 | $602.10 | $50.80–$52.78 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW BIOPSY INTERP PS P30321103 | $361.26 | $602.10 | $210.74–$529.85 | 83% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATHOLOGY P28630236 | $344.07 | $573.45 | $200.71–$504.64 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATHOLOGY P31030236 | $344.07 | $573.45 | $200.71–$504.64 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 NERVEPATH LEVEL IV WET TS (NPWT) P28632773 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW BIOPSY INTERP PS P30321103 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEV IV P31088305 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 ASPIRATE CLOT SECTION PROCESSING P30325216 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEV IV P30350321 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEV IV GROSS/MICRO EXAM-DPL | $361.26 | $602.10 | $163.77–$529.85 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 NERVEPATH LEVEL IV WET TS (NPWT) P31032773 | $361.26 | $602.10 | $210.74–$529.85 | — | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD PRODUCTS P31022017 | $62.01 | $103.35 | $28.11–$90.95 | 44% below | 40% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD P31022014 | $62.01 | $103.35 | $28.11–$90.95 | 44% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD P86522014 | $62.01 | $103.35 | $28.11–$90.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD P31022014 | $62.01 | $103.35 | $28.11–$90.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD PRODUCTS P31022017 | $62.01 | $103.35 | $28.11–$90.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD PRODUCTS P86522017 | $62.01 | $103.35 | $28.11–$90.95 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY CHARGE P31020984 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JIMC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JMOI | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JNC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JOB | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE -JPED | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JPOD | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JSCM | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JENT | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JMDS | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JOBS | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENOUS STICK-JSS | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JPCU | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE -MFCC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-OCJC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-CSJC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY CHARGE P16520984 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY CHARGE P28620984 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY ONLY P28625383 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY CHARGE P28820984 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY CHARGE P29620984 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY ONLY P29625383 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JDHC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY ONLY P31025383 | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENOUS STICK-IVT | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-CHPC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-CBCC | $16.80 | $28.00 | $7.62–$24.64 | 3% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-EC | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUCJ | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUCX | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUC | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JUTR | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JER | $20.40 | $34.00 | $9.25–$29.92 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JFML | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P86520984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY ONLY P31025383 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P31020984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY ONLY P29625383 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P29620984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P28820984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY ONLY P28625383 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P28620984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY CHARGE P16520984 | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-CCJC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-CSJC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-CSAS | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-OCJC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE -MFCC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JPCU | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENOUS STICK-JSS | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JOBS | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JMDS | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JRGC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JIGC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JENT | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JSCM | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JPOD | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE -JPED | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JOB | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JNC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JMOI | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JIMC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JDHC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JFMV | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-JFMO | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-JFMD | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD; VENIPUNCTURE-JFMB | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JFMM | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JFME | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JFMC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MFMC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-FMCJ | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-CBCC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD VENIPUNCTURE-CHPC | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-SDCP | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-FFH | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENOUS STICK-IVT | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-AFM | $16.80 | $28.00 | $7.62–$24.64 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUCJ | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUC | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-MUCX | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JUTR | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-JER | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECT VENOUS BLOOD BY VENIPUNCTURE-EC | $20.40 | $34.00 | $9.25–$29.92 | — | 40% |
| Blood glucose (sugar) test CPT 82947 GLU 2HR POST PRANDIAL P31020234 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLU 2HR POST PRANDIAL P28620234 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING P28620238 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING P31020238 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL P31029071 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL P28629071 | $17.79 | $29.65 | $8.06–$26.09 | 40% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE BLOOD (POC) P28625808 | $23.64 | $39.40 | $10.72–$34.67 | 21% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE BLOOD (POC) P31025808 | $23.64 | $39.40 | $10.72–$34.67 | 21% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLU 2HR POST PRANDIAL P31020234 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING P31020238 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING P28620238 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LEVEL P28629071 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLU 2HR POST PRANDIAL P28620234 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LEVEL P31029071 | $17.79 | $29.65 | $8.06–$26.09 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANTITATIVE BLOOD (POC) P31025808 | $23.64 | $39.40 | $10.72–$34.67 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANTITATIVE BLOOD (POC) P28625808 | $23.64 | $39.40 | $10.72–$34.67 | — | 40% |
| Blood lead test CPT 83655 LEAD P31037220 | $73.98 | $123.30 | $33.54–$108.50 | 35% above | 40% |
| Blood lead test CPT 83655 LEAD P28637220 | $73.98 | $123.30 | $33.54–$108.50 | 35% above | 40% |
| Blood lead test CPT 83655 LEAD P28630627 | $83.37 | $138.95 | $37.79–$122.28 | 53% above | 40% |
| Blood lead test CPT 83655 HEAVY METALS SCRN; LEAD B (HMDB) P28632822 | $83.37 | $138.95 | $37.79–$122.28 | 53% above | 40% |
| Blood lead test CPT 83655 ASSAY OF LEAD (MAYO) P31036023 | $83.37 | $138.95 | $37.79–$122.28 | 53% above | 40% |
| Blood lead test CPT 83655 HEAVY METALS SCRN; LEAD B (HMDB) P31032822 | $83.37 | $138.95 | $37.79–$122.28 | 53% above | 40% |
| Blood lead test CPT 83655 ASSAY OF LEAD (MAYO) P28636023 | $83.37 | $138.95 | $37.79–$122.28 | 53% above | 40% |
| Blood lead test inpatient CPT 83655 LEAD LEVEL P86520779 | $64.77 | $107.95 | $29.36–$95.00 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD P31037220 | $73.98 | $123.30 | $33.54–$108.50 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD P28637220 | $73.98 | $123.30 | $33.54–$108.50 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD P28630627 | $83.37 | $138.95 | $37.79–$122.28 | — | 40% |
| Blood lead test inpatient CPT 83655 ASSAY OF LEAD (MAYO) P28636023 | $83.37 | $138.95 | $37.79–$122.28 | — | 40% |
| Blood lead test inpatient CPT 83655 ASSAY OF LEAD (MAYO) P31036023 | $83.37 | $138.95 | $37.79–$122.28 | — | 40% |
| Blood lead test inpatient CPT 83655 HEAVY METALS SCRN; LEAD B (HMDB) P28632822 | $83.37 | $138.95 | $37.79–$122.28 | — | 40% |
| Blood lead test inpatient CPT 83655 HEAVY METALS SCRN; LEAD B (HMDB) P31032822 | $83.37 | $138.95 | $37.79–$122.28 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HUMAN CHORIONIC GONADOTROPIN QUALITATIVE P28625382 | $34.02 | $56.70 | $15.42–$49.90 | 36% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HUMAN CHORIONIC GONADOTROPIN QUALITATIVE P31025382 | $34.02 | $56.70 | $15.42–$49.90 | 36% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST (POC); AUTOMATED P28625820 | $52.32 | $87.20 | $23.72–$76.74 | 2% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST (POC); AUTOMATED P31025820 | $52.32 | $87.20 | $23.72–$76.74 | 2% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HUMAN CHORIONIC GONADOTROPIN QUALITATIVE P31025382 | $34.02 | $56.70 | $15.42–$49.90 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HUMAN CHORIONIC GONADOTROPIN QUALITATIVE P28625382 | $34.02 | $56.70 | $15.42–$49.90 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST (POC); AUTOMATED P31025820 | $52.32 | $87.20 | $23.72–$76.74 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST (POC); AUTOMATED P28625820 | $52.32 | $87.20 | $23.72–$76.74 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO P28621213 | $102.24 | $170.40 | $59.64–$149.95 | 105% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO P16530202 | $102.24 | $170.40 | $122.56–$127.32 | 105% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO (OB) P28829003 | $102.24 | $170.40 | $59.64–$149.95 | 105% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO P28821213 | $102.24 | $170.40 | $122.56–$127.32 | 105% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO P29621213 | $102.24 | $170.40 | $122.56–$127.32 | 105% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86900 P31037168 | $140.76 | $234.60 | $122.56–$127.32 | 182% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86900 P28637168 | $140.76 | $234.60 | $82.11–$206.45 | 182% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO (OB) P28829003 | $102.24 | $170.40 | $59.64–$149.95 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO P28821213 | $102.24 | $170.40 | $59.64–$149.95 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO P29621213 | $102.24 | $170.40 | $59.64–$149.95 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO P28621213 | $102.24 | $170.40 | $59.64–$149.95 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING; ABO P16530202 | $102.24 | $170.40 | $59.64–$149.95 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86900 P31037168 | $140.76 | $234.60 | $82.11–$206.45 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86900 P28637168 | $140.76 | $234.60 | $82.11–$206.45 | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN P31020200 | $23.31 | $38.85 | $10.57–$34.19 | 37% below | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN P28620200 | $23.31 | $38.85 | $10.57–$34.19 | 37% below | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN P28620200 | $23.31 | $38.85 | $10.57–$34.19 | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN P31020200 | $23.31 | $38.85 | $10.57–$34.19 | — | 40% |
| C-peptide blood test CPT 84681 C-PEPTIDE P28620201 | $113.64 | $189.40 | $51.52–$166.67 | 8% above | 40% |
| C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE P31033160 | $119.88 | $199.80 | $54.35–$175.82 | 14% above | 40% |
| C-peptide blood test CPT 84681 C-PEPTIDE P28631966 | $119.88 | $199.80 | $54.35–$175.82 | 14% above | 40% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE P28620201 | $113.64 | $189.40 | $51.52–$166.67 | — | 40% |
| C-peptide blood test inpatient CPT 84681 ASSAY OF C-PEPTIDE P31033160 | $119.88 | $199.80 | $54.35–$175.82 | — | 40% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE P28631966 | $119.88 | $199.80 | $54.35–$175.82 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN P28620904 | $31.11 | $51.85 | $14.10–$45.63 | 48% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN P31020904 | $31.11 | $51.85 | $14.10–$45.63 | 48% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN P28630074 | $32.85 | $54.75 | $14.89–$48.18 | 45% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN P31030074 | $32.85 | $54.75 | $14.89–$48.18 | 45% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN P28620904 | $31.11 | $51.85 | $14.10–$45.63 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN P31020904 | $31.11 | $51.85 | $14.10–$45.63 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN P31030074 | $32.85 | $54.75 | $14.89–$48.18 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN P28630074 | $32.85 | $54.75 | $14.89–$48.18 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE P31022095 | $203.52 | $339.20 | $92.26–$298.50 | 34% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE P31022095 | $203.52 | $339.20 | $92.26–$298.50 | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE P86522095 | $203.52 | $339.20 | $92.26–$298.50 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN QUANT; CA 19-9 P28625913 | $120.45 | $200.75 | $54.60–$176.66 | 14% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 P31037140 | $123.48 | $205.80 | $55.98–$181.10 | 17% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 P28637140 | $123.48 | $205.80 | $55.98–$181.10 | 17% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 P31033144 | $123.48 | $205.80 | $55.98–$181.10 | 17% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE ANTIGEN 19-9 (CA 19-9) PF (199PT) P28634610 | $653.67 | $1,089.45 | $296.33–$958.72 | 521% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN QUANT; CA 19-9 P28625913 | $120.45 | $200.75 | $54.60–$176.66 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9 P31033144 | $123.48 | $205.80 | $55.98–$181.10 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 P31037140 | $123.48 | $205.80 | $55.98–$181.10 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 P28637140 | $123.48 | $205.80 | $55.98–$181.10 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARBOHYDRATE ANTIGEN 19-9 (CA 19-9) PF (199PT) P28634610 | $653.67 | $1,089.45 | $296.33–$958.72 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 P28620202 | $122.73 | $204.55 | $55.64–$180.00 | 12% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN QUANT CA 125 P28634213 | $127.08 | $211.80 | $57.61–$186.38 | 16% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 P31033099 | $127.08 | $211.80 | $57.61–$186.38 | 16% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 ROMA SCORE SERUM (ROMA) 86304 P28637130 | $1,022.49 | $1,704.15 | $463.53–$1,499.65 | 836% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 ROMA SCORE SERUM (ROMA) 86304 P31037130 | $1,022.49 | $1,704.15 | $463.53–$1,499.65 | 836% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 P28620202 | $122.73 | $204.55 | $55.64–$180.00 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN QUANT CA 125 P28634213 | $127.08 | $211.80 | $57.61–$186.38 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125 P31033099 | $127.08 | $211.80 | $57.61–$186.38 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 ROMA SCORE SERUM (ROMA) 86304 P31037130 | $1,022.49 | $1,704.15 | $463.53–$1,499.65 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 ROMA SCORE SERUM (ROMA) 86304 P28637130 | $1,022.49 | $1,704.15 | $463.53–$1,499.65 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 P28629035 | $96.39 | $160.65 | $56.23–$141.37 | 1% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 P31029035 | $96.39 | $160.65 | $52.85–$54.90 | 1% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 P86529035 | $96.39 | $160.65 | $43.70–$141.37 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 P31029035 | $96.39 | $160.65 | $56.23–$141.37 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 P28629035 | $96.39 | $160.65 | $56.23–$141.37 | — | 40% |
| Calcium blood test, total CPT 82310 CALCIUM LEVEL TOTAL P31020203 | $22.47 | $37.45 | $10.19–$32.96 | 52% below | 40% |
| Calcium blood test, total CPT 82310 UR CALCIUM P28620206 | $22.47 | $37.45 | $10.19–$32.96 | 52% below | 40% |
| Calcium blood test, total CPT 82310 CALCIUM LEVEL TOTAL P28620203 | $22.47 | $37.45 | $10.19–$32.96 | 52% below | 40% |
| Calcium blood test, total CPT 82310 CALCIUM; TOTAL P28631225 | $29.73 | $49.55 | $13.48–$43.60 | 36% below | 40% |
| Calcium blood test, total CPT 82310 CALCIUM; TOTAL P31031225 | $29.73 | $49.55 | $13.48–$43.60 | 36% below | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM LEVEL TOTAL P28620203 | $22.47 | $37.45 | $10.19–$32.96 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 UR CALCIUM P28620206 | $22.47 | $37.45 | $10.19–$32.96 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM LEVEL TOTAL P31020203 | $22.47 | $37.45 | $10.19–$32.96 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM; TOTAL P31031225 | $29.73 | $49.55 | $13.48–$43.60 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM; TOTAL P28631225 | $29.73 | $49.55 | $13.48–$43.60 | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN FLUID P28625423 | $109.74 | $182.90 | $49.75–$160.95 | 8% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN P31020209 | $109.74 | $182.90 | $49.75–$160.95 | 8% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN P28620209 | $109.74 | $182.90 | $49.75–$160.95 | 8% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN P28634075 | $115.77 | $192.95 | $52.48–$169.80 | 14% above | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN P28620209 | $109.74 | $182.90 | $49.75–$160.95 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN FLUID P28625423 | $109.74 | $182.90 | $49.75–$160.95 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN P31020209 | $109.74 | $182.90 | $49.75–$160.95 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN P28634075 | $115.77 | $192.95 | $52.48–$169.80 | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA- ZOSTER P31030177 | $80.13 | $133.55 | $36.33–$117.52 | 9% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA- ZOSTER P28630177 | $80.13 | $133.55 | $36.33–$117.52 | 9% above | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY P86520817 | $75.99 | $126.65 | $34.45–$111.45 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA- ZOSTER P28630177 | $80.13 | $133.55 | $36.33–$117.52 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA- ZOSTER P31030177 | $80.13 | $133.55 | $36.33–$117.52 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR P31020756 | $203.43 | $339.05 | $92.22–$298.36 | 130% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR P86520756 | $203.43 | $339.05 | $92.22–$298.36 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR P31020756 | $203.43 | $339.05 | $92.22–$298.36 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE P31020281 | $70.32 | $117.20 | $31.88–$103.14 | 31% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE P28620281 | $70.32 | $117.20 | $31.88–$103.14 | 31% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P31030476 | $83.31 | $138.85 | $37.77–$122.19 | 18% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P28630476 | $83.31 | $138.85 | $37.77–$122.19 | 18% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE P28620281 | $70.32 | $117.20 | $31.88–$103.14 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE P31020281 | $70.32 | $117.20 | $31.88–$103.14 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P31030476 | $83.31 | $138.85 | $37.77–$122.19 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P28630476 | $83.31 | $138.85 | $37.77–$122.19 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF P28620289 | $40.80 | $68.00 | $18.50–$59.84 | 19% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF P31020289 | $40.80 | $68.00 | $18.50–$59.84 | 19% below | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF P31020289 | $40.80 | $68.00 | $18.50–$59.84 | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF P28620289 | $40.80 | $68.00 | $18.50–$59.84 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITH MANUAL DIFF P28620290 | $32.28 | $53.80 | $14.63–$47.34 | 39% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITH MANUAL DIFF P31020290 | $32.28 | $53.80 | $14.63–$47.34 | 39% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED P28620288 | $32.28 | $53.80 | $14.63–$47.34 | 39% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MANUAL DIFF P31020290 | $32.28 | $53.80 | $14.63–$47.34 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED P28620288 | $32.28 | $53.80 | $14.63–$47.34 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MANUAL DIFF P28620290 | $32.28 | $53.80 | $14.63–$47.34 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL P31020939 | $86.10 | $143.50 | $39.03–$126.28 | 28% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL P28620939 | $86.10 | $143.50 | $39.03–$126.28 | 28% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P31037206 | $829.86 | $1,383.10 | $376.20–$1,217.13 | 593% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P28637206 | $829.86 | $1,383.10 | $376.20–$1,217.13 | 593% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL P28620939 | $86.10 | $143.50 | $39.03–$126.28 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL P31020939 | $86.10 | $143.50 | $39.03–$126.28 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P31037206 | $829.86 | $1,383.10 | $376.20–$1,217.13 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P28637206 | $829.86 | $1,383.10 | $376.20–$1,217.13 | — | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL 60 MIN. POST INJECTION P28625050 | $72.39 | $120.65 | $32.82–$106.17 | 17% below | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL 30 MIN. POST INJECTION P28625049 | $72.39 | $120.65 | $32.82–$106.17 | 17% below | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL LEVEL P28620217 | $72.39 | $120.65 | $32.82–$106.17 | 17% below | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL SALIVA (SALCT) P31032520 | $96.72 | $161.20 | $43.85–$141.86 | 11% above | 40% |
| Cortisol blood test, total CPT 82533 CAH PROFILE CORTISOL P31032870 | $96.72 | $161.20 | $43.85–$141.86 | 11% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL SALIVA (SALCT) P28632520 | $96.72 | $161.20 | $43.85–$141.86 | 11% above | 40% |
| Cortisol blood test, total CPT 82533 CAH PROFILE CORTISOL P28632870 | $96.72 | $161.20 | $43.85–$141.86 | 11% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL; TOTAL P28630540 | $96.72 | $161.20 | $43.85–$141.86 | 11% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL, FREE AND TOTAL, SERUM (CORTO) 82533 P31037112 | $339.75 | $566.25 | $154.02–$498.30 | 290% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL, FREE AND TOTAL, SERUM (CORTO) 82533 P28637112 | $339.75 | $566.25 | $154.02–$498.30 | 290% above | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL LEVEL P28620217 | $72.39 | $120.65 | $32.82–$106.17 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 60 MIN. POST INJECTION P28625050 | $72.39 | $120.65 | $32.82–$106.17 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 30 MIN. POST INJECTION P28625049 | $72.39 | $120.65 | $32.82–$106.17 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CAH PROFILE CORTISOL P28632870 | $96.72 | $161.20 | $43.85–$141.86 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CAH PROFILE CORTISOL P31032870 | $96.72 | $161.20 | $43.85–$141.86 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL; TOTAL P28630540 | $96.72 | $161.20 | $43.85–$141.86 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVA (SALCT) P28632520 | $96.72 | $161.20 | $43.85–$141.86 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVA (SALCT) P31032520 | $96.72 | $161.20 | $43.85–$141.86 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL, FREE AND TOTAL, SERUM (CORTO) 82533 P31037112 | $339.75 | $566.25 | $154.02–$498.30 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL, FREE AND TOTAL, SERUM (CORTO) 82533 P28637112 | $339.75 | $566.25 | $154.02–$498.30 | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE P31020215 | $35.52 | $59.20 | $16.10–$52.10 | 43% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE P28620215 | $35.52 | $59.20 | $16.10–$52.10 | 43% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE; TOTAL P28630449 | $40.50 | $67.50 | $18.36–$59.40 | 35% below | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE P31020215 | $35.52 | $59.20 | $16.10–$52.10 | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE P28620215 | $35.52 | $59.20 | $16.10–$52.10 | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE; TOTAL P28630449 | $40.50 | $67.50 | $18.36–$59.40 | — | 40% |
| Creatinine blood test CPT 82565 CREATININE P28620218 | $27.96 | $46.60 | $12.68–$41.01 | 13% below | 40% |
| Creatinine blood test CPT 82565 CREATININE P31020218 | $27.96 | $46.60 | $12.68–$41.01 | 13% below | 40% |
| Creatinine blood test CPT 82565 POC CREATININE P28625424 | $35.04 | $58.40 | $15.88–$51.39 | 10% above | 40% |
| Creatinine blood test CPT 82565 POC CREATININE P31025424 | $35.04 | $58.40 | $15.88–$51.39 | 10% above | 40% |
| Creatinine blood test inpatient CPT 82565 CREATININE P31020218 | $27.96 | $46.60 | $12.68–$41.01 | — | 40% |
| Creatinine blood test inpatient CPT 82565 CREATININE P28620218 | $27.96 | $46.60 | $12.68–$41.01 | — | 40% |
| Creatinine blood test inpatient CPT 82565 POC CREATININE P28625424 | $35.04 | $58.40 | $15.88–$51.39 | — | 40% |
| Creatinine blood test inpatient CPT 82565 POC CREATININE P31025424 | $35.04 | $58.40 | $15.88–$51.39 | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CMV (CMVP-1/2) P28632156 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) P16530691 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB IGG SERUM (CMVG) P31032213 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CMV (CMVP-1/2) P31032156 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) P28630691 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB IGG SERUM (CMVG) P28632213 | $82.89 | $138.15 | $37.58–$121.57 | 19% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY (MTN) P16535041 | $127.08 | $211.80 | $57.61–$186.38 | 82% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG AVIDITY (FCYTG) P28634294 | $381.00 | $635.00 | $172.72–$558.80 | 446% above | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) P16530691 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) P28630691 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CMV (CMVP-1/2) P28632156 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB IGG SERUM (CMVG) P28632213 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CMV (CMVP-1/2) P31032156 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB IGG SERUM (CMVG) P31032213 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY (MTN) P16535041 | $127.08 | $211.80 | $57.61–$186.38 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG AVIDITY (FCYTG) P28634294 | $381.00 | $635.00 | $172.72–$558.80 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE P28620725 | $46.05 | $76.75 | $20.88–$67.54 | 63% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE P31020725 | $46.05 | $76.75 | $20.88–$67.54 | 63% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (DIRM) R P31032466 | $64.53 | $107.55 | $29.25–$94.64 | 48% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (DIRM) R P28632466 | $64.53 | $107.55 | $29.25–$94.64 | 48% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER; QUANTITATIVE P28631741 | $64.53 | $107.55 | $29.25–$94.64 | 48% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE P31020725 | $46.05 | $76.75 | $20.88–$67.54 | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE P28620725 | $46.05 | $76.75 | $20.88–$67.54 | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (DIRM) R P31032466 | $64.53 | $107.55 | $29.25–$94.64 | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (DIRM) R P28632466 | $64.53 | $107.55 | $29.25–$94.64 | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER; QUANTITATIVE P28631741 | $64.53 | $107.55 | $29.25–$94.64 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE SERUM (DHES) P28632138 | $128.07 | $213.45 | $58.06–$187.84 | 10% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE SERUM (DHES) P31032138 | $128.07 | $213.45 | $58.06–$187.84 | 10% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE SERUM (DHES) P31032138 | $128.07 | $213.45 | $58.06–$187.84 | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE SERUM (DHES) P28632138 | $128.07 | $213.45 | $58.06–$187.84 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC ANTIDEPRESSANT SCREEN P28625865 | $59.07 | $98.45 | $26.78–$86.64 | 24% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE SCREEN, U (OXYSU) P31037287 | $100.29 | $167.15 | $45.46–$147.09 | 30% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE SCREEN, U (OXYSU) P28637287 | $100.29 | $167.15 | $45.46–$147.09 | 30% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE(10 PANEL)ALCOHOL SCRN SERUM(FDA1S) P28634370 | $133.35 | $222.25 | $60.45–$195.58 | 73% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, PRESCRIPTION/OTC, URINE (PDSU) P28631392 | $143.19 | $238.65 | $64.91–$210.01 | 85% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, PRESCRIPTION OTC (PDSU) P31033193 | $143.19 | $238.65 | $64.91–$210.01 | 85% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, PRESCRIPTION OTC (PDSU) P28633193 | $143.19 | $238.65 | $64.91–$210.01 | 85% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PRESCRIPTION/OTC SERUM (DSS) P28634142 | $175.47 | $292.45 | $79.55–$257.36 | 127% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE SCREEN MECONIUM 5 (DASM5)-MAYO P31033044 | $245.67 | $409.45 | $111.37–$360.32 | 218% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE SCREEN MECONIUM 5 (DASM5)-MAYO P28633044 | $245.67 | $409.45 | $111.37–$360.32 | 218% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CANNABINOID ANALYSIS WHOLE BLOOD (FMARI) P28634244 | $265.08 | $441.80 | $120.17–$388.78 | 243% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SYNTHETIC CANNABINOID SCREEN, URINE (FCSC) P31037222 | $268.35 | $447.25 | $121.65–$393.58 | 247% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SYNTHETIC CANNABINOID SCREEN, URINE (FCSC) P28637222 | $268.35 | $447.25 | $121.65–$393.58 | 247% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR P31033087 | $274.89 | $458.15 | $124.62–$403.17 | 256% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 11 W/CONF SERUM (ZW80) MAYO P28631605 | $315.39 | $525.65 | $142.98–$462.57 | 308% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 8 P28625875 | $315.84 | $526.40 | $143.18–$463.23 | 309% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 8 P31025875 | $315.84 | $526.40 | $143.18–$463.23 | 309% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CORDSTAT 7 P28625867 | $317.07 | $528.45 | $143.74–$465.04 | 311% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUCURONIDE SCREEN RANDOM URINE (ETGS) P28634193 | $323.70 | $539.50 | $146.74–$474.76 | 319% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SYNTHETIC CANNAB METAB SCR EXP U (FSCMS) -MAYO P28631690 | $324.60 | $541.00 | $147.15–$476.08 | 320% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUCURONIDE SCREEN WITH REFLEX URINE (ETGR) P28631391 | $340.53 | $567.55 | $154.37–$499.44 | 341% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE SCREEN (10 PANEL) SERUM (FD10S) P28634189 | $354.96 | $591.60 | $160.92–$520.61 | 360% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE CHEMISTRY ANALYZERS P28637120 | $357.93 | $596.55 | $162.26–$524.96 | 363% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE CHEMISTRY ANALYZERS P31037120 | $357.93 | $596.55 | $162.26–$524.96 | 363% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 9 PANEL W/REFLEX TO MS QUANT. (ZW242) P28631929 | $382.35 | $637.25 | $173.33–$560.78 | 395% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CORDSTAT 13 P28625871 | $435.51 | $725.85 | $197.43–$638.75 | 464% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SEDATIVE HYPNOTIC PANEL, UR (FSHPU) P28637223 | $559.92 | $933.20 | $253.83–$821.22 | 625% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SEDATIVE HYPNOTIC PANEL, UR (FSHPU) P31037223 | $559.92 | $933.20 | $253.83–$821.22 | 625% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUCURONIDE SCREEN UC (FEGUC) P28634186 | $569.43 | $949.05 | $258.14–$835.16 | 637% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLIC ANTIDEPRESSANT SCREEN P28625865 | $59.07 | $98.45 | $26.78–$86.64 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE SCREEN, U (OXYSU) P31037287 | $100.29 | $167.15 | $45.46–$147.09 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE SCREEN, U (OXYSU) P28637287 | $100.29 | $167.15 | $45.46–$147.09 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE(10 PANEL)ALCOHOL SCRN SERUM(FDA1S) P28634370 | $133.35 | $222.25 | $60.45–$195.58 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, PRESCRIPTION/OTC, URINE (PDSU) P28631392 | $143.19 | $238.65 | $64.91–$210.01 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, PRESCRIPTION OTC (PDSU) P31033193 | $143.19 | $238.65 | $64.91–$210.01 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, PRESCRIPTION OTC (PDSU) P28633193 | $143.19 | $238.65 | $64.91–$210.01 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PRESCRIPTION/OTC SERUM (DSS) P28634142 | $175.47 | $292.45 | $79.55–$257.36 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE SCREEN MECONIUM 5 (DASM5)-MAYO P28633044 | $245.67 | $409.45 | $111.37–$360.32 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE SCREEN MECONIUM 5 (DASM5)-MAYO P31033044 | $245.67 | $409.45 | $111.37–$360.32 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CANNABINOID ANALYSIS WHOLE BLOOD (FMARI) P28634244 | $265.08 | $441.80 | $120.17–$388.78 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYNTHETIC CANNABINOID SCREEN, URINE (FCSC) P28637222 | $268.35 | $447.25 | $121.65–$393.58 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYNTHETIC CANNABINOID SCREEN, URINE (FCSC) P31037222 | $268.35 | $447.25 | $121.65–$393.58 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR P31033087 | $274.89 | $458.15 | $124.62–$403.17 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 11 W/CONF SERUM (ZW80) MAYO P28631605 | $315.39 | $525.65 | $142.98–$462.57 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 8 P28625875 | $315.84 | $526.40 | $143.18–$463.23 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 8 P31025875 | $315.84 | $526.40 | $143.18–$463.23 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 8 P86525875 | $315.84 | $526.40 | $143.18–$463.23 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CORDSTAT 7 P28625867 | $317.07 | $528.45 | $143.74–$465.04 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUCURONIDE SCREEN RANDOM URINE (ETGS) P28634193 | $323.70 | $539.50 | $146.74–$474.76 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SYNTHETIC CANNAB METAB SCR EXP U (FSCMS) -MAYO P28631690 | $324.60 | $541.00 | $147.15–$476.08 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUCURONIDE SCREEN WITH REFLEX URINE (ETGR) P28631391 | $340.53 | $567.55 | $154.37–$499.44 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE SCREEN (10 PANEL) SERUM (FD10S) P28634189 | $354.96 | $591.60 | $160.92–$520.61 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE CHEMISTRY ANALYZERS P31037120 | $357.93 | $596.55 | $162.26–$524.96 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE CHEMISTRY ANALYZERS P28637120 | $357.93 | $596.55 | $162.26–$524.96 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 9 PANEL W/REFLEX TO MS QUANT. (ZW242) P28631929 | $382.35 | $637.25 | $173.33–$560.78 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CORDSTAT 13 P28625871 | $435.51 | $725.85 | $197.43–$638.75 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN (URINE) SINGLE DRUG CLASS METHOD 14 P86525876 | $552.75 | $921.25 | $250.58–$810.70 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SEDATIVE HYPNOTIC PANEL, UR (FSHPU) P31037223 | $559.92 | $933.20 | $253.83–$821.22 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SEDATIVE HYPNOTIC PANEL, UR (FSHPU) P28637223 | $559.92 | $933.20 | $253.83–$821.22 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUCURONIDE SCREEN UC (FEGUC) P28634186 | $569.43 | $949.05 | $258.14–$835.16 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN SINGLE DRUG CLASS METHOD 18 P86525877 | $710.61 | $1,184.35 | $322.14–$1,042.23 | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL P31020222 | $31.71 | $52.85 | $14.38–$46.51 | 62% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL P28620222 | $31.71 | $52.85 | $14.38–$46.51 | 62% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL P28620222 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL P31020222 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P16530725 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRUS IGM ANTI-VCA SERUM P28632296 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P28630725 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRUS IGM ANTI-VCA SERUM P31032296 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRUS IGG ANTI-VCA SERUM P31032295 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRUS IGG ANTI-VCA SERUM P28632295 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P31030725 | $104.49 | $174.15 | $47.37–$153.25 | 32% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA (MTN) P16535043 | $235.11 | $391.85 | $106.58–$344.83 | 197% above | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRUS IGM ANTI-VCA SERUM P31032296 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRUS IGG ANTI-VCA SERUM P31032295 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P31030725 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P16530725 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS VIRAL CAPSID P28630725 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRUS IGG ANTI-VCA SERUM P28632295 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRUS IGM ANTI-VCA SERUM P28632296 | $104.49 | $174.15 | $47.37–$153.25 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR CAPSID VCA (MTN) P16535043 | $235.11 | $391.85 | $106.58–$344.83 | — | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL LEVEL P28620870 | $152.58 | $254.30 | $69.17–$223.78 | 7% above | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL LEVEL P31020870 | $152.58 | $254.30 | $69.17–$223.78 | 7% above | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL LEVEL P28620870 | $152.58 | $254.30 | $69.17–$223.78 | — | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL LEVEL P31020870 | $152.58 | $254.30 | $69.17–$223.78 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE P31020230 | $99.42 | $165.70 | $45.07–$145.82 | 3% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE P28620230 | $99.42 | $165.70 | $45.07–$145.82 | 3% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE P31020230 | $99.42 | $165.70 | $45.07–$145.82 | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE P28620230 | $99.42 | $165.70 | $45.07–$145.82 | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL P28629125 | $113.61 | $189.35 | $51.50–$166.63 | 40% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL (CALPR) P28632370 | $119.85 | $199.75 | $54.33–$175.78 | 36% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL P28630667 | $119.85 | $199.75 | $54.33–$175.78 | 36% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL P28634666 | $119.85 | $199.75 | $54.33–$175.78 | 36% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL (CALPR) P31032370 | $119.85 | $199.75 | $54.33–$175.78 | 36% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL P86529125 | $113.61 | $189.35 | $51.50–$166.63 | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL P28629125 | $113.61 | $189.35 | $51.50–$166.63 | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL P28630667 | $119.85 | $199.75 | $54.33–$175.78 | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL (CALPR) P31032370 | $119.85 | $199.75 | $54.33–$175.78 | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL (CALPR) P28632370 | $119.85 | $199.75 | $54.33–$175.78 | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL P28634666 | $119.85 | $199.75 | $54.33–$175.78 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL P31020225 | $65.70 | $109.50 | $29.78–$96.36 | 31% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL P28620225 | $65.70 | $109.50 | $29.78–$96.36 | 31% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN P31031324 | $78.51 | $130.85 | $35.59–$115.15 | 18% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN P28631324 | $78.51 | $130.85 | $35.59–$115.15 | 18% below | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN LEVEL P31020225 | $65.70 | $109.50 | $29.78–$96.36 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN LEVEL P28620225 | $65.70 | $109.50 | $29.78–$96.36 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN P31031324 | $78.51 | $130.85 | $35.59–$115.15 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN P28631324 | $78.51 | $130.85 | $35.59–$115.15 | — | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ASSAY P28620737 | $43.17 | $71.95 | $19.57–$63.32 | 53% below | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ASSAY P31020737 | $43.17 | $71.95 | $19.57–$63.32 | 53% below | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY TEG P28629062 | $43.17 | $71.95 | $19.57–$63.32 | 53% below | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN (FIBC) R P31032478 | $59.37 | $98.95 | $26.91–$87.08 | 35% below | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN (FIBC) R P28632478 | $59.37 | $98.95 | $26.91–$87.08 | 35% below | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY P28631742 | $59.37 | $98.95 | $26.91–$87.08 | 35% below | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ASSAY P31020737 | $43.17 | $71.95 | $19.57–$63.32 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY TEG P28629062 | $43.17 | $71.95 | $19.57–$63.32 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ASSAY P28620737 | $43.17 | $71.95 | $19.57–$63.32 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN (FIBC) R P28632478 | $59.37 | $98.95 | $26.91–$87.08 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN (FIBC) R P31032478 | $59.37 | $98.95 | $26.91–$87.08 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN; ACTIVITY P28631742 | $59.37 | $98.95 | $26.91–$87.08 | — | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATE LEVEL P28620229 | $68.79 | $114.65 | $31.18–$100.89 | 16% below | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATE LEVEL P31020229 | $68.79 | $114.65 | $31.18–$100.89 | 16% below | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE LEVEL P31020229 | $68.79 | $114.65 | $31.18–$100.89 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE LEVEL P28620229 | $68.79 | $114.65 | $31.18–$100.89 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE P31020320 | $83.10 | $138.50 | $37.67–$121.88 | 16% below | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE P28620320 | $83.10 | $138.50 | $37.67–$121.88 | 16% below | 40% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3 FREE P28634483 | $103.44 | $172.40 | $46.89–$151.71 | 4% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE P28620320 | $83.10 | $138.50 | $37.67–$121.88 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE P31020320 | $83.10 | $138.50 | $37.67–$121.88 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3 FREE P28634483 | $103.44 | $172.40 | $46.89–$151.71 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE P28620231 | $44.22 | $73.70 | $20.05–$64.86 | 43% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE P31020231 | $44.22 | $73.70 | $20.05–$64.86 | 43% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; TOTAL, FREE P31037155 | $56.13 | $93.55 | $25.45–$82.32 | 27% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; TOTAL, FREE P28637155 | $56.13 | $93.55 | $25.45–$82.32 | 27% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE P28634101 | $59.19 | $98.65 | $26.83–$86.81 | 23% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 (THYROXINE) FREE BY DIALYSIS (FRT4D) P31032419 | $59.19 | $98.65 | $26.83–$86.81 | 23% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 (THYROXINE) FREE BY DIALYSIS (FRT4D) P28632419 | $59.19 | $98.65 | $26.83–$86.81 | 23% below | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE P28620231 | $44.22 | $73.70 | $20.05–$64.86 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE P31020231 | $44.22 | $73.70 | $20.05–$64.86 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; TOTAL, FREE P31037155 | $56.13 | $93.55 | $25.45–$82.32 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; TOTAL, FREE P28637155 | $56.13 | $93.55 | $25.45–$82.32 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 (THYROXINE) FREE BY DIALYSIS (FRT4D) P28632419 | $59.19 | $98.65 | $26.83–$86.81 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE P28634101 | $59.19 | $98.65 | $26.83–$86.81 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 (THYROXINE) FREE BY DIALYSIS (FRT4D) P31032419 | $59.19 | $98.65 | $26.83–$86.81 | — | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE P28632001 | $146.73 | $244.55 | $66.52–$215.20 | 19% above | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE P28630094 | $146.73 | $244.55 | $66.52–$215.20 | 19% above | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE P31032001 | $146.73 | $244.55 | $66.52–$215.20 | 19% above | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE P31030094 | $146.73 | $244.55 | $66.52–$215.20 | 19% above | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE P28632001 | $146.73 | $244.55 | $66.52–$215.20 | — | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE P28630094 | $146.73 | $244.55 | $66.52–$215.20 | — | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE P31030094 | $146.73 | $244.55 | $66.52–$215.20 | — | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE P31032001 | $146.73 | $244.55 | $66.52–$215.20 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE P31020233 | $31.98 | $53.30 | $14.50–$46.90 | 44% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE P28620233 | $31.98 | $53.30 | $14.50–$46.90 | 44% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE P31020233 | $31.98 | $53.30 | $14.50–$46.90 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE P28620233 | $31.98 | $53.30 | $14.50–$46.90 | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL P28629045 | $204.00 | $340.00 | $92.48–$299.20 | 29% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL P31029045 | $204.00 | $340.00 | $92.48–$299.20 | 29% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL P28629045 | $204.00 | $340.00 | $92.48–$299.20 | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL P31029045 | $204.00 | $340.00 | $92.48–$299.20 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 HOUR GLUCOSE P31021283 | $20.70 | $34.50 | $9.38–$30.36 | 51% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE SCREEN PREGNANCY P28620236 | $20.70 | $34.50 | $9.38–$30.36 | 51% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 HOUR GLUCOSE P28621283 | $20.70 | $34.50 | $9.38–$30.36 | 51% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE SCREEN PREGNANCY P31020236 | $20.70 | $34.50 | $9.38–$30.36 | 51% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 2 HOUR GLUCOSE P28621283 | $20.70 | $34.50 | $9.38–$30.36 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE SCREEN PREGNANCY P28620236 | $20.70 | $34.50 | $9.38–$30.36 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE SCREEN PREGNANCY P31020236 | $20.70 | $34.50 | $9.38–$30.36 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 2 HOUR GLUCOSE P31021283 | $20.70 | $34.50 | $9.38–$30.36 | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SAMPLES P28621285 | $52.92 | $88.20 | $23.99–$77.62 | 42% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST 3 SAMPLES P31021285 | $52.92 | $88.20 | $23.99–$77.62 | 42% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SAMPLES P31021285 | $52.92 | $88.20 | $23.99–$77.62 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SAMPLES P28621285 | $52.92 | $88.20 | $23.99–$77.62 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB P31033104 | $202.14 | $336.90 | $91.64–$296.47 | 151% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE BY PCR P31025470 | $203.43 | $339.05 | $92.22–$298.36 | 153% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB P31033104 | $202.14 | $336.90 | $91.64–$296.47 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE BY PCR P31025470 | $203.43 | $339.05 | $92.22–$298.36 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE BY PCR P86525470 | $203.43 | $339.05 | $92.22–$298.36 | — | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI STOOL (HPSA) P28634100 | $89.46 | $149.10 | $40.56–$131.21 | 24% below | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL DETECT BY IMMUNOASSAY P86522093 | $84.81 | $141.35 | $38.45–$124.39 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL (HPSA) P28634100 | $89.46 | $149.10 | $40.56–$131.21 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DETECTION (DNA OR RNA); HIV-1 P28630803 | $490.20 | $817.00 | $222.22–$718.96 | 41% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DETECTION (DNA OR RNA); HIV-1 P31030803 | $490.20 | $817.00 | $222.22–$718.96 | 41% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV QUANTITATIVE PCR P86520768 | $464.67 | $774.45 | $210.65–$681.52 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT DETECTION (DNA OR RNA); HIV-1 P31030803 | $490.20 | $817.00 | $222.22–$718.96 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT DETECTION (DNA OR RNA); HIV-1 P28630803 | $490.20 | $817.00 | $222.22–$718.96 | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV P28620812 | $66.54 | $110.90 | $30.16–$97.59 | 38% below | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 AND HIV-2 SINGLE RESULT P28631340 | $85.32 | $142.20 | $38.68–$125.14 | 21% below | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 AND HIV-2 SINGLE RESULT P16531340 | $85.32 | $142.20 | $38.68–$125.14 | 21% below | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 RAPID HIV P28620812 | $66.54 | $110.90 | $30.16–$97.59 | — | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 AND HIV-2 SINGLE RESULT P28631340 | $85.32 | $142.20 | $38.68–$125.14 | — | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 AND HIV-2 SINGLE RESULT P16531340 | $85.32 | $142.20 | $38.68–$125.14 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 & 2 ANTIGEN/ANTIBODY P31025758 | $155.10 | $258.50 | $70.31–$227.48 | 75% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1,2 ANTIGEN/ANTIBODY P28625758 | $155.10 | $258.50 | $70.31–$227.48 | 75% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/HIV-2 1 RESULT ANTBDY (MTN) P16535110 | $563.40 | $939.00 | $255.41–$826.32 | 534% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 & 2 ANTIGEN/ANTIBODY P31025758 | $155.10 | $258.50 | $70.31–$227.48 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1,2 ANTIGEN/ANTIBODY P28625758 | $155.10 | $258.50 | $70.31–$227.48 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/HIV-2 1 RESULT ANTBDY (MTN) P16535110 | $563.40 | $939.00 | $255.41–$826.32 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES P31033096 | $202.14 | $336.90 | $91.64–$296.47 | 83% above | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMAVIRUS (HPV) HIGH-RISK TYPES P86525742 | $191.61 | $319.35 | $86.86–$281.03 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES P31033096 | $202.14 | $336.90 | $91.64–$296.47 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA TISSUE TESTING-DPL | $1,012.41 | $1,687.35 | $458.96–$1,484.87 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C P28620247 | $50.04 | $83.40 | $22.68–$73.39 | 17% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C P31020247 | $50.04 | $83.40 | $22.68–$73.39 | 17% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 POC HEMOGLOBIN A1C P28629033 | $53.04 | $88.40 | $24.04–$77.79 | 12% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 POC HEMOGLOBIN A1C P31029033 | $53.04 | $88.40 | $24.04–$77.79 | 12% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C P31033090 | $55.95 | $93.25 | $25.36–$82.06 | 7% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED (A1C) P31037146 | $55.95 | $93.25 | $25.36–$82.06 | 7% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C P31020247 | $50.04 | $83.40 | $22.68–$73.39 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C P28620247 | $50.04 | $83.40 | $22.68–$73.39 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 POC HEMOGLOBIN A1C P28629033 | $53.04 | $88.40 | $24.04–$77.79 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 POC HEMOGLOBIN A1C P31029033 | $53.04 | $88.40 | $24.04–$77.79 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED (A1C) P31037146 | $55.95 | $93.25 | $25.36–$82.06 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C P31033090 | $55.95 | $93.25 | $25.36–$82.06 | — | 40% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB) (RT)-JRT | $13.17 | $21.95 | $5.97–$19.32 | 52% below | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN P31021108 | $13.17 | $21.95 | $5.97–$19.32 | 52% below | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN P28621108 | $13.17 | $21.95 | $5.97–$19.32 | 52% below | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN P31033136 | $15.06 | $25.10 | $6.83–$22.09 | 46% below | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN (POC) P28625477 | $16.83 | $28.05 | $7.63–$24.68 | 39% below | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN (POC) P31025477 | $16.83 | $28.05 | $7.63–$24.68 | 39% below | 40% |
| Hemoglobin blood test one side CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)-RT | $13.17 | $21.95 | $5.97–$19.32 | 52% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P86521108 | $13.17 | $21.95 | $5.97–$19.32 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P31021108 | $13.17 | $21.95 | $5.97–$19.32 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB) (RT)-JRT | $13.17 | $21.95 | $5.97–$19.32 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P28621108 | $13.17 | $21.95 | $5.97–$19.32 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN P31033136 | $15.06 | $25.10 | $6.83–$22.09 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (POC) P31025477 | $16.83 | $28.05 | $7.63–$24.68 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (POC) P28625477 | $16.83 | $28.05 | $7.63–$24.68 | — | 40% |
| Hemoglobin blood test inpatient one side CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)-RT | $13.17 | $21.95 | $5.97–$19.32 | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY P28620252 | $58.47 | $97.45 | $26.51–$85.76 | 13% below | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL P28631338 | $74.97 | $124.95 | $33.99–$109.96 | 12% above | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL P16531338 | $74.97 | $124.95 | $33.99–$109.96 | 12% above | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL (MTN) P16535037 | $516.81 | $861.35 | $234.29–$757.99 | 671% above | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY P28620252 | $58.47 | $97.45 | $26.51–$85.76 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL P28631338 | $74.97 | $124.95 | $33.99–$109.96 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL P16531338 | $74.97 | $124.95 | $33.99–$109.96 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL (MTN) P16535037 | $516.81 | $861.35 | $234.29–$757.99 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY P28620254 | $51.15 | $85.25 | $23.19–$75.02 | 24% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY P31020254 | $51.15 | $85.25 | $23.19–$75.02 | 24% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ABY QUAL/QUANT SERUM (HBAB) P31032741 | $65.61 | $109.35 | $29.74–$96.23 | 2% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) P28631817 P31031817 | $65.61 | $109.35 | $29.74–$96.23 | 2% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ABY QUAL/QUANT SERUM (HBAB) P28632741 | $65.61 | $109.35 | $29.74–$96.23 | 2% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) P16531817 | $65.61 | $109.35 | $29.74–$96.23 | 2% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY P31020254 | $51.15 | $85.25 | $23.19–$75.02 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY P28620254 | $51.15 | $85.25 | $23.19–$75.02 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ABY QUAL/QUANT SERUM (HBAB) P28632741 | $65.61 | $109.35 | $29.74–$96.23 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) P16531817 | $65.61 | $109.35 | $29.74–$96.23 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) P28631817 P31031817 | $65.61 | $109.35 | $29.74–$96.23 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ABY QUAL/QUANT SERUM (HBAB) P31032741 | $65.61 | $109.35 | $29.74–$96.23 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN P31020255 | $50.13 | $83.55 | $22.73–$73.52 | 20% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN P28620255 | $50.13 | $83.55 | $22.73–$73.52 | 20% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN BY EIA QUAL OR SEMIQUANT P28631343 | $64.29 | $107.15 | $29.14–$94.29 | 3% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN BY EIA QUAL OR SEMIQUANT P16531343 | $64.29 | $107.15 | $29.14–$94.29 | 3% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIBODY (MTN) P16535038 | $427.86 | $713.10 | $193.96–$627.53 | 586% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN P31020255 | $50.13 | $83.55 | $22.73–$73.52 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN P28620255 | $50.13 | $83.55 | $22.73–$73.52 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECTIOUS AGENT ANTIGEN BY EIA QUAL OR SEMIQUANT P16531343 | $64.29 | $107.15 | $29.14–$94.29 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECTIOUS AGENT ANTIGEN BY EIA QUAL OR SEMIQUANT P28631343 | $64.29 | $107.15 | $29.14–$94.29 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIBODY (MTN) P16535038 | $427.86 | $713.10 | $193.96–$627.53 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 RAPID HCV ANTIBODY POC P28629132 | $76.35 | $127.25 | $34.61–$111.98 | 2% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY P31020257 | $76.35 | $127.25 | $34.61–$111.98 | 2% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY P28620257 | $76.35 | $127.25 | $34.61–$111.98 | 2% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY P28631341 | $84.66 | $141.10 | $38.38–$124.17 | 9% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY P16531341 | $84.66 | $141.10 | $38.38–$124.17 | 9% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY P31031341 | $84.66 | $141.10 | $38.38–$124.17 | 9% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST (MTN) P16535039 | $1,338.60 | $2,231.00 | $606.83–$1,963.28 | 1623% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY P31020257 | $76.35 | $127.25 | $34.61–$111.98 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY P28620257 | $76.35 | $127.25 | $34.61–$111.98 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 RAPID HCV ANTIBODY POC P28629132 | $76.35 | $127.25 | $34.61–$111.98 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY P16531341 | $84.66 | $141.10 | $38.38–$124.17 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY P31031341 | $84.66 | $141.10 | $38.38–$124.17 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY P28631341 | $84.66 | $141.10 | $38.38–$124.17 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST (MTN) P16535039 | $1,338.60 | $2,231.00 | $606.83–$1,963.28 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT DETECTION; HEP C QUANTIFICATION P31031627 | $246.78 | $411.30 | $111.87–$361.94 | 17% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT DETECTION; HEP C QUANTIFICATION P28631627 | $246.78 | $411.30 | $111.87–$361.94 | 17% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ P31033094 | $246.78 | $411.30 | $111.87–$361.94 | 17% below | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV QUANTITATIVE BY PCR P86525195 | $240.93 | $401.55 | $109.22–$353.36 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECTIOUS AGENT DETECTION; HEP C QUANTIFICATION P28631627 | $246.78 | $411.30 | $111.87–$361.94 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECTIOUS AGENT DETECTION; HEP C QUANTIFICATION P31031627 | $246.78 | $411.30 | $111.87–$361.94 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ P31033094 | $246.78 | $411.30 | $111.87–$361.94 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY; HERPES SIMPLEX TYPE 1 P28630154 | $75.99 | $126.65 | $34.45–$111.45 | 19% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV HERPES SIMPLEX TYPE 1 IGG (HSVG) 1/2 P31032355 | $75.99 | $126.65 | $34.45–$111.45 | 19% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV HERPES SIMPLEX TYPE 1 IGG (HSVG) 1/2 P28632355 | $75.99 | $126.65 | $34.45–$111.45 | 19% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV HERPES SIMPLEX TYPE 1 IGG (HSVG) 1/2 P31032355 | $75.99 | $126.65 | $34.45–$111.45 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY; HERPES SIMPLEX TYPE 1 P28630154 | $75.99 | $126.65 | $34.45–$111.45 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV HERPES SIMPLEX TYPE 1 IGG (HSVG) 1/2 P28632355 | $75.99 | $126.65 | $34.45–$111.45 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV HERPES SIMPLEX TYPE 2 IGG (HSVG) 2/2 P28632356 | $111.48 | $185.80 | $50.54–$163.50 | 75% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV HERPES SIMPLEX TYPE 2 IGG (HSVG) 2/2 P31032356 | $111.48 | $185.80 | $50.54–$163.50 | 75% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY; HERPES SIMPLEX TYPE 2 P28630155 | $111.48 | $185.80 | $50.54–$163.50 | 75% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV HERPES SIMPLEX TYPE 2 IGG (HSVG) 2/2 P28632356 | $111.48 | $185.80 | $50.54–$163.50 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY; HERPES SIMPLEX TYPE 2 P28630155 | $111.48 | $185.80 | $50.54–$163.50 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV HERPES SIMPLEX TYPE 2 IGG (HSVG) 2/2 P31032356 | $111.48 | $185.80 | $50.54–$163.50 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY P31029104 | $58.59 | $97.65 | $26.56–$85.93 | 19% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-HIGH SENSITIVITY SERUM (HSCRP) P28632136 | $80.58 | $134.30 | $36.53–$118.18 | 12% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN-HIGH SENSITIVITY SERUM (HSCRP) P31032136 | $80.58 | $134.30 | $36.53–$118.18 | 12% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY P28634324 | $80.58 | $134.30 | $36.53–$118.18 | 12% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY P31029104 | $58.59 | $97.65 | $26.56–$85.93 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-HIGH SENSITIVITY SERUM (HSCRP) P31032136 | $80.58 | $134.30 | $36.53–$118.18 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN-HIGH SENSITIVITY SERUM (HSCRP) P28632136 | $80.58 | $134.30 | $36.53–$118.18 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY P28634324 | $80.58 | $134.30 | $36.53–$118.18 | — | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE P31020261 | $79.56 | $132.60 | $36.07–$116.69 | 35% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE P28631777 | $106.32 | $177.20 | $48.20–$155.94 | 13% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA (HCYSP) P31032123 | $106.32 | $177.20 | $48.20–$155.94 | 13% below | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE TOTAL PLASMA (HCYSP) P28632123 | $106.32 | $177.20 | $48.20–$155.94 | 13% below | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE P31020261 | $79.56 | $132.60 | $36.07–$116.69 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE P28631777 | $106.32 | $177.20 | $48.20–$155.94 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL PLASMA (HCYSP) P28632123 | $106.32 | $177.20 | $48.20–$155.94 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOTAL PLASMA (HCYSP) P31032123 | $106.32 | $177.20 | $48.20–$155.94 | — | 40% |
| Insulin blood test CPT 83525 INSULIN LEVEL P28620264 | $62.43 | $104.05 | $28.30–$91.56 | 4% above | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN LEVEL P28620264 | $62.43 | $104.05 | $28.30–$91.56 | — | 40% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL P28620271 | $31.71 | $52.85 | $14.38–$46.51 | 30% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL P31020271 | $31.71 | $52.85 | $14.38–$46.51 | 30% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON P31030777 | $37.29 | $62.15 | $16.90–$54.69 | 18% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE (FET) P28634309 | $174.87 | $291.45 | $79.27–$256.48 | 284% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON LEVEL P28620271 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON LEVEL P31020271 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON P31030777 | $37.29 | $62.15 | $16.90–$54.69 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON LIVER TISSUE (FET) P28634309 | $174.87 | $291.45 | $79.27–$256.48 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY TOTAL P31020273 | $43.65 | $72.75 | $19.79–$64.02 | 35% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY TOTAL P28620273 | $43.65 | $72.75 | $19.79–$64.02 | 35% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY P31034537 | $50.37 | $83.95 | $22.83–$73.88 | 25% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY TOTAL P28620273 | $43.65 | $72.75 | $19.79–$64.02 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY TOTAL P31020273 | $43.65 | $72.75 | $19.79–$64.02 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY P31034537 | $50.37 | $83.95 | $22.83–$73.88 | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL P31020312 | $48.21 | $80.35 | $21.86–$70.71 | 56% below | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL P28620312 | $48.21 | $80.35 | $21.86–$70.71 | 56% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL P31020312 | $48.21 | $80.35 | $21.86–$70.71 | — | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL P28620312 | $48.21 | $80.35 | $21.86–$70.71 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE P31020283 | $99.09 | $165.15 | $44.92–$145.33 | 3% below | 40% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE P28620283 | $99.09 | $165.15 | $44.92–$145.33 | 3% below | 40% |
| LH (luteinizing hormone) test CPT 83002 LH, PEDIATRICS, S (LHPED) P28637286 | $446.91 | $744.85 | $202.60–$655.47 | 338% above | 40% |
| LH (luteinizing hormone) test CPT 83002 LH, PEDIATRICS, S (LHPED) P31037286 | $446.91 | $744.85 | $202.60–$655.47 | 338% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE P31020283 | $99.09 | $165.15 | $44.92–$145.33 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE P28620283 | $99.09 | $165.15 | $44.92–$145.33 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH, PEDIATRICS, S (LHPED) P31037286 | $446.91 | $744.85 | $202.60–$655.47 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH, PEDIATRICS, S (LHPED) P28637286 | $446.91 | $744.85 | $202.60–$655.47 | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID CSF P31025161 | $52.35 | $87.25 | $23.73–$76.78 | 40% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID CSF P28625161 | $52.35 | $87.25 | $23.73–$76.78 | 40% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID FLUID P28625162 | $52.35 | $87.25 | $23.73–$76.78 | 40% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LVL P28620278 | $59.37 | $98.95 | $26.91–$87.08 | 32% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LVL P31020278 | $59.37 | $98.95 | $26.91–$87.08 | 32% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 POC I-STAT LACTATE P28625836 | $68.22 | $113.70 | $30.93–$100.06 | 22% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 POC I-STATE LACTATE P31025836 | $68.22 | $113.70 | $30.93–$100.06 | 22% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $72.00 | $120.00 | $32.64–$105.60 | 18% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) (RT)-JRT | $72.00 | $120.00 | $32.64–$105.60 | 18% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) P28630330 | $72.00 | $120.00 | $32.64–$105.60 | 18% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 D-LACTATE URINE (DLAU) P28634317 | $72.00 | $120.00 | $32.64–$105.60 | 18% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE PYRUVATE PANEL, PLASMA (LAPYP) 83605 P31037106 | $296.10 | $493.50 | $134.23–$434.28 | 238% above | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE PYRUVATE PANEL, PLASMA (LAPYP) 83605 P28637106 | $296.10 | $493.50 | $134.23–$434.28 | 238% above | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID CSF P31025161 | $52.35 | $87.25 | $23.73–$76.78 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID CSF P28625161 | $52.35 | $87.25 | $23.73–$76.78 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID FLUID P28625162 | $52.35 | $87.25 | $23.73–$76.78 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID LVL P28620278 | $59.37 | $98.95 | $26.91–$87.08 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID LVL P31020278 | $59.37 | $98.95 | $26.91–$87.08 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 POC I-STATE LACTATE P31025836 | $68.22 | $113.70 | $30.93–$100.06 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 POC I-STAT LACTATE P28625836 | $68.22 | $113.70 | $30.93–$100.06 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE URINE (DLAU) P28634317 | $72.00 | $120.00 | $32.64–$105.60 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) | $72.00 | $120.00 | $32.64–$105.60 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) (RT)-JRT | $72.00 | $120.00 | $32.64–$105.60 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) P28630330 | $72.00 | $120.00 | $32.64–$105.60 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE PYRUVATE PANEL, PLASMA (LAPYP) 83605 P31037106 | $296.10 | $493.50 | $134.23–$434.28 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE PYRUVATE PANEL, PLASMA (LAPYP) 83605 P28637106 | $296.10 | $493.50 | $134.23–$434.28 | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE FLUID P31025215 | $27.33 | $45.55 | $12.39–$40.08 | 47% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE FLUID P28625215 | $27.33 | $45.55 | $12.39–$40.08 | 47% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE P28620276 | $35.64 | $59.40 | $16.16–$52.27 | 31% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE P31020276 | $35.64 | $59.40 | $16.16–$52.27 | 31% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD I) 1/2 P28632446 | $37.59 | $62.65 | $17.04–$55.13 | 27% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD I) 1/2 P31032446 | $37.59 | $62.65 | $17.04–$55.13 | 27% below | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE FLUID P31025215 | $27.33 | $45.55 | $12.39–$40.08 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE FLUID P28625215 | $27.33 | $45.55 | $12.39–$40.08 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE P31020276 | $35.64 | $59.40 | $16.16–$52.27 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE P28620276 | $35.64 | $59.40 | $16.16–$52.27 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD I) 1/2 P31032446 | $37.59 | $62.65 | $17.04–$55.13 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD I) 1/2 P28632446 | $37.59 | $62.65 | $17.04–$55.13 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE FLUID P28620280 | $33.42 | $55.70 | $15.15–$49.02 | 55% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL P31021106 | $34.41 | $57.35 | $15.60–$50.47 | 54% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL P28621106 | $34.41 | $57.35 | $15.60–$50.47 | 54% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE P31037101 | $43.65 | $72.75 | $19.79–$64.02 | 42% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE P28637101 | $43.65 | $72.75 | $19.79–$64.02 | 42% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE FLUID P28620280 | $33.42 | $55.70 | $15.15–$49.02 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL P28621106 | $34.41 | $57.35 | $15.60–$50.47 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL P31021106 | $34.41 | $57.35 | $15.60–$50.47 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE P31037101 | $43.65 | $72.75 | $19.79–$64.02 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE P28637101 | $43.65 | $72.75 | $19.79–$64.02 | — | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL P31020249 | $36.96 | $61.60 | $16.76–$54.21 | 67% below | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL P28620249 | $36.96 | $61.60 | $16.76–$54.21 | 67% below | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL P31020249 | $36.96 | $61.60 | $16.76–$54.21 | — | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL P28620249 | $36.96 | $61.60 | $16.76–$54.21 | — | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB SCREEN CSF (LNBAB) P31032055 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test CPT 86618 LYME IGG AB INDEX; LYME DISEASE (LNBAI) 3/4 P31032974 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI P28630197 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB SCREEN CSF (LNBAB) P28632055 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test CPT 86618 LYME IGG AB INDEX; LYME DISEASE (LNBAI) 3/4 P28632974 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI P31030197 | $98.10 | $163.50 | $44.47–$143.88 | 7% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI (LYME DISEASE) IGM P86525802 | $93.00 | $155.00 | $42.16–$136.40 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI (LYME DISEASE) IGG P86525801 | $93.00 | $155.00 | $42.16–$136.40 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB SCREEN CSF (LNBAB) P31032055 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG AB INDEX; LYME DISEASE (LNBAI) 3/4 P28632974 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI P28630197 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB SCREEN CSF (LNBAB) P28632055 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG AB INDEX; LYME DISEASE (LNBAI) 3/4 P31032974 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI P31030197 | $98.10 | $163.50 | $44.47–$143.88 | — | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL P28625164 | $33.45 | $55.75 | $15.16–$49.06 | 30% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM IONIZED P28620270 | $33.45 | $55.75 | $15.16–$49.06 | 30% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL P31025164 | $33.45 | $55.75 | $15.16–$49.06 | 30% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM P31030379 | $41.70 | $69.50 | $18.90–$61.16 | 12% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM P28630379 | $41.70 | $69.50 | $18.90–$61.16 | 12% below | 40% |
| Magnesium blood test CPT 83735 URINE TOTAL VOLUME MAGNESIUM P28620287 | $41.97 | $69.95 | $19.03–$61.56 | 12% below | 40% |
| Magnesium blood test CPT 83735 ELECTROLYTE OSMOLALITY PANEL MAGNESIUM (EFPO) 3/6 P28632672 | $44.82 | $74.70 | $20.32–$65.74 | 6% below | 40% |
| Magnesium blood test CPT 83735 ELECTROLYTE OSMOLALITY PANEL MAGNESIUM (EFPO) 3/6 P31032672 | $44.82 | $74.70 | $20.32–$65.74 | 6% below | 40% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM (MAYO) P31036027 | $44.82 | $74.70 | $20.32–$65.74 | 6% below | 40% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM (MAYO) P28636027 | $44.82 | $74.70 | $20.32–$65.74 | 6% below | 40% |
| Magnesium blood test CPT 83735 CATHARTIC LAXATIVES PROFILE, STOOL (FCLPF) 83735 P28637001 | $217.95 | $363.25 | $98.80–$319.66 | 358% above | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL P28625164 | $33.45 | $55.75 | $15.16–$49.06 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM IONIZED P28620270 | $33.45 | $55.75 | $15.16–$49.06 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL P31025164 | $33.45 | $55.75 | $15.16–$49.06 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM P28630379 | $41.70 | $69.50 | $18.90–$61.16 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM P31030379 | $41.70 | $69.50 | $18.90–$61.16 | — | 40% |
| Magnesium blood test inpatient CPT 83735 URINE TOTAL VOLUME MAGNESIUM P28620287 | $41.97 | $69.95 | $19.03–$61.56 | — | 40% |
| Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM (MAYO) P31036027 | $44.82 | $74.70 | $20.32–$65.74 | — | 40% |
| Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM (MAYO) P28636027 | $44.82 | $74.70 | $20.32–$65.74 | — | 40% |
| Magnesium blood test inpatient CPT 83735 ELECTROLYTE OSMOLALITY PANEL MAGNESIUM (EFPO) 3/6 P28632672 | $44.82 | $74.70 | $20.32–$65.74 | — | 40% |
| Magnesium blood test inpatient CPT 83735 ELECTROLYTE OSMOLALITY PANEL MAGNESIUM (EFPO) 3/6 P31032672 | $44.82 | $74.70 | $20.32–$65.74 | — | 40% |
| Magnesium blood test inpatient CPT 83735 CATHARTIC LAXATIVES PROFILE, STOOL (FCLPF) 83735 P28637001 | $217.95 | $363.25 | $98.80–$319.66 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) ANTIBODY, IGG, SERUM (ROPG) P31032167 | $74.19 | $123.65 | $33.63–$108.81 | 45% above | 40% |
| Measles (rubeola) antibody test CPT 86765 ANTIBOEDY; RUBEOLA P28630176 | $74.19 | $123.65 | $33.63–$108.81 | 45% above | 40% |
| Measles (rubeola) antibody test CPT 86765 ANTIBOEDY; RUBEOLA P31030176 | $74.19 | $123.65 | $33.63–$108.81 | 45% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) IGG ANTIBODY P86525799 | $70.35 | $117.25 | $31.89–$103.18 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) ANTIBODY, IGG, SERUM (ROPG) P31032167 | $74.19 | $123.65 | $33.63–$108.81 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTIBOEDY; RUBEOLA P31030176 | $74.19 | $123.65 | $33.63–$108.81 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 ANTIBOEDY; RUBEOLA P28630176 | $74.19 | $123.65 | $33.63–$108.81 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN P28620808 | $25.14 | $41.90 | $11.40–$36.87 | 39% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN P31020808 | $25.14 | $41.90 | $11.40–$36.87 | 39% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS; SCREENING (POC) P31025815 | $31.11 | $51.85 | $14.10–$45.63 | 25% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS; SCREENING (POC) P28625815 | $31.11 | $51.85 | $14.10–$45.63 | 25% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN P28634269 | $32.85 | $54.75 | $14.89–$48.18 | 21% below | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS SCREEN P31020808 | $25.14 | $41.90 | $11.40–$36.87 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS SCREEN P28620808 | $25.14 | $41.90 | $11.40–$36.87 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS; SCREENING (POC) P28625815 | $31.11 | $51.85 | $14.10–$45.63 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS; SCREENING (POC) P31025815 | $31.11 | $51.85 | $14.10–$45.63 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN P28634269 | $32.85 | $54.75 | $14.89–$48.18 | — | 40% |
| Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS P31030181 | $75.18 | $125.30 | $34.08–$110.26 | 27% above | 40% |
| Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS P28630181 | $75.18 | $125.30 | $34.08–$110.26 | 27% above | 40% |
| Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGM SERUM (MMPM) P31032448 | $75.18 | $125.30 | $34.08–$110.26 | 27% above | 40% |
| Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGM SERUM (MMPM) P28632448 | $75.18 | $125.30 | $34.08–$110.26 | 27% above | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGG ANTIBODY P86525800 | $71.28 | $118.80 | $32.31–$104.54 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGM SERUM (MMPM) P28632448 | $75.18 | $125.30 | $34.08–$110.26 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGM SERUM (MMPM) P31032448 | $75.18 | $125.30 | $34.08–$110.26 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS P28630181 | $75.18 | $125.30 | $34.08–$110.26 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS P31030181 | $75.18 | $125.30 | $34.08–$110.26 | — | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL P31029089 | $196.50 | $327.50 | $89.08–$288.20 | 33% below | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL P28629089 | $196.50 | $327.50 | $89.08–$288.20 | 33% below | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL P31029089 | $196.50 | $327.50 | $89.08–$288.20 | — | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL P28629089 | $196.50 | $327.50 | $89.08–$288.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA; FREE P31032141 | $105.93 | $176.55 | $48.02–$155.36 | 32% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA; FREE P28632141 | $105.93 | $176.55 | $48.02–$155.36 | 32% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA; FREE P31032141 | $105.93 | $176.55 | $48.02–$155.36 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA; FREE P28632141 | $105.93 | $176.55 | $48.02–$155.36 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P31020308 | $86.04 | $143.40 | $39.00–$126.19 | 10% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P28620308 | $86.04 | $143.40 | $39.00–$126.19 | 10% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA; TOTAL P31032140 | $105.93 | $176.55 | $48.02–$155.36 | 35% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA; TOTAL P28632140 | $105.93 | $176.55 | $48.02–$155.36 | 35% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P28620308 | $86.04 | $143.40 | $39.00–$126.19 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P31020308 | $86.04 | $143.40 | $39.00–$126.19 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA; TOTAL P28632140 | $105.93 | $176.55 | $48.02–$155.36 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA; TOTAL P31032140 | $105.93 | $176.55 | $48.02–$155.36 | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST LIQUID BASE P30350407 | $110.64 | $184.40 | $50.16–$162.27 | 51% above | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP TEST LIQUID BASE P30350407 | $110.64 | $184.40 | $50.16–$162.27 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTRA OPERATIVE PTH P28620268 | $225.39 | $375.65 | $102.18–$330.57 | 28% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH P31020267 | $225.39 | $375.65 | $102.18–$330.57 | 28% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTRA OPERATIVE PTH P31020268 | $225.39 | $375.65 | $102.18–$330.57 | 28% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH P28620267 | $225.39 | $375.65 | $102.18–$330.57 | 28% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) P28631275 | $237.78 | $396.30 | $107.79–$348.74 | 35% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH P28620267 | $225.39 | $375.65 | $102.18–$330.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH P31020267 | $225.39 | $375.65 | $102.18–$330.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTRA OPERATIVE PTH P31020268 | $225.39 | $375.65 | $102.18–$330.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTRA OPERATIVE PTH P28620268 | $225.39 | $375.65 | $102.18–$330.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PARATHYROID HORMONE) P28631275 | $237.78 | $396.30 | $107.79–$348.74 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME P31020747 | $30.00 | $50.00 | $13.60–$44.00 | 44% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT LUPUS PANEL P28629020 | $30.00 | $50.00 | $13.60–$44.00 | 44% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME P28620747 | $30.00 | $50.00 | $13.60–$44.00 | 44% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS APTT P31032225 | $38.07 | $63.45 | $17.26–$55.84 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS APTT P28632225 | $38.07 | $63.45 | $17.26–$55.84 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL; PLASMA /WHOLE BLOOD P28631744 | $38.07 | $63.45 | $17.26–$55.84 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT LUPUS PANEL P28629020 | $30.00 | $50.00 | $13.60–$44.00 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME P31020747 | $30.00 | $50.00 | $13.60–$44.00 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME P28620747 | $30.00 | $50.00 | $13.60–$44.00 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS APTT P31032225 | $38.07 | $63.45 | $17.26–$55.84 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS APTT P28632225 | $38.07 | $63.45 | $17.26–$55.84 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL; PLASMA /WHOLE BLOOD P28631744 | $38.07 | $63.45 | $17.26–$55.84 | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL P31020300 | $23.76 | $39.60 | $10.77–$34.85 | 37% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL P28620300 | $23.76 | $39.60 | $10.77–$34.85 | 37% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC; PHOSPHATE P31030380 | $29.52 | $49.20 | $13.38–$43.30 | 21% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC; PHOSPHATE P28630380 | $29.52 | $49.20 | $13.38–$43.30 | 21% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 ELECTROLYTE OSMOLALITY PANEL PHOSPORUS (EFPO) 5/6 P28632674 | $31.71 | $52.85 | $14.38–$46.51 | 15% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 ELECTROLYTE OSMOLALITY PANEL PHOSPORUS (EFPO) 5/6 P31032674 | $31.71 | $52.85 | $14.38–$46.51 | 15% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 CATHARTIC LAXATIVES PROFILE, STOOL (FCLPF) 84100 P28637002 | $217.95 | $363.25 | $98.80–$319.66 | 482% above | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS LEVEL P28620300 | $23.76 | $39.60 | $10.77–$34.85 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS LEVEL P31020300 | $23.76 | $39.60 | $10.77–$34.85 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC; PHOSPHATE P28630380 | $29.52 | $49.20 | $13.38–$43.30 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC; PHOSPHATE P31030380 | $29.52 | $49.20 | $13.38–$43.30 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 ELECTROLYTE OSMOLALITY PANEL PHOSPORUS (EFPO) 5/6 P28632674 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 ELECTROLYTE OSMOLALITY PANEL PHOSPORUS (EFPO) 5/6 P31032674 | $31.71 | $52.85 | $14.38–$46.51 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 CATHARTIC LAXATIVES PROFILE, STOOL (FCLPF) 84100 P28637002 | $217.95 | $363.25 | $98.80–$319.66 | — | 40% |
| Potassium blood test CPT 84132 POTASSIUM LEVEL P31020302 | $25.53 | $42.55 | $11.57–$37.44 | 35% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM SERUM RC (RT)-JRT | $25.53 | $42.55 | $11.57–$37.44 | 35% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM SERUM RC | $25.53 | $42.55 | $11.57–$37.44 | 35% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM LEVEL P28620302 | $25.53 | $42.55 | $11.57–$37.44 | 35% below | 40% |
| Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM P28634211 | $29.61 | $49.35 | $13.42–$43.43 | 25% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM I-STAT POC P28625404 | $32.04 | $53.40 | $14.52–$46.99 | 19% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM I-STAT POC P31025404 | $32.04 | $53.40 | $14.52–$46.99 | 19% below | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM LEVEL P31020302 | $25.53 | $42.55 | $11.57–$37.44 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM RC | $25.53 | $42.55 | $11.57–$37.44 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM LEVEL P28620302 | $25.53 | $42.55 | $11.57–$37.44 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM RC (RT)-JRT | $25.53 | $42.55 | $11.57–$37.44 | — | 40% |
| Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM P28634211 | $29.61 | $49.35 | $13.42–$43.43 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM I-STAT POC P31025404 | $32.04 | $53.40 | $14.52–$46.99 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM I-STAT POC P28625404 | $32.04 | $53.40 | $14.52–$46.99 | — | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE LVEL P28625474 | $113.91 | $189.85 | $51.64–$167.07 | 4% above | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE LVEL P31025474 | $113.91 | $189.85 | $51.64–$167.07 | 4% above | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE P28630544 | $120.18 | $200.30 | $54.48–$176.26 | 10% above | 40% |
| Progesterone blood test CPT 84144 CAH PROFILE PROGESTERONE P28632875 | $120.18 | $200.30 | $54.48–$176.26 | 10% above | 40% |
| Progesterone blood test CPT 84144 CAH PROFILE PROGESTERONE P31032875 | $120.18 | $200.30 | $54.48–$176.26 | 10% above | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE LVEL P31025474 | $113.91 | $189.85 | $51.64–$167.07 | — | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE LVEL P28625474 | $113.91 | $189.85 | $51.64–$167.07 | — | 40% |
| Progesterone blood test inpatient CPT 84144 CAH PROFILE PROGESTERONE P31032875 | $120.18 | $200.30 | $54.48–$176.26 | — | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE P28630544 | $120.18 | $200.30 | $54.48–$176.26 | — | 40% |
| Progesterone blood test inpatient CPT 84144 CAH PROFILE PROGESTERONE P28632875 | $120.18 | $200.30 | $54.48–$176.26 | — | 40% |
| Prolactin blood test CPT 84146 PROLACTIN LEVEL P28620307 | $84.45 | $140.75 | $38.28–$123.86 | 28% below | 40% |
| Prolactin blood test CPT 84146 PROLACTIN LEVEL P31020307 | $84.45 | $140.75 | $38.28–$123.86 | 28% below | 40% |
| Prolactin blood test CPT 84146 PROLACTIN P28630009 | $111.63 | $186.05 | $50.61–$163.72 | 4% below | 40% |
| Prolactin blood test CPT 84146 PROLACTIN P31030009 | $111.63 | $186.05 | $50.61–$163.72 | 4% below | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN LEVEL P28620307 | $84.45 | $140.75 | $38.28–$123.86 | — | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN LEVEL P31020307 | $84.45 | $140.75 | $38.28–$123.86 | — | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN P31030009 | $111.63 | $186.05 | $50.61–$163.72 | — | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN P28630009 | $111.63 | $186.05 | $50.61–$163.72 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P31020746 | $21.84 | $36.40 | $9.90–$32.03 | 23% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME LUPUS PANEL P28629019 | $21.84 | $36.40 | $9.90–$32.03 | 23% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P28620746 | $21.84 | $36.40 | $9.90–$32.03 | 23% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS PT P28632223 | $26.70 | $44.50 | $12.10–$39.16 | 6% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS PT P31032223 | $26.70 | $44.50 | $12.10–$39.16 | 6% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P28630255 | $26.70 | $44.50 | $12.10–$39.16 | 6% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC PT INR CAPILLARY OR VENOUS P31025414 | $27.36 | $45.60 | $12.40–$40.13 | 4% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC PT INR CAPILLARY OR VENOUS P28625414 | $27.36 | $45.60 | $12.40–$40.13 | 4% below | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P31020746 | $21.84 | $36.40 | $9.90–$32.03 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME LUPUS PANEL P28629019 | $21.84 | $36.40 | $9.90–$32.03 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P28620746 | $21.84 | $36.40 | $9.90–$32.03 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P28630255 | $26.70 | $44.50 | $12.10–$39.16 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS PT P31032223 | $26.70 | $44.50 | $12.10–$39.16 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS PT P28632223 | $26.70 | $44.50 | $12.10–$39.16 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT INR CAPILLARY OR VENOUS P31025414 | $27.36 | $45.60 | $12.40–$40.13 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT INR CAPILLARY OR VENOUS P28625414 | $27.36 | $45.60 | $12.40–$40.13 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE COTININE (POC) P28625844 | $68.82 | $114.70 | $31.20–$100.94 | 1% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN (CUP) P28625841 | $68.82 | $114.70 | $31.20–$100.94 | 1% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN (CUP) P31025841 | $68.82 | $114.70 | $31.20–$100.94 | 1% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN POC P28625854 | $68.82 | $114.70 | $31.20–$100.94 | 1% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN (CUP) P31025841 | $68.82 | $114.70 | $31.20–$100.94 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN POC P28625854 | $68.82 | $114.70 | $31.20–$100.94 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE COTININE (POC) P28625844 | $68.82 | $114.70 | $31.20–$100.94 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN (CUP) P28625841 | $68.82 | $114.70 | $31.20–$100.94 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B P31025660 | $74.85 | $124.75 | $33.93–$109.78 | 26% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A P31025659 | $74.85 | $124.75 | $33.93–$109.78 | 26% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA P31025756 | $99.42 | $165.70 | $45.07–$145.82 | 68% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A P31025659 | $74.85 | $124.75 | $33.93–$109.78 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B P31025660 | $74.85 | $124.75 | $33.93–$109.78 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA P31025756 | $99.42 | $165.70 | $45.07–$145.82 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA P28625955 | $72.90 | $121.50 | $33.05–$106.92 | 62% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 POCT GROUP A RAPID STREP P28625043 | $72.90 | $121.50 | $33.05–$106.92 | 62% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA POC P31025956 | $72.90 | $121.50 | $33.05–$106.92 | 62% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA POC P28625956 | $72.90 | $121.50 | $33.05–$106.92 | 62% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA POC P31025956 | $72.90 | $121.50 | $33.05–$106.92 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA P28625955 | $72.90 | $121.50 | $33.05–$106.92 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS GROUP A RAPID SOFIA FIA POC P28625956 | $72.90 | $121.50 | $33.05–$106.92 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 POCT GROUP A RAPID STREP P28625043 | $72.90 | $121.50 | $33.05–$106.92 | — | 40% |
| Renin blood test CPT 84244 RENIN ACTIVITY PLASMA (PRA) P28632150 | $126.69 | $211.15 | $57.43–$185.81 | at median | 40% |
| Renin blood test CPT 84244 RENIN ACTIVITY PLASMA (PRA) P31032150 | $126.69 | $211.15 | $57.43–$185.81 | at median | 40% |
| Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA (PRA) P31032150 | $126.69 | $211.15 | $57.43–$185.81 | — | 40% |
| Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA (PRA) P28632150 | $126.69 | $211.15 | $57.43–$185.81 | — | 40% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) P16530203 | $35.31 | $58.85 | $37.32–$38.77 | 21% below | 40% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) P28821214 | $35.31 | $58.85 | $37.32–$38.77 | 21% below | 40% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) P29621214 | $35.31 | $58.85 | $37.32–$38.77 | 21% below | 40% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) P28621214 | $35.31 | $58.85 | $20.60–$51.79 | 21% below | 40% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) (OB) P28829004 | $35.31 | $58.85 | $20.60–$51.79 | 21% below | 40% |
| Rh blood typing CPT 86901 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86901 P31037169 | $140.76 | $234.60 | $37.32–$38.77 | 214% above | 40% |
| Rh blood typing CPT 86901 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86901 P28637169 | $140.76 | $234.60 | $82.11–$206.45 | 214% above | 40% |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D) P16530203 | $35.31 | $58.85 | $20.60–$51.79 | — | 40% |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D) P28621214 | $35.31 | $58.85 | $20.60–$51.79 | — | 40% |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D) P28821214 | $35.31 | $58.85 | $20.60–$51.79 | — | 40% |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D) (OB) P28829004 | $35.31 | $58.85 | $20.60–$51.79 | — | 40% |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING; RH (D) P29621214 | $35.31 | $58.85 | $20.60–$51.79 | — | 40% |
| Rh blood typing inpatient CPT 86901 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86901 P28637169 | $140.76 | $234.60 | $82.11–$206.45 | — | 40% |
| Rh blood typing inpatient CPT 86901 IMMUNOHEMATOLOGY SEROLOGY DAT NEGATIVE(ZW121)86901 P31037169 | $140.76 | $234.60 | $82.11–$206.45 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE P31020813 | $33.45 | $55.75 | $15.16–$49.06 | 32% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE P28620813 | $33.45 | $55.75 | $15.16–$49.06 | 32% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE P28630318 | $35.28 | $58.80 | $15.99–$51.74 | 28% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE P31030318 | $35.28 | $58.80 | $15.99–$51.74 | 28% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE (RFPN) P31037159 | $68.85 | $114.75 | $31.21–$100.98 | 41% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE (RFPN) P28637159 | $68.85 | $114.75 | $31.21–$100.98 | 41% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE P31020813 | $33.45 | $55.75 | $15.16–$49.06 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE P28620813 | $33.45 | $55.75 | $15.16–$49.06 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE P31030318 | $35.28 | $58.80 | $15.99–$51.74 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE P28630318 | $35.28 | $58.80 | $15.99–$51.74 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE (RFPN) P31037159 | $68.85 | $114.75 | $31.21–$100.98 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE (RFPN) P28637159 | $68.85 | $114.75 | $31.21–$100.98 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY P31025378 | $63.48 | $105.80 | $28.78–$93.10 | 24% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG P28625378 | $63.48 | $105.80 | $28.78–$93.10 | 24% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGM P28620651 | $78.57 | $130.95 | $35.62–$115.24 | 53% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA P31031667 | $82.89 | $138.15 | $37.58–$121.57 | 61% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY P31033110 | $82.89 | $138.15 | $37.58–$121.57 | 61% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA P28631667 | $82.89 | $138.15 | $37.58–$121.57 | 61% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY P31025378 | $63.48 | $105.80 | $28.78–$93.10 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG P28625378 | $63.48 | $105.80 | $28.78–$93.10 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGM P28620651 | $78.57 | $130.95 | $35.62–$115.24 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA P31031667 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY P31033110 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA P28631667 | $82.89 | $138.15 | $37.58–$121.57 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ERYTHROCYTE SEDIMENTATION RATE P28625436 | $12.21 | $20.35 | $5.54–$17.91 | 65% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ERYTHROCYTE SEDIMENTATION RATE P31025436 | $12.21 | $20.35 | $5.54–$17.91 | 65% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ERYTHROCYTE SEDIMENTATION RATE P31025436 | $12.21 | $20.35 | $5.54–$17.91 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ERYTHROCYTE SEDIMENTATION RATE P28625436 | $12.21 | $20.35 | $5.54–$17.91 | — | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS P31029109 | $55.68 | $92.80 | $25.24–$81.66 | 62% below | 40% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS P31029109 | $55.68 | $92.80 | $25.24–$81.66 | — | 40% |
| Sodium blood test CPT 84295 SODIUM SERUM RC | $26.73 | $44.55 | $12.12–$39.20 | 32% below | 40% |
| Sodium blood test CPT 84295 SODIUM SERUM RC (RT)-JRT | $26.73 | $44.55 | $12.12–$39.20 | 32% below | 40% |
| Sodium blood test CPT 84295 SODIUM LEVEL P28620316 | $26.73 | $44.55 | $12.12–$39.20 | 32% below | 40% |
| Sodium blood test CPT 84295 SODIUM LEVEL P31020316 | $26.73 | $44.55 | $12.12–$39.20 | 32% below | 40% |
| Sodium blood test CPT 84295 SODIUM I-STAT POC P28625403 | $33.51 | $55.85 | $15.19–$49.15 | 15% below | 40% |
| Sodium blood test CPT 84295 SODIUM I-STAT POC P31025403 | $33.51 | $55.85 | $15.19–$49.15 | 15% below | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM LEVEL P28620316 | $26.73 | $44.55 | $12.12–$39.20 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM RC | $26.73 | $44.55 | $12.12–$39.20 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM LEVEL P31020316 | $26.73 | $44.55 | $12.12–$39.20 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM RC (RT)-JRT | $26.73 | $44.55 | $12.12–$39.20 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM I-STAT POC P28625403 | $33.51 | $55.85 | $15.19–$49.15 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM I-STAT POC P31025403 | $33.51 | $55.85 | $15.19–$49.15 | — | 40% |
| Stool ova and parasites exam CPT 87177 PARASITIC EXAMINATION OVA & PARASITES (OAP) 2/2 P28632641 | $51.27 | $85.45 | $23.24–$75.20 | 13% below | 40% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS P31033106 | $51.27 | $85.45 | $23.24–$75.20 | 13% below | 40% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES DIRECT SMEARS P28630534 | $51.27 | $85.45 | $23.24–$75.20 | 13% below | 40% |
| Stool ova and parasites exam CPT 87177 PARASITIC EXAMINATION OVA & PARASITES (OAP) 2/2 P31032641 | $51.27 | $85.45 | $23.24–$75.20 | 13% below | 40% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES DIRECT SMEARS P28630534 | $51.27 | $85.45 | $23.24–$75.20 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS P31033106 | $51.27 | $85.45 | $23.24–$75.20 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 PARASITIC EXAMINATION OVA & PARASITES (OAP) 2/2 P31032641 | $51.27 | $85.45 | $23.24–$75.20 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 PARASITIC EXAMINATION OVA & PARASITES (OAP) 2/2 P28632641 | $51.27 | $85.45 | $23.24–$75.20 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FECAL BY IMMUNOASSAY (DIAGNOSTIC) P31025380 | $92.22 | $153.70 | $41.81–$135.26 | 81% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FECAL BY IMMUNOASSAY (DIAGNOSTIC) P28625380 | $92.22 | $153.70 | $41.81–$135.26 | 81% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD OCCULT FECAL BY IMMUNOASSAY (DIAGNOSTIC) P31025380 | $92.22 | $153.70 | $41.81–$135.26 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD OCCULT FECAL BY IMMUNOASSAY (DIAGNOSTIC) P28625380 | $92.22 | $153.70 | $41.81–$135.26 | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY P28625994 | $58.41 | $97.35 | $26.48–$85.67 | 15% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY BY TP-PA SERUM P31032869 | $76.29 | $127.15 | $34.58–$111.89 | 50% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM P28631035 | $76.29 | $127.15 | $34.58–$111.89 | 50% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM P31031035 | $76.29 | $127.15 | $34.58–$111.89 | 50% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY BY TP-PA SERUM P28632869 | $76.29 | $127.15 | $34.58–$111.89 | 50% above | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY P28625994 | $58.41 | $97.35 | $26.48–$85.67 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY BY TP-PA SERUM P31032869 | $76.29 | $127.15 | $34.58–$111.89 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY BY TP-PA SERUM P28632869 | $76.29 | $127.15 | $34.58–$111.89 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM P28631035 | $76.29 | $127.15 | $34.58–$111.89 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM P31031035 | $76.29 | $127.15 | $34.58–$111.89 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUALITATIVE P31020313 | $20.73 | $34.55 | $9.40–$30.40 | 26% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL AB; QUALITATIVE P28630230 | $26.58 | $44.30 | $12.05–$38.98 | 5% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SPINAL FLUID (VDSF) P28632367 | $26.58 | $44.30 | $12.05–$38.98 | 5% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL AB; QUALITATIVE P16530230 | $26.58 | $44.30 | $12.05–$38.98 | 5% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SPINAL FLUID (VDSF) P31032367 | $26.58 | $44.30 | $12.05–$38.98 | 5% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL (MTN) P16535042 | $38.13 | $63.55 | $17.29–$55.92 | 36% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SCREEN W/ REFLEX TO TITER,S (RPRT1) P31037161 | $97.23 | $162.05 | $44.08–$142.60 | 247% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SCREEN W/ REFLEX TO TITER,S (RPRT1) P28637161 | $97.23 | $162.05 | $44.08–$142.60 | 247% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAITATIVE P86520313 | $20.73 | $34.55 | $9.40–$30.40 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUALITATIVE P31020313 | $20.73 | $34.55 | $9.40–$30.40 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SPINAL FLUID (VDSF) P31032367 | $26.58 | $44.30 | $12.05–$38.98 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SPINAL FLUID (VDSF) P28632367 | $26.58 | $44.30 | $12.05–$38.98 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL AB; QUALITATIVE P16530230 | $26.58 | $44.30 | $12.05–$38.98 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL AB; QUALITATIVE P28630230 | $26.58 | $44.30 | $12.05–$38.98 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL (MTN) P16535042 | $38.13 | $63.55 | $17.29–$55.92 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SCREEN W/ REFLEX TO TITER,S (RPRT1) P28637161 | $97.23 | $162.05 | $44.08–$142.60 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SCREEN W/ REFLEX TO TITER,S (RPRT1) P31037161 | $97.23 | $162.05 | $44.08–$142.60 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE P31033113 | $357.03 | $595.05 | $161.85–$523.64 | 100% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 MYCOBACTERIUM TUBERCULOSIS BY ELISA P86520286 | $338.43 | $564.05 | $153.42–$496.36 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE P31033113 | $357.03 | $595.05 | $161.85–$523.64 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL P28620324 | $124.32 | $207.20 | $56.36–$182.34 | 4% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL P31020324 | $124.32 | $207.20 | $56.36–$182.34 | 4% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL P28632002 | $148.68 | $247.80 | $67.40–$218.06 | 25% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL P31032002 | $148.68 | $247.80 | $67.40–$218.06 | 25% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE P31033070 | $148.68 | $247.80 | $67.40–$218.06 | 25% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH PROFILE TESTOSTERONE SERUM TOTAL P31032878 | $159.87 | $266.45 | $72.47–$234.48 | 34% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL P31030095 | $159.87 | $266.45 | $72.47–$234.48 | 34% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH PROFILE TESTOSTERONE SERUM TOTAL P28632878 | $159.87 | $266.45 | $72.47–$234.48 | 34% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL P28630095 | $159.87 | $266.45 | $72.47–$234.48 | 34% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL P28620324 | $124.32 | $207.20 | $56.36–$182.34 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL P31020324 | $124.32 | $207.20 | $56.36–$182.34 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL P28632002 | $148.68 | $247.80 | $67.40–$218.06 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL P31032002 | $148.68 | $247.80 | $67.40–$218.06 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE P31033070 | $148.68 | $247.80 | $67.40–$218.06 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH PROFILE TESTOSTERONE SERUM TOTAL P31032878 | $159.87 | $266.45 | $72.47–$234.48 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL P31030095 | $159.87 | $266.45 | $72.47–$234.48 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL P28630095 | $159.87 | $266.45 | $72.47–$234.48 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH PROFILE TESTOSTERONE SERUM TOTAL P28632878 | $159.87 | $266.45 | $72.47–$234.48 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY P28625831 | $79.47 | $132.45 | $36.03–$116.56 | 2% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY P31025831 | $79.47 | $132.45 | $36.03–$116.56 | 2% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH P31032989 | $83.82 | $139.70 | $38.00–$122.94 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH P28630078 | $83.82 | $139.70 | $38.00–$122.94 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH P28632989 | $83.82 | $139.70 | $38.00–$122.94 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH P31033102 | $83.82 | $139.70 | $38.00–$122.94 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM1 P86525966 | $79.47 | $132.45 | $36.03–$116.56 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY P28625831 | $79.47 | $132.45 | $36.03–$116.56 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY P31025831 | $79.47 | $132.45 | $36.03–$116.56 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH P31033102 | $83.82 | $139.70 | $38.00–$122.94 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH P28630078 | $83.82 | $139.70 | $38.00–$122.94 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH P28632989 | $83.82 | $139.70 | $38.00–$122.94 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH P31032989 | $83.82 | $139.70 | $38.00–$122.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION P28620677 | $86.55 | $144.25 | $39.24–$126.94 | 113% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION P31020677 | $86.55 | $144.25 | $39.24–$126.94 | 113% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE P28630077 | $96.78 | $161.30 | $43.87–$141.94 | 138% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE P31032987 | $96.78 | $161.30 | $43.87–$141.94 | 138% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE P31030077 | $96.78 | $161.30 | $43.87–$141.94 | 138% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE P28632987 | $96.78 | $161.30 | $43.87–$141.94 | 138% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION P28620677 | $86.55 | $144.25 | $39.24–$126.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION P31020677 | $86.55 | $144.25 | $39.24–$126.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE P28630077 | $96.78 | $161.30 | $43.87–$141.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE P28632987 | $96.78 | $161.30 | $43.87–$141.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE P31030077 | $96.78 | $161.30 | $43.87–$141.94 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE P31032987 | $96.78 | $161.30 | $43.87–$141.94 | — | 40% |
| Total IgE blood test CPT 82785 GAMMAGLOBULIN;IGE P28630873 | $94.83 | $158.05 | $42.99–$139.08 | 31% above | 40% |
| Total IgE blood test inpatient CPT 82785 IGE TOTAL P86520328 | $89.88 | $149.80 | $40.75–$131.82 | — | 40% |
| Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN; IGE TOTAL (WITH ALLERGEN TESTING) P86525810 | $89.88 | $149.80 | $40.75–$131.82 | — | 40% |
| Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN;IGE P28630873 | $94.83 | $158.05 | $42.99–$139.08 | — | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL P28620214 | $19.68 | $32.80 | $8.92–$28.86 | 41% below | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL P31020214 | $19.68 | $32.80 | $8.92–$28.86 | 41% below | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL FLUID P28625214 | $19.68 | $32.80 | $8.92–$28.86 | 41% below | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL FLUID P28625214 | $19.68 | $32.80 | $8.92–$28.86 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL P28620214 | $19.68 | $32.80 | $8.92–$28.86 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL P31020214 | $19.68 | $32.80 | $8.92–$28.86 | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE P28620042 | $31.08 | $51.80 | $14.09–$45.58 | 48% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE P31020042 | $31.08 | $51.80 | $14.09–$45.58 | 48% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL P31037065 | $42.78 | $71.30 | $19.39–$62.74 | 28% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL P28637065 | $42.78 | $71.30 | $19.39–$62.74 | 28% below | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE P31020042 | $31.08 | $51.80 | $14.09–$45.58 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE P28620042 | $31.08 | $51.80 | $14.09–$45.58 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE; TOTAL P28637065 | $42.78 | $71.30 | $19.39–$62.74 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE; TOTAL P31037065 | $42.78 | $71.30 | $19.39–$62.74 | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE P31020321 | $82.08 | $136.80 | $37.21–$120.38 | 9% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE P28620321 | $82.08 | $136.80 | $37.21–$120.38 | 9% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL SERUM (T3) P28634308 | $84.15 | $140.25 | $38.15–$123.42 | 12% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3) P31033077 | $84.15 | $140.25 | $38.15–$123.42 | 12% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3) P28633077 | $84.15 | $140.25 | $38.15–$123.42 | 12% above | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE P31020321 | $82.08 | $136.80 | $37.21–$120.38 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE P28620321 | $82.08 | $136.80 | $37.21–$120.38 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 (TRIIODOTHYRONINE) TOTAL SERUM (T3) P28634308 | $84.15 | $140.25 | $38.15–$123.42 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONINE (T3) P28633077 | $84.15 | $140.25 | $38.15–$123.42 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONINE (T3) P31033077 | $84.15 | $140.25 | $38.15–$123.42 | — | 40% |
| Transferrin blood test CPT 84466 TRANSFERRIN P28620816 | $69.69 | $116.15 | $31.59–$102.21 | 18% below | 40% |
| Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN(MAYO) P31036058 | $73.50 | $122.50 | $33.32–$107.80 | 13% below | 40% |
| Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN(MAYO) P28636058 | $73.50 | $122.50 | $33.32–$107.80 | 13% below | 40% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN P28620816 | $69.69 | $116.15 | $31.59–$102.21 | — | 40% |
| Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN(MAYO) P28636058 | $73.50 | $122.50 | $33.32–$107.80 | — | 40% |
| Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN(MAYO) P31036058 | $73.50 | $122.50 | $33.32–$107.80 | — | 40% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECHNIQUE P31025722 | $191.61 | $319.35 | $86.86–$281.03 | 39% above | 40% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMOSA VAGINALIS AMPLIFIED PROBE TECHIQUE P28630114 | $202.14 | $336.90 | $91.64–$296.47 | 47% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECHNIQUE P86525722 | $191.61 | $319.35 | $86.86–$281.03 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECHNIQUE P31025722 | $191.61 | $319.35 | $86.86–$281.03 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMOSA VAGINALIS AMPLIFIED PROBE TECHIQUE P28630114 | $202.14 | $336.90 | $91.64–$296.47 | — | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDE P28625172 | $25.98 | $43.30 | $11.78–$38.10 | 42% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDE P31025172 | $25.98 | $43.30 | $11.78–$38.10 | 42% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES FLUID P28620330 | $25.98 | $43.30 | $11.78–$38.10 | 42% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES FLUID P31020330 | $25.98 | $43.30 | $11.78–$38.10 | 42% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES P31030159 | $35.73 | $59.55 | $16.20–$52.40 | 21% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES P28630159 | $35.73 | $59.55 | $16.20–$52.40 | 21% below | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE P28625172 | $25.98 | $43.30 | $11.78–$38.10 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES FLUID P31020330 | $25.98 | $43.30 | $11.78–$38.10 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE P31025172 | $25.98 | $43.30 | $11.78–$38.10 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES FLUID P28620330 | $25.98 | $43.30 | $11.78–$38.10 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES P31030159 | $35.73 | $59.55 | $16.20–$52.40 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES P28630159 | $35.73 | $59.55 | $16.20–$52.40 | — | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN T GEN5 P28629042 | $54.36 | $90.60 | $24.64–$79.73 | 51% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN P31029042 | $54.36 | $90.60 | $24.64–$79.73 | 51% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN-I P28620332 | $56.40 | $94.00 | $25.57–$82.72 | 49% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN-1 P31020332 | $56.40 | $94.00 | $25.57–$82.72 | 49% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN QUANTITATIVE P28630998 | $79.05 | $131.75 | $35.84–$115.94 | 28% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN I HIGH SENSITIVITY P (HSTNI) P28634868 | $359.19 | $598.65 | $162.83–$526.81 | 225% above | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN P31029042 | $54.36 | $90.60 | $24.64–$79.73 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN T GEN5 P28629042 | $54.36 | $90.60 | $24.64–$79.73 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN-I P28620332 | $56.40 | $94.00 | $25.57–$82.72 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN-1 P31020332 | $56.40 | $94.00 | $25.57–$82.72 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANTITATIVE P28630998 | $79.05 | $131.75 | $35.84–$115.94 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I HIGH SENSITIVITY P (HSTNI) P28634868 | $359.19 | $598.65 | $162.83–$526.81 | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID P28620336 | $25.14 | $41.90 | $11.40–$36.87 | 40% below | 40% |
| Uric acid blood test CPT 84550 URIC ACID P31020336 | $25.14 | $41.90 | $11.40–$36.87 | 40% below | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID P31020336 | $25.14 | $41.90 | $11.40–$36.87 | — | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID P28620336 | $25.14 | $41.90 | $11.40–$36.87 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P28621002 | $19.05 | $31.75 | $8.64–$27.94 | 46% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P31025144 | $19.05 | $31.75 | $8.64–$27.94 | 46% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P28625144 | $19.05 | $31.75 | $8.64–$27.94 | 46% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P31025144 | $19.05 | $31.75 | $8.64–$27.94 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P28621002 | $19.05 | $31.75 | $8.64–$27.94 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P28625144 | $19.05 | $31.75 | $8.64–$27.94 | — | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JIMC | $21.00 | $35.00 | $9.52–$30.80 | 21% below | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JPED | $21.00 | $35.00 | $9.52–$30.80 | 21% below | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JDHC | $21.00 | $35.00 | $9.52–$30.80 | 21% below | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JOB | $21.00 | $35.00 | $9.52–$30.80 | 21% below | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMB | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMC | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFML | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMO | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMV | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JDHC | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JIMC | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JOB | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JPED | $21.00 | $35.00 | $9.52–$30.80 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P28625806 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P28625807 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P31025807 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P31025806 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P31025805 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P28625805 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP STICK ONLY P28625145 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONES P28620361 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP STICK ONLY P31025145 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONES P31020361 | $13.53 | $22.55 | $6.13–$19.84 | 40% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP STICK ONLY P31025145 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONES P28620361 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP STICK ONLY P28625145 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P28625805 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P28625806 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P28625807 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONES P31020361 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P31025805 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P31025806 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P31025807 | $13.53 | $22.55 | $6.13–$19.84 | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NON AUTO POC P31025046 | $20.16 | $33.60 | $9.14–$29.57 | 46% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NON AUTO POC P31025046 | $20.16 | $33.60 | $9.14–$29.57 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE P31022043 | $47.61 | $79.35 | $21.58–$69.83 | 29% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL CULTURE AEROBIC WITH SUSC U (URNS) P28634847 | $50.52 | $84.20 | $22.90–$74.10 | 25% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE P86522043 | $47.61 | $79.35 | $21.58–$69.83 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE P31022043 | $47.61 | $79.35 | $21.58–$69.83 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 BACTERIAL CULTURE AEROBIC WITH SUSC U (URNS) P28634847 | $50.52 | $84.20 | $22.90–$74.10 | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR URINE P28620807 | $31.53 | $52.55 | $14.29–$46.24 | 9% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE P31020806 | $31.53 | $52.55 | $14.29–$46.24 | 9% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE P28620806 | $31.53 | $52.55 | $14.29–$46.24 | 9% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE P31020807 | $31.53 | $52.55 | $14.29–$46.24 | 9% below | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE P31020807 | $31.53 | $52.55 | $14.29–$46.24 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE P31020806 | $31.53 | $52.55 | $14.29–$46.24 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR URINE P28620807 | $31.53 | $52.55 | $14.29–$46.24 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE P28620806 | $31.53 | $52.55 | $14.29–$46.24 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 POCT URINE HCG P28625047 | $51.75 | $86.25 | $23.46–$75.90 | 7% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST (BETA HCG QUAL) VISUAL P28625804 | $51.75 | $86.25 | $23.46–$75.90 | 7% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 POCT URINE HCG P31025047 | $51.75 | $86.25 | $23.46–$75.90 | 7% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST (BETA HCG QUAL) VISUAL P31025804 | $51.75 | $86.25 | $23.46–$75.90 | 7% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST (BETA HCG QUAL) VISUAL P31025804 | $51.75 | $86.25 | $23.46–$75.90 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 POCT URINE HCG P28625047 | $51.75 | $86.25 | $23.46–$75.90 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 POCT URINE HCG P31025047 | $51.75 | $86.25 | $23.46–$75.90 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST (BETA HCG QUAL) VISUAL P28625804 | $51.75 | $86.25 | $23.46–$75.90 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL P28620340 | $70.59 | $117.65 | $32.00–$103.53 | 10% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 LEVEL P31020340 | $70.59 | $117.65 | $32.00–$103.53 | 10% below | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 LEVEL P28620340 | $70.59 | $117.65 | $32.00–$103.53 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 LEVEL P31020340 | $70.59 | $117.65 | $32.00–$103.53 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D LEVEL P28625473 | $134.46 | $224.10 | $60.96–$197.21 | 1% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D LEVEL P31025473 | $134.46 | $224.10 | $60.96–$197.21 | 1% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25 HYDROXY INCLUDES FRACTION(S) P31030068 | $174.63 | $291.05 | $79.17–$256.12 | 29% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25 HYDROXY INCLUDES FRACTION(S) P28630068 | $174.63 | $291.05 | $79.17–$256.12 | 29% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 AND D3 S (25HDN) P31032008 | $183.33 | $305.55 | $83.11–$268.88 | 36% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 AND D3 S (25HDN) P28632008 | $183.33 | $305.55 | $83.11–$268.88 | 36% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D LEVEL P28625473 | $134.46 | $224.10 | $60.96–$197.21 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D LEVEL P31025473 | $134.46 | $224.10 | $60.96–$197.21 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D; 25 HYDROXY INCLUDES FRACTION(S) P31030068 | $174.63 | $291.05 | $79.17–$256.12 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D; 25 HYDROXY INCLUDES FRACTION(S) P28630068 | $174.63 | $291.05 | $79.17–$256.12 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 AND D3 S (25HDN) P31032008 | $183.33 | $305.55 | $83.11–$268.88 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 AND D3 S (25HDN) P28632008 | $183.33 | $305.55 | $83.11–$268.88 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D; 1 25 DIHYDROXY INCLUDES FRACTION(S) P28634016 | $221.76 | $369.60 | $100.53–$325.25 | 28% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 1 25-DIHYDROXYVITAMIN D SERUM (DHVD) P28632130 | $221.76 | $369.60 | $100.53–$325.25 | 28% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 1 25-DIHYDROXYVITAMIN D SERUM (DHVD) P31032130 | $221.76 | $369.60 | $100.53–$325.25 | 28% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D; 1 25 DIHYDROXY INCLUDES FRACTION(S) P31034016 | $221.76 | $369.60 | $100.53–$325.25 | 28% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1 25-DIHYDROXYVITAMIN D SERUM (DHVD) P28632130 | $221.76 | $369.60 | $100.53–$325.25 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D; 1 25 DIHYDROXY INCLUDES FRACTION(S) P31034016 | $221.76 | $369.60 | $100.53–$325.25 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D; 1 25 DIHYDROXY INCLUDES FRACTION(S) P28634016 | $221.76 | $369.60 | $100.53–$325.25 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1 25-DIHYDROXYVITAMIN D SERUM (DHVD) P31032130 | $221.76 | $369.60 | $100.53–$325.25 | — | 40% |
| Zinc blood test CPT 84630 ZINC SERUM (ZNS) P28632129 | $67.59 | $112.65 | $30.64–$99.13 | 14% above | 40% |
| Zinc blood test CPT 84630 ZINC SERUM (ZNS) P31032129 | $67.59 | $112.65 | $30.64–$99.13 | 14% above | 40% |
| Zinc blood test CPT 84630 ZINC P28630186 | $67.59 | $112.65 | $30.64–$99.13 | 14% above | 40% |
| Zinc blood test inpatient CPT 84630 ZINC P28630186 | $67.59 | $112.65 | $30.64–$99.13 | — | 40% |
| Zinc blood test inpatient CPT 84630 ZINC SERUM (ZNS) P31032129 | $67.59 | $112.65 | $30.64–$99.13 | — | 40% |
| Zinc blood test inpatient CPT 84630 ZINC SERUM (ZNS) P28632129 | $67.59 | $112.65 | $30.64–$99.13 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HUMAN CHORIONIC GONADOTROPIN QUANTITATIVE P31020196 | $73.83 | $123.05 | $33.47–$108.28 | 12% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HUMAN CHORIONIC GONADOTROPIN QUANTITATIVE P28620196 | $73.83 | $123.05 | $33.47–$108.28 | 12% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG I-STAT P31029100 | $87.12 | $145.20 | $39.49–$127.78 | 4% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QUANT TUMOR MARKER P28620420 | $87.12 | $145.20 | $39.49–$127.78 | 4% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE SERUM (BHCG) P31032236 | $91.89 | $153.15 | $41.66–$134.77 | 9% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC (HCG); QUANT P28630174 | $91.89 | $153.15 | $41.66–$134.77 | 9% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE SERUM (BHCG) P28632236 | $91.89 | $153.15 | $41.66–$134.77 | 9% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HUMAN CHORIONIC GONADOTROPIN QUANTITATIVE P28620196 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HUMAN CHORIONIC GONADOTROPIN QUANTITATIVE P31020196 | $73.83 | $123.05 | $33.47–$108.28 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG I-STAT P31029100 | $87.12 | $145.20 | $39.49–$127.78 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG QUANT TUMOR MARKER P28620420 | $87.12 | $145.20 | $39.49–$127.78 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE SERUM (BHCG) P28632236 | $91.89 | $153.15 | $41.66–$134.77 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC (HCG); QUANT P28630174 | $91.89 | $153.15 | $41.66–$134.77 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE SERUM (BHCG) P31032236 | $91.89 | $153.15 | $41.66–$134.77 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-CPCR | $393.00 | $655.00 | $0.01 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-JIR | $393.00 | $655.00 | $280.68–$1,795.00 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-XO | $393.00 | $655.00 | $280.68–$1,795.00 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-PMR | $393.00 | $655.00 | $0.01 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-OPH | $393.00 | $655.00 | $280.68–$291.58 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE BILATERAL-NCK | $393.00 | $655.00 | $280.68–$291.58 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE BILATERAL-JPMR | $393.00 | $655.00 | $280.68–$291.58 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE/ BILATERAL-JNC | $393.00 | $655.00 | $280.68–$291.58 | — | 40% |
| Botox injections for chronic migraine both sides CPT 64615 CHEMODENERVATION MUSCLE; BILATERAL-MEE | $393.00 | $655.00 | $280.68–$291.58 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-PMR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE/ BILATERAL-JNC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE; BILATERAL-MEE | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE BILATERAL-JPMR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-DSSC | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-CPCR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE BILATERAL-NCK | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-JIR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-XO | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 CHEMODENERVATION MUSCLE, BILATERAL-OPH | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 BIOPSY BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE-BI | $2,960.40 | $4,934.00 | $1,726.90–$4,341.92 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE-JMAM | $2,960.40 | $4,934.00 | $1,540.58–$1,600.41 | 28% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient both sides CPT 19081 BIOPSY BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE-BI | $2,960.40 | $4,934.00 | $1,726.90–$4,341.92 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE-JMAM | $2,960.40 | $4,934.00 | $1,726.90–$4,341.92 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION-MCLN | $359.40 | $599.00 | $228.09–$236.94 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION SM | $359.40 | $599.00 | $228.09–$236.94 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-CSJC | $359.40 | $599.00 | $228.09–$236.94 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION-OCJC | $359.40 | $599.00 | $0.01 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-JPOD | $359.40 | $599.00 | $228.09–$236.94 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-JMOI | $359.40 | $599.00 | $0.01 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-POSC | $359.40 | $599.00 | $228.09–$236.94 | 18% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TREATMENT DISTAL FIBULAR FX W/0 MANIPULATION-EC | $432.00 | $720.00 | $252.00–$633.60 | 1% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-POSC | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION SM | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-JMOI | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-CSJC | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION-OCJC | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT PROXIMAL FIBULAR FX W/0 MANIPULATION-MCLN | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIBULA FX W/O MANIP-JPOD | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TREATMENT DISTAL FIBULAR FX W/0 MANIPULATION-EC | $432.00 | $720.00 | $252.00–$633.60 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -CSJC | $316.80 | $528.00 | $0.01 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -MCLN | $316.80 | $528.00 | $228.09–$236.94 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -POSC | $316.80 | $528.00 | $228.09–$236.94 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JMOI | $316.80 | $528.00 | $0.01 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JPOD | $316.80 | $528.00 | $228.09–$236.94 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METATARSAL FRACTURE.WO MANIPEA-OCJC | $316.80 | $528.00 | $228.09–$236.94 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METATARSAL FRACTURE.WO MANIP,EA-SM | $316.80 | $528.00 | $228.09–$236.94 | 18% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JER | $379.80 | $633.00 | $221.55–$557.04 | 2% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX OF METATARSAL FX; W/O MANIPU., EA-EC | $379.80 | $633.00 | $228.09–$236.94 | 2% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -POSC | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METATARSAL FRACTURE.WO MANIPEA-OCJC | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -MCLN | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JMOI | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JPOD | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METATARSAL FRACTURE.WO MANIP,EA-SM | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -CSJC | $316.80 | $528.00 | $184.80–$464.64 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX OF METATARSAL FX; W/O MANIPU., EA-EC | $379.80 | $633.00 | $221.55–$557.04 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIP EA -JER | $379.80 | $633.00 | $221.55–$557.04 | — | 40% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 CATH/ANGIO LEFT HEART INJ LV CORONARY ART-JCLB | $9,609.60 | $16,016.00 | $5,605.60–$14,094.08 | 3% above | 40% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 CATH/ANGIO LEFT HEART INJ LV CORONARY ART | $9,609.60 | $16,016.00 | $3,058.27–$11,830.00 | 3% above | 40% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CATH/ANGIO LEFT HEART INJ LV CORONARY ART | $9,609.60 | $16,016.00 | $5,605.60–$14,094.08 | — | 40% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CATH/ANGIO LEFT HEART INJ LV CORONARY ART-JCLB | $9,609.60 | $16,016.00 | $5,605.60–$14,094.08 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION-JCRD | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | 17% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRICAL (EXTERNAL) | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | 17% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION-CTST | $1,237.80 | $2,063.00 | $622.21–$646.37 | 17% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRICAL (EXTERNAL)-JCLB | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | 17% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ER CARDIOVERSION-EC | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | 40% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRICAL COVERSION ARRHYTHMIA EXTERNAL-JER | $1,486.20 | $2,477.00 | $622.21–$646.37 | 40% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION-JCRD | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRICAL (EXTERNAL) | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION-CTST | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRICAL (EXTERNAL)-JCLB | $1,237.80 | $2,063.00 | $722.05–$1,815.44 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRICAL COVERSION ARRHYTHMIA EXTERNAL-JER | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ER CARDIOVERSION-EC | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL-OCJC | $3,036.60 | $5,061.00 | $1,856.76–$5,200.00 | 19% above | 40% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL | $3,036.60 | $5,061.00 | $1,771.35–$4,453.68 | 19% above | 40% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL-MCLN | $3,036.60 | $5,061.00 | $1,856.76–$5,200.00 | 19% above | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL-OCJC | $3,036.60 | $5,061.00 | $1,771.35–$4,453.68 | — | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL | $3,036.60 | $5,061.00 | $1,771.35–$4,453.68 | — | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY/TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL-MCLN | $3,036.60 | $5,061.00 | $1,771.35–$4,453.68 | — | 40% |
| Catheter ablation for atrial fibrillation CPT 93656 COMPRHNSVE ELECTRPHYSILOGIC EVAL ABLTION PVI W/3D MAPG-CARD | $30,851.40 | $51,419.00 | $9,317.00–$27,000.00 | 28% above | 40% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPRHNSVE ELECTRPHYSILOGIC EVAL ABLTION PVI W/3D MAPG-CARD | $30,851.40 | $51,419.00 | $17,996.65–$45,248.72 | — | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-IVF | $1,015.80 | $1,693.00 | $827.93–$860.08 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SNGLE OR MULT WITH OR WOUT FULGURATION-JOB | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 EF BX CERVIX SNGLE/MULT W/ OR W/O FULGURATION | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX, SNGLE OR MULT, WITH OR WOUT FULGURATION FUL | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 BX CERVIX SNGL/MULTI W OR W/O FULGURATION -NSOB | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR WO FULGURATION-FIPS | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 CERVIX BIOPSY-SPFM | $1,015.80 | $1,693.00 | $827.93–$860.08 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE/MULTIPLE W/W/O FULGURATION NSFM | $1,015.80 | $1,693.00 | $827.93–$860.08 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-OBC | $1,015.80 | $1,693.00 | $0.01 | 31% above | 40% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-EC | $1,218.60 | $2,031.00 | $710.85–$1,787.28 | 57% above | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SNGLE OR MULT WITH OR WOUT FULGURATION-JOB | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-IVF | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 CERVIX BIOPSY-SPFM | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX, SNGLE OR MULT, WITH OR WOUT FULGURATION FUL | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR WO FULGURATION-FIPS | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE/MULTIPLE W/W/O FULGURATION NSFM | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SNGLE OR MULT WITH OR WOUT FULGURATION-MFMC | $1,015.80 | $1,693.00 | $460.50–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SNGLE OR MULT WITH OR WOUT FULGURATION-BAMB | $1,015.80 | $1,693.00 | $460.50–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SNGLE OR MULT WITH OR WOUT FULGURATION-FFH | $1,015.80 | $1,693.00 | $460.50–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BX CERVIX SNGL/MULTI W OR W/O FULGURATION -NSOB | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-OBC | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 EF BX CERVIX SNGLE/MULT W/ OR W/O FULGURATION | $1,015.80 | $1,693.00 | $592.55–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-FMCK | $1,015.80 | $1,693.00 | $460.50–$1,489.84 | — | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE OR MULTIPLE W/ OR W/O FULGURATION-EC | $1,218.60 | $2,031.00 | $710.85–$1,787.28 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION SURGICAL EXCISION O/T CLAMP OLDER 28 DAYS-PESC | $3,174.00 | $5,290.00 | $1,017.00–$5,200.00 | 15% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION, SURGICAL EXCISION O/T CLAMP, OLDER 28 DAYS-SC | $3,174.00 | $5,290.00 | $1,017.00–$5,200.00 | 15% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION SURGICAL EXCISION O/T CLAMP OLDER 28 DAYS-FMCK | $3,174.00 | $5,290.00 | $1,438.88–$4,655.20 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION SURGICAL EXCISION O/T CLAMP OLDER 28 DAYS-PESC | $3,174.00 | $5,290.00 | $1,851.50–$4,655.20 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION, SURGICAL EXCISION O/T CLAMP, OLDER 28 DAYS-SC | $3,174.00 | $5,290.00 | $1,851.50–$4,655.20 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-MNU | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-NICC | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-CBCC | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-CHPC | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK -JPED | $3,331.80 | $5,553.00 | $0.01 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-JOBS | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-SPFM | $3,331.80 | $5,553.00 | $0.01 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-SC | $3,331.80 | $5,553.00 | $1,017.00–$5,200.00 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-NFM | $3,331.80 | $5,553.00 | $1,947.79–$2,023.44 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION; USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-PESC | $3,331.80 | $5,553.00 | $1,947.79–$2,023.44 | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-CHPC | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-CBCC | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-NICC | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-MNU | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-JFMC | $3,331.80 | $5,553.00 | $1,510.42–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK -JPED | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-JOBS | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION; USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-PESC | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-NFM | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-SC | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,USING CLAMP/DEVICE W/RGNL DRSL/RING BLCK-SPFM | $3,331.80 | $5,553.00 | $1,943.55–$4,886.64 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION,USING CLAMP/ DEVICE W/RGNL DRSL/RING BLCK-BAMB | $3,331.80 | $5,553.00 | $1,510.42–$4,886.64 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP,WWO FX ULNA STYLD.WO MPLT-SM | $299.40 | $499.00 | $0.01 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-JMOI | $299.40 | $499.00 | $228.09–$236.94 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-POSC | $299.40 | $499.00 | $228.09–$236.94 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEPWWO FX ULNA STYLD.WO MPLT-OCJC | $299.40 | $499.00 | $0.01 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-CSJC | $299.40 | $499.00 | $228.09–$236.94 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEPWWO FX ULNA STYLD WO MAN-MCLN | $299.40 | $499.00 | $0.01 | 28% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP,WWO FX ULNA STYLD.WO MPLT-EC | $359.40 | $599.00 | $228.09–$236.94 | 14% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEPWWO FX ULNA STYLD WO MAN-MCLN | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-JMOI | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-CSJC | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP,WWO FX ULNA STYLD.WO MPLT-SM | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEPWWO FX ULNA STYLD.WO MPLT-OCJC | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP WWO FX ULNA STYLD.WO MPLT-POSC | $299.40 | $499.00 | $174.65–$439.12 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DSTL RDL FX/EPIPH SEP,WWO FX ULNA STYLD.WO MPLT-EC | $359.40 | $599.00 | $209.65–$527.12 | — | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND-JEGC | $1,563.00 | $2,605.00 | $1,121.11–$2,650.00 | 44% below | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND-GIKC | $1,563.00 | $2,605.00 | $911.75–$2,292.40 | 44% below | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND | $1,563.00 | $2,605.00 | $911.75–$2,292.40 | 44% below | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND-GIKC | $1,563.00 | $2,605.00 | $911.75–$2,292.40 | — | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND-JEGC | $1,563.00 | $2,605.00 | $911.75–$2,292.40 | — | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND | $1,563.00 | $2,605.00 | $911.75–$2,292.40 | — | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-GIKC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 3% below | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 3% below | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE -FVGI | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 3% below | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-JEGC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | 3% below | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-JEGC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-GIKC | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE -FVGI | $1,650.00 | $2,750.00 | $962.50–$2,420.00 | — | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | 1% below | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. -FVGI | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | 1% below | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN.-JEGC | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | 1% below | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN-GIKC | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | 1% below | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN.-JEGC | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | — | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | — | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. -FVGI | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | — | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN-GIKC | $1,491.00 | $2,485.00 | $869.75–$2,186.80 | — | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-GIKC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | 25% below | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-ORSC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | 25% below | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | 25% below | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC -FVGI | $1,264.80 | $2,108.00 | $866.89–$2,650.00 | 25% below | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-JEGC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | 25% below | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-GIKC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | — | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | — | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-JEGC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | — | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-ORSC | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | — | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC -FVGI | $1,264.80 | $2,108.00 | $737.80–$1,855.04 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-NFM | $3,067.20 | $5,112.00 | $3,023.21–$3,140.61 | 36% above | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-OBC | $3,067.20 | $5,112.00 | $3,023.21–$3,140.61 | 36% above | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-FUL | $3,067.20 | $5,112.00 | $0.01 | 36% above | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-FMCK | $3,067.20 | $5,112.00 | $1,390.46–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-FUL | $3,067.20 | $5,112.00 | $1,789.20–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-NFM | $3,067.20 | $5,112.00 | $1,789.20–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-OBC | $3,067.20 | $5,112.00 | $1,789.20–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-MFMC | $3,067.20 | $5,112.00 | $1,390.46–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-BAMB | $3,067.20 | $5,112.00 | $1,390.46–$4,498.56 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCPY CERVIX UP/ADJ VAG W LP ELECT BX CERVX-FFH | $3,067.20 | $5,112.00 | $1,390.46–$4,498.56 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-JOB | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 EF COLPOSCOPY W/BX | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY OF CERVIX UP/ADJ VAGINA W BX&CURETTAGE-FIPS | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CERV INC UP/ADJ VAG W/BX CERV/ENDCERV CURET-NSFM | $454.20 | $757.00 | $289.23–$300.47 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-SPFM | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-FAY | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPO CERV INC UP/ADJ VAG W/BX CERV/ENDCERV CURET-FUL | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY OF CERVIX UP/ADJ VAGINA W BX&CURETTAGE-OBC | $454.20 | $757.00 | $289.23–$300.47 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX UP/ADJ VAGINA W BX&CURETTAGE -NSOB | $454.20 | $757.00 | $0.01 | 20% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY OF CERVIX UP/ADJ VAGINA W BX&CURETTAGE-OBC | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-SPFM | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-FMCK | $454.20 | $757.00 | $205.90–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-MFMC | $454.20 | $757.00 | $205.90–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-BAMB | $454.20 | $757.00 | $205.90–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-FFH | $454.20 | $757.00 | $205.90–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY OF CERVIX UP/ADJ VAGINA W BX&CURETTAGE-FIPS | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 EF COLPOSCOPY W/BX | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/BX CERV/ENDCERV CURET-NSFM | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-JOB | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX UP/ADJ VAGINA W BX&CURETTAGE -NSOB | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/BX CERV/ENDCERV CURET-FUL | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPO CERV INC UP/ADJ VAG W/ BX CERV/ENDOCERV CURET-FAY | $454.20 | $757.00 | $264.95–$666.16 | — | 40% |
| Coronary stent placement, one artery CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE LAD-JCLB | $13,529.40 | $22,549.00 | $7,892.15–$19,843.12 | 3% below | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE LAD-JCLB | $13,529.40 | $22,549.00 | $7,892.15–$19,843.12 | — | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE LAD | $13,529.40 | $22,549.00 | $6,133.33–$19,843.12 | — | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE MAIN | $13,529.40 | $22,549.00 | $6,133.33–$19,843.12 | — | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE CIRC | $13,529.40 | $22,549.00 | $6,133.33–$19,843.12 | — | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE RAMUS | $13,529.40 | $22,549.00 | $6,133.33–$19,843.12 | — | 40% |
| Coronary stent placement, one artery inpatient one side CPT 92928 REVASC ART CORONARY STENT/PTCA SINGLE RIGHT | $13,529.40 | $22,549.00 | $6,133.33–$19,843.12 | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY W/INSERTION INDWELLING URETERAL STENT-EFOU | $3,843.00 | $6,405.00 | $2,241.75–$5,636.40 | 25% below | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY W/INSERTION INDWELLING URETERAL STENT-EC | $4,611.00 | $7,685.00 | $1,285.00–$6,762.80 | 10% below | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY W/INSERTION INDWELLING URETERAL STENT-EFOU | $3,843.00 | $6,405.00 | $2,241.75–$5,636.40 | — | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY W/INSERTION INDWELLING URETERAL STENT-EC | $4,611.00 | $7,685.00 | $1,285.00–$6,762.80 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 EF CYSTOURETHROSCOPY | $1,012.80 | $1,688.00 | $634.65–$659.30 | 38% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY-OBC | $1,012.80 | $1,688.00 | $634.65–$659.30 | 38% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY-FIPS | $1,012.80 | $1,688.00 | $0.01 | 38% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY-PESC | $1,012.80 | $1,688.00 | $634.65–$659.30 | 38% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY. | $1,012.80 | $1,688.00 | $0.01 | 38% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY-JER | $1,215.00 | $2,025.00 | $634.65–$659.30 | 25% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE)-EC | $1,215.00 | $2,025.00 | $634.65–$659.30 | 25% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 EF CYSTOURETHROSCOPY | $1,012.80 | $1,688.00 | $590.80–$1,485.44 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY-OBC | $1,012.80 | $1,688.00 | $590.80–$1,485.44 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY-PESC | $1,012.80 | $1,688.00 | $590.80–$1,485.44 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY. | $1,012.80 | $1,688.00 | $590.80–$1,485.44 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY-FIPS | $1,012.80 | $1,688.00 | $590.80–$1,485.44 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY-JER | $1,215.00 | $2,025.00 | $708.75–$1,782.00 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE)-EC | $1,215.00 | $2,025.00 | $708.75–$1,782.00 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-SPFM | $3,493.80 | $5,823.00 | $3,023.21–$3,140.61 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-NFM | $3,493.80 | $5,823.00 | $3,023.21–$3,140.61 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-IVF | $3,493.80 | $5,823.00 | $3,023.21–$3,140.61 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-FUL | $3,493.80 | $5,823.00 | $0.01 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-JOB | $3,493.80 | $5,823.00 | $3,023.21–$3,140.61 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-FAY | $3,493.80 | $5,823.00 | $3,023.21–$3,140.61 | 5% below | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-SPFM | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-IVF | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-JOB | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-FAY | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-FUL | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX&/THER NONOBSTETRIC-NFM | $3,493.80 | $5,823.00 | $2,038.05–$5,124.24 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE-NFM | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JIMC | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OPH | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE-FUL | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE-FAY | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE.FV | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE-SPFM | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-SPGP | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE.JCD | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT,ANY METHOD,INC LASER W/W/0 SURG CURETT FIRST LES | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 SURG DEST BENIGN OR PREMALIGN, 1 SINGLE LESION EF | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-PESC | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JSCM | $156.60 | $261.00 | $0.01 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OBC | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OCJC | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT LESION BY ANY METHOD 1ST LESION-HBVC | $156.60 | $261.00 | $188.93–$196.27 | 14% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE-NFM | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SURG DEST BENIGN OR PREMALIGN, 1 SINGLE LESION EF | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT,ANY METHOD,INC LASER W/W/0 SURG CURETT FIRST LES | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE.JCD | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-SPGP | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE-SPFM | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG EXC SK TAG,CUTAN VAS PROLIF.1ST LE.FV | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE-FAY | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN/PRMLG LES EXC SK TAG,CUTAN VAS PROLIF.1ST LE-FUL | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OPH | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OCJC | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-OBC | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-PESC | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JSCM | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JSCC | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JIMC | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMV | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMO | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFML | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMD | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMB | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMM | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFME | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-JFMC | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 SURG DEST BENIGN OR PREMALIGN, 1 SINGLE LESION-DSSC | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-FMCK | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-MFMC | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-FMCJ | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-BAMB | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-FFH | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGANT LESION 1ST LESION-AFM | $156.60 | $261.00 | $70.99–$229.68 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT LESION BY ANY METHOD 1ST LESION-HBVC | $156.60 | $261.00 | $91.35–$229.68 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-JENT | $563.40 | $939.00 | $0.01 | 4% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-EAC | $563.40 | $939.00 | $0.01 | 4% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSCOPY, PE TUBE INSERTION EACH EF | $563.40 | $939.00 | $0.01 | 4% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSCOPY, PE TUBE INSERTION EACH-HBVC | $563.40 | $939.00 | $0.01 | 4% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-EC | $676.20 | $1,127.00 | $394.45–$991.76 | 25% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY, PE TUBE INSERTION EACH EF | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY, PE TUBE INSERTION EACH-HBVC | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-CENT | $563.40 | $939.00 | $255.41–$826.32 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-EAC | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-JENT | $563.40 | $939.00 | $328.65–$826.32 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSCOPY (REQ INSERT VENT TUBE) LOCAL/TOPICAL ANES-EC | $676.20 | $1,127.00 | $394.45–$991.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-NFM | $113.40 | $189.00 | $56.48–$58.67 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FUL | $113.40 | $189.00 | $0.01 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FAY | $113.40 | $189.00 | $56.48–$58.67 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JIMC | $113.40 | $189.00 | $56.48–$58.67 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JPED | $113.40 | $189.00 | $0.01 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-WRIM | $113.40 | $189.00 | $0.01 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-SPGP | $113.40 | $189.00 | $0.01 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-SPFM | $113.40 | $189.00 | $0.01 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FV | $113.40 | $189.00 | $56.48–$58.67 | 3% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUCX | $136.20 | $227.00 | $79.45–$199.76 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JER | $136.20 | $227.00 | $56.48–$58.67 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUCJ | $136.20 | $227.00 | $79.45–$199.76 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JUTR | $136.20 | $227.00 | $79.45–$199.76 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED CERUMEN BY IRRIGATION/LAVAGE, UNILAT-EC | $136.20 | $227.00 | $79.45–$199.76 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUC | $136.20 | $227.00 | $79.45–$199.76 | 23% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JPED | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-AFM | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FFH | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-BAMB | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FMCJ | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MFMC | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FMCK | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMC | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFME | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMM | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMB | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMD | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFML | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMO | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JFMV | $113.40 | $189.00 | $51.41–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JIMC | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-NFM | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FUL | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FAY | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-FV | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-SPFM | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-SPGP | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-WRIM | $113.40 | $189.00 | $66.15–$166.32 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JER | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED CERUMEN BY IRRIGATION/LAVAGE, UNILAT-EC | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUC | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUCX | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-MUCJ | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION/LAVAGE UNILATERAL-JUTR | $136.20 | $227.00 | $79.45–$199.76 | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-EAC | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-NFM | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-SPGP | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 EAR WAX REMOVAL | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-CBCC | $95.40 | $159.00 | $56.48–$1,795.00 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-CHPC | $95.40 | $159.00 | $56.48–$1,795.00 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-FUL | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE/BOTH EARS-FAY | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX-HBVC | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-FV | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-PESC | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-JIMC | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX EF | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-SPFM | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL-JUTR | $114.60 | $191.00 | $66.85–$168.08 | 10% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL-EC | $114.60 | $191.00 | $66.85–$168.08 | 10% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-JER | $114.60 | $191.00 | $56.48–$58.67 | 10% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL-MUC | $114.60 | $191.00 | $66.85–$168.08 | 10% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL-MUCJ | $114.60 | $191.00 | $66.85–$168.08 | 10% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL-MUCX | $114.60 | $191.00 | $66.85–$168.08 | 10% above | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JENT | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JPED | $95.40 | $159.00 | $0.01 | 8% below | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-OCJC | $95.40 | $159.00 | $56.48–$58.67 | 8% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-FMCK | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE/BOTH EARS-FAY | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-EAC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-SPGP | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-FUL | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX-HBVC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-CHPC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-SPFM | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-CBCC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-FV | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATIONUNILATERAL-MFMC | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATIONUNILATERAL-FFH | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX EF | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-PESC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-JIMC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN,ONE OR BOTH EARS-NFM | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 EAR WAX REMOVAL | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL-EC | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN ONE OR BOTH EARS-JER | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL-MUC | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL-MUCX | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL-MUCJ | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL-JUTR | $114.60 | $191.00 | $66.85–$168.08 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JENT | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-AFM | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-CENT | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-BAMB | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-FMCJ | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMC | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFME | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMM | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMB | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMD | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFML | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMO | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JFMV | $95.40 | $159.00 | $43.25–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-JPED | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN REQ INSTRUMENTATION UNILATERAL-OCJC | $95.40 | $159.00 | $55.65–$139.92 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL WO CERV DILAT; ANY MTHD-FIPS | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL W/O CERV DILAT; ANY MTHD-IVF | $334.20 | $557.00 | $191.28–$198.71 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 EF ENDOMETRIAL BX | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-SPFM | $334.20 | $557.00 | $191.28–$198.71 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-FAY | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-FUL | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET BX W-W/O ENDOCERV SAMP W/O CERV DILTN -NSOB | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-NFM | $334.20 | $557.00 | $191.28–$198.71 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL W/O CERV DILAT; ANY METHD-OBC | $334.20 | $557.00 | $0.01 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-JOB | $334.20 | $557.00 | $191.28–$198.71 | 31% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-EC | $401.40 | $669.00 | $234.15–$588.72 | 57% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-JOB | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-NFM | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-JFMC | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 EF ENDOMETRIAL BX | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-MFMC | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-FMCJ | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-BAMB | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL SAMPLING W/WO ENDOCERV SAMPLE WO CERV DILAT-FFH | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL W/O CERV DILAT; ANY METHD-OBC | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET BX W-W/O ENDOCERV SAMP W/O CERV DILTN -NSOB | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-SPFM | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL WO CERV DILAT; ANY MTHD-FIPS | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-FAY | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL W/O CERV DILAT; ANY MTHD-FMCK | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET BX W/WO ENDOCERV SAMPL W/O CERV DILAT; ANY MTHD-IVF | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-FUL | $334.20 | $557.00 | $194.95–$490.16 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET SAMPL W/WO ENDOCERV SAMPL,WO CERV DILAT-EC | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS SURG ENDOSCOPY W/FRONTAL SINUS TISS RMVL-CENT | $5,348.40 | $8,914.00 | $2,424.61–$7,844.32 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, W/ MAXILLARY ANTROSTOMY-EAC | $2,926.80 | $4,878.00 | $1,017.00–$5,200.00 | 12% below | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY, SURGICAL, W/ MAXILLARY ANTROSTOMY-EAC | $2,926.80 | $4,878.00 | $1,707.30–$4,292.64 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JCT | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-AM | $1,006.20 | $1,677.00 | $658.47–$1,980.00 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-XM | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JIR | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-XO | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-SC | $1,006.20 | $1,677.00 | $658.47–$684.04 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-CSJC | $1,006.20 | $1,677.00 | $0.01 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JPMC | $1,006.20 | $1,677.00 | $0.01 | 34% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JPMC | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-XM | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JIR | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-AM | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-JCT | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-XO | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-SC | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ(S) DX/THER SBST INTRLMNR CRV/THRC W/IMG GUID-CSJC | $1,006.20 | $1,677.00 | $586.95–$1,475.76 | — | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT-MEE | $435.00 | $725.00 | $315.38–$327.63 | 31% above | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT-MEDI | $435.00 | $725.00 | $253.75–$638.00 | 31% above | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECT, PHARMACOLOGIC | $435.00 | $725.00 | $0.01 | 31% above | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECT, PHARMACOLOGIC -EC | $522.60 | $871.00 | $315.38–$327.63 | 58% above | 40% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECT, PHARMACOLOGIC | $435.00 | $725.00 | $253.75–$638.00 | — | 40% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT-MEE | $435.00 | $725.00 | $253.75–$638.00 | — | 40% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECTION OF PHARMACOLOGIC AGENT-MEDI | $435.00 | $725.00 | $253.75–$638.00 | — | 40% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECT, PHARMACOLOGIC -EC | $522.60 | $871.00 | $304.85–$766.48 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-AM | $1,486.20 | $2,477.00 | $846.52–$1,980.00 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-JCT | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT LMBR/SAC 1 LEVEL-XO | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-CPCR | $1,486.20 | $2,477.00 | $0.01 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-MCLN | $1,486.20 | $2,477.00 | $0.01 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-MOC | $1,486.20 | $2,477.00 | $846.52–$1,980.00 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-JIR | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-CM | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | 37% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-MOC | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-MCLN | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-CPCR | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT LMBR/SAC 1 LEVEL-XO | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-JCT | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-JIR | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT FACET LUMB/SCRL SINGLE LVL-CM | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAG/THER AGENT PARAVERT FACET JT, LMBR/SAC 1 LEVEL-AM | $1,486.20 | $2,477.00 | $866.95–$2,179.76 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOID FF DIAGNOSTIC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | 3% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOID FF DIAGNOSTIC -FVGI | $1,204.20 | $2,007.00 | $866.89–$1,980.00 | 3% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOID FF DIAGNOSTIC-JEGC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | 3% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/O/W SPECIMEN COLL EF | $1,204.20 | $2,007.00 | $0.01 | 3% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOID FF DIAGNOSTIC-GIKC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | 3% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/O/W SPECIMEN COLL EF | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOID FF DIAGNOSTIC-JEGC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOID FF DIAGNOSTIC-GIKC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOID FF DIAGNOSTIC | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX; DIAGNOSTIC W/O/W SPECIMEN COLLECT-CSAS | $1,204.20 | $2,007.00 | $545.90–$1,766.16 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOID FF DIAGNOSTIC -FVGI | $1,204.20 | $2,007.00 | $702.45–$1,766.16 | — | 40% |
| Hammertoe correction surgery CPT 28285 CORRECTION, HAMMERTOE-MCLN | $2,529.60 | $4,216.00 | $1,475.60–$3,710.08 | at median | 40% |
| Hammertoe correction surgery inpatient CPT 28285 CORRECTION, HAMMERTOE-MCLN | $2,529.60 | $4,216.00 | $1,475.60–$3,710.08 | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMMORRHOIDECTOMY INTERNAL BY RUBBER BAND LIGATION EF | $940.80 | $1,568.00 | $0.01 | 31% below | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMMORRHOIDECTOMY INTERNAL BY RUBBER BAND LIGATION EF | $940.80 | $1,568.00 | $548.80–$1,379.84 | — | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMMORRHOIDECTOMY INTERNAL BY RUBBER BAND LIGATION-JSCC | $940.80 | $1,568.00 | $426.50–$1,379.84 | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL&EXTERNAL SINGLE COLUMN/GROUP-OBC | $3,000.60 | $5,001.00 | $2,607.56–$2,708.82 | at median | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL&EXTERNAL SINGLE COLUMN/GROUP-FFH | $3,000.60 | $5,001.00 | $1,360.27–$4,400.88 | — | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL&EXTERNAL SINGLE COLUMN/GROUP-OBC | $3,000.60 | $5,001.00 | $1,750.35–$4,400.88 | — | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL&EXTERNAL SINGLE COLUMN/GROUP-MFMC | $3,000.60 | $5,001.00 | $1,360.27–$4,400.88 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-JOB | $334.20 | $557.00 | $0.01 | 44% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-XM | $334.20 | $557.00 | $151.50–$490.16 | 44% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-JDI | $334.20 | $557.00 | $151.50–$490.16 | 44% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-IVF | $334.20 | $557.00 | $151.50–$490.16 | 44% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTERGRPH/HYSTERSALPINGOGRPH-OBC | $334.20 | $557.00 | $0.01 | 44% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTERGRPH/HYSTERSALPINGOGRPH-OBC | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-JOB | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-IVF | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-XM | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI-JDI | $334.20 | $557.00 | $151.50–$490.16 | — | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY SURGICAL WITH ENDOMETRIAL ABLATION-BAMB | $4,768.20 | $7,947.00 | $2,161.58–$6,993.36 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY SURG W/BX ENDOMETRIUM /POLYPECTOMY W/WO DC-OBC | $4,156.80 | $6,928.00 | $0.01 | 5% below | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C-IVF | $4,156.80 | $6,928.00 | $1,017.00–$5,200.00 | 5% below | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C-IVF | $4,156.80 | $6,928.00 | $2,424.80–$6,096.64 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY SURG W/BX ENDOMETRIUM /POLYPECTOMY W/WO DC-OBC | $4,156.80 | $6,928.00 | $2,424.80–$6,096.64 | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-MFCC | $418.20 | $697.00 | $189.58–$613.36 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FAY | $418.20 | $697.00 | $189.58–$613.36 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-OBC | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE-SPFM | $418.20 | $697.00 | $189.58–$613.36 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FIPS | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE-NFM | $418.20 | $697.00 | $189.58–$613.36 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERING DEVICE -NSOB | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE EF | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE-FUL | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JOB | $418.20 | $697.00 | $0.01 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-IVF | $418.20 | $697.00 | $189.58–$613.36 | at median | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE-EC | $502.20 | $837.00 | $227.66–$736.56 | 20% above | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-MFCC | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-OBC | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-IVF | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE-NFM | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERING DEVICE -NSOB | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE-FUL | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FAY | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE-SPFM | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE EF | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FIPS | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-AFM | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FFH | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-BAMB | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FMCJ | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-MFMC | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-FMCK | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JFMC | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JFMM | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JFMD | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JFMV | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IUD)-JOB | $418.20 | $697.00 | $189.58–$613.36 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE-EC | $502.20 | $837.00 | $227.66–$736.56 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SM | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EFOU | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MCLN | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OBTR | $254.40 | $424.00 | $188.93–$1,795.00 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-HVCK | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MOIP | $254.40 | $424.00 | $188.93–$1,795.00 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-NFM | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-WRIM | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-NSOB | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EF | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CAC | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-LAD | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FIPS | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FUL | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JIMC | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PC | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FAY | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EAC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FV | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JMOI | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JOB | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-POSC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OPU | $254.40 | $424.00 | $188.93–$1,795.00 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PACU | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OCJC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-TSBW | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-HBVC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SS | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CSJC | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MED | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MEDI | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CHPC | $254.40 | $424.00 | $188.93–$1,795.00 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PESC | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MEE | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OBC | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EDOU | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-AM | $254.40 | $424.00 | $148.40–$373.12 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE -JPED | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JSCM | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SPFM | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JENT | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SPGP | $254.40 | $424.00 | $0.01 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JCD | $254.40 | $424.00 | $188.93–$196.27 | 10% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUCX | $305.40 | $509.00 | $188.93–$264.00 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUCJ | $305.40 | $509.00 | $178.15–$447.92 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUC | $305.40 | $509.00 | $178.15–$447.92 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JER | $305.40 | $509.00 | $188.93–$196.27 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JUTR | $305.40 | $509.00 | $178.15–$447.92 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EC | $305.40 | $509.00 | $178.15–$447.92 | 8% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-BAMB | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EFOU | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EAC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FIPS | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MOIP | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MCLN | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-POSC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MEDI | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MED | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SS | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-HBVC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-TSBW | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PACU | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OPU | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-AFM | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FFH | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EDOU | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MEE | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CHPC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FMCJ | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MFMC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FMCK | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-DSSC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-LAD | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFME | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMM | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMB | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMD | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFML | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMO | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JFMV | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JIMC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JMOI | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JOB | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE -JPED | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JSCC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JSCM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JENT | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-PESC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OBC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OCJC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CSAS | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CSJC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-OBTR | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-HVCK | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-NFM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-NSOB | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-CAC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FUL | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FAY | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-FV | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SPFM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SPGP | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JCD | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-SM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-WRIM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EF | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-AM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUC | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-EC | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUCX | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-MUCJ | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JER | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE-JUTR | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-AM | $401.40 | $669.00 | $280.68–$1,795.00 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-CSJC | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ,TEND SHEATH,LIG,TRIGGER PTS/GANG CYST-WRIM | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JMOI | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER POINT INJECTION SM | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER POINT INJECTION-CPCR | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-MCLN | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH,LIG TRIGGER PT OR GANG | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JIR | $401.40 | $669.00 | $234.15–$588.72 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-SPFM | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ. TENDON SHEATH, LIGA., TRIGGER/GANGLION CYST | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-FV | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-NFM | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-FUL | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH, LIGAMENT, APONEUROSIS-XO | $401.40 | $669.00 | $280.68–$1,795.00 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-FAY | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-POSC | $401.40 | $669.00 | $0.01 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JPOD | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER POINT INJECTION-PMR | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ. TENDON SHEATH LIGA. TRIGGER/GANGLION CYST-OCJC | $401.40 | $669.00 | $280.68–$291.58 | 24% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-FUL | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-AM | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JIR | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH, LIGAMENT, APONEUROSIS-XO | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER POINT INJECTION-PMR | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ,TEND SHEATH,LIG,TRIGGER PTS/GANG CYST-WRIM | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER POINT INJECTION SM | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-SPFM | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-FV | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-FAY | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-POSC | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-AFM | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-FFH | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-BAMB | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER POINT INJECTION-CPCR | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-MCLN | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH,LIG TRIGGER PT OR GANG | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ. TENDON SHEATH, LIGA., TRIGGER/GANGLION CYST | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH/LIGAMENT,APONEUROSIS-NFM | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-CSJC | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ. TENDON SHEATH LIGA. TRIGGER/GANGLION CYST-OCJC | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JPOD | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JMOI | $401.40 | $669.00 | $234.15–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JFMV | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JFMD | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JFMB | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JFMM | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-JFMC | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-FMCK | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-MFMC | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH/LIGAMENT APONEUROSIS-FMCJ | $401.40 | $669.00 | $181.97–$588.72 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJECT LARGE JOINT XM | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-CBCC | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JIR | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-PC | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JCT | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-XO | $453.60 | $756.00 | $280.68–$1,795.00 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIRATION/INJ, MAJ JNT/BURSA W/O US GUID-EF | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-FUL | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JPMR | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCNTESIS, ASP AND/OR INJECT; MAJOR JT/BURS/GANG CYST-SC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROSCENTESIS, ASP/INJ; MAJOR JT, BURSA, OR GANG. CYST-MS | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-NFM | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-CSJC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JIMC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESISASPIRATION/INJ MAJ JNT/BURSA W/O US GUID-OCJC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JMOI | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-PESC | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS; ASP AND/OR INJECT MAJOR JT/BURS/GANG CYST | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JVC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, MAJOR JOINT OR BURSA | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJECTION LARGE JOINT SM | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-SPFM | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROSCENTESIS, ASP/INJ; MAJOR JNT, BURSA, GANG. CYST-OPU | $453.60 | $756.00 | $280.68–$1,795.00 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA.FV | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-7E | $453.60 | $756.00 | $280.68–$1,795.00 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS,ASP/INJ.MAJOR JOINT OR BURSA-FAY | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-POSC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-MCLN | $453.60 | $756.00 | $280.68–$291.58 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJECTION LARGE JOINT-CPCR | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJECT LARGE JOINT-AM | $453.60 | $756.00 | $264.60–$665.28 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JPMC | $453.60 | $756.00 | $0.01 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJECT LARGE JOINT-CM | $453.60 | $756.00 | $280.68–$1,795.00 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-CHPC | $453.60 | $756.00 | $280.68–$1,795.00 | 56% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUCX | $544.20 | $907.00 | $202.00–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-EC | $544.20 | $907.00 | $280.68–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUCJ | $544.20 | $907.00 | $202.00–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JER | $544.20 | $907.00 | $280.68–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JUTR | $544.20 | $907.00 | $202.00–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUC | $544.20 | $907.00 | $202.00–$291.58 | 87% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JVC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA W/O US-FFH | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA W/O US-AFM | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROSCENTESIS, ASP/INJ; MAJOR JNT, BURSA, GANG. CYST-OPU | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JPMR | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JPMC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-7E | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JMOI | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-PESC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-POSC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JIMC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESISASPIRATION/INJ MAJ JNT/BURSA W/O US GUID-OCJC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-CSJC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMV | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-NFM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMO | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFML | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROSCENTESIS, ASP/INJ; MAJOR JT, BURSA, OR GANG. CYST-MS | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCNTESIS, ASP AND/OR INJECT; MAJOR JT/BURS/GANG CYST-SC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMD | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMB | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-FUL | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMM | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ.MAJOR JOINT OR BURSA-FAY | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA.FV | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFME | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JFMC | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS,ASP/INJ MAJOR JOINT/BURSA-SPFM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA- MTJR | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJECTION LARGE JOINT SM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-MCLN | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-FMCK | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, MAJOR JOINT OR BURSA | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS; ASP AND/OR INJECT MAJOR JT/BURS/GANG CYST | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA W/O US-MFMC | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, ASPIRATION/INJ, MAJ JNT/BURSA W/O US GUID-EF | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-FMCJ | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-XO | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-PC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-JCT | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JIR | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-CBCC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ MAJOR JOINT/BURSA-CHPC | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJECT LARGE JOINT XM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJECT LARGE JOINT-CM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJECTION LARGE JOINT-CPCR | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJECT LARGE JOINT-AM | $453.60 | $756.00 | $264.60–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATN &/INJECT MJR JNT/BURSA WO US-BAMB | $453.60 | $756.00 | $205.63–$665.28 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JER | $544.20 | $907.00 | $317.45–$798.16 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUC | $544.20 | $907.00 | $296.00–$798.16 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUCJ | $544.20 | $907.00 | $296.00–$798.16 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-EC | $544.20 | $907.00 | $317.45–$798.16 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS/ASPIRATN &/INJECT MJR JNT/BURSA WO US-JUTR | $544.20 | $907.00 | $296.00–$798.16 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASP/INJ LARGE JT SHLDR HIP KNEE-MUCX | $544.20 | $907.00 | $296.00–$798.16 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-FUL | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-SPFM | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-FAY | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-SC | $186.00 | $310.00 | $122.56–$127.32 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-NSOB | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-NSFM | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN/DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-OBC | $186.00 | $310.00 | $122.56–$127.32 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-PESC | $186.00 | $310.00 | $122.56–$127.32 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-MFCC | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JOB | $186.00 | $310.00 | $0.01 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-CBCC | $186.00 | $310.00 | $122.56–$1,795.00 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-CHPC | $186.00 | $310.00 | $108.50–$272.80 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB; BIODEGRD; NONBIODEGRD)-PACU | $186.00 | $310.00 | $108.50–$272.80 | 1% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB; BIODEGRD; NONBIODEGRD)-DSSC | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JFMM | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-SPFM | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN/DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-OBC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JFMC | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-FMCK | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-PESC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-BAMB | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-FUL | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-CHPC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-CBCC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB; BIODEGRD; NONBIODEGRD)-FMCJ | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB BIODEGRD NONBIODEGRD)-MFMC | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-SC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-FFH | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-MFCC | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-AFM | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-NSOB | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB; BIODEGRD; NONBIODEGRD)-PACU | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JOB | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-FAY | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JFMV | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN DRUG-DEL IMP (BIORESRB/BIODEGRD/NONBIODEGRD)-JFMD | $186.00 | $310.00 | $84.32–$272.80 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTN, DRUG-DEL IMP (BIORESRB, BIODEGRD, NONBIODEGRD)-NSFM | $186.00 | $310.00 | $108.50–$272.80 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-OCJC | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-CSJC | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT/BURSA-NFM | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT/BURSA-SPFM | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION/INJECTION MEDIUM JOINT SM | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-WRIM | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS; ASP AND/OR INJECT INTERMEDJT/BURS/GANG CYST | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-XO | $393.00 | $655.00 | $229.25–$576.40 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JCT | $393.00 | $655.00 | $280.68–$1,795.00 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JIR | $393.00 | $655.00 | $280.68–$1,795.00 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR INJECT INTERMEDIATE JT-AM | $393.00 | $655.00 | $280.68–$1,795.00 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR INJECT INTERMEDIATE JT-MOC | $393.00 | $655.00 | $229.25–$576.40 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,ASP/INJ INT JOINT/BURSA-FUL | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, ASP AND/OR INJ INTERM BURSA,JT,GANG CYST | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, ASP/INJ;INTERMED. JOINT,BURSA, OR GANG CYST | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERMEDIATE JOINT OR BURSA-FAY | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-EAC | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-MCLN | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT OR BURSA-POSC | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION/INJECTION MEDIUM JOINT-CPCR | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT OR BURSA-FV | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-CHPC | $393.00 | $655.00 | $280.68–$1,795.00 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JIMC | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JMOI | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPMC | $393.00 | $655.00 | $0.01 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPOD | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPMR | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JSS | $393.00 | $655.00 | $229.25–$576.40 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-PESC | $393.00 | $655.00 | $280.68–$291.58 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-CBCC | $393.00 | $655.00 | $229.25–$576.40 | 16% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JER | $471.60 | $786.00 | $280.68–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP/INJ INTERMED JT BURSA -EC | $471.60 | $786.00 | $280.68–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUCJ | $471.60 | $786.00 | $202.00–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JUTR | $471.60 | $786.00 | $202.00–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUCX | $471.60 | $786.00 | $202.00–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUC | $471.60 | $786.00 | $202.00–$291.58 | 39% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA W/O US-MFMC | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-FMCJ | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-CBCC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, ASP AND/OR INJ INTERM BURSA,JT,GANG CYST | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,ASP/INJ INT JOINT/BURSA-FUL | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR INJECT INTERMEDIATE JT-MOC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR INJECT INTERMEDIATE JT-AM | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JIR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JCT | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-XO | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS; ASP AND/OR INJECT INTERMEDJT/BURS/GANG CYST | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-WRIM | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFMB | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INTERMEDIATE JOINT OR BURSA-FAY | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT/BURSA-NFM | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION/INJECTION MEDIUM JOINT SM | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFMO | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT/BURSA-SPFM | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-CSJC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-PESC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-CHPC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFMV | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JIMC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JSS | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JMOI | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPMC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-OCJC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA W/O US-AFM | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT OR BURSA-FV | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA W/O US-FFH | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-BAMB | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPOD | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION/INJECTION MEDIUM JOINT-CPCR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JPMR | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFME | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-MCLN | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,ASP/INJ INTERMEDIATE JOINT OR BURSA-POSC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP AND/OR INJECT INTERMED JNT/BURSA-EAC | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFMC | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, ASP/INJ;INTERMED. JOINT,BURSA, OR GANG CYST | $393.00 | $655.00 | $229.25–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JFMM | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-FMCK | $393.00 | $655.00 | $178.16–$576.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JUTR | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUC | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP/INJ INTERMED JT BURSA -EC | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUCJ | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPIRATN &/INJECT INTMD JNT/BURSA WO US-JER | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASP/INJ MED JOINT BURSA CYST WST/AKL-MUCX | $471.60 | $786.00 | $275.10–$691.68 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-PESC | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JPOD | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-FV | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,ASP/INJ SMLGL JOINT/BURSA-SPFM | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMLGL JOINT/BURSA-NSFM | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-FUL | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JIMC | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-FAY | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROSCENTESIS ASP./INJ.;SM. JT BURSAOR GANG. CYST-OCJC | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-SPGP | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION/INJECTION SMALL JOINT SM | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROSCENTESIS, ASP./INJ.;SM. JT, BURSA,OR GANG. CYST-MS | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE W/O US-PMR | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JMOI | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA W/O US-XO | $376.80 | $628.00 | $280.68–$1,795.00 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JPMR | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-CSJC | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION/INJECTION SMALL JOINT-CPCR | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-CHPC | $376.80 | $628.00 | $280.68–$1,795.00 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-CBCC | $376.80 | $628.00 | $219.80–$552.64 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-MCLN | $376.80 | $628.00 | $280.68–$291.58 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP AND/OR INJ SM BURSA,JT,OR GANG CYST | $376.80 | $628.00 | $0.01 | 38% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JER | $451.80 | $753.00 | $280.68–$291.58 | 65% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-MUCX | $451.80 | $753.00 | $202.00–$291.58 | 65% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-MUCJ | $451.80 | $753.00 | $202.00–$291.58 | 65% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-EC | $451.80 | $753.00 | $280.68–$291.58 | 65% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROSCENTESIS ASP./INJ.;SM. JT BURSAOR GANG. CYST-OCJC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-PESC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JPMR | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JPOD | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JMOI | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JIMC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JFMV | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JFMO | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-CSJC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMLGL JOINT/BURSA-NSFM | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROSCENTESIS, ASP./INJ.;SM. JT, BURSA,OR GANG. CYST-MS | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP AND/OR INJ SM BURSA,JT,OR GANG CYST | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-FUL | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-FAY | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-MCLN | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-FV | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,ASP/INJ SMLGL JOINT/BURSA-SPFM | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,ASP/INJ SM JOINT/BURSA-SPGP | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION/INJECTION SMALL JOINT SM | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE W/O US-PMR | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA W/O US-XO | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JFMB | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-JFMC | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-FMCK | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA W/O US-MFMC | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS/ASPIRATN &/INJECT SML JOINT/BURSA WO US-FMCJ | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-CBCC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-CHPC | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION/INJECTION SMALL JOINT-CPCR | $376.80 | $628.00 | $219.80–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-BAMB | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA W/O US-FFH | $376.80 | $628.00 | $170.82–$552.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATN &/INJECT SML JOINT/BURSA WO US-JER | $451.80 | $753.00 | $263.55–$662.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-EC | $451.80 | $753.00 | $263.55–$662.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-MUCJ | $451.80 | $753.00 | $263.55–$662.64 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP/INJ SMALL JT BURSA FINGER/TOE-MUCX | $451.80 | $753.00 | $263.55–$662.64 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPIC KNEE SURGERY; DEBRIDE/SHAVE ARTCLR CARTLG-OCJC | $3,750.00 | $6,250.00 | $3,085.09–$5,900.00 | 46% below | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPIC KNEE SURGERY; DEBRIDE/SHAVE ARTCLR CARTLG-MCLN | $3,750.00 | $6,250.00 | $3,085.09–$5,900.00 | 46% below | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPIC KNEE SURGERY; DEBRIDE/SHAVE ARTCLR CARTLG-MCLN | $3,750.00 | $6,250.00 | $2,187.50–$5,500.00 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPIC KNEE SURGERY; DEBRIDE/SHAVE ARTCLR CARTLG-OCJC | $3,750.00 | $6,250.00 | $2,187.50–$5,500.00 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY, SURGICAL, APPENDECTOMY-EC | $7,317.60 | $12,196.00 | $5,547.51–$7,500.00 | 9% above | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY, SURGICAL, APPENDECTOMY-EC | $7,317.60 | $12,196.00 | $1,285.00–$10,732.48 | — | 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 | $521.63–$541.89 | 1% above | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 LASER SURGERY (ONE OR MORE STAGES) | $766.20 | $1,277.00 | $521.63–$541.89 | 1% above | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 LASER SURGERY (ONE OR MORE STAGES) | $766.20 | $1,277.00 | $446.95–$1,123.76 | — | 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 | $446.95–$1,123.76 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-MCLN | $484.80 | $808.00 | $379.89–$1,795.00 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-CHPC | $484.80 | $808.00 | $282.80–$711.04 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-EAC | $484.80 | $808.00 | $0.01 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS WOUND SCP,AX,TRK,EXT 2.5CM OR LESS | $484.80 | $808.00 | $379.89–$394.64 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-CBCC | $484.80 | $808.00 | $379.89–$1,795.00 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-EOU | $484.80 | $808.00 | $282.80–$711.04 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JIMC | $484.80 | $808.00 | $379.89–$394.64 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE SCLP,TRUNK EXTREMITIES 2.5CM OR LESS-HBVC | $484.80 | $808.00 | $0.01 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS WND SCLP,AXILLAE,TRUNK,EXTREM.2.5CM/LES-NSFM | $484.80 | $808.00 | $0.01 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-SPFM | $484.80 | $808.00 | $0.01 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JSCM | $484.80 | $808.00 | $379.89–$394.64 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR, SCALP, TRUNK, EXT. 0-2.5CM EF | $484.80 | $808.00 | $0.01 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-PESC | $484.80 | $808.00 | $379.89–$394.64 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAY CLOS WND SCALP,AXILLAE,TRUNK,EXTREM.2.5 CM/LES-JCD | $484.80 | $808.00 | $379.89–$394.64 | 12% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE WND SCLP TNK EXT 2.5CM OR LESS-EC | $582.00 | $970.00 | $339.50–$853.60 | 34% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JER | $582.00 | $970.00 | $339.50–$853.60 | 34% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JIMC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-EAC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-MCLN | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE SCLP,TRUNK EXTREMITIES 2.5CM OR LESS-HBVC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-AFM | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-FFH | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-EOU | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-CHPC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE WOUNDS SCLP/AX/TK AND/EXT 2.5CM/LSS-CBCC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-FMCJ | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-MFMC | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE REPAIR, SCALP, TRUNK, EXT. 0-2.5CM-DSSC | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JFML | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JSCM | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-PESC | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-CSAS | $484.80 | $808.00 | $219.78–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS WND SCLP,AXILLAE,TRUNK,EXTREM.2.5CM/LES-NSFM | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS WOUND SCP,AX,TRK,EXT 2.5CM OR LESS | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-SPFM | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAY CLOS WND SCALP,AXILLAE,TRUNK,EXTREM.2.5 CM/LES-JCD | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE REPAIR, SCALP, TRUNK, EXT. 0-2.5CM EF | $484.80 | $808.00 | $282.80–$711.04 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE WND SCLP TNK EXT 2.5CM OR LESS-EC | $582.00 | $970.00 | $339.50–$853.60 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE WOUND REPAIR SCALP/AX/TRUNK/EXT 2.5CM/LESS-JER | $582.00 | $970.00 | $339.50–$853.60 | — | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV-JCLB | $7,387.80 | $12,313.00 | $3,058.27–$11,830.00 | 12% above | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV | $7,387.80 | $12,313.00 | $3,058.27–$11,830.00 | 12% above | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV-JCLB | $7,387.80 | $12,313.00 | $4,309.55–$10,835.44 | — | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV | $7,387.80 | $12,313.00 | $4,309.55–$10,835.44 | — | 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 | $710.50–$1,786.40 | 15% below | 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 | $710.50–$1,786.40 | 15% below | 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 | $0.01 | 15% below | 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 | $0.01 | 15% below | 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 | $710.50–$1,786.40 | 15% below | 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 | $0.01 | 15% below | 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 | $658.47–$1,980.00 | 15% below | 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 | $710.50–$1,786.40 | 15% below | 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 | $710.50–$1,786.40 | 15% below | 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 | $710.50–$1,786.40 | 15% below | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $710.50–$1,786.40 | — | 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 | $649.95–$1,634.16 | at median | 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 | $846.52–$1,980.00 | at median | 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 | $649.95–$1,634.16 | at median | 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 | $649.95–$1,634.16 | — | 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 | $649.95–$1,634.16 | — | 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 | $649.95–$1,634.16 | — | 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 | $846.52–$1,980.00 | 2% below | 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 | $846.52–$879.39 | 2% below | 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 | $861.00–$2,164.80 | 2% below | 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 | $846.52–$1,980.00 | 2% below | 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 | $846.52–$1,980.00 | 2% below | 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 | $861.00–$2,164.80 | 2% below | 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 | $846.52–$1,980.00 | 2% below | 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 | $0.01 | 2% below | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 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 | $861.00–$2,164.80 | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL - EF | $4,332.00 | $7,220.00 | $2,527.00–$6,353.60 | 19% above | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL - EF | $4,332.00 | $7,220.00 | $2,527.00–$6,353.60 | — | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TRTMNT OF MISSED ABORTION; 1ST TRIMESTER-OBTR | $3,793.80 | $6,323.00 | $3,023.21–$5,200.00 | 19% below | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISSED ABORTION 1ST TRIMESTER-IVF | $3,793.80 | $6,323.00 | $3,023.21–$5,200.00 | 19% below | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TRTMNT OF MISSED ABORTION 1ST TRIMESTER-EC | $4,552.20 | $7,587.00 | $1,285.00–$6,676.56 | 3% below | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TRTMNT OF MISSED ABORTION; 1ST TRIMESTER-OBTR | $3,793.80 | $6,323.00 | $2,213.05–$5,564.24 | — | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT OF MISSED ABORTION 1ST TRIMESTER-IVF | $3,793.80 | $6,323.00 | $2,213.05–$5,564.24 | — | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TRTMNT OF MISSED ABORTION 1ST TRIMESTER-EC | $4,552.20 | $7,587.00 | $1,285.00–$6,676.56 | — | 40% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS HD, NK, FEET UP TO 5 TISSUE BLKS-DSSC | $669.60 | $1,116.00 | $303.55–$982.08 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARMS,LEGS.0.5 CM/LES-FUL | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LES EXC SK TAG TRUNK ARMS LEGS.0.5 CM/LESS-CHPC | $849.00 | $1,415.00 | $495.25–$1,245.20 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-HBVC | $849.00 | $1,415.00 | $0.01 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LES EXC SK TAG TRUNK ARMS LEGS.0.5 CM/LESS-CBCC | $849.00 | $1,415.00 | $669.00–$1,980.00 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JIMC | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JSCM | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-PESC | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-OBC | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC,BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES-NFM | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC GEN SKIN LES X SKIN TAG TRK,ARMS,LEGS 0.5CM OR LESS | $849.00 | $1,415.00 | $0.01 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARMS,LEGS.0.5 CM/LES-FAY | $849.00 | $1,415.00 | $0.01 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC,BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES-SPFM | $849.00 | $1,415.00 | $0.01 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES.JCD | $849.00 | $1,415.00 | $0.01 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC. BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS EF | $849.00 | $1,415.00 | $669.00–$694.98 | 54% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUCJ | $1,018.80 | $1,698.00 | $202.00–$694.98 | 84% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUC | $1,018.80 | $1,698.00 | $202.00–$694.98 | 84% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUCX | $1,018.80 | $1,698.00 | $202.00–$694.98 | 84% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-PESC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JSCM | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JSCC | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JIMC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JFML | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JFMM | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-JFME | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS-DSSC | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-FMCK | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LES EXC SK TAG TRUNK ARMS LEGS.0.5 CM/LESS-CHPC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-BAMB | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-FFH | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-AFM | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-HBVC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC GEN SKIN LES X SKIN TAG TRK,ARMS,LEGS 0.5CM OR LESS | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-CSAS | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-OBC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LES EXC SK TAG TRUNK ARMS LEGS.0.5 CM/LESS-CBCC | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARMS,LEGS.0.5 CM/LES-FUL | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC,BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES-NFM | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-MFMC | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LSN EXPT SKN TAG TRUNK/ARMS/LEGS.0.5CM/LS-FMCJ | $849.00 | $1,415.00 | $384.88–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARMS,LEGS.0.5 CM/LES-FAY | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC. BENIGN LESION TRUNK, ARMS, LEGS 0.5 CM OR LESS EF | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC,BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES-SPFM | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LES,EXC SK TAG,TRUNK,ARM,LEG.0.5 CM/LES.JCD | $849.00 | $1,415.00 | $495.25–$1,245.20 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUCX | $1,018.80 | $1,698.00 | $296.00–$1,494.24 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUCJ | $1,018.80 | $1,698.00 | $296.00–$1,494.24 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BGN LSN TNK ARM LG 0.5CM OR LESS-MUC | $1,018.80 | $1,698.00 | $296.00–$1,494.24 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OTH BGN LSN FCE ERS EYLDS NS LPS MMEMB 0.5CM/LESS-CBCC | $1,058.40 | $1,764.00 | $669.00–$1,980.00 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-EAC | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC.OTHER BENIGN LESION 0.5CM OR LESS-HBVC | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-MEE | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OTH BGN LSN FCE ERS EYLDS NS LPS MMEMB 0.5CM/LESS-CHPC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-JSCM | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-JENT | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-PESC | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BEN LES FCE,EAR,EYLDS,NS,LIPS, 0.5CM OR LESS-NSFM | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES FCE, EARS, EYLDS,NS,LIPS, MMEM 0.5CM OR LESS | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BNG LSN FCE EARS EYELIDS NOSE LIP .5CM OR LESS | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BGN LSN FACE EARS EYELIDS NOSE LIP .5CM OR LESS-FUL | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BGN LSN FACE EARS EYELIDS NOSE LIP .5CM OR LESS-FAY | $1,058.40 | $1,764.00 | $669.00–$694.98 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC OTH BGN LES FA,EAR,EYLD,NS,LP,MUC MEMB.0.5CM/LES-SPFM | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC,OTH BGN LES,FAC,EAR,EYLD,NS,LP,MUC MEM.0.5CM/LES-JCD | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC. LESION FACE,EARS,EYELIDS,NOSE,LIPS,MUC. 0-.5CM EF | $1,058.40 | $1,764.00 | $0.01 | 67% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BNG LSN FCE EARS EYELIDS NOSE LIP .5CM OR LESS | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC.OTHER BENIGN LESION 0.5CM OR LESS-HBVC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BGN LSN FACE EARS EYELIDS NOSE LIP .5CM OR LESS-FUL | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES FCE, EARS, EYLDS,NS,LIPS, MMEM 0.5CM OR LESS | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-FFH | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-EAC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-CENT | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-BAMB | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-MEE | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OTH BGN LSN FCE ERS EYLDS NS LPS MMEMB 0.5CM/LESS-CHPC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OTH BGN LSN FCE ERS EYLDS NS LPS MMEMB 0.5CM/LESS-CBCC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-FMCJ | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-MFMC | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-FMCK | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BEN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM 5CM/LS-DSSC | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-JSCM | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-JENT | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-PESC | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LSN EXPT SKN TG FC/ER/EYLD/NS/LP/MM .5CM/LS-CSAS | $1,058.40 | $1,764.00 | $479.81–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BEN LES FCE,EAR,EYLDS,NS,LIPS, 0.5CM OR LESS-NSFM | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC,OTH BGN LES,FAC,EAR,EYLD,NS,LP,MUC MEM.0.5CM/LES-JCD | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC OTH BGN LES FA,EAR,EYLD,NS,LP,MUC MEMB.0.5CM/LES-SPFM | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC. LESION FACE,EARS,EYELIDS,NOSE,LIPS,MUC. 0-.5CM EF | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BGN LSN FACE EARS EYELIDS NOSE LIP .5CM OR LESS-FAY | $1,058.40 | $1,764.00 | $617.40–$1,552.32 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE JCD | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-SPFM | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-FV | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSE NAIL PLATE,PARTIAL/COMP,SIMPLE.SINGLE-FAY | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PART/COMPLETE SINGLE SIMPLE-MCLN | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE, PARTIAL/COMPLETE, SIMPLE SINGLE-POSC | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE (PART/COMPL, SIMPLE, SINGL)-TSBW | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE;SINGLE-CHPC | $234.60 | $391.00 | $136.85–$344.08 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE;SINGLE-CBCC | $234.60 | $391.00 | $188.93–$1,795.00 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JMOI | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JPOD | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JSCM | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-CSJC | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-NFM | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-SC | $234.60 | $391.00 | $188.93–$1,795.00 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-FUL | $234.60 | $391.00 | $0.01 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-EF | $234.60 | $391.00 | $188.93–$196.27 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SINGLE SIMPLE-JUTR | $281.40 | $469.00 | $164.15–$412.72 | 14% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUC | $281.40 | $469.00 | $188.93–$264.00 | 14% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUCX | $281.40 | $469.00 | $188.93–$264.00 | 14% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JER | $281.40 | $469.00 | $164.15–$412.72 | 14% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUCJ | $281.40 | $469.00 | $164.15–$412.72 | 14% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-EC | $281.40 | $469.00 | $188.93–$196.27 | 14% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE--FMCJ | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-MFMC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-FMCK | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART/COMPLETE SINGLE SIMPLE-DSSC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE;SINGLE-CHPC | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-FFH | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-BAMB | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-NFM | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE JCD | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE;SINGLE-CBCC | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMO | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-FV | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMV | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-SPFM | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JMOI | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-SC | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JPOD | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JSCM | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PART/COMPLETE SINGLE SIMPLE-MCLN | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-CSAS | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE, PARTIAL/COMPLETE, SIMPLE SINGLE-POSC | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-EF | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-CSJC | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE (PART/COMPL, SIMPLE, SINGL)-TSBW | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-AFM | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFME | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMM | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMB | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE,PARTIAL/COMPLETE,SIMPLE.SINGLE-FUL | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JFMD | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSE NAIL PLATE,PARTIAL/COMP,SIMPLE.SINGLE-FAY | $234.60 | $391.00 | $136.85–$344.08 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUCX | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE SINGLE-JER | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUCJ | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-EC | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE SIMPLE-MUC | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SINGLE SIMPLE-JUTR | $281.40 | $469.00 | $164.15–$412.72 | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-7E | $543.60 | $906.00 | $280.68–$1,795.00 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-AM | $543.60 | $906.00 | $280.68–$1,795.00 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-JIR | $543.60 | $906.00 | $280.68–$1,795.00 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-XO | $543.60 | $906.00 | $317.10–$797.28 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-PMR | $543.60 | $906.00 | $0.01 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-NCK | $543.60 | $906.00 | $280.68–$291.58 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-CSJC | $543.60 | $906.00 | $0.01 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-JPMC | $543.60 | $906.00 | $0.01 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-JNC | $543.60 | $906.00 | $280.68–$291.58 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-CPCR | $543.60 | $906.00 | $0.01 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-HBVC | $543.60 | $906.00 | $0.01 | 43% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-EC | $652.80 | $1,088.00 | $280.68–$291.58 | 72% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-JER | $652.80 | $1,088.00 | $280.68–$291.58 | 72% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUCX | $652.80 | $1,088.00 | $296.00–$957.44 | 72% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUCJ | $652.80 | $1,088.00 | $296.00–$957.44 | 72% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUC | $652.80 | $1,088.00 | $202.00–$291.58 | 72% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-NCK | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-AM | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-7E | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-FMCK | $543.60 | $906.00 | $246.43–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-HBVC | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-JNC | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-JPMC | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-CSJC | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES. GRT OCCIPITAL NERVE-CPCR | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-PMR | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-XO | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-JIR | $543.60 | $906.00 | $317.10–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-JFMM | $543.60 | $906.00 | $246.43–$797.28 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUC | $652.80 | $1,088.00 | $296.00–$957.44 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUCJ | $652.80 | $1,088.00 | $296.00–$957.44 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-JER | $652.80 | $1,088.00 | $380.80–$957.44 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-EC | $652.80 | $1,088.00 | $380.80–$957.44 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANEST AND/ STEROID; GREATER OCCIPITAL NERVE-MUCX | $652.80 | $1,088.00 | $296.00–$957.44 | — | 40% |
| Pacemaker implant (dual chamber) CPT 33208 PACEMAKER INSERT ELECT & GEN DUAL | $11,719.80 | $19,533.00 | $6,836.55–$17,189.04 | 29% below | 40% |
| Pacemaker implant (dual chamber) CPT 33208 PACEMAKER INSERT ELECT & GEN DUAL-JCLB | $11,719.80 | $19,533.00 | $7,314.00–$10,337.23 | 29% below | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER INSERT ELECT & GEN DUAL-JCLB | $11,719.80 | $19,533.00 | $6,836.55–$17,189.04 | — | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER INSERT ELECT & GEN DUAL | $11,719.80 | $19,533.00 | $6,836.55–$17,189.04 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING-JIR | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING AM | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING CM | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING-JCT | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-JEGC | $1,387.80 | $2,313.00 | $891.46–$2,650.00 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE-EFOU | $1,387.80 | $2,313.00 | $891.46–$2,650.00 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-MEDI | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-SICU | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W IMAGING GUIDANCE-AMS | $1,387.80 | $2,313.00 | $891.46–$2,650.00 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-OPU | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | 38% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-JER | $1,665.00 | $2,775.00 | $891.46–$926.08 | 65% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE EC | $1,665.00 | $2,775.00 | $891.46–$926.08 | 65% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-OPU | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-SICU | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING-JIR | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING CM | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING-JCT | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-JEGC | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W IMAGING GUIDANCE-AMS | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR ABD PARACENTISIS/DIAG OR THERAP WITH IMAGING AM | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE-EFOU | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-MEDI | $1,387.80 | $2,313.00 | $809.55–$2,035.44 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE-JER | $1,665.00 | $2,775.00 | $971.25–$2,442.00 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGING GUIDANCE EC | $1,665.00 | $2,775.00 | $971.25–$2,442.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-CHPC | $488.40 | $814.00 | $284.90–$716.32 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-SPFM | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JCD | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-MCLN | $488.40 | $814.00 | $379.89–$1,795.00 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-POSC | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-CBCC | $488.40 | $814.00 | $379.89–$1,795.00 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JMOI | $488.40 | $814.00 | $379.89–$1,795.00 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JPOD | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JEGC | $488.40 | $814.00 | $284.90–$716.32 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL & MATRIX EXCISION-OCJC | $488.40 | $814.00 | $379.89–$1,795.00 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-CSJC | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-NFM | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL & MATRIX EXCISION | $488.40 | $814.00 | $379.89–$394.64 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX,PARTIAL/COMPLETE,PERM REMOVE-FUL | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX,PARTIAL/COMP PERM REMOVAL-FAY | $488.40 | $814.00 | $0.01 | 17% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-EC | $585.60 | $976.00 | $341.60–$858.88 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JER | $585.60 | $976.00 | $341.60–$858.88 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX,PART/COMP PERM REMOVAL-MUC | $585.60 | $976.00 | $202.00–$394.64 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JUTR | $585.60 | $976.00 | $202.00–$394.64 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-MUCX | $585.60 | $976.00 | $202.00–$394.64 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-MUCJ | $585.60 | $976.00 | $296.00–$858.88 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-CHPC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX,PARTIAL/COMP PERM REMOVAL-FAY | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL & MATRIX EXCISION-OCJC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-CBCC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-FMCJ | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-MFMC | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-FMCK | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-MCLN | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-NFM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-POSC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-FFH | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-BAMB | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX,PARTIAL/COMPLETE,PERM REMOVE-FUL | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JPOD | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-CSJC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL & MATRIX EXCISION | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JMOI | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JFMV | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-SPFM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JCD | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCIS,NAIL AND NAIL MATRIX,PART/COMP PERM REMOVAL-DSSC | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JFME | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JFMB | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JFMD | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JFMO | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JEGC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/NAIL MATRIX,PART/COMPL,PERM REMOV-EC | $585.60 | $976.00 | $341.60–$858.88 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-MUCJ | $585.60 | $976.00 | $296.00–$858.88 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX,PART/COMP PERM REMOVAL-MUC | $585.60 | $976.00 | $296.00–$858.88 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL AND NAIL MATRIX PART/COMP PERM REMOVAL-MUCX | $585.60 | $976.00 | $296.00–$858.88 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JUTR | $585.60 | $976.00 | $296.00–$858.88 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISE NAIL/NAIL MATRIX PARTIAL/COMP PERM REMOVAL-JER | $585.60 | $976.00 | $341.60–$858.88 | — | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-EF | $1,790.40 | $2,984.00 | $0.01 | 35% below | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-CM | $1,790.40 | $2,984.00 | $1,017.00–$2,650.00 | 35% below | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH | $1,790.40 | $2,984.00 | $1,947.79–$2,023.44 | 35% below | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-EF | $1,790.40 | $2,984.00 | $1,044.40–$2,625.92 | — | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-CM | $1,790.40 | $2,984.00 | $1,044.40–$2,625.92 | — | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH | $1,790.40 | $2,984.00 | $1,044.40–$2,625.92 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-MCLN | $2,754.60 | $4,591.00 | $0.01 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-JPMC | $2,754.60 | $4,591.00 | $0.01 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-XM | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-AM | $2,754.60 | $4,591.00 | $1,017.00–$5,200.00 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-CSJC | $2,754.60 | $4,591.00 | $0.01 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-JIR | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-XO | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | 52% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-CSJC | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-AM | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-XM | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-JIR | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-JPMC | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-XO | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCT FACET NERVE(S) LUMBAR/SACRAL SINGLE W/IMAGING-MCLN | $2,754.60 | $4,591.00 | $1,606.85–$4,040.08 | — | 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 | $1,017.00–$5,200.00 | 78% above | 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 | $2,558.50–$6,432.80 | 78% above | 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 | $0.01 | 78% above | 40% |
| Removal of a breast lump, open surgery CPT 19120 EF EXCISIONAL BX BREAST | $4,386.00 | $7,310.00 | $2,558.50–$6,432.80 | 78% above | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EF EXCISIONAL BX BREAST | $4,386.00 | $7,310.00 | $2,558.50–$6,432.80 | — | 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 | $1,988.32–$6,432.80 | — | 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 | $2,558.50–$6,432.80 | — | 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 | $2,558.50–$6,432.80 | — | 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 | $2,558.50–$6,432.80 | — | 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 | $1,988.32–$6,432.80 | — | 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 | $1,988.32–$6,432.80 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SC | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-AM | $448.20 | $747.00 | $379.89–$1,795.00 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JSCM | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EF | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SM | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SPGP | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SPFM | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FC | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FAY | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FUL | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-NSOB | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EAC | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MCLN | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-HBVC | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-TSBW | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-IM | $448.20 | $747.00 | $379.89–$1,795.00 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-NFM | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CSJC | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-OCJC | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-PESC | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CHPC | $448.20 | $747.00 | $261.45–$657.36 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CBCC | $448.20 | $747.00 | $379.89–$1,795.00 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JENT | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JIMC | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JMOI | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JOB | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE -JPED | $448.20 | $747.00 | $0.01 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JPOD | $448.20 | $747.00 | $379.89–$394.64 | 9% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUCX | $538.80 | $898.00 | $202.00–$394.64 | 10% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EC | $538.80 | $898.00 | $314.30–$790.24 | 10% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUCJ | $538.80 | $898.00 | $202.00–$394.64 | 10% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JUTR | $538.80 | $898.00 | $296.00–$790.24 | 10% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JER | $538.80 | $898.00 | $379.89–$394.64 | 10% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUC | $538.80 | $898.00 | $296.00–$790.24 | 10% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-NFM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMV | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CSJC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JPOD | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CSAS | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-OCJC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JIMC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-BAMB | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JENT | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CHPC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE -JPED | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-PESC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JMOI | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-AM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-CBCC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FMCJ | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MFMC | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JOB | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SPGP | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SPFM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FMCK | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FAY | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-DSSC | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMC | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FUL | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JSCM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-SC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFME | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-NSOB | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EAC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMM | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MCLN | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMB | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMD | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-HBVC | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFML | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-TSBW | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-AFM | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EF | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-FFH | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JFMO | $448.20 | $747.00 | $203.18–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-IM | $448.20 | $747.00 | $261.45–$657.36 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-EC | $538.80 | $898.00 | $314.30–$790.24 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUCJ | $538.80 | $898.00 | $296.00–$790.24 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUCX | $538.80 | $898.00 | $296.00–$790.24 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JER | $538.80 | $898.00 | $314.30–$790.24 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-JUTR | $538.80 | $898.00 | $296.00–$790.24 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY/SUBQ TISSUES SIMPLE-MUC | $538.80 | $898.00 | $296.00–$790.24 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT-GIKC | $1,401.60 | $2,336.00 | $866.89–$1,980.00 | 3% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT-JEGC | $1,401.60 | $2,336.00 | $866.89–$1,980.00 | 3% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT -FVGI | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | 3% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT | $1,401.60 | $2,336.00 | $866.89–$1,980.00 | 3% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT -FVGI | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT-GIKC | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY CA SCRN NON HIGH RISK PT-JEGC | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREEN, HI RISK INDIV | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | 4% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREEN HI RISK INDIV-GIKC | $1,401.60 | $2,336.00 | $866.89–$1,980.00 | 4% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREEN HI RISK INDIV-JEGC | $1,401.60 | $2,336.00 | $866.89–$1,980.00 | 4% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCREEN, HI RISK INDIV -FVGI | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | 4% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCREEN, HI RISK INDIV -FVGI | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCREEN HI RISK INDIV-GIKC | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCREEN HI RISK INDIV-JEGC | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCREEN, HI RISK INDIV | $1,401.60 | $2,336.00 | $817.60–$2,055.68 | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF ELBOW TO FINGER CAST SM | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-JPOD | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF CAST SHORT ARM (ELBOW TO FINGER)-MCLN | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM) -POSC | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-CSJC | $270.00 | $450.00 | $0.01 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-JMOI | $270.00 | $450.00 | $0.01 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION SHORT ARM CAST-OCJC | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM)-FAY | $270.00 | $450.00 | $0.01 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION SHORT ARM CAST | $270.00 | $450.00 | $252.52–$262.33 | 1% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-MUCX | $324.60 | $541.00 | $202.00–$264.00 | 21% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST- ADULT SHORT ARM-EC | $324.60 | $541.00 | $189.35–$476.08 | 21% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-MUCJ | $324.60 | $541.00 | $202.00–$264.00 | 21% above | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF CAST SHORT ARM (ELBOW TO FINGER)-MCLN | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-BAMB | $270.00 | $450.00 | $122.40–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM)-FAY | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION SHORT ARM CAST | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-CSJC | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION SHORT ARM CAST-OCJC | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-JPOD | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-JMOI | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM) -POSC | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF ELBOW TO FINGER CAST SM | $270.00 | $450.00 | $157.50–$396.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST- ADULT SHORT ARM-EC | $324.60 | $541.00 | $189.35–$476.08 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-MUCX | $324.60 | $541.00 | $189.35–$476.08 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW TO FINGER (SHORT ARM)-MUCJ | $324.60 | $541.00 | $189.35–$476.08 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-JMOI | $202.80 | $338.00 | $0.01 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT (FOREARM TO HAND) STATIC-NFM | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-LAD | $202.80 | $338.00 | $122.56–$1,795.00 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT (FOREARM TO H&)STATIC-FUL | $202.80 | $338.00 | $0.01 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC-EDOU | $202.80 | $338.00 | $122.56–$1,795.00 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC FAY | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATN OF SHORT ARM SPLINT (FOREARM TO HAND) STATIC-SPFM | $202.80 | $338.00 | $0.01 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-MCLN | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-POSC | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-SURG | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC SM | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-OCJC | $202.80 | $338.00 | $122.56–$127.32 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC -JPED | $202.80 | $338.00 | $0.01 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-CSJC | $202.80 | $338.00 | $0.01 | 9% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUC | $243.60 | $406.00 | $122.56–$264.00 | 31% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-JER | $243.60 | $406.00 | $142.10–$357.28 | 31% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-JUTR | $243.60 | $406.00 | $142.10–$357.28 | 31% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-EC | $243.60 | $406.00 | $142.10–$357.28 | 31% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUCX | $243.60 | $406.00 | $122.56–$264.00 | 31% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUCJ | $243.60 | $406.00 | $122.56–$264.00 | 31% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-FFH | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-MCLN | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-POSC | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-AFM | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC-EDOU | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-BAMB | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND; STATIC FMCJ | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-MFMC | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATN OF SHORT ARM SPLINT (FOREARM TO HAND) STATIC-FMCK | $202.80 | $338.00 | $91.94–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-LAD | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-JMOI | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC -JPED | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-OCJC | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC-CSJC | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT (FOREARM TO HAND) STATIC-NFM | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-SURG | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT (FOREARM TO H&)STATIC-FUL | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC FAY | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATN OF SHORT ARM SPLINT (FOREARM TO HAND) STATIC-SPFM | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT, STATIC SM | $202.80 | $338.00 | $118.30–$297.44 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-JER | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-EC | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUCX | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUCJ | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-MUC | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT-JUTR | $243.60 | $406.00 | $142.10–$357.28 | — | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-POSC | $321.60 | $536.00 | $252.52–$262.33 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CBCC | $321.60 | $536.00 | $252.52–$1,795.00 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CHPC | $321.60 | $536.00 | $252.52–$1,795.00 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JMOI | $321.60 | $536.00 | $0.01 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JPOD | $321.60 | $536.00 | $252.52–$262.33 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-MCLN | $321.60 | $536.00 | $252.52–$262.33 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST-OCJC | $321.60 | $536.00 | $252.52–$262.33 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CSJC | $321.60 | $536.00 | $0.01 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST SM | $321.60 | $536.00 | $252.52–$262.33 | 13% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JER | $385.80 | $643.00 | $225.05–$565.84 | 36% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST-MUC | $385.80 | $643.00 | $202.00–$264.00 | 36% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST-MUCJ | $385.80 | $643.00 | $202.00–$264.00 | 36% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST-JUTR | $385.80 | $643.00 | $225.05–$565.84 | 36% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST PLAS-EC | $385.80 | $643.00 | $252.52–$262.33 | 36% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST-MUCX | $385.80 | $643.00 | $202.00–$264.00 | 36% above | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JPOD | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CHPC | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CBCC | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-MCLN | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST SM | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST-OCJC | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-CSJC | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-WPT | $321.60 | $536.00 | $145.79–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JMOI | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-POSC | $321.60 | $536.00 | $187.60–$471.68 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST-MUCX | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST PLAS-EC | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST-MUCJ | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST-MUC | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST-JUTR | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST (BELOW KNEE TO TOES)-JER | $385.80 | $643.00 | $225.05–$565.84 | — | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-POSC | $216.60 | $361.00 | $150.03–$155.86 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT SM | $216.60 | $361.00 | $150.03–$155.86 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-CSJC | $216.60 | $361.00 | $0.01 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-JPOD | $216.60 | $361.00 | $150.03–$155.86 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-JMOI | $216.60 | $361.00 | $0.01 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-MCLN | $216.60 | $361.00 | $150.03–$155.86 | 9% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUCX | $260.40 | $434.00 | $150.03–$264.00 | 31% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATON OF SHORT LEG SPLINT-EC | $260.40 | $434.00 | $150.03–$155.86 | 31% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATON OF SHORT LEG SPLINT-JER | $260.40 | $434.00 | $151.90–$381.92 | 31% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUCJ | $260.40 | $434.00 | $150.03–$264.00 | 31% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUC | $260.40 | $434.00 | $150.03–$264.00 | 31% above | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT-JUTR | $260.40 | $434.00 | $151.90–$381.92 | 31% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-POSC | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-FFH | $216.60 | $361.00 | $98.19–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-JMOI | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-JFML | $216.60 | $361.00 | $98.19–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-MFMC | $216.60 | $361.00 | $98.19–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-JFME | $216.60 | $361.00 | $98.19–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-CSJC | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-MCLN | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT SM | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT (CALF TO FOOT)-JPOD | $216.60 | $361.00 | $126.35–$317.68 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUC | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-JUTR | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATON OF SHORT LEG SPLINT-JER | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUCX | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT LEG SPLINT-MUCJ | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATON OF SHORT LEG SPLINT-EC | $260.40 | $434.00 | $151.90–$381.92 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-LAD | $261.00 | $435.00 | $152.25–$382.80 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JIMC | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-OBTR | $261.00 | $435.00 | $152.25–$382.80 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-HVCK | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-NFM | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCLP,TRUNK, NK 2.5CM OR LESS-SUR | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CAC | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-FUL | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMP RPR SPRFCL WND OF SCLP,NCK 2.5 CM/ LES-FAY | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-SPFM | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCLP,TRUNK, NK 2.5CM OR LESS-SPGP | $261.00 | $435.00 | $0.01 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPERF WND SCLP, NK, AX, TRUNK 2.5CM OR LESS-JCD | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 2.5CM OR LESS SKP NKTRK HNDS FEET-MCLN | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-TSBW | $261.00 | $435.00 | $188.93–$196.27 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-AMS | $261.00 | $435.00 | $188.93–$1,795.00 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCLP TRUNK NK 2.5CM OR LESS-EDOU | $261.00 | $435.00 | $152.25–$382.80 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-PC | $261.00 | $435.00 | $152.25–$382.80 | 1% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP. WND SCALP, NO FACE/EAR 0-2.5CM-EC | $313.80 | $523.00 | $183.05–$460.24 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JER | $313.80 | $523.00 | $183.05–$460.24 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCALP NO FACE/EARS 0-2.5CM-MUCJ | $313.80 | $523.00 | $183.05–$460.24 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JUTR | $313.80 | $523.00 | $188.93–$264.00 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCALP, NO FACE/EARS 0-2.5CM-MUC | $313.80 | $523.00 | $188.93–$264.00 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE RPR SUP WND SCALP NO FACE/EARS 0-2.5CM-MUCX | $313.80 | $523.00 | $188.93–$264.00 | 22% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CAC | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-BAMB | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFME | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-FUL | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMP RPR SPRFCL WND OF SCLP,NCK 2.5 CM/ LES-FAY | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMC | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 2.5CM OR LESS SKP, NK,HNDS FEET-DSSC | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-SPFM | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-LAD | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCLP,TRUNK, NK 2.5CM OR LESS-SPGP | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-PC | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPERF WND SCLP, NK, AX, TRUNK 2.5CM OR LESS-JCD | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-FMCJ | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMB | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-FFH | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-FMCK | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMP RPR SUP WND SCLP,NCK 2.5 CM/ LES-NFM | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCLP,TRUNK, NK 2.5CM OR LESS-SUR | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCLP TRUNK NK 2.5CM OR LESS-EDOU | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 2.5CM OR LESS SKP NKTRK HNDS FEET-MCLN | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-MFMC | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-TSBW | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-AMS | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-AFM | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMM | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-HVCK | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMD | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFML | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMO | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JFMV | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JIMC | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JSCC | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CSAS | $261.00 | $435.00 | $118.32–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-OBTR | $261.00 | $435.00 | $152.25–$382.80 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JER | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCALP, NO FACE/EARS 0-2.5CM-MUC | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-JUTR | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCALP NO FACE/EARS 0-2.5CM-MUCJ | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP. WND SCALP, NO FACE/EAR 0-2.5CM-EC | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE RPR SUP WND SCALP NO FACE/EARS 0-2.5CM-MUCX | $313.80 | $523.00 | $183.05–$460.24 | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MEDI | $346.20 | $577.00 | $201.95–$507.76 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MCLN | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-KENT | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EF | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EDOU | $346.20 | $577.00 | $201.95–$507.76 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MEE | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-LAD | $346.20 | $577.00 | $201.95–$507.76 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-OPU | $346.20 | $577.00 | $379.89–$1,795.00 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JPOD | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JOB | $346.20 | $577.00 | $0.01 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JCD | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JNC | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JIMC | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-TSBW | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JSCM | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JENT | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-SPFM | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FAY | $346.20 | $577.00 | $0.01 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-PESC | $346.20 | $577.00 | $0.01 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-OBC | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FUL | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-SC | $346.20 | $577.00 | $0.01 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MS | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NSOB | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-HBVC | $346.20 | $577.00 | $0.01 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NCK | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NSFM | $346.20 | $577.00 | $379.89–$394.64 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-7E | $346.20 | $577.00 | $379.89–$1,795.00 | 4% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EC | $415.20 | $692.00 | $379.89–$394.64 | 25% above | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NCK | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MEE | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JOB | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-BAMB | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EDOU | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-FFH | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-AFM | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-OPU | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JPOD | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JSCC | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-TSBW | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JSCM | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JENT | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-PESC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-OBC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-HBVC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-CSAS | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FMCJ | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NSFM | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MEDI | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-7E | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MCLN | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-KENT | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-NSOB | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-MS | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-SC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FUL | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FAY | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-SPFM | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JIMC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JNC | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFMV | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JCD | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFMO | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFML | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFMD | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFMB | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EF | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-JFMM | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFME | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-JFMC | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-LAD | $346.20 | $577.00 | $201.95–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-DSSC | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-FMCK | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE) SINGLE LESION-MFMC | $346.20 | $577.00 | $156.94–$507.76 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (W SIMPLE CLOSURE); SINGLE LESION-EC | $415.20 | $692.00 | $242.20–$608.96 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-HBVC | $834.00 | $1,390.00 | $669.00–$694.98 | 32% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-FUL | $834.00 | $1,390.00 | $0.01 | 32% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC. MALIGNANT LESION TRUNK,ARMS,OR LEGS 0-.5CM EF | $834.00 | $1,390.00 | $0.01 | 32% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0.5CM/LESS-FAY | $834.00 | $1,390.00 | $0.01 | 32% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-JSCM | $834.00 | $1,390.00 | $0.01 | 32% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK,ARMS,OR LEGS 0-5CM-DSSC | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-HBVC | $834.00 | $1,390.00 | $486.50–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-FFH | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0.5CM/LESS-FAY | $834.00 | $1,390.00 | $486.50–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-JSCM | $834.00 | $1,390.00 | $486.50–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-CSAS | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-FUL | $834.00 | $1,390.00 | $486.50–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-FMCK | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC. MALIGNANT LESION TRUNK,ARMS,OR LEGS 0-.5CM EF | $834.00 | $1,390.00 | $486.50–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-MFMC | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MALIGNANT LESION TRUNK/ARMS/LEGS 0-0.5CM-JFMC | $834.00 | $1,390.00 | $378.08–$1,223.20 | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OBTR | $222.60 | $371.00 | $129.85–$326.48 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OBC | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-PESC | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS -JPED | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JOB | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MEE | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-CBCC | $222.60 | $371.00 | $188.93–$1,795.00 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-IVP | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FIPS | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JIMC | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-POSC | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-CHPC | $222.60 | $371.00 | $129.85–$326.48 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-WRIM | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-EF | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FUL | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OPH | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SC | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-NSOB | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-NFM | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JCD | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SPGP | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SPFM | $222.60 | $371.00 | $0.01 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FV | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FAY | $222.60 | $371.00 | $188.93–$196.27 | 32% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUC | $267.00 | $445.00 | $188.93–$264.00 | 59% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-EC | $267.00 | $445.00 | $188.93–$196.27 | 59% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUCJ | $267.00 | $445.00 | $188.93–$264.00 | 59% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUCX | $267.00 | $445.00 | $188.93–$264.00 | 59% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JUTR | $267.00 | $445.00 | $155.75–$391.60 | 59% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-WRIM | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-IVP | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FIPS | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-POSC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-AFM | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FFH | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-BAMB | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MEE | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-CHPC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-CBCC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FMCJ | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MFMC | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FMCK | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-DSSC | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMC | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFME | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMM | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMB | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMD | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFML | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMO | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JFMV | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JIMC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JOB | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS -JPED | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JSCC | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-PESC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OBC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-CSAS | $222.60 | $371.00 | $100.91–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OBTR | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-NFM | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-NSOB | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SC | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-OPH | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FUL | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FAY | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-FV | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SPFM | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-SPGP | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JCD | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-EF | $222.60 | $371.00 | $129.85–$326.48 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-JUTR | $267.00 | $445.00 | $155.75–$391.60 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUCX | $267.00 | $445.00 | $155.75–$391.60 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUCJ | $267.00 | $445.00 | $155.75–$391.60 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-EC | $267.00 | $445.00 | $155.75–$391.60 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS MULT FIBROCUTANEOUS UP TO 15 LESIONS-MUC | $267.00 | $445.00 | $155.75–$391.60 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC-SS | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-CHPC | $906.00 | $1,510.00 | $658.47–$1,980.00 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE, DIAGNOSTIC-7E | $906.00 | $1,510.00 | $658.47–$1,980.00 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE-EF | $906.00 | $1,510.00 | $0.01 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC-EDOU | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-CBCC | $906.00 | $1,510.00 | $658.47–$1,980.00 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG -JIR | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC-SC | $906.00 | $1,510.00 | $658.47–$684.04 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG XM | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG AM | $906.00 | $1,510.00 | $658.47–$684.04 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC-PC | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE, DIAGNOSTIC-OPU | $906.00 | $1,510.00 | $528.50–$1,328.80 | 36% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-JER | $1,087.20 | $1,812.00 | $658.47–$684.04 | 63% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE-EC | $1,087.20 | $1,812.00 | $634.20–$1,594.56 | 63% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE, DIAGNOSTIC-OPU | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-CHPC | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG AM | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC-PC | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG XM | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG -JIR | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE, DIAGNOSTIC-7E | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC-SC | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-CBCC | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC-SS | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE-EF | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC-EDOU | $906.00 | $1,510.00 | $528.50–$1,328.80 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC-JER | $1,087.20 | $1,812.00 | $634.20–$1,594.56 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE-EC | $1,087.20 | $1,812.00 | $634.20–$1,594.56 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM - OBTR | $290.40 | $484.00 | $169.40–$425.92 | 10% 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 SMPL REPR SPRFCL WND SCLP, NECK 2.6-2.75 CM - FUL | $290.40 | $484.00 | $0.01 | 10% 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 SMPL REPR SPRFCL WND SCLP,NCK 2.6-7.5 CM-FAY | $290.40 | $484.00 | $0.01 | 10% 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 REPAIR SUPERFCL WOUNDS 2.6 7.5 CM-SPFM | $290.40 | $484.00 | $0.01 | 10% 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JOB | $290.40 | $484.00 | $0.01 | 10% 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JSCM | $290.40 | $484.00 | $188.93–$196.27 | 10% 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 SIMPLE RPR SUP WND SCALP NO FACE/EARS 2.6-7.5CM-MUCJ | $348.60 | $581.00 | $203.35–$511.28 | 8% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR. SUP. WND SCALP, NO FACE/EAR 2.6-7.5CM-EC | $348.60 | $581.00 | $203.35–$511.28 | 8% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR SUP WND SCALP, NO FACE/EARS 2.6-7.5CM-MUC | $348.60 | $581.00 | $188.93–$264.00 | 8% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR SUP WND SCALP NO FACE/EARS 2.6-7.5CM-MUCX | $348.60 | $581.00 | $188.93–$264.00 | 8% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JER | $348.60 | $581.00 | $203.35–$511.28 | 8% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JUTR | $348.60 | $581.00 | $188.93–$264.00 | 8% 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JSCM | $290.40 | $484.00 | $169.40–$425.92 | — | 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 REPAIR SUPERFCL WOUNDS 2.6 7.5 CM-SPFM | $290.40 | $484.00 | $169.40–$425.92 | — | 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 SMPL REPR SPRFCL WND SCLP,NCK 2.6-7.5 CM-FAY | $290.40 | $484.00 | $169.40–$425.92 | — | 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 SMPL REPR SPRFCL WND SCLP, NECK 2.6-2.75 CM - FUL | $290.40 | $484.00 | $169.40–$425.92 | — | 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 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM - OBTR | $290.40 | $484.00 | $169.40–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JSCC | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JOB | $290.40 | $484.00 | $169.40–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JFMV | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JFMO | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JFMB | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JFME | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JFMC | $290.40 | $484.00 | $131.65–$425.92 | — | 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 REPAIR SUPERFCL WOUNDS 2.6 7.5 CM-DSSC | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-MFMC | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-FMCJ | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-BAMB | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-FFH | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-AFM | $290.40 | $484.00 | $131.65–$425.92 | — | 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 SIMPLE RPR SUP WND SCALP NO FACE/EARS 2.6-7.5CM-MUCJ | $348.60 | $581.00 | $203.35–$511.28 | — | 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 SIMPLE RPR SUP WND SCALP NO FACE/EARS 2.6-7.5CM-MUCX | $348.60 | $581.00 | $203.35–$511.28 | — | 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 SIMPLE RPR SUP WND SCALP, NO FACE/EARS 2.6-7.5CM-MUC | $348.60 | $581.00 | $203.35–$511.28 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JER | $348.60 | $581.00 | $203.35–$511.28 | — | 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 SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.6-7.5CM-JUTR | $348.60 | $581.00 | $203.35–$511.28 | — | 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 SIMPLE RPR. SUP. WND SCALP, NO FACE/EAR 2.6-7.5CM-EC | $348.60 | $581.00 | $203.35–$511.28 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-EF | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR SUPERFICIAL WOUNDS OF FACE 2.5 CM OR LESS-SPFM | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JPED | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-NFM | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-SPGP | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MPOP | $254.40 | $424.00 | $188.93–$1,795.00 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FACE,EYE,NOSE,LIPS,MUC MEMB 2.5CM OR LESS-SC | $254.40 | $424.00 | $188.93–$196.27 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FACE,EYE,NOSE,LIPS,MUC MEMB 2.5CM OR LESS-JCD | $254.40 | $424.00 | $188.93–$196.27 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MEE | $254.40 | $424.00 | $188.93–$196.27 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPLE REPAIR SUPERFICIAL WOUNDS OF FACE 2.5 CM OR LESS-HBVC | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MCLN | $254.40 | $424.00 | $188.93–$196.27 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR SUPRFCL WND FC,EAR,EYLD,NS 2.5 CM/LES-FUL | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR SUPRFCL WND FC,EAR,EYLD,NS 2.5 CM/LES-FAY | $254.40 | $424.00 | $0.01 | at median | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JER | $305.40 | $509.00 | $178.15–$447.92 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JUTR | $305.40 | $509.00 | $188.93–$264.00 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUP WND FACE EARS NOSE LIPS MUC MEMB 0-2.5CM-MUCX | $305.40 | $509.00 | $188.93–$264.00 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUP WND FACE,EARS,NOSE,LIPS,MUC MEMB 0-2.5CM-MUC | $305.40 | $509.00 | $188.93–$264.00 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUP WND FACE EARS NOSE LIPS MUC MEMB 0-2.5CM-MUCJ | $305.40 | $509.00 | $178.15–$447.92 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE RPR SUP WND FACE,EAR,NOSE,LIP,MUC MEMB 0-2.5CM-EC | $305.40 | $509.00 | $178.15–$447.92 | 20% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPLE REPAIR SUPERFICIAL WOUNDS OF FACE 2.5 CM OR LESS-HBVC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPR FCE, ERS,LPS 2.5CM/LESS-DSSC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JFME | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MEE | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JFML | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JFMO | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-EF | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JFMV | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-FMCJ | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JPED | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-NFM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FACE,EYE,NOSE,LIPS,MUC MEMB 2.5CM OR LESS-SC | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL RPR SUPRFCL WND FC,EAR,EYLD,NS 2.5 CM/LES-FUL | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL RPR SUPRFCL WND FC,EAR,EYLD,NS 2.5 CM/LES-FAY | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR SUPERFICIAL WOUNDS OF FACE 2.5 CM OR LESS-SPFM | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-SPGP | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MFMC | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MCLN | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-MPOP | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FACE,EYE,NOSE,LIPS,MUC MEMB 2.5CM OR LESS-JCD | $254.40 | $424.00 | $148.40–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-FFH | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-BAMB | $254.40 | $424.00 | $115.33–$373.12 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUP WND FACE,EAR,NOSE,LIP,MUC MEMB 0-2.5CM-EC | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUP WND FACE EARS NOSE LIPS MUC MEMB 0-2.5CM-MUCJ | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUP WND FACE EARS NOSE LIPS MUC MEMB 0-2.5CM-MUCX | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JUTR | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUPRFCL WND FC/EAR/EYLD/NS/LP/MM 2.5 CM/LS-JER | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE RPR SUP WND FACE,EARS,NOSE,LIPS,MUC MEMB 0-2.5CM-MUC | $305.40 | $509.00 | $178.15–$447.92 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-WRIM | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-KENT | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-MCLN | $219.00 | $365.00 | $188.93–$1,795.00 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-HBVC | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-TSBW | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-JIMC | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-PESC | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-OBC | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-NSFM | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-NSOB | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SC | $219.00 | $365.00 | $127.75–$321.20 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FUL | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FAY | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FV | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SPFM | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SPGP | $219.00 | $365.00 | $0.01 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-EF | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JCD | $219.00 | $365.00 | $188.93–$196.27 | 13% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-EC | $262.20 | $437.00 | $188.93–$196.27 | 5% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-CSAS | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-OBC | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-PESC | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JSCC | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-JIMC | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFMV | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFMO | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFML | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFMD | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-FFH | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-WRIM | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FV | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-KENT | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-MCLN | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-HBVC | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-TSBW | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-AFM | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FMCJ | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-BAMB | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SPGP | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SPFM | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FAY | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JCD | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FUL | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-SC | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFMB | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-JFMM | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-JFMC | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-DSSC | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-FMCK | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-NSOB | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-NSFM | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-EF | $219.00 | $365.00 | $127.75–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION-MFMC | $219.00 | $365.00 | $99.28–$321.20 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION-EC | $262.20 | $437.00 | $152.95–$384.56 | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-CAC | $1,519.20 | $2,532.00 | $0.01 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-CM | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-AM | $1,519.20 | $2,532.00 | $587.86–$610.69 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE OR CATHETER WITH IMAGING GUIDANCE-EFOU | $1,519.20 | $2,532.00 | $587.86–$1,980.00 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-OPU | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-PFT | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATHETER W/IMAGING GUIDANCE (PFT)-JRT | $1,519.20 | $2,532.00 | $587.86–$1,980.00 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE OR CATHETER WITH IMAGING GUIDANCE-HVCK | $1,519.20 | $2,532.00 | $0.01 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-SC | $1,519.20 | $2,532.00 | $587.86–$610.69 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-EF | $1,519.20 | $2,532.00 | $0.01 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-JCT | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-JIR | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | 49% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-EC | $1,823.40 | $3,039.00 | $587.86–$610.69 | 78% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-JER | $1,823.40 | $3,039.00 | $1,063.65–$2,674.32 | 78% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE OR CATHETER WITH IMAGING GUIDANCE-EFOU | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-OPU | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-CM | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-AM | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-PFT | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATHETER W/IMAGING GUIDANCE (PFT)-JRT | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE OR CATHETER WITH IMAGING GUIDANCE-HVCK | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-SC | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-CAC | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-JIR | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-EF | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORAC NEEDLE/CATH ASPIR PLEURAL W IMING-JCT | $1,519.20 | $2,532.00 | $886.20–$2,228.16 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-EC | $1,823.40 | $3,039.00 | $1,063.65–$2,674.32 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS,NEEDLE OR CATHETER, WITH IMAGING GUIDANCE-JER | $1,823.40 | $3,039.00 | $1,063.65–$2,674.32 | — | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION (EG, TRIGGER FINGER)-FAY | $2,004.60 | $3,341.00 | $0.01 | 1% above | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER) | $2,004.60 | $3,341.00 | $1,521.72–$1,580.82 | 1% above | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER)-MCLN | $2,004.60 | $3,341.00 | $1,017.00–$2,650.00 | 1% above | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER)-EC | $2,405.40 | $4,009.00 | $1,521.72–$1,580.82 | 21% above | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER) | $2,004.60 | $3,341.00 | $1,169.35–$2,940.08 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG, TRIGGER FINGER)-FFH | $2,004.60 | $3,341.00 | $908.75–$2,940.08 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG, TRIGGER FINGER)-AFM | $2,004.60 | $3,341.00 | $908.75–$2,940.08 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER)-MCLN | $2,004.60 | $3,341.00 | $1,169.35–$2,940.08 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG, TRIGGER FINGER)-FAY | $2,004.60 | $3,341.00 | $1,169.35–$2,940.08 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISE (EG TRIGGER FINGER)-EC | $2,405.40 | $4,009.00 | $1,285.00–$3,527.92 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-NFM | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-OBC | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-SPFM | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT, ONE/TWO MUSCLES-EF | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-OCJC | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-WRIM | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-CSJC | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE SC | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-EAC | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-OBTR | $486.60 | $811.00 | $283.85–$713.68 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -MOC | $486.60 | $811.00 | $283.85–$713.68 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JNC | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-FIPS | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-FUL | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-MCLN | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-POSC | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE/MULT 1-2 MUSCLE NEURO-NCK | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE OR MULT/MUSCLE AM | $486.60 | $811.00 | $283.85–$713.68 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULT. TRIGGER PTS,ONE/TWO MUSCLE-CPCR | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -CM | $486.60 | $811.00 | $280.68–$1,795.00 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -JIR | $486.60 | $811.00 | $283.85–$713.68 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JMOI | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPMC | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-NSOB | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPOD | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MS | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPMR | $486.60 | $811.00 | $280.68–$291.58 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT SGLE OR MULT/MUSCLE-XO | $486.60 | $811.00 | $280.68–$1,795.00 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JOB | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ(S); SINGLE/MULTI TRIGGER POINT(S), 1 OR 2 MUSCLE(S)-FAY | $486.60 | $811.00 | $0.01 | 58% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUCX | $584.40 | $974.00 | $202.00–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUCJ | $584.40 | $974.00 | $202.00–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE -EC | $584.40 | $974.00 | $280.68–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUC | $584.40 | $974.00 | $202.00–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JUTR | $584.40 | $974.00 | $202.00–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JER | $584.40 | $974.00 | $280.68–$291.58 | 89% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-WRIM | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-SPFM | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ(S); SINGLE/MULTI TRIGGER POINT(S), 1 OR 2 MUSCLE(S)-FAY | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-FUL | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE SC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MS | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-NSOB | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS,ONE/TWO MUSCLE-NFM | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE/MULT 1-2 MUSCLE NEURO-NCK | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-OBTR | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-CSJC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-OCJC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-OBC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPMR | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPOD | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JPMC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JOB | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JNC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JMOI | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFMV | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFMO | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFML | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFMB | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFMM | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JFMC | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-FMCK | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION; SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-MFMC | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION; SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-FMCJ | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULT. TRIGGER PTS,ONE/TWO MUSCLE-CPCR | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-BAMB | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION; SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-FFH | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-AFM | $486.60 | $811.00 | $220.59–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-POSC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-MCLN | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-FIPS | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER POINTS ONE/TWO MUSCLE-EAC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -MOC | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE OR MULT/MUSCLE AM | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -CM | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE OR MULT MUSCLE -JIR | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT SGLE OR MULT/MUSCLE-XO | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT, ONE/TWO MUSCLES-EF | $486.60 | $811.00 | $283.85–$713.68 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JER | $584.40 | $974.00 | $340.90–$857.12 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUC | $584.40 | $974.00 | $296.00–$857.12 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MULTI TRIGGER POINT 1 OR 2 MUSCLES-JUTR | $584.40 | $974.00 | $296.00–$857.12 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE -EC | $584.40 | $974.00 | $340.90–$857.12 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUCJ | $584.40 | $974.00 | $296.00–$857.12 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ ONE OR TWO MUSCLE-MUCX | $584.40 | $974.00 | $296.00–$857.12 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-BI | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-AMS | $2,358.00 | $3,930.00 | $1,540.58–$1,600.41 | 34% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-UM | $2,358.00 | $3,930.00 | $1,540.58–$1,600.41 | 34% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JIR | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | 34% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JUC | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | 34% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JUTR | $2,829.60 | $4,716.00 | $202.00–$1,600.41 | 61% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient both sides CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-BI | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JIR | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-UM | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-AMS | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JUC | $2,358.00 | $3,930.00 | $1,375.50–$3,458.40 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE-JUTR | $2,829.60 | $4,716.00 | $296.00–$4,150.08 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY UGI BALLOON DIALATION | $1,713.00 | $2,855.00 | $1,281.00–$2,650.00 | 5% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-GIKC | $1,713.00 | $2,855.00 | $1,281.00–$2,650.00 | 5% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-ORSC | $1,713.00 | $2,855.00 | $1,281.00–$2,650.00 | 5% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-JEGC | $1,713.00 | $2,855.00 | $1,281.00–$2,650.00 | 5% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY UGI BALLOON DIALATION -FVGI | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | 5% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-JEGC | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-ORSC | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY UGI BALLOON DIALATION-GIKC | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY UGI BALLOON DIALATION | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY UGI BALLOON DIALATION -FVGI | $1,713.00 | $2,855.00 | $999.25–$2,512.40 | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN.-JEGC | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | 2% below | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. -FVGI | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | 2% below | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-ORSC | $1,352.40 | $2,254.00 | $891.46–$2,650.00 | 2% below | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-GIKC | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | 2% below | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | 2% below | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-ORSC | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | — | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-GIKC | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | — | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN.-JEGC | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | — | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. -FVGI | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | — | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. | $1,352.40 | $2,254.00 | $788.90–$1,983.52 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST.-JEGC | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | 40% below | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST-GIKC | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | 40% below | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST. | $1,213.80 | $2,023.00 | $891.46–$2,650.00 | 40% below | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST. -FVGI | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | 40% below | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST. | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST-GIKC | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST. -FVGI | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI WITH DIRECTED SUBMUCOSAL INJECTIONS ANY SUBST.-JEGC | $1,213.80 | $2,023.00 | $708.05–$1,780.24 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-JEGC | $1,722.60 | $2,871.00 | $1,281.00–$2,650.00 | 2% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE -FVGI | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | 2% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE | $1,722.60 | $2,871.00 | $1,281.00–$2,650.00 | 2% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-ORSC | $1,722.60 | $2,871.00 | $1,281.00–$2,650.00 | 2% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-GIKC | $1,722.60 | $2,871.00 | $1,281.00–$2,650.00 | 2% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE -FVGI | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-ORSC | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-JEGC | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE-GIKC | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ENDOSCOPY UGI REMOVE POLYP/SNARE | $1,722.60 | $2,871.00 | $1,004.85–$2,526.48 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT-GIKC | $1,143.00 | $1,905.00 | $891.46–$2,650.00 | 35% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT. | $1,143.00 | $1,905.00 | $891.46–$2,650.00 | 35% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT.-JEGC | $1,143.00 | $1,905.00 | $891.46–$2,650.00 | 35% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT. -FVGI | $1,143.00 | $1,905.00 | $666.75–$1,676.40 | 35% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT. -FVGI | $1,143.00 | $1,905.00 | $666.75–$1,676.40 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT-GIKC | $1,143.00 | $1,905.00 | $666.75–$1,676.40 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT.-JEGC | $1,143.00 | $1,905.00 | $666.75–$1,676.40 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ENDOSCOPY UGI GUIDEWIRE/DILAT. | $1,143.00 | $1,905.00 | $666.75–$1,676.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | 1% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC-GIKC | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | 1% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-ORSC | $1,488.00 | $2,480.00 | $891.46–$2,650.00 | 1% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC.-JEGC | $1,488.00 | $2,480.00 | $891.46–$2,650.00 | 1% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. -FVGI | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | 1% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-EC | $1,786.20 | $2,977.00 | $1,041.95–$2,619.76 | 19% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC-GIKC | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-ORSC | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC.-JEGC | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. -FVGI | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. | $1,488.00 | $2,480.00 | $868.00–$2,182.40 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-EC | $1,786.20 | $2,977.00 | $1,041.95–$2,619.76 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST-GIKC | $4,453.80 | $7,423.00 | $2,598.05–$6,532.24 | 61% below | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST | $4,453.80 | $7,423.00 | $1,281.00–$5,879.95 | 61% below | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST-JEGC | $4,453.80 | $7,423.00 | $2,598.05–$6,532.24 | 61% below | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST | $4,453.80 | $7,423.00 | $2,598.05–$6,532.24 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST-JEGC | $4,453.80 | $7,423.00 | $2,598.05–$6,532.24 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 ENDO UGI W/TRANSMURAL DRAIN PSEUDOCYST-GIKC | $4,453.80 | $7,423.00 | $2,598.05–$6,532.24 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNILATERAL/BILATERAL INCLD POSTOP SEMEN EXM-JSCM | $2,269.20 | $3,782.00 | $0.01 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing one side CPT 55250 VASECTOMY,UNILAT/BIL, INC POSTOP SEMEN EXAM-SPFM | $2,269.20 | $3,782.00 | $0.01 | 73% above | 40% |
| Vasectomy, one or both sides, including follow-up semen testing one side CPT 55250 VASECTOMY,UNILAT/BIL, INC POSTOP SEMEM EXAM | $2,269.20 | $3,782.00 | $1,017.00–$5,200.00 | 73% above | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL/BILATERAL, INCLD POSTOP SEMEN EXM-AFM | $2,269.20 | $3,782.00 | $1,028.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNILATERAL/BILATERAL INCLD POSTOP SEMEN EXM-JSCC | $2,269.20 | $3,782.00 | $1,028.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNILATERAL/BILATERAL INCLD POSTOP SEMEN EXM-JFMM | $2,269.20 | $3,782.00 | $1,028.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL/BILATERAL, INCLD POSTOP SEMEN EXM-BAMB | $2,269.20 | $3,782.00 | $1,028.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNILATERAL/BILATERAL INCLD POSTOP SEMEN EXM-JSCM | $2,269.20 | $3,782.00 | $1,323.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient one side CPT 55250 VASECTOMY,UNILAT/BIL, INC POSTOP SEMEN EXAM-SPFM | $2,269.20 | $3,782.00 | $1,323.70–$3,328.16 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient one side CPT 55250 VASECTOMY,UNILAT/BIL, INC POSTOP SEMEM EXAM | $2,269.20 | $3,782.00 | $1,323.70–$3,328.16 | — | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION INCMPTNT VEIN,RFA; 1ST VEIN-CAC | $4,059.00 | $6,765.00 | $0.01 | 4% below | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION INCMPTNT VEIN RFA; 1ST VEIN-HVCK | $4,059.00 | $6,765.00 | $2,992.75–$3,108.97 | 4% below | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, 1ST VEIN SC | $4,059.00 | $6,765.00 | $1,017.00–$5,740.00 | 4% below | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETNT VEIN 1ST VEIN-JVC | $4,059.00 | $6,765.00 | $2,992.75–$3,108.97 | 4% below | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, 1ST VEIN SC | $4,059.00 | $6,765.00 | $2,367.75–$5,953.20 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION INCMPTNT VEIN,RFA; 1ST VEIN-CAC | $4,059.00 | $6,765.00 | $2,367.75–$5,953.20 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION INCMPTNT VEIN RFA; 1ST VEIN-HVCK | $4,059.00 | $6,765.00 | $2,367.75–$5,953.20 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETNT VEIN 1ST VEIN-JVC | $4,059.00 | $6,765.00 | $2,367.75–$5,953.20 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETNT VEIN 1ST VEIN-MFMC | $4,059.00 | $6,765.00 | $1,840.08–$5,953.20 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN,1ST VEIN-FFH | $4,059.00 | $6,765.00 | $1,840.08–$5,953.20 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-PESC | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-MCLN | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS,EXPT SK TG/CUT VAS PROLIF,UP TO 14-HBVC | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIFUP TO 14-MEE | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS-CHPC | $175.20 | $292.00 | $188.93–$1,795.00 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS-CBCC | $175.20 | $292.00 | $102.20–$256.96 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JIMC | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JMOI | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JOB | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JPED | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JPOD | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JSCM | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-OBC | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-OCJC | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-CSJC | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-NFM | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESION, UP TO 14 LESIONS-NSOB | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESIONS, UP TO 14 LESIONS-MS | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION ANY METHOD/FLAT WARTS, UP TO 14 LESIONS-SURG | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST LSN WARTS ETC UP TO 14 | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-FUL | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.TO 14 LES-FAY | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES.FV | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-SPFM | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-SPGP | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES.JCD | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRCTN MALGN LSN TRNK ARMS LEGS 0.5CM OR LESS | $175.20 | $292.00 | $0.01 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 NILLIA, NILLUSCUM, FLAT WARTS EF | $175.20 | $292.00 | $188.93–$196.27 | 3% below | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JUTR | $210.00 | $350.00 | $188.93–$264.00 | 17% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-OBC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRCTN MALGN LSN TRNK ARMS LEGS 0.5CM OR LESS | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS-CHPC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LESION, UP TO 14 LESIONS-NSOB | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-PESC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-NFM | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JSCM | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMO | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JSCC | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFML | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JPOD | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES.JCD | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMD | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.TO 14 LES-FAY | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-OCJC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-FUL | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-FMCJ | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JMOI | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-SPGP | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-SPFM | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST LSN WARTS ETC UP TO 14 | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS-CBCC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JPED | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES.FV | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION ANY METHOD/FLAT WARTS, UP TO 14 LESIONS-SURG | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JIMC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNSEXPT SK TG/CUT VAS PROLIF UP TO 14-MFMC | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESIONS, UP TO 14 LESIONS-MS | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DEST FLAT WART/MOLLUSCUM CONTAGIOSUM/MILIA.UP/14 LES-MCLN | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMB | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 NILLIA, NILLUSCUM, FLAT WARTS-DSSC | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-FMCK | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS,EXPT SK TG/CUT VAS PROLIF,UP TO 14-HBVC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-AFM | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNSEXPT SK TG/CUT VAS PROLIF UP TO 14-FFH | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 NILLIA, NILLUSCUM, FLAT WARTS EF | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMM | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-CSJC | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFME | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMV | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JOB | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-BAMB | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JFMC | $175.20 | $292.00 | $79.42–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIFUP TO 14-MEE | $175.20 | $292.00 | $102.20–$256.96 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LSNS EXPT SK TG/CUT VAS PROLIF UP TO 14-JUTR | $210.00 | $350.00 | $122.50–$308.00 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CSJC | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EF | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SM | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-PACU | $488.40 | $814.00 | $284.90–$716.32 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FV | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SICU | $488.40 | $814.00 | $379.89–$1,795.00 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-TSBW | $488.40 | $814.00 | $0.01 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-HBVC | $488.40 | $814.00 | $0.01 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-MEDI | $488.40 | $814.00 | $284.90–$716.32 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-POSC | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-MCLN | $488.40 | $814.00 | $379.89–$1,795.00 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EAC | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-NSFM | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-HVCK | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-OBTR | $488.40 | $814.00 | $284.90–$716.32 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SPFM | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JCD | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JSCM | $488.40 | $814.00 | $0.01 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JPOD | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JMOI | $488.40 | $814.00 | $379.89–$1,795.00 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FAY | $488.40 | $814.00 | $0.01 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FUL | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CAC | $488.40 | $814.00 | $379.89–$394.64 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CBCC | $488.40 | $814.00 | $379.89–$1,795.00 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CHPC | $488.40 | $814.00 | $284.90–$716.32 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SC | $488.40 | $814.00 | $0.01 | 13% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EC | $585.60 | $976.00 | $379.89–$394.64 | 4% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JER | $585.60 | $976.00 | $379.89–$394.64 | 4% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CSJC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FAY | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FUL | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CAC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-NSFM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-HVCK | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-OBTR | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CSAS | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JSCM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JSCC | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JPOD | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JMOI | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JFMV | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JFME | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-DSSC | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FMCK | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-MFMC | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FMCJ | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CBCC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-CHPC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-BAMB | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FFH | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-AFM | $488.40 | $814.00 | $221.41–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JCD | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-PACU | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SICU | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-TSBW | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-HBVC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-MEDI | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-POSC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-MCLN | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EAC | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-SPFM | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-FV | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EF | $488.40 | $814.00 | $284.90–$716.32 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-EC | $585.60 | $976.00 | $341.60–$858.88 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS-JER | $585.60 | $976.00 | $341.60–$858.88 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION FEE P28821269 | $970.80 | $1,618.00 | $566.30–$1,423.84 | 48% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION FEE P29621269 | $970.80 | $1,618.00 | $415.69–$431.83 | 48% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION FEE P28821269 | $970.80 | $1,618.00 | $566.30–$1,423.84 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION FEE P29621269 | $970.80 | $1,618.00 | $566.30–$1,423.84 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MEDICATION ADMIN OUTPATIENT SUBSEQUENT (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED INHALATION TREATMENT (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JIMC | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT -JPED | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MED NEBULIZER INITIAL TX | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MED NEBULIZER SUBS TX (PFT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MED NEBULIZER (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTRAPULMONARY PERCUSSIVE VENTILATION TREATMENT (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MED NEBULIZER INITIAL TX (PFT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALED MEDICATION ADMIN OUTPATIENT INITIAL (RT)-JRT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER-JUTR | $266.40 | $444.00 | $155.40–$390.72 | 90% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 INHALED MED NEBULIZER-RT | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 METERED DOSE INHALER-RT | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 PRESSURIZED INHALATION TREATMENT-RT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 INHALED MEDICATION ADMINISTRATION OUTPATIENT, INITIAL-RT | $221.40 | $369.00 | $193.39–$200.90 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 INTRAPULMONARY PERCUSSIVE VENTILATION TREATMENT-RT | $221.40 | $369.00 | $129.15–$324.72 | 58% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-BAMB | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INTRAPULMONARY PERCUSSIVE VENTILATION TREATMENT (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE INHALER (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT -JPED | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED INHALATION TREATMENT (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-MFMC | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFMC | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFME | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFMM | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MED NEBULIZER (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MED NEBULIZER SUBS TX (PFT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MED NEBULIZER INITIAL TX | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MED NEBULIZER-SUBS TX | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFMB | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFMD | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFML | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-AFM | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JIMC | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-JFMO | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MEDICATION ADMIN OUTPATIENT SUBSEQUENT (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT-FFH | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MED NEBULIZER INITIAL TX (PFT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALED MEDICATION ADMIN OUTPATIENT INITIAL (RT)-JRT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE INHALER-JIGC | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE INHALER-JUTR | $266.40 | $444.00 | $155.40–$390.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 PRESSURIZED INHALATION TREATMENT-RT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 INHALED MED NEBULIZER-RT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 METERED DOSE INHALER-RT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 INHALED MEDICATION ADMINISTRATION OUTPATIENT, INITIAL-RT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 INHALED MEDICATION ADMINISTRATION OUTPATIENT, SUBSEQUENT-RT | $221.40 | $369.00 | $100.37–$324.72 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 INTRAPULMONARY PERCUSSIVE VENTILATION TREATMENT-RT | $221.40 | $369.00 | $129.15–$324.72 | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AIUK | $569.40 | $949.00 | $332.15–$835.12 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AMS | $569.40 | $949.00 | $315.38–$327.63 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AIU | $569.40 | $949.00 | $315.38–$327.63 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-MEDI | $569.40 | $949.00 | $332.15–$835.12 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-7E | $569.40 | $949.00 | $315.38–$327.63 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-PC | $569.40 | $949.00 | $332.15–$835.12 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-CBCC | $569.40 | $949.00 | $315.38–$327.63 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-OPU | $569.40 | $949.00 | $315.38–$327.63 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-EF AT UMC | $569.40 | $949.00 | $332.15–$835.12 | 32% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-CHPC | $569.40 | $949.00 | $332.15–$835.12 | 32% above | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AMS | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-MEDI | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-7E | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-EF AT UMC | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AIU | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-AIUK | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-JIGC | $569.40 | $949.00 | $258.13–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-PC | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-CBCC | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-CHPC | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INF SNGL/INITL DRUG BTWN 16-90 MINS CHEMO-OPU | $569.40 | $949.00 | $332.15–$835.12 | — | 40% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTH MED EXAM & EVAL W/INIT DIAG & TX COMPREHEN NEW PT-MEE | $126.60 | $211.00 | $122.53–$127.29 | 1% below | 40% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE NEW PT-OPH | $126.60 | $211.00 | $122.53–$127.29 | 1% below | 40% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTH MED EXAM & EVAL W/INIT DIAG & TX COMPREHEN NEW PT-MEE | $126.60 | $211.00 | $73.85–$185.68 | — | 40% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE NEW PT-OPH | $126.60 | $211.00 | $73.85–$185.68 | — | 40% |
| Comprehensive eye exam, returning patient CPT 92014 OPHTH MED EXAM & EVAL W/INIT DIAG &TX COMPREHEN ESTAB PT-MEE | $108.60 | $181.00 | $122.53–$127.29 | 3% above | 40% |
| Comprehensive eye exam, returning patient CPT 92014 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE ESTAB PT-OPH | $108.60 | $181.00 | $122.53–$127.29 | 3% above | 40% |
| Comprehensive eye exam, returning patient CPT 92014 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE ESTAB PT-JUTR | $130.80 | $218.00 | $76.30–$191.84 | 24% above | 40% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTH MED EXAM & EVAL W/INIT DIAG &TX COMPREHEN ESTAB PT-MEE | $108.60 | $181.00 | $63.35–$159.28 | — | 40% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE ESTAB PT-OPH | $108.60 | $181.00 | $63.35–$159.28 | — | 40% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 OPHTH MEDICAL EXAM AND EVAL COMPREHENSIVE ESTAB PT-JUTR | $130.80 | $218.00 | $76.30–$191.84 | — | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-EAC | $177.00 | $295.00 | $103.25–$259.60 | 12% above | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-HBVC | $177.00 | $295.00 | $148.77–$154.54 | 12% above | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-PESC | $177.00 | $295.00 | $103.25–$259.60 | 12% above | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY THRSHLD EVAL & SPEECH RECOGNTN-JAUD | $177.00 | $295.00 | $148.77–$154.54 | 12% above | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY THRSHLD EVAL & SPEECH RECOGNTN-CENT | $177.00 | $295.00 | $80.24–$259.60 | — | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-HBVC | $177.00 | $295.00 | $103.25–$259.60 | — | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY THRSHLD EVAL & SPEECH RECOGNTN-JAUD | $177.00 | $295.00 | $103.25–$259.60 | — | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-EAC | $177.00 | $295.00 | $103.25–$259.60 | — | 40% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY AND SPEECH RECOGNITION-PESC | $177.00 | $295.00 | $103.25–$259.60 | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 ER Crit Care 1st hr | $3,168.00 | $5,280.00 | $801.18–$832.30 | 54% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 ER LEVEL VI CRITICAL CARE-JER | $3,168.00 | $5,280.00 | $801.18–$832.30 | 54% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ER LEVEL VI CRITICAL CARE-JER | $3,168.00 | $5,280.00 | $1,285.00–$4,646.40 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ER Crit Care 1st hr | $3,168.00 | $5,280.00 | $1,285.00–$4,646.40 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY ROUTINE-JEEG | $907.80 | $1,513.00 | $296.09–$307.59 | 21% above | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY-ROUTINE PORTABL | $907.80 | $1,513.00 | $296.09–$307.59 | 21% above | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY-ROUTINE PORTABLE CPT 95816-EMU | $907.80 | $1,513.00 | $296.09–$307.59 | 21% above | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY-ROUTINE | $907.80 | $1,513.00 | $296.09–$307.59 | 21% above | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 ABORTED EEG AWAKE/DROWSY ROUTINE-JEEG | $907.80 | $1,513.00 | $411.54–$1,331.44 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 ABORTED EEG ROUTINE | $907.80 | $1,513.00 | $411.54–$1,331.44 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY-ROUTINE | $907.80 | $1,513.00 | $529.55–$1,331.44 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY ROUTINE-JEEG | $907.80 | $1,513.00 | $529.55–$1,331.44 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY-ROUTINE PORTABL | $907.80 | $1,513.00 | $529.55–$1,331.44 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY-ROUTINE PORTABLE CPT 95816-EMU | $907.80 | $1,513.00 | $529.55–$1,331.44 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM -CSC | $214.80 | $358.00 | $125.30–$315.04 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-JCRD | $214.80 | $358.00 | $125.30–$315.04 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM PEDIATRIC-CTST | $214.80 | $358.00 | $56.48–$58.67 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-CTST | $214.80 | $358.00 | $56.48–$58.67 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM ADULT-CSC | $214.80 | $358.00 | $125.30–$315.04 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM PEDIATRIC-JCRD | $214.80 | $358.00 | $125.30–$315.04 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-JIMC | $214.80 | $358.00 | $56.48–$58.67 | 16% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-JER | $257.40 | $429.00 | $56.48–$58.67 | 39% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM-JUTR | $257.40 | $429.00 | $150.15–$377.52 | 39% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMO | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM PEDIATRIC-CTST | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM PEDIATRIC-JCRD | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JCRD | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMB | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMD | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFML | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM -CSC | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMV | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JIMC | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFME | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMM | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JFMC | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-CCDC | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM ADULT-CSC | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-CTST | $214.80 | $358.00 | $125.30–$315.04 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JER | $257.40 | $429.00 | $150.15–$377.52 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM-JUTR | $257.40 | $429.00 | $150.15–$377.52 | — | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 OR ELECTROCONVULSIVE THERAPY | $1,300.20 | $2,167.00 | $504.51–$827.00 | at median | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 OR ELECTROCONVULSIVE THERAPY | $1,300.20 | $2,167.00 | $697.00–$1,906.96 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL I-JER | $258.60 | $431.00 | $150.85–$379.28 | 8% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL I-EC | $258.60 | $431.00 | $83.72–$86.97 | 8% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL I-JER | $258.60 | $431.00 | $150.85–$379.28 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT LEVEL I-EC | $258.60 | $431.00 | $150.85–$379.28 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL II-JER | $480.00 | $800.00 | $280.00–$704.00 | 31% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL II-EC | $480.00 | $800.00 | $150.57–$156.42 | 31% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL II-JER | $480.00 | $800.00 | $280.00–$704.00 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT LEVEL II-EC | $480.00 | $800.00 | $280.00–$704.00 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL III-EC | $1,017.60 | $1,696.00 | $263.28–$273.50 | 20% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL III-JER | $1,017.60 | $1,696.00 | $263.28–$273.50 | 20% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL III-EC | $1,017.60 | $1,696.00 | $593.60–$1,492.48 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT LEVEL III-JER | $1,017.60 | $1,696.00 | $593.60–$1,492.48 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL IV-JER | $1,512.00 | $2,520.00 | $404.88–$420.61 | 66% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL IV-EC | $1,512.00 | $2,520.00 | $404.88–$420.61 | 66% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL IV-JER | $1,512.00 | $2,520.00 | $882.00–$2,217.60 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT LEVEL IV-EC | $1,512.00 | $2,520.00 | $882.00–$2,217.60 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL V-JER | $2,287.80 | $3,813.00 | $582.96–$605.60 | 47% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL V-EC | $2,287.80 | $3,813.00 | $582.96–$605.60 | 47% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL V-EC | $2,287.80 | $3,813.00 | $1,285.00–$3,355.44 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT LEVEL V-JER | $2,287.80 | $3,813.00 | $1,285.00–$3,355.44 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 PHARMACHOLOGICAL STRESS TEST-JCRD | $842.40 | $1,404.00 | $491.40–$1,235.52 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE EKG TREADMILL OR BIKE-JCRD | $842.40 | $1,404.00 | $491.40–$1,235.52 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 PHARMACHOLOGICAL STRESS TEST-CTST | $842.40 | $1,404.00 | $296.09–$307.59 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE EKG TREADMILL OR BIKE-JNM | $842.40 | $1,404.00 | $491.40–$1,235.52 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CSC | $842.40 | $1,404.00 | $491.40–$1,235.52 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE EKG TREADMILL OR BIKE-NM | $842.40 | $1,404.00 | $491.40–$1,235.52 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CTST | $842.40 | $1,404.00 | $296.09–$307.59 | 9% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CSC | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-JNM | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-NM | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PHARMACHOLOGICAL STRESS TEST-CTST | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PHARMACHOLOGICAL STRESS TEST-JCRD | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CTST | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CCJC | $842.40 | $1,404.00 | $381.89–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-CCDJ | $842.40 | $1,404.00 | $381.89–$1,235.52 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE EKG TREADMILL OR BIKE-JCRD | $842.40 | $1,404.00 | $491.40–$1,235.52 | — | 40% |
| Eye exam, returning patient, intermediate CPT 92012 OPHTH MEDICAL EXAM AND EVAL INTERMEDIATE ESTAB PT-OPH | $104.40 | $174.00 | $122.53–$127.29 | 8% below | 40% |
| Eye exam, returning patient, intermediate CPT 92012 OPHTH MED EXAM & EVAL W/INIT DIAG &TX INTERMED ESTAB PT-MEE | $104.40 | $174.00 | $122.53–$127.29 | 8% below | 40% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTH MEDICAL EXAM AND EVAL INTERMEDIATE ESTAB PT-OPH | $104.40 | $174.00 | $60.90–$153.12 | — | 40% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 OPHTH MED EXAM & EVAL W/INIT DIAG &TX INTERMED ESTAB PT-MEE | $104.40 | $174.00 | $60.90–$153.12 | — | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-SPGP | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SPAP | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-ACM | $187.80 | $313.00 | $109.55–$275.44 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-WMM | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JNC | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN -JPED | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-PESC | $187.80 | $313.00 | $109.55–$275.44 | 18% below | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SC | $187.80 | $313.00 | $152.77–$158.70 | 18% below | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTERAPY W/ PATIENT, 50 MIN-TCA | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTERAPY W/ PATIENT, 50 MIN-TCOP | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-FFH | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-PESC | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN -JPED | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-BAMB | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SC | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JNC | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-CAP | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-WMM | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-SPGP | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JFMM | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-JMWC | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT; 50 MIN-JFMV | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SPAP | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-JCWM | $187.80 | $313.00 | $85.14–$275.44 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-ACM | $187.80 | $313.00 | $109.55–$275.44 | — | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-MCLN | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT/ 50 MIN-JNC | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-WMM | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SPGP | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-SPAP | $177.60 | $296.00 | $103.60–$260.48 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-PESC | $177.60 | $296.00 | $103.60–$260.48 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-ACM | $177.60 | $296.00 | $103.60–$260.48 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JPED | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SC | $177.60 | $296.00 | $152.77–$158.70 | 24% below | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-JCWM | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-FFH | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-BAMB | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-WMM | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JFMD | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-JFMV | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-JMWC | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT/ 50 MIN-JNC | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JPED | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-PESC | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-TCOP | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SC | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SPGP | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-SPAP | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-CAP | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-MCLN | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-TCA | $177.60 | $296.00 | $80.51–$260.48 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-ACM | $177.60 | $296.00 | $103.60–$260.48 | — | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-JPED | $131.40 | $219.00 | $87.95–$91.37 | 38% below | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-WMM | $131.40 | $219.00 | $87.95–$91.37 | 38% below | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-SPAP | $131.40 | $219.00 | $76.65–$192.72 | 38% below | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-PESC | $131.40 | $219.00 | $76.65–$192.72 | 38% below | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-ACM | $131.40 | $219.00 | $76.65–$192.72 | 38% below | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JCWM | $131.40 | $219.00 | $59.57–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JPED | $131.40 | $219.00 | $76.65–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JMWC | $131.40 | $219.00 | $59.57–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-WMM | $131.40 | $219.00 | $76.65–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-FFH | $131.40 | $219.00 | $59.57–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-ACM | $131.40 | $219.00 | $76.65–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-TCA | $131.40 | $219.00 | $59.57–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-PESC | $131.40 | $219.00 | $76.65–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-TCOP | $131.40 | $219.00 | $59.57–$192.72 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-SPAP | $131.40 | $219.00 | $76.65–$192.72 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-CHPC | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SICU | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-AMS | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-OPU | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN TO 60 MIN-IM | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EDOU | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-PICC | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-CBCC | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-PC | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MNU | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MIN-LAD | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JMDS | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JOBS | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JSS | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JPCU | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-7PCT | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MIN-OBTR | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-AIUK | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-FUL | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-90MIN - FAY | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SPFM | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-AIU | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EF | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EF AT UMC | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MOR | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MOIP | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-7E | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MEDI | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, HYDRATION; INITIAL, 31 MIN TO 60 MIN-NSIC | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MED | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SS | $373.80 | $623.00 | $218.05–$548.24 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-PCU | $373.80 | $623.00 | $200.33–$208.11 | 56% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JER | $448.80 | $748.00 | $200.33–$208.11 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MUCX | $448.80 | $748.00 | $200.33–$264.00 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JUTR | $448.80 | $748.00 | $261.80–$658.24 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MUC | $448.80 | $748.00 | $261.80–$658.24 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EC | $448.80 | $748.00 | $261.80–$658.24 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MUCJ | $448.80 | $748.00 | $261.80–$658.24 | 87% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-CBCC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-CHPC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JMDS | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MIN-OBTR | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-AIUK | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-FUL | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN - 60 MIN-FMCJ | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-PC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-PICC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN TO 60 MIN-BAMB | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EDOU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN TO 60 MIN-IM | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN TO 60 MIN-AFM | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-OPU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-AMS | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SICU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-90MIN - FAY | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SPFM | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-AIU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EF | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MED | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MOR | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-PCU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MOIP | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-7E | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EF AT UMC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-FMCK | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MNU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MEDI | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MIN-LAD | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JFMO | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JIGC | $373.80 | $623.00 | $169.46–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, HYDRATION; INITIAL, 31 MIN TO 60 MIN-NSIC | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JOBS | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JSS | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-SS | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JPCU | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-7PCT | $373.80 | $623.00 | $218.05–$548.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MUCJ | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-MUC | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL, BTWN 31-90 MINS-EC | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-MUCX | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JUTR | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION INITIAL BTWN 31-90 MINS-JER | $448.80 | $748.00 | $261.80–$658.24 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEM-TICU/CCU-09 | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-PICC | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION IV THRP/PROPH/DIAG INITIAL 16-90 MIN NONCHEMO | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEM-EFUMC-09 | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-MOIP | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AIUK | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-7E | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MEDI | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AMS (09) | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEMO-WRIM (09) | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-7PCT | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AIU (09) | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-NSIC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-JPCU | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION IV THRP/PROPH/DIAG INITIAL 16-90 MIN NONCHEMO-JSS | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-JOBS | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-JICU | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JMDS | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MED (09) | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-IM | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-OPU | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-CHPC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-CBCC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-EDOU | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MNIC | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-PCU | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-MNU | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AAI | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-DU (09) | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-OCJC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-PC | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-OBTR | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JNC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-SS | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-JIMC | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEMO-FAY | $384.60 | $641.00 | $224.35–$564.08 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-LAD | $384.60 | $641.00 | $200.33–$208.11 | 34% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-JUTR | $461.40 | $769.00 | $269.15–$676.72 | 60% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-JER | $461.40 | $769.00 | $200.33–$208.11 | 60% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUCJ | $461.40 | $769.00 | $269.15–$676.72 | 60% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUC | $461.40 | $769.00 | $269.15–$676.72 | 60% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-EC | $461.40 | $769.00 | $269.15–$676.72 | 60% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUCX | $461.40 | $769.00 | $200.33–$264.00 | 60% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-PCU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEM-EFUMC-09 | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-MOIP | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-7E | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MEDI | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-NSIC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MED (09) | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-SS | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-MNIC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEM-TICU/CCU-09 | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AMS (09) | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-OPU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-IM | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-EDOU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION IV THRP/PROPH/DIAG INITIAL 16-90 MIN NONCHEMO | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-PICC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-CHPC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-CBCC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-PC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-FMCJ | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-DU (09) | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AAI | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-MNU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-LAD | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-JFMC | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-JFMD | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JFML | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-JFMV | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DIAG 1ST UP TO 1 HOUR-JIMC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JNC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JIGC | $384.60 | $641.00 | $174.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-JMDS | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-JICU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-JOBS | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION IV THRP/PROPH/DIAG INITIAL 16-90 MIN NONCHEMO-JSS | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-JPCU | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90MIN NONCHEMO-7PCT | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-OCJC | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NON CHEMO-OBTR | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AIUK | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEMO-FAY | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MIN NONCHEMO-WRIM (09) | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-AIU (09) | $384.60 | $641.00 | $224.35–$564.08 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DIAG INIT BTWN 16-90 MIN NONCHEMO-EC | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INIT BTWN 16-90 MINS NONCHEMO-JER | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUCX | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUC | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-JUTR | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THRP/PROPH/DX INITIAL UP TO 1 HOUR-MUCJ | $461.40 | $769.00 | $269.15–$676.72 | — | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MOIP | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MPEO | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-DU | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-7E | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG- MEDI | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-NSIC | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MED | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-PC | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-SS | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-CBCC | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-CHPC | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-PICC | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EDOU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-IM | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-OPU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EFR | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EF | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-AIU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-WRIM | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-FV | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JEGC | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-FAY | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-GIKC | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-LAD | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-AMS | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 INJECT; IV PUSH SINGLE/INTL DRUG-JSS | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-OBTR | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EFOU | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH; SINGLE/INITL DRUG-MNU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 INJECT; IV PUSH, SINGLE/INTL DRUG-MOR | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-GI | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-PCU | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-NCK | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-AIUK | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JCT | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JPCU | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION IV PUSH SINGLE/INITL DRUG-7PCT | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 INJECT; IV PUSH, SINGLE/INTL DRUG-OR | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-CICU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JMDS | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION IV PUSH SINGLE/INITL DRUG-JICU | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-SICU | $231.00 | $385.00 | $134.75–$338.80 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MNIC | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JOBS | $231.00 | $385.00 | $200.33–$208.11 | 29% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH-MUC | $277.20 | $462.00 | $161.70–$406.56 | 54% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH-MUCX | $277.20 | $462.00 | $200.33–$264.00 | 54% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EC | $277.20 | $462.00 | $161.70–$406.56 | 54% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH-JUTR | $277.20 | $462.00 | $161.70–$406.56 | 54% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JER | $277.20 | $462.00 | $200.33–$208.11 | 54% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH-MUCJ | $277.20 | $462.00 | $161.70–$406.56 | 54% above | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-PC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-LAD | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JIGC | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JEGC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JMDS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION IV PUSH SINGLE/INITL DRUG-JICU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JOBS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECT; IV PUSH SINGLE/INTL DRUG-JSS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JPCU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION IV PUSH SINGLE/INITL DRUG-7PCT | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EFOU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECT; IV PUSH, SINGLE/INTL DRUG-MOR | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MOIP | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-7E | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG- MEDI | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-NSIC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MED | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-OBTR | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECT; IV PUSH/SINGLE/INTL DRUG-CCDJ | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-NCK | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-AIUK | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-GIKC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-SS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-PCU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MNIC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-SICU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-CICU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECT; IV PUSH, SINGLE/INTL DRUG-OR | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-AMS | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-FAY | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-FV | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-WRIM | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-AIU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EF | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-OPU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PSH SNGL/INIT DRUG THRP/PROPH/DIAG NONCHEM-AFM | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-IM | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EDOU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION IV PUSH SINGLE/INITL DRUG-BAMB | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-PICC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-CHPC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-CBCC | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PSH SNGL/INIT DRUG THRP/PROPH/DIAG NONCHEM-FMCJ | $231.00 | $385.00 | $104.72–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-DU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-MPEO | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EFR | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JCT | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-GI | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH; SINGLE/INITL DRUG-MNU | $231.00 | $385.00 | $134.75–$338.80 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH, SINGLE/INITL DRUG-EC | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH-MUC | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH-MUCJ | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH-MUCX | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERA/PROPH/DIAG INJECTION; IV PUSH SINGLE/INITL DRUG-JER | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH-JUTR | $277.20 | $462.00 | $161.70–$406.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JDHC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MM | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-NM | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JNM | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EF | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AIU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PMR | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-WRIM | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SM | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JCD | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPAP | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPGP | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPFM | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FV | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FAY | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FUL | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CAC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MS | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-DHFC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NSOB | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NFM | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AIUK | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NCK | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-HVCK | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-OBTR | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CSJC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OCJC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-7PCT | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OBC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-PESC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MFCC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JPCU | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JSS | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JOBS | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-JICU | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JMDS | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JENT | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JPOD | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM -JPED | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JPMC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JOB | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JNC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JMOI | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JIMC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EFOU | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-LAD | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MNU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MPEO | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-DU | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CBCC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CHPC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CPCR | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CIDE | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MEE | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EDOU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-IM | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OPU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AMS | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CICU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SICU | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MNIC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-HBVC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PCU | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SS | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MED | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGNOSTIC INJECTION;SUBQ/IM-NSIC | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM- MEDI | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-7E | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MCLN | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MOIP | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MOR | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FIPS | $97.20 | $162.00 | $67.67–$70.30 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-IVF | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EAC | $97.20 | $162.00 | $56.70–$142.56 | 5% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JER | $117.00 | $195.00 | $67.67–$70.30 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EC | $117.00 | $195.00 | $68.25–$171.60 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM SB Q NOT FLU; HEP B; PNEU MED-JUTR | $117.00 | $195.00 | $68.25–$171.60 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM SB Q NOT FLU HEP B PNEU MED-MUCX | $117.00 | $195.00 | $67.67–$264.00 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM SB Q NOT FLU HEP B PNEU MED-MUCJ | $117.00 | $195.00 | $68.25–$171.60 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM SB Q NOT FLU, HEP B, PNEU MED-MUC | $117.00 | $195.00 | $68.25–$171.60 | 26% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM -JPED | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OPU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JPMC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGNOSTIC INJECTION;SUBQ/IM-NSIC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JOB | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AMS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM- MEDI | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JNC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JMOI | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CICU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JMWC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JIMC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EAC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JDHC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SICU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMV | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMO | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFML | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMD | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMB | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMM | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFME | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JFMC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-NM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-LAD | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JNM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-7E | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MNU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EF | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AIU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MNIC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MPEO | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PMR | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-WRIM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FIPS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-DSSC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JCD | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FMCK | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-DU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPAP | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-HBVC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPGP | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SPFM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FV | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-FFH | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JMDS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JIGC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-JENT | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JPOD | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-AFM | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-IVF | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JSS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-IM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MOR | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JOBS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-JICU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FAY | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MFMC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-FUL | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC/PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-FMCJ | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CAC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MCLN | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-PCU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CBCC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-DHFC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NSOB | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CHPC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EFOU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NFM | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-AIUK | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-NCK | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-HVCK | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-SS | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CCJC | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-OBTR | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-CPCR | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CSJC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-CIDE | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MOIP | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OCJC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-MEE | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-7PCT | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-OBC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MED | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION; SUBQ/IM-PESC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THERAPEUTIC PROPHYLACTIC/DIAGNOSTIC SUBQ/IM-BAMB | $97.20 | $162.00 | $44.06–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-MFCC | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EDOU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JPCU | $97.20 | $162.00 | $56.70–$142.56 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM SB Q NOT FLU HEP B PNEU MED-MUCX | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM SB Q NOT FLU; HEP B; PNEU MED-JUTR | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-EC | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM SB Q NOT FLU HEP B PNEU MED-MUCJ | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC/PROPHYLACTIC/DIAGOSTIC INJECTION;SUBQ/IM-JER | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM SB Q NOT FLU, HEP B, PNEU MED-MUC | $117.00 | $195.00 | $68.25–$171.60 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-PESC | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION, ADULT-MPEO | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION, PEDIATRIC -MPEO | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-PMR | $172.80 | $288.00 | $100.80–$253.44 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SC | $172.80 | $288.00 | $100.80–$253.44 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPAP | $172.80 | $288.00 | $100.80–$253.44 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPFM | $172.80 | $288.00 | $100.80–$253.44 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JNC | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-ACM | $172.80 | $288.00 | $100.80–$253.44 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JOB | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPGP | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-WMM | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION -JPED | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-MCLN | $172.80 | $288.00 | $152.77–$158.70 | 19% below | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPGP | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION, PEDIATRIC -MPEO | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-TCA | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TELEMED PSYCHIATRIC DIAGNOSTIC EVALUATION AUDIO/VISUAL-ACM | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TELEMED PSYCHIATRIC DIAGNOSTIC EVALUATION AUDIO-ACM | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-ACM | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-FFH | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-BAMB | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-WMM | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JFMV | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JOB | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION -JPED | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-PESC | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JCWM | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JMWC | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-PMR | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-TCOP | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SC | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPFM | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JNC | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JFMD | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-SPAP | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-CAP | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-JFMM | $172.80 | $288.00 | $78.34–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION-MCLN | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION, ADULT-MPEO | $172.80 | $288.00 | $100.80–$253.44 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-MCLN | $757.20 | $1,262.00 | $441.70–$1,110.56 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES | $757.20 | $1,262.00 | $441.70–$1,110.56 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-CSJC | $757.20 | $1,262.00 | $441.70–$1,110.56 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-JPMR | $757.20 | $1,262.00 | $296.09–$307.59 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-JMOI | $757.20 | $1,262.00 | $296.09–$307.59 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-PMR | $757.20 | $1,262.00 | $441.70–$1,110.56 | 18% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-PMR | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-MCLN | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-CSJC | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-JPMR | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES-JMOI | $757.20 | $1,262.00 | $441.70–$1,110.56 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MOPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-WPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-WPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-WPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-EFCR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-EFCR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 O.T NEUROMUSCULAR RE-ED 15 MINUTES (EFCR) | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 P.T. NEUROMUSCULAR RE-ED 15 MINUTES (EFCR) | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN ASSISTANT-JSCH | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-JSCH | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN ASSISTANT-JOT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-JOT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN ASSISTANT-JPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-JPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-PIPR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-PIPR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MOPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MOPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MOPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-WPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MIP | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MIP | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15MIN-CTTC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-CTTC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-CTTC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-EDUCATION EA 15MIN-CTTC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MTR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-TNC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-TNC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-TNC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-TNC | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-SHPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-SHPT | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTAY | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTAY | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTFM | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTFM | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTFM | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTF | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTF | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MTB | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MTB | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTB | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTB | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTSE | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTSE | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTMX | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTMX | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTBW | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTBW | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MTBW | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION EA 15 MIN-MTBW | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTJR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTJR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 TELEMED PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTJR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-MTJR | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN ASSISTANT-JTM | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-JTM | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN ASSISTANT-JSCH | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE EDUCATION EA 15 MIN-JSCH | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION TX; INITIAL, INDIV, FACE-TO-FACE, 15 MIN-CLNT | $49.20 | $82.00 | $22.30–$72.16 | 23% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION TX; INITIAL INDIV FACE-TO-FACE 15 MIN-CNJC | $49.20 | $82.00 | $22.30–$72.16 | 23% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION TX; INITIAL INDIV FACE-TO-FACE 15 MIN-CNJC | $49.20 | $82.00 | $22.30–$72.16 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TELEMED MED NUTRITION TX INDVL, INITIAL, F2F, 15 MIN-CLNT | $49.20 | $82.00 | $22.30–$72.16 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION TX; INITIAL, INDIV, FACE-TO-FACE, 15 MIN-CLNT | $49.20 | $82.00 | $22.30–$72.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-EFCR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-EFCR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MTJR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-WPT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-WPT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MIP | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-CTTC | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-CTTC | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MOPT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MOPT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-PIPR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-JOT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-JSCH | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MTJR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MTBW | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MTBW | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MTB | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MTB | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MTFM | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-SHPT | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-TNC | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-TNC | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY-MTR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 TELEMED OT EVAL LOW COMPLEXITY-MTR | $214.20 | $357.00 | $97.10–$314.16 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-JPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTB | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTF | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTF | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTFM | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTFM | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTAY | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTAY | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-SHPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-SHPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTB | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-WPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-WPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MIP | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-EFCR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-EFCR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTSE | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-CTTC | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-CTTC | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-TNC | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-TNC | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MOPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MOPT | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-PIPR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTSE | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTMX | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTMX | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTBW | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTBW | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 TELEMED PT EVAL HIGH COMPLEXITY-MTJR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-MTJR | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-JTM | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY-JSCH | $271.80 | $453.00 | $123.22–$398.64 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-EFCR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MIP | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-CTTC | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-CTTC | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MOPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MOPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-PIPR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-JPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-JSCH | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-JTM | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTJR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTJR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTBW | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTBW | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTMX | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTMX | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTSE | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTSE | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTB | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTB | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTF | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTF | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTFM | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTFM | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTAY | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTAY | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-SHPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-SHPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-TNC | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-TNC | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-MTR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-MTR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-EFCR | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 TELEMED PT EVAL LOW COMPLEXITY-WPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY-WPT | $205.80 | $343.00 | $93.30–$301.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-SHPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-EFCR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-EFCR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-TNC | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTAY | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTAY | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTFM | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTFM | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTF | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTF | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTB | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTB | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTSE | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTSE | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTMX | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-TNC | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTMX | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTBW | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTBW | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MTJR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTJR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-JTM | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-JSCH | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-JPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-PIPR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MTR | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-MOPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MOPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-CTTC | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-CTTC | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-MIP | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 TELEMED PT EVAL MOD COMPLEXITY-WPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-WPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY-SHPT | $235.80 | $393.00 | $106.90–$345.84 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES, 1 OR MORE REGIONS, EA 15 MIN-MCLN | $93.60 | $156.00 | $42.43–$137.28 | 15% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN ASSISTANT-JSCH | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES 1/MORE REGIONS EA 15 MIN-JSCH | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TECHNIQUES, 1 OR MORE REGIONS, EA 15 MIN-MCLN | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 O.T. MANUAL THERAPY PER 15 MINUTES (EFCR) | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 P.T. MANUAL THERAPY EACH 15 MINUTES (EFCR) | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-TNC | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-TNC | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-SHPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTAY | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTFM | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTF | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTB | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTB | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTSE | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTMX | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN ASSISTANT-JOT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-JOT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN ASSISTANT-JPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-JPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-PIPR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-PIPR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MOPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MOPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15MIN-CTTC | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15MIN-CTTC | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MIP | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MIP | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-WPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-WPT | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTBW | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTBW | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTJR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-MTJR | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN ASSISTANT-JTM | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY TECHNIQUES EA 15 MIN-JTM | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQUES 1/MORE REGIONS EA 15 MIN-JSCH | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY TECHNIQ 1/MORE REGIONS EA 15 MIN ASST-JSCH | $93.60 | $156.00 | $42.43–$137.28 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JTM | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JSCH | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JSCH | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MIP | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MIP | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JSCH | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-JSCH | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JOT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-JOT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-PIPR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-PIPR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTMX | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTMX | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTSE | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTSE | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTF | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTF | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTAY | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTAY | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-SHPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-SHPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 P.T. 1/1 TREATMENT PER 15 MINUTES (EFCR) | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 O.T. THERAPEUTIC PROCEDURE 15 MINUTES (EFCR) | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-EFCR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-EFCR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JTM | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | $42.70–$138.16 | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/ MEDICAL SRVCS, ADULT-MPEO | $189.60 | $316.00 | $152.77–$158.70 | 12% above | 40% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-SPAP | $189.60 | $316.00 | $110.60–$278.08 | 12% above | 40% |
| Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/ MEDICAL SRVCS, PEDIATRIC-MPEO | $189.60 | $316.00 | $152.77–$158.70 | 12% above | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-TCOP | $189.60 | $316.00 | $85.95–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-TCA | $189.60 | $316.00 | $85.95–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/ MEDICAL SRVCS, PEDIATRIC-MPEO | $189.60 | $316.00 | $110.60–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-JMWC | $189.60 | $316.00 | $85.95–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-SPAP | $189.60 | $316.00 | $110.60–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-BAMB | $189.60 | $316.00 | $85.95–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVALUATION WITH MEDICAL SERVICES-CAP | $189.60 | $316.00 | $85.95–$278.08 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/ MEDICAL SRVCS, ADULT-MPEO | $189.60 | $316.00 | $110.60–$278.08 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-MCLN | $247.20 | $412.00 | $296.09–$307.59 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-EF | $247.20 | $412.00 | $144.20–$362.56 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-PMR | $247.20 | $412.00 | $144.20–$362.56 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-SPGP | $247.20 | $412.00 | $296.09–$307.59 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-SC | $247.20 | $412.00 | $296.09–$307.59 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP; 1ST HOUR-NCK | $247.20 | $412.00 | $144.20–$362.56 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP; 1ST HOUR-PESC | $247.20 | $412.00 | $144.20–$362.56 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCSPHYS/QHP1ST HR-WMM | $247.20 | $412.00 | $296.09–$307.59 | 8% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-SPGP | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCSPHYS/QHP1ST HR-JCWM | $247.20 | $412.00 | $112.06–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-MCLN | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCSPHYS/QHP1ST HR-WMM | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP; 1ST HOUR-PESC | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-SC | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-PMR | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP;1ST HOUR-EF | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCS,PHYS/QHP,1ST HR-TCA | $247.20 | $412.00 | $112.06–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCS,PHYS/QHP,1ST HR-TCOP | $247.20 | $412.00 | $112.06–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCH TEST EVAL SVCS BY PHYS/QHP; 1ST HOUR-NCK | $247.20 | $412.00 | $144.20–$362.56 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING EVALUATION SRVCS,PHYS/QHP,1ST HR-CAP | $247.20 | $412.00 | $112.06–$362.56 | — | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-MCLN | $198.60 | $331.00 | $152.77–$158.70 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-JOB | $198.60 | $331.00 | $115.85–$291.28 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-PESC | $198.60 | $331.00 | $152.77–$158.70 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-ACM | $198.60 | $331.00 | $115.85–$291.28 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-WMM | $198.60 | $331.00 | $152.77–$158.70 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-PMR | $198.60 | $331.00 | $115.85–$291.28 | 7% below | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-BAMB | $198.60 | $331.00 | $90.03–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-PESC | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-JCWM | $198.60 | $331.00 | $90.03–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-TCOP | $198.60 | $331.00 | $90.03–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-CAP | $198.60 | $331.00 | $90.03–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-PMR | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-JOB | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS FIRST 60 MINUTES-WMM | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-ACM | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-TCA | $198.60 | $331.00 | $90.03–$291.28 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS, FIRST 60 MINUTES-MCLN | $198.60 | $331.00 | $115.85–$291.28 | — | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SPAP | $162.60 | $271.00 | $94.85–$238.48 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT AND/OR FAMILY-PESC | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SC | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-MCLN | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS W/ PATIENT-SPFM | $162.60 | $271.00 | $94.85–$238.48 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-ACM | $162.60 | $271.00 | $94.85–$238.48 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-SPGP | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JOB | $162.60 | $271.00 | $94.85–$238.48 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JNC | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-PMR | $162.60 | $271.00 | $94.85–$238.48 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-WMM | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JPED | $162.60 | $271.00 | $152.77–$158.70 | at median | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-TCA | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-SPGP | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-FFH | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-ACM | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SPAP | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-CAP | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-PMR | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-MCLN | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JMWC | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JFMV | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JFMM | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-WMM | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JOB | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-BAMB | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JPED | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT AND/OR FAMILY-PESC | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JCWM | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-TCOP | $162.60 | $271.00 | $73.71–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SC | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JNC | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS W/ PATIENT-SPFM | $162.60 | $271.00 | $94.85–$238.48 | — | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-WMM | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-PMR | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SPAP | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-SPGP | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS W/ PATIENT-SPFM | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SC | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-ACM | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JNC | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JOB | $166.20 | $277.00 | $96.95–$243.76 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JPED | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT AND/OR FAMILY-PESC | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY-MCLN | $166.20 | $277.00 | $152.77–$158.70 | 13% below | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMV | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMM | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-TCOP | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-JCWM | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-WMM | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-ACM | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-TCA | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT AND/OR FAMILY-PESC | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-BAMB | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-FFH | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JPED | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JOB | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JNC | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JMWC | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY-MCLN | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMD | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SC | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS W/ PATIENT-SPFM | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-SPGP | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SPAP | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY MEMBER-CAP | $166.20 | $277.00 | $75.34–$243.76 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-PMR | $166.20 | $277.00 | $96.95–$243.76 | — | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-SPGP | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-SPAP | $184.80 | $308.00 | $107.80–$271.04 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT AND/OR FAMILY-PESC | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-WMM | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-PMR | $184.80 | $308.00 | $107.80–$271.04 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JNC | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-ACM | $184.80 | $308.00 | $107.80–$271.04 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JPED | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS W/ PATIENT-SPFM | $184.80 | $308.00 | $107.80–$271.04 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY-MCLN | $184.80 | $308.00 | $152.77–$158.70 | 23% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JOB | $184.80 | $308.00 | $107.80–$271.04 | 23% below | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-TCOP | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS W/ PATIENT-SPFM | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-SPGP | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-SPAP | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY MEMBER-CAP | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-PMR | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-TCA | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JFMD | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/FAMILY MEMBER-BAMB | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/FAMILY MEMBER-FFH | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-ACM | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JFMM | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JNC | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY-MCLN | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-WMM | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JMWC | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JFMV | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JOB | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JPED | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT AND/OR FAMILY-PESC | $184.80 | $308.00 | $107.80–$271.04 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JCWM | $184.80 | $308.00 | $83.78–$271.04 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-EAC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FIPS | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-MCLN | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-POSC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-TSBW | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-MEE | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CIDE | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION INTERMEDIATE 3-10 MIN-CARB | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION INTERMEDIATE 3-10 MIN-PULR | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-ECSC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-WMM | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JDHC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JIMC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JMOI | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JNC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN -JPED | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JSCM | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-PESC | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-OBC | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CSJC | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-HVCK | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-NCK | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-NSOB | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-DHFC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN MED | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SC | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CAC | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-OPH | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FUL | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FAY | $34.20 | $57.00 | $28.33–$29.43 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SPFM | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SM | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-WRIM | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN EF | $34.20 | $57.00 | $19.95–$50.16 | 28% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-AFM | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-TSBW | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-POSC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CAC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-MCLN | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-OPH | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FUL | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FIPS | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-PESC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JSCM | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN -JPED | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JNC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JMOI | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JIMC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JGCC | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JDHC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JFMV | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JFMO | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JFML | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JFMM | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JFME | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-DSSC | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FMCK | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-WMM | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-ECSC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FAY | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-EAC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION INTERMEDIATE 3-10 MIN-PULR | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SPFM | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-NSOB | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-DHFC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FFH | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN MED | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-SM | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-WRIM | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN EF | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION INTERMEDIATE 3-10 MIN-CARB | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-MFMC | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-FMCJ | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-JCWM | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CSAS | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CSJC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CIDE | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CCJC | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-MEE | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-HVCK | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-BAMB | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-OBC | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-NCK | $34.20 | $57.00 | $19.95–$50.16 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MIN-CENT | $34.20 | $57.00 | $15.50–$50.16 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 TELEMED SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-WPT | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS-WPT | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 TELEMED SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-CTTC | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS-PIPR | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS-JSPT | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-JSCH | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 TELEMED SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-MTFM | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENS/EXPRESS-TNC | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 TELEMED SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-TNC | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 TELEMED SP EVAL SPEECH SOUND PROD LANG COMPRHSN/EXPRESS-EFCR | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS-EFCR | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SP EVAL SPEECH SOUND PRODUCT LANG COMPREHENS/EXPRESS-CTTC | $378.00 | $630.00 | $157.00–$554.40 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 TELEMED SP SPEECH INDIVIDUAL TREATMENT-WPT | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 S.P. SPEECH INDIVUDUAL TREATMENT-EFCR | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 TELEMED SP SPEECH INDIVIDUAL TREATMENT-EFCR | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 TELEMED SP SPEECH INDIVIDUAL TREATMENT-TNC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-TNC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 TELEMED SP SPEECH INDIVIDUAL TREATMENT-MTFM | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-JSCH | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-JSPT | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-PIPR | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVUDUAL TREATMENT | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 TELEMED SP SPEECH INDIVIDUAL TREATMENT-CTTC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-CTTC | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH INDIVIDUAL TREATMENT-WPT | $234.60 | $391.00 | $106.35–$344.08 | — | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY-WRIM | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETERY | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 PEDIATRIC SPIROMETRY | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETERY (PFT)-JRT | $291.00 | $485.00 | $148.77–$154.54 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 PEDIATRIC SPIROMETRY (PFT)-JRT | $291.00 | $485.00 | $148.77–$154.54 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY -PESC | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETERY-OCJC | $291.00 | $485.00 | $148.77–$154.54 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY-NCK | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY-FUL | $291.00 | $485.00 | $169.75–$426.80 | 26% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY-FV | $291.00 | $485.00 | $148.77–$154.54 | 26% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-WRIM | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-FV | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-FUL | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-NCK | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETERY-OCJC | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY -PESC | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PEDIATRIC SPIROMETRY (PFT)-JRT | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETERY (PFT)-JRT | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PEDIATRIC SPIROMETRY | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETERY | $291.00 | $485.00 | $169.75–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETERY-JFML | $291.00 | $485.00 | $131.92–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-JFMB | $291.00 | $485.00 | $131.92–$426.80 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY-BAMB | $291.00 | $485.00 | $131.92–$426.80 | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL-NCK | $491.40 | $819.00 | $286.65–$720.72 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL -PESC | $491.40 | $819.00 | $286.65–$720.72 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PED SPIROMETRY BRONCHOSPASM EVAL (PFT)-JRT | $491.40 | $819.00 | $296.09–$307.59 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY BRONCHOSPASM EVAL (PFT)-JRT | $491.40 | $819.00 | $296.09–$307.59 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PED SPIROMETRY-BRONCHOSPASM EVAL | $491.40 | $819.00 | $286.65–$720.72 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL | $491.40 | $819.00 | $286.65–$720.72 | 12% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL-FUL | $491.40 | $819.00 | $286.65–$720.72 | 12% above | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY BRONCHOSPASM EVAL (PFT)-JRT | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PED SPIROMETRY-BRONCHOSPASM EVAL | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL-BAMB | $491.40 | $819.00 | $222.77–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL-FUL | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL-NCK | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY-BRONCHOSPASM EVAL -PESC | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PED SPIROMETRY BRONCHOSPASM EVAL (PFT)-JRT | $491.40 | $819.00 | $286.65–$720.72 | — | 40% |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 THERAPEUTIC REPETITIVE TMS TREATMENT; INITIAL-SPAP | $286.80 | $478.00 | $296.09–$307.59 | — | 40% |
| TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 THERAPEUTIC REPETITIVE TMS TREATMENT; INITIAL-BAMB | $286.80 | $478.00 | $130.02–$420.64 | — | 40% |
| TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 THERAPEUTIC REPETITIVE TMS TREATMENT; INITIAL-SPAP | $286.80 | $478.00 | $167.30–$420.64 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-WPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-EFCR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-EFCR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 O.T. THERAPEUTIC ACTIVITIES 15 MINUTES (EFCR) | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 P.T. THERAPEUTIC ACTIVITIES 15 MINUTES (EFCR) | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES, KINETIC EA 15 MIN-MTR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-TNC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-TNC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-TNC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-TNC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-SHPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-SHPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTAY | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTAY | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTFM | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTFM | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTFM | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTF | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTF | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTB | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTB | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITY EA 15 MIN-MTB | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITY EA 15 MIN-MTB | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTSE | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTSE | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTMX | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTMX | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITY EA 15 MIN-MTBW | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITY EA 15 MIN-MTBW | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTBW | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTBW | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MTJR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES KINETIC EA 15 MIN-MTJR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MTJR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES KINETIC EA 15 MIN-MTJR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN ASSISTANT-JTM | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-JTM | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN ASSISTANT-JSCH | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-JSCH | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN ASST-JSCH | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-JSCH | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN ASSISTANT-JOT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-JOT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN ASSISTANT-JPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-JPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-PIPR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-PIPR | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-MOPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MOPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-MOPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-MOPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-CTTC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-CTTC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-CTTC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-CTTC | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIVITIES EA 15 MIN-MIP | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-MIP | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED PT THERAPEUTIC ACTIVITIES EA 15 MIN-WPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TELEMED OT THERAPEUTIC ACTIVITIES EA 15 MIN-WPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES EA 15 MIN-WPT | $98.40 | $164.00 | $44.61–$144.32 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY-JSS | $211.80 | $353.00 | $123.55–$310.64 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY SSC | $211.80 | $353.00 | $122.56–$127.32 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY- AIUK | $211.80 | $353.00 | $123.55–$310.64 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY- AIU | $211.80 | $353.00 | $123.55–$310.64 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY-OPU | $211.80 | $353.00 | $122.56–$127.32 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY-CBCC | $211.80 | $353.00 | $122.56–$127.32 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY P29621170 | $211.80 | $353.00 | $122.56–$127.32 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY-CHPC | $211.80 | $353.00 | $122.56–$127.32 | 22% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY P29621170 | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY- AIUK | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-JSS | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-JIGC | $211.80 | $353.00 | $96.02–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-FMCJ | $211.80 | $353.00 | $96.02–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-CBCC | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-CHPC | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY-OPU | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY SSC | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY- AIU | $211.80 | $353.00 | $123.55–$310.64 | — | 40% |
| Visual field test, extended both sides CPT 92083 VISUAL FIELD EXAM UNILAT/BILAT EXTENDED HUMPHREY/GOLDMAN-MEE | $121.80 | $203.00 | $122.56–$127.32 | — | 40% |
| Visual field test, extended CPT 92083 VISUAL FIELD TESTING, EXT. HUMPHREY/GOLDMANN | $121.80 | $203.00 | $71.05–$178.64 | 2% below | 40% |
| Visual field test, extended inpatient both sides CPT 92083 VISUAL FIELD EXAM UNILAT/BILAT EXTENDED HUMPHREY/GOLDMAN-MEE | $121.80 | $203.00 | $71.05–$178.64 | — | 40% |
| Visual field test, extended inpatient CPT 92083 VISUAL FIELD TESTING, EXT. HUMPHREY/GOLDMANN | $121.80 | $203.00 | $71.05–$178.64 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza vaccine (Fluad) PF 0.5 mL Inj (65 years and greater) | $75.00 | $125.00 | $34.00–$110.00 | 98% above | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza vaccine (Fluad) PF 0.5 mL Inj (65 years and greater) | $75.00 | $125.00 | $34.00–$110.00 | 98% above | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza vaccine (Fluad) PF 0.5 mL Inj (65 years and greater) | $75.00 | $125.00 | $34.00–$110.00 | — | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza vaccine (Fluad) PF 0.5 mL Inj (65 years and greater) | $75.00 | $125.00 | $34.00–$110.00 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 (Moderna 12y+) Vaccine 50 mcg/0.5 mL Inj | $171.60 | $286.00 | $77.79–$251.68 | at median | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 (Moderna 12y+) Vaccine 50 mcg/0.5 mL Inj | $171.60 | $286.00 | $77.79–$251.68 | at median | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 (Moderna 12y+) Vaccine 50 mcg/0.5 mL Inj | $171.60 | $286.00 | $77.79–$251.68 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 (Moderna 12y+) Vaccine 50 mcg/0.5 mL Inj | $171.60 | $286.00 | $77.79–$251.68 | — | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 (Pfizer 12y+) Vaccine 30 mcg/0.3 mL Inj | $169.20 | $282.00 | $76.70–$248.16 | 37% below | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 (Pfizer 12y+) Vaccine 30 mcg/0.3 mL Inj | $169.20 | $282.00 | $76.70–$248.16 | 37% below | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 (Pfizer 12y+) Vaccine 30 mcg/0.3 mL Inj | $169.20 | $282.00 | $76.70–$248.16 | — | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 (Pfizer 12y+) Vaccine 30 mcg/0.3 mL Inj | $169.20 | $282.00 | $76.70–$248.16 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus Vaccine 0.5 mL Inj | $494.70 | $824.50 | $224.26–$725.56 | 198% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus Vaccine 0.5 mL Inj | $494.70 | $824.50 | $224.26–$725.56 | 198% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC 0.5ML | $536.66 | $894.43 | $243.28–$787.10 | 223% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC 0.5ML | $536.66 | $894.43 | $243.28–$787.10 | 223% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus Vaccine 0.5 mL Inj | $494.70 | $824.50 | $224.26–$725.56 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus Vaccine 0.5 mL Inj | $494.70 | $824.50 | $224.26–$725.56 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC 0.5ML | $536.66 | $894.43 | $243.28–$787.10 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC 0.5ML | $536.66 | $894.43 | $243.28–$787.10 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 diphtheria/pertussis acel/tetanus/polio Inj 0.5 mL | $160.02 | $266.70 | $72.54–$234.70 | 208% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 diphtheria/pertussis acel/tetanus/polio Inj 0.5 mL | $160.02 | $266.70 | $72.54–$234.70 | 208% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH/TET/PERT ACEL/POLIO (DTAP/IPV) 0.5 ML INJ | $164.87 | $274.79 | $74.74–$241.82 | 217% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH/TET/PERT ACEL/POLIO (DTAP/IPV) 0.5 ML INJ | $164.87 | $274.79 | $74.74–$241.82 | 217% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 diphtheria/pertussis acel/tetanus/polio Inj 0.5 mL | $160.02 | $266.70 | $72.54–$234.70 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 diphtheria/pertussis acel/tetanus/polio Inj 0.5 mL | $160.02 | $266.70 | $72.54–$234.70 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH/TET/PERT ACEL/POLIO (DTAP/IPV) 0.5 ML INJ | $164.87 | $274.79 | $74.74–$241.82 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH/TET/PERT ACEL/POLIO (DTAP/IPV) 0.5 ML INJ | $164.87 | $274.79 | $74.74–$241.82 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertussis acel (DTaP) | $74.32 | $123.87 | $33.69–$109.01 | 8% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertussis acel (DTaP) | $74.32 | $123.87 | $33.69–$109.01 | 8% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA/TETANUS/PERTUS ACEL (DTAP) VACCINE 0.5 ML INJ | $76.00 | $126.67 | $34.45–$111.47 | 6% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA/TETANUS/PERTUS ACEL (DTAP) VACCINE 0.5 ML INJ | $76.00 | $126.67 | $34.45–$111.47 | 6% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diph/teta/a-pert (DAPTACEL DTaP) 0.5 mL Inj | $86.80 | $144.66 | $39.35–$127.30 | 7% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diph/teta/a-pert (DAPTACEL DTaP) 0.5 mL Inj | $86.80 | $144.66 | $39.35–$127.30 | 7% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertussis acel (DTaP) | $74.32 | $123.87 | $33.69–$109.01 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertussis acel (DTaP) | $74.32 | $123.87 | $33.69–$109.01 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTHERIA/TETANUS/PERTUS ACEL (DTAP) VACCINE 0.5 ML INJ | $76.00 | $126.67 | $34.45–$111.47 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTHERIA/TETANUS/PERTUS ACEL (DTAP) VACCINE 0.5 ML INJ | $76.00 | $126.67 | $34.45–$111.47 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diph/teta/a-pert (DAPTACEL DTaP) 0.5 mL Inj | $86.80 | $144.66 | $39.35–$127.30 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diph/teta/a-pert (DAPTACEL DTaP) 0.5 mL Inj | $86.80 | $144.66 | $39.35–$127.30 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphtheria/hepB/pertussis acel/polio/tetanus - Ora | $182.77 | $304.61 | $82.85–$268.06 | 43% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphtheria/hepB/pertussis acel/polio/tetanus - Ora | $182.77 | $304.61 | $82.85–$268.06 | 43% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEPATITIS B / DTAP / IPV VACCINES 0.5ML (PEDIARIX) | $188.14 | $313.57 | $85.29–$275.94 | 48% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEPATITIS B / DTAP / IPV VACCINES 0.5ML (PEDIARIX) | $188.14 | $313.57 | $85.29–$275.94 | 48% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphtheria/hepB/pertussis acel/polio/tetanus - Ora | $182.77 | $304.61 | $82.85–$268.06 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphtheria/hepB/pertussis acel/polio/tetanus - Ora | $182.77 | $304.61 | $82.85–$268.06 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEPATITIS B / DTAP / IPV VACCINES 0.5ML (PEDIARIX) | $188.14 | $313.57 | $85.29–$275.94 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEPATITIS B / DTAP / IPV VACCINES 0.5ML (PEDIARIX) | $188.14 | $313.57 | $85.29–$275.94 | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 dip/tet/pert acel/polio/haemB(PENTACEL)0.5mL Inj | $282.20 | $470.33 | $127.93–$413.89 | 125% above | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 dip/tet/pert acel/polio/haemB(PENTACEL)0.5mL Inj | $282.20 | $470.33 | $127.93–$413.89 | 125% above | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 dip/tet/pert acel/polio/haemB(PENTACEL)0.5mL Inj | $282.20 | $470.33 | $127.93–$413.89 | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 dip/tet/pert acel/polio/haemB(PENTACEL)0.5mL Inj | $282.20 | $470.33 | $127.93–$413.89 | — | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DIPHTH/TETA/A-PERT/POLIO/HAEM/HEPB (VAXELIS) 0.5 ML | $481.46 | $802.44 | $218.26–$706.15 | 245% above | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DIPHTH/TETA/A-PERT/POLIO/HAEM/HEPB (VAXELIS) 0.5 ML | $481.46 | $802.44 | $218.26–$706.15 | 245% above | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DIPHTH/TETA/A-PERT/POLIO/HAEM/HEPB (VAXELIS) 0.5 ML | $481.46 | $802.44 | $218.26–$706.15 | — | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DIPHTH/TETA/A-PERT/POLIO/HAEM/HEPB (VAXELIS) 0.5 ML | $481.46 | $802.44 | $218.26–$706.15 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 TRAVEL CLINIC INFLUENZA VACCINE PF 0.5 ML INJ (6 MO OR MR) | $10.20 | $17.00 | $4.62–$14.96 | 78% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 TRAVEL CLINIC INFLUENZA VACCINE PF 0.5 ML INJ (6 MO OR MR) | $10.20 | $17.00 | $4.62–$14.96 | 78% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza Vaccine PF 0.5 mL Inj ( >/= 6 mo) | $25.20 | $42.00 | $11.42–$36.96 | 46% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza Vaccine PF 0.5 mL Inj ( >/= 6 mo) | $25.20 | $42.00 | $11.42–$36.96 | 46% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 TRAVEL CLINIC INFLUENZA VACCINE PF 0.5 ML INJ (6 MO OR MR) | $10.20 | $17.00 | $4.62–$14.96 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 TRAVEL CLINIC INFLUENZA VACCINE PF 0.5 ML INJ (6 MO OR MR) | $10.20 | $17.00 | $4.62–$14.96 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza Vaccine PF 0.5 mL Inj ( >/= 6 mo) | $25.20 | $42.00 | $11.42–$36.96 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza Vaccine PF 0.5 mL Inj ( >/= 6 mo) | $25.20 | $42.00 | $11.42–$36.96 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent | $609.56 | $1,015.93 | $276.33–$894.02 | 85% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent | $609.56 | $1,015.93 | $276.33–$894.02 | 85% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT VACCINE(GARDASIL 9) 0.5 ML INJ | $665.54 | $1,109.24 | $301.71–$976.13 | 102% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT VACCINE(GARDASIL 9) 0.5 ML INJ | $665.54 | $1,109.24 | $301.71–$976.13 | 102% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent | $609.56 | $1,015.93 | $276.33–$894.02 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent | $609.56 | $1,015.93 | $276.33–$894.02 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT VACCINE(GARDASIL 9) 0.5 ML INJ | $665.54 | $1,109.24 | $301.71–$976.13 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT VACCINE(GARDASIL 9) 0.5 ML INJ | $665.54 | $1,109.24 | $301.71–$976.13 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TRAVEL CLINIC HEPATITIS A&B VACCINE PF (TWINRIX) SYR INJ | $112.80 | $188.00 | $51.14–$165.44 | 13% above | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TRAVEL CLINIC HEPATITIS A&B VACCINE PF (TWINRIX) SYR INJ | $112.80 | $188.00 | $51.14–$165.44 | 13% above | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A-hepatitis B vaccine PF (TWINRIX) Syr Inj | $280.80 | $468.00 | $127.30–$411.84 | 182% above | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A-hepatitis B vaccine PF (TWINRIX) Syr Inj | $280.80 | $468.00 | $127.30–$411.84 | 182% above | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TRAVEL CLINIC HEPATITIS A&B VACCINE PF (TWINRIX) SYR INJ | $112.80 | $188.00 | $51.14–$165.44 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TRAVEL CLINIC HEPATITIS A&B VACCINE PF (TWINRIX) SYR INJ | $112.80 | $188.00 | $51.14–$165.44 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A-hepatitis B vaccine PF (TWINRIX) Syr Inj | $280.80 | $468.00 | $127.30–$411.84 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A-hepatitis B vaccine PF (TWINRIX) Syr Inj | $280.80 | $468.00 | $127.30–$411.84 | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (VAQTA) 1 ML SYR INJ | $70.80 | $118.00 | $32.10–$103.84 | 8% below | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (VAQTA) 1 ML SYR INJ | $70.80 | $118.00 | $32.10–$103.84 | 8% below | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (HAVRIX) 1 ML INJ | $77.40 | $129.00 | $35.09–$113.52 | 1% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (HAVRIX) 1 ML INJ | $77.40 | $129.00 | $35.09–$113.52 | 1% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 50 units/mL Ora | $176.83 | $294.72 | $80.16–$259.35 | 130% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 50 units/mL Ora | $176.83 | $294.72 | $80.16–$259.35 | 130% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 | $192.85 | $321.42 | $87.43–$282.85 | 151% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 | $192.85 | $321.42 | $87.43–$282.85 | 151% above | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (VAQTA) 1 ML SYR INJ | $70.80 | $118.00 | $32.10–$103.84 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (VAQTA) 1 ML SYR INJ | $70.80 | $118.00 | $32.10–$103.84 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (HAVRIX) 1 ML INJ | $77.40 | $129.00 | $35.09–$113.52 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 TRAVEL CLINIC HEPATITIS A VACCINE ADULT (HAVRIX) 1 ML INJ | $77.40 | $129.00 | $35.09–$113.52 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 50 units/mL Ora | $176.83 | $294.72 | $80.16–$259.35 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 50 units/mL Ora | $176.83 | $294.72 | $80.16–$259.35 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 | $192.85 | $321.42 | $87.43–$282.85 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 | $192.85 | $321.42 | $87.43–$282.85 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (HAVRIX) 0.5 ML INJ | $39.00 | $65.00 | $17.68–$57.20 | at median | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (HAVRIX) 0.5 ML INJ | $39.00 | $65.00 | $17.68–$57.20 | at median | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (VAQTA PED) 0.5 ML INJ | $41.40 | $69.00 | $18.77–$60.72 | 6% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (VAQTA PED) 0.5 ML INJ | $41.40 | $69.00 | $18.77–$60.72 | 6% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pediatric vaccine 720 | $96.10 | $160.16 | $43.56–$140.94 | 146% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A pediatric vaccine 720 | $96.10 | $160.16 | $43.56–$140.94 | 146% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A Vaccine Ped (VAQTA PED) 0.5 mL Inj | $102.83 | $171.38 | $46.62–$150.81 | 163% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 hepatitis A Vaccine Ped (VAQTA PED) 0.5 mL Inj | $102.83 | $171.38 | $46.62–$150.81 | 163% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (HAVRIX) 0.5 ML INJ | $39.00 | $65.00 | $17.68–$57.20 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (HAVRIX) 0.5 ML INJ | $39.00 | $65.00 | $17.68–$57.20 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (VAQTA PED) 0.5 ML INJ | $41.40 | $69.00 | $18.77–$60.72 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 TRAVEL CLINIC HEPATITIS A VACCINE PED (VAQTA PED) 0.5 ML INJ | $41.40 | $69.00 | $18.77–$60.72 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pediatric vaccine 720 | $96.10 | $160.16 | $43.56–$140.94 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A pediatric vaccine 720 | $96.10 | $160.16 | $43.56–$140.94 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A Vaccine Ped (VAQTA PED) 0.5 mL Inj | $102.83 | $171.38 | $46.62–$150.81 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 hepatitis A Vaccine Ped (VAQTA PED) 0.5 mL Inj | $102.83 | $171.38 | $46.62–$150.81 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (RECOMBIVAX) 3 DSE SCHD IM | $57.00 | $95.00 | $25.84–$83.60 | 27% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (RECOMBIVAX) 3 DSE SCHD IM | $57.00 | $95.00 | $25.84–$83.60 | 27% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (ENGERIX-B) 3 DSE SCHD IM | $63.00 | $105.00 | $28.56–$92.40 | 19% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (ENGERIX-B) 3 DSE SCHD IM | $63.00 | $105.00 | $28.56–$92.40 | 19% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B Vaccine (PF) Adult 10 mcg/1 mL Inj | $142.00 | $236.66 | $64.37–$208.26 | 82% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B Vaccine (PF) Adult 10 mcg/1 mL Inj | $142.00 | $236.66 | $64.37–$208.26 | 82% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg/mL Ora | $157.49 | $262.49 | $71.40–$230.99 | 101% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg/mL Ora | $157.49 | $262.49 | $71.40–$230.99 | 101% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (RECOMBIVAX) 3 DSE SCHD IM | $57.00 | $95.00 | $25.84–$83.60 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (RECOMBIVAX) 3 DSE SCHD IM | $57.00 | $95.00 | $25.84–$83.60 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (ENGERIX-B) 3 DSE SCHD IM | $63.00 | $105.00 | $28.56–$92.40 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 TRAVEL CLINIC HEPATITIS B VACCINE (ENGERIX-B) 3 DSE SCHD IM | $63.00 | $105.00 | $28.56–$92.40 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B Vaccine (PF) Adult 10 mcg/1 mL Inj | $142.00 | $236.66 | $64.37–$208.26 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B Vaccine (PF) Adult 10 mcg/1 mL Inj | $142.00 | $236.66 | $64.37–$208.26 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg/mL Ora | $157.49 | $262.49 | $71.40–$230.99 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg/mL Ora | $157.49 | $262.49 | $71.40–$230.99 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (ENGERIX-B) 10MCG/0.5ML | $25.80 | $43.00 | $11.70–$37.84 | 66% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (ENGERIX-B) 10MCG/0.5ML | $25.80 | $43.00 | $11.70–$37.84 | 66% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (RECOMBIVAX) 5 MCG/0.5 ML | $28.20 | $47.00 | $12.78–$41.36 | 62% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (RECOMBIVAX) 5 MCG/0.5 ML | $28.20 | $47.00 | $12.78–$41.36 | 62% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B ped (ENGERIX) 10 mcg/0.5 mL | $64.13 | $106.88 | $29.07–$94.05 | 14% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B ped (ENGERIX) 10 mcg/0.5 mL | $64.13 | $106.88 | $29.07–$94.05 | 14% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine 5 mcg/0.5 mL | $69.91 | $116.52 | $31.69–$102.54 | 7% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B vaccine 5 mcg/0.5 mL | $69.91 | $116.52 | $31.69–$102.54 | 7% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (ENGERIX-B) 10MCG/0.5ML | $25.80 | $43.00 | $11.70–$37.84 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (ENGERIX-B) 10MCG/0.5ML | $25.80 | $43.00 | $11.70–$37.84 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (RECOMBIVAX) 5 MCG/0.5 ML | $28.20 | $47.00 | $12.78–$41.36 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 TRAVEL CLINIC HEPATITIS B VAC PED (RECOMBIVAX) 5 MCG/0.5 ML | $28.20 | $47.00 | $12.78–$41.36 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B ped (ENGERIX) 10 mcg/0.5 mL | $64.13 | $106.88 | $29.07–$94.05 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B ped (ENGERIX) 10 mcg/0.5 mL | $64.13 | $106.88 | $29.07–$94.05 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B vaccine 5 mcg/0.5 mL | $69.91 | $116.52 | $31.69–$102.54 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B vaccine 5 mcg/0.5 mL | $69.91 | $116.52 | $31.69–$102.54 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 0.5 mL CRH | $92.81 | $154.69 | $42.08–$136.13 | 168% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 0.5 mL CRH | $92.81 | $154.69 | $42.08–$136.13 | 168% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B CONJ (PRP-OMP) (PEDVAXHIB) 0.5 ML | $97.76 | $162.93 | $44.32–$143.38 | 183% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B CONJ (PRP-OMP) (PEDVAXHIB) 0.5 ML | $97.76 | $162.93 | $44.32–$143.38 | 183% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 0.5 mL CRH | $92.81 | $154.69 | $42.08–$136.13 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 0.5 mL CRH | $92.81 | $154.69 | $42.08–$136.13 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B CONJ (PRP-OMP) (PEDVAXHIB) 0.5 ML | $97.76 | $162.93 | $44.32–$143.38 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B CONJ (PRP-OMP) (PEDVAXHIB) 0.5 ML | $97.76 | $162.93 | $44.32–$143.38 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) Vaccine Inj | $34.70 | $57.84 | $15.73–$50.90 | 1% below | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) Vaccine Inj | $34.70 | $57.84 | $15.73–$50.90 | 1% below | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine | $37.81 | $63.02 | $17.14–$55.46 | 8% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine | $37.81 | $63.02 | $17.14–$55.46 | 8% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILIS-B VACCINE, PRP-T CONJUGATE (ACTHIB) | $37.82 | $63.03 | $17.14–$55.47 | 8% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILIS-B VACCINE, PRP-T CONJUGATE (ACTHIB) | $37.82 | $63.03 | $17.14–$55.47 | 8% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) Vaccine Inj | $34.70 | $57.84 | $15.73–$50.90 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) Vaccine Inj | $34.70 | $57.84 | $15.73–$50.90 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine | $37.81 | $63.02 | $17.14–$55.46 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine | $37.81 | $63.02 | $17.14–$55.46 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILIS-B VACCINE, PRP-T CONJUGATE (ACTHIB) | $37.82 | $63.03 | $17.14–$55.47 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILIS-B VACCINE, PRP-T CONJUGATE (ACTHIB) | $37.82 | $63.03 | $17.14–$55.47 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 TRAVEL CLINIC JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM | $172.20 | $287.00 | $78.06–$252.56 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 TRAVEL CLINIC JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM | $172.20 | $287.00 | $78.06–$252.56 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Japanese encephalitis Vac inactivated 0.5mL Inj | $430.44 | $717.40 | $195.13–$631.31 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Japanese encephalitis Vac inactivated 0.5mL Inj | $430.44 | $717.40 | $195.13–$631.31 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 TRAVEL CLINIC JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM | $172.20 | $287.00 | $78.06–$252.56 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 TRAVEL CLINIC JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM | $172.20 | $287.00 | $78.06–$252.56 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Japanese encephalitis Vac inactivated 0.5mL Inj | $430.44 | $717.40 | $195.13–$631.31 | — | 40% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Japanese encephalitis Vac inactivated 0.5mL Inj | $430.44 | $717.40 | $195.13–$631.31 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 TRAVEL CLINIC RUBELLA MUMPS MEASLES VACCINE INJ | $100.80 | $168.00 | $45.70–$147.84 | 37% below | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 TRAVEL CLINIC RUBELLA MUMPS MEASLES VACCINE INJ | $100.80 | $168.00 | $45.70–$147.84 | 37% below | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine live Priorix | $229.66 | $382.76 | $104.11–$336.83 | 44% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine live Priorix | $229.66 | $382.76 | $104.11–$336.83 | 44% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACCINE PRIORIX | $231.57 | $385.95 | $104.98–$339.64 | 46% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACCINE PRIORIX | $231.57 | $385.95 | $104.98–$339.64 | 46% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine | $250.91 | $418.18 | $113.74–$368.00 | 58% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine | $250.91 | $418.18 | $113.74–$368.00 | 58% above | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 TRAVEL CLINIC RUBELLA MUMPS MEASLES VACCINE INJ | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 TRAVEL CLINIC RUBELLA MUMPS MEASLES VACCINE INJ | $100.80 | $168.00 | $45.70–$147.84 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine live Priorix | $229.66 | $382.76 | $104.11–$336.83 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine live Priorix | $229.66 | $382.76 | $104.11–$336.83 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACCINE PRIORIX | $231.57 | $385.95 | $104.98–$339.64 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACCINE PRIORIX | $231.57 | $385.95 | $104.98–$339.64 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine | $250.91 | $418.18 | $113.74–$368.00 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine | $250.91 | $418.18 | $113.74–$368.00 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus Vaccine | $634.21 | $1,057.02 | $287.51–$930.18 | 149% above | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus Vaccine | $634.21 | $1,057.02 | $287.51–$930.18 | 149% above | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE | $653.84 | $1,089.74 | $296.41–$958.97 | 156% above | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE | $653.84 | $1,089.74 | $296.41–$958.97 | 156% above | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles/mumps/rubella/varicella virus Vaccine | $634.21 | $1,057.02 | $287.51–$930.18 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles/mumps/rubella/varicella virus Vaccine | $634.21 | $1,057.02 | $287.51–$930.18 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE | $653.84 | $1,089.74 | $296.41–$958.97 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA VIRUS VACCINE | $653.84 | $1,089.74 | $296.41–$958.97 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 TRAVEL CLINIC MENINGOCOCCL VAC (MENACWY)0.5ML INJ NO RECONST | $121.80 | $203.00 | $55.22–$178.64 | 4% below | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 TRAVEL CLINIC MENINGOCOCCL VAC (MENACWY)0.5ML INJ NO RECONST | $121.80 | $203.00 | $55.22–$178.64 | 4% below | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal Vaccine(MENVEO-MenACWY) 0.5 mL Inj | $303.69 | $506.15 | $137.67–$445.41 | 138% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal Vaccine(MENVEO-MenACWY) 0.5 mL Inj | $303.69 | $506.15 | $137.67–$445.41 | 138% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE A,C,Y,W-135 (MENACWY) 0.5 ML INJ | $314.24 | $523.74 | $142.46–$460.89 | 146% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE A,C,Y,W-135 (MENACWY) 0.5 ML INJ | $314.24 | $523.74 | $142.46–$460.89 | 146% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine | $526.43 | $877.39 | $238.65–$772.10 | 313% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine | $526.43 | $877.39 | $238.65–$772.10 | 313% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE 0.5 ML INJ | $526.44 | $877.40 | $238.65–$772.11 | 313% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE 0.5 ML INJ | $526.44 | $877.40 | $238.65–$772.11 | 313% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 TRAVEL CLINIC MENINGOCOCCL VAC (MENACWY)0.5ML INJ NO RECONST | $121.80 | $203.00 | $55.22–$178.64 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 TRAVEL CLINIC MENINGOCOCCL VAC (MENACWY)0.5ML INJ NO RECONST | $121.80 | $203.00 | $55.22–$178.64 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal Vaccine(MENVEO-MenACWY) 0.5 mL Inj | $303.69 | $506.15 | $137.67–$445.41 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal Vaccine(MENVEO-MenACWY) 0.5 mL Inj | $303.69 | $506.15 | $137.67–$445.41 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE A,C,Y,W-135 (MENACWY) 0.5 ML INJ | $314.24 | $523.74 | $142.46–$460.89 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE A,C,Y,W-135 (MENACWY) 0.5 ML INJ | $314.24 | $523.74 | $142.46–$460.89 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine | $526.43 | $877.39 | $238.65–$772.10 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine | $526.43 | $877.39 | $238.65–$772.10 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE 0.5 ML INJ | $526.44 | $877.40 | $238.65–$772.11 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE 0.5 ML INJ | $526.44 | $877.40 | $238.65–$772.11 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACCINE(BEXSERO) 0.5ML INJ | $483.01 | $805.01 | $218.96–$708.41 | 57% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACCINE(BEXSERO) 0.5ML INJ | $483.01 | $805.01 | $218.96–$708.41 | 57% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal B vaccine (BEXSERO) 0.5 mL Inj | $483.08 | $805.13 | $219.00–$708.51 | 57% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal B vaccine (BEXSERO) 0.5 mL Inj | $483.08 | $805.13 | $219.00–$708.51 | 57% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUP B VACCINE(BEXSERO) 0.5ML INJ | $483.01 | $805.01 | $218.96–$708.41 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUP B VACCINE(BEXSERO) 0.5ML INJ | $483.01 | $805.01 | $218.96–$708.41 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal B vaccine (BEXSERO) 0.5 mL Inj | $483.08 | $805.13 | $219.00–$708.51 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal B vaccine (BEXSERO) 0.5 mL Inj | $483.08 | $805.13 | $219.00–$708.51 | — | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL VACCINE (TRUMENBA) 0.5 ML INJ | $83.24 | $138.73 | $37.73–$122.08 | 39% below | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL VACCINE (TRUMENBA) 0.5 ML INJ | $83.24 | $138.73 | $37.73–$122.08 | 39% below | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal B vaccine (TRUMENBA) 0.5 mL Inj | $416.20 | $693.67 | $188.68–$610.43 | 207% above | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal B vaccine (TRUMENBA) 0.5 mL Inj | $416.20 | $693.67 | $188.68–$610.43 | 207% above | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOCOCCAL VACCINE (TRUMENBA) 0.5 ML INJ | $83.24 | $138.73 | $37.73–$122.08 | — | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOCOCCAL VACCINE (TRUMENBA) 0.5 ML INJ | $83.24 | $138.73 | $37.73–$122.08 | — | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal B vaccine (TRUMENBA) 0.5 mL Inj | $416.20 | $693.67 | $188.68–$610.43 | — | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal B vaccine (TRUMENBA) 0.5 mL Inj | $416.20 | $693.67 | $188.68–$610.43 | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent vaccine | $574.31 | $957.18 | $260.35–$842.32 | 134% above | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent vaccine | $574.31 | $957.18 | $260.35–$842.32 | 134% above | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent vaccine | $574.31 | $957.18 | $260.35–$842.32 | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent vaccine | $574.31 | $957.18 | $260.35–$842.32 | — | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 pneumo-15 vacc (Vaxneuvance) 0.5 mL | $481.64 | $802.74 | $218.35–$706.41 | 98% above | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 pneumo-15 vacc (Vaxneuvance) 0.5 mL | $481.64 | $802.74 | $218.35–$706.41 | 98% above | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMO-15 VACC (VAXNEUVANCE) 0.5 ML | $533.43 | $889.05 | $241.82–$782.36 | 119% above | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMO-15 VACC (VAXNEUVANCE) 0.5 ML | $533.43 | $889.05 | $241.82–$782.36 | 119% above | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 pneumo-15 vacc (Vaxneuvance) 0.5 mL | $481.64 | $802.74 | $218.35–$706.41 | — | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 pneumo-15 vacc (Vaxneuvance) 0.5 mL | $481.64 | $802.74 | $218.35–$706.41 | — | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMO-15 VACC (VAXNEUVANCE) 0.5 ML | $533.43 | $889.05 | $241.82–$782.36 | — | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMO-15 VACC (VAXNEUVANCE) 0.5 ML | $533.43 | $889.05 | $241.82–$782.36 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 TRAVEL CLINIC PNEUMO-20 VACC (PREVNAR) 0.5 ML | $214.80 | $358.00 | $97.38–$315.04 | 57% below | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 TRAVEL CLINIC PNEUMO-20 VACC (PREVNAR) 0.5 ML | $214.80 | $358.00 | $97.38–$315.04 | 57% below | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumo- 20 vacc (Prevnar) 0.5 mL | $536.92 | $894.86 | $243.40–$787.48 | 7% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumo- 20 vacc (Prevnar) 0.5 mL | $536.92 | $894.86 | $243.40–$787.48 | 7% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 TRAVEL CLINIC PNEUMO-20 VACC (PREVNAR) 0.5 ML | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 TRAVEL CLINIC PNEUMO-20 VACC (PREVNAR) 0.5 ML | $214.80 | $358.00 | $97.38–$315.04 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumo- 20 vacc (Prevnar) 0.5 mL | $536.92 | $894.86 | $243.40–$787.48 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumo- 20 vacc (Prevnar) 0.5 mL | $536.92 | $894.86 | $243.40–$787.48 | — | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMO-21 VACCINE (CAPVAXIVE) 0.5 ML | $535.87 | $893.12 | $242.93–$785.95 | at median | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMO-21 VACCINE (CAPVAXIVE) 0.5 ML | $535.87 | $893.12 | $242.93–$785.95 | at median | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMO-21 VACCINE (CAPVAXIVE) 0.5 ML | $535.87 | $893.12 | $242.93–$785.95 | — | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMO-21 VACCINE (CAPVAXIVE) 0.5 ML | $535.87 | $893.12 | $242.93–$785.95 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-polyvalent vaccine - Ora | $326.12 | $543.53 | $147.84–$478.31 | 87% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-polyvalent vaccine - Ora | $326.12 | $543.53 | $147.84–$478.31 | 87% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VALENT (PNEUMOVAX) O.5 ML INJ | $333.64 | $556.07 | $151.25–$489.34 | 91% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VALENT (PNEUMOVAX) O.5 ML INJ | $333.64 | $556.07 | $151.25–$489.34 | 91% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-polyvalent vaccine - Ora | $326.12 | $543.53 | $147.84–$478.31 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-polyvalent vaccine - Ora | $326.12 | $543.53 | $147.84–$478.31 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VALENT (PNEUMOVAX) O.5 ML INJ | $333.64 | $556.07 | $151.25–$489.34 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VALENT (PNEUMOVAX) O.5 ML INJ | $333.64 | $556.07 | $151.25–$489.34 | — | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 TRAVEL CLINIC POLIOVIRUS VACCINE INACTIVE (IPOL) 0.5 ML | $52.20 | $87.00 | $23.66–$76.56 | 21% above | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 TRAVEL CLINIC POLIOVIRUS VACCINE INACTIVE (IPOL) 0.5 ML | $52.20 | $87.00 | $23.66–$76.56 | 21% above | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine inactivated | $129.17 | $215.28 | $58.56–$189.45 | 199% above | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 poliovirus vaccine inactivated | $129.17 | $215.28 | $58.56–$189.45 | 199% above | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 TRAVEL CLINIC POLIOVIRUS VACCINE INACTIVE (IPOL) 0.5 ML | $52.20 | $87.00 | $23.66–$76.56 | — | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 TRAVEL CLINIC POLIOVIRUS VACCINE INACTIVE (IPOL) 0.5 ML | $52.20 | $87.00 | $23.66–$76.56 | — | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 poliovirus vaccine inactivated | $129.17 | $215.28 | $58.56–$189.45 | — | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 poliovirus vaccine inactivated | $129.17 | $215.28 | $58.56–$189.45 | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip 100 mg/mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | 22% above | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip 100 mg/mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | 22% above | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab-alip 100 mg/mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab-alip 100 mg/mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg/0.5 mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | 22% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip 50 mg/0.5 mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | 22% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip 50 mg/0.5 mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip 50 mg/0.5 mL Inj Syr | $1,351.25 | $2,252.08 | $612.57–$1,981.83 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE (ABRYSVO) 0.5 ML INJ | $590.24 | $983.73 | $267.57–$865.68 | 26% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE (ABRYSVO) 0.5 ML INJ | $590.24 | $983.73 | $267.57–$865.68 | 26% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 respiratory syncytial virus vaccine (Abrysvo) 0.5 mL Inj | $622.65 | $1,037.75 | $282.27–$913.22 | 33% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 respiratory syncytial virus vaccine (Abrysvo) 0.5 mL Inj | $622.65 | $1,037.75 | $282.27–$913.22 | 33% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE (ABRYSVO) 0.5 ML INJ | $590.24 | $983.73 | $267.57–$865.68 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESPIRATORY SYNCYTIAL VIRUS VACCINE (ABRYSVO) 0.5 ML INJ | $590.24 | $983.73 | $267.57–$865.68 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 respiratory syncytial virus vaccine (Abrysvo) 0.5 mL Inj | $622.65 | $1,037.75 | $282.27–$913.22 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 respiratory syncytial virus vaccine (Abrysvo) 0.5 mL Inj | $622.65 | $1,037.75 | $282.27–$913.22 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 respiratory syncytial virus vaccine (Arexvy) 0.5 mL Inj | $574.04 | $956.73 | $260.23–$841.92 | 29% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 respiratory syncytial virus vaccine (Arexvy) 0.5 mL Inj | $574.04 | $956.73 | $260.23–$841.92 | 29% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE (AREXVY) 0.5 ML INJ | $582.33 | $970.55 | $263.99–$854.08 | 30% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE (AREXVY) 0.5 ML INJ | $582.33 | $970.55 | $263.99–$854.08 | 30% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 respiratory syncytial virus vaccine (Arexvy) 0.5 mL Inj | $574.04 | $956.73 | $260.23–$841.92 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 respiratory syncytial virus vaccine (Arexvy) 0.5 mL Inj | $574.04 | $956.73 | $260.23–$841.92 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE (AREXVY) 0.5 ML INJ | $582.33 | $970.55 | $263.99–$854.08 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE (AREXVY) 0.5 ML INJ | $582.33 | $970.55 | $263.99–$854.08 | — | 40% |
| Rabies vaccine, one dose CPT 90675 TRAVEL CLINIC RABIES VACCINE (RABAVERT) 1ML INJ IM | $288.00 | $480.00 | $164.64–$422.40 | 66% below | 40% |
| Rabies vaccine, one dose CPT 90675 TRAVEL CLINIC RABIES VACCINE (RABAVERT) 1ML INJ IM | $288.00 | $480.00 | $296.69–$308.21 | 66% below | 40% |
| Rabies vaccine, one dose CPT 90675 TRAVEL CLINIC RABIES VACCINE (IMOVAX) 2.5 INT'L UNITS INJ IM | $340.80 | $568.00 | $194.82–$499.84 | 60% below | 40% |
| Rabies vaccine, one dose CPT 90675 TRAVEL CLINIC RABIES VACCINE (IMOVAX) 2.5 INT'L UNITS INJ IM | $340.80 | $568.00 | $296.69–$308.21 | 60% below | 40% |
| Rabies vaccine, one dose CPT 90675 rabies Vaccine (RABAVERT) 1 mL Inj (IM) | $718.73 | $1,197.89 | $410.88–$1,054.14 | 15% below | 40% |
| Rabies vaccine, one dose CPT 90675 rabies Vaccine (RABAVERT) 1 mL Inj (IM) | $718.73 | $1,197.89 | $296.69–$308.21 | 15% below | 40% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine human diploid 2.5 intl units Inj | $851.98 | $1,419.96 | $296.69–$308.21 | at median | 40% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine human diploid 2.5 intl units Inj | $851.98 | $1,419.96 | $487.05–$1,249.56 | at median | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 TRAVEL CLINIC RABIES VACCINE (RABAVERT) 1ML INJ IM | $288.00 | $480.00 | $164.64–$422.40 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 TRAVEL CLINIC RABIES VACCINE (RABAVERT) 1ML INJ IM | $288.00 | $480.00 | $164.64–$422.40 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 TRAVEL CLINIC RABIES VACCINE (IMOVAX) 2.5 INT'L UNITS INJ IM | $340.80 | $568.00 | $194.82–$499.84 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 TRAVEL CLINIC RABIES VACCINE (IMOVAX) 2.5 INT'L UNITS INJ IM | $340.80 | $568.00 | $194.82–$499.84 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies Vaccine (RABAVERT) 1 mL Inj (IM) | $718.73 | $1,197.89 | $410.88–$1,054.14 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies Vaccine (RABAVERT) 1 mL Inj (IM) | $718.73 | $1,197.89 | $410.88–$1,054.14 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine human diploid 2.5 intl units Inj | $851.98 | $1,419.96 | $487.05–$1,249.56 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine human diploid 2.5 intl units Inj | $851.98 | $1,419.96 | $487.05–$1,249.56 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent 1 mL *CRH* | $290.92 | $484.87 | $131.88–$426.69 | 24% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent 1 mL *CRH* | $290.92 | $484.87 | $131.88–$426.69 | 24% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE LIVE MONOVALENT ORAL 1 ML | $290.93 | $484.88 | $131.89–$426.69 | 24% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE LIVE MONOVALENT ORAL 1 ML | $290.93 | $484.88 | $131.89–$426.69 | 24% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vacc PF 1.5 mL Oral Susp | $293.33 | $488.89 | $132.98–$430.22 | 25% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vacc PF 1.5 mL Oral Susp | $293.33 | $488.89 | $132.98–$430.22 | 25% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE MONOVALENT 1.5 ML ORAL SUSP | $308.16 | $513.60 | $139.70–$451.97 | 32% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE MONOVALENT 1.5 ML ORAL SUSP | $308.16 | $513.60 | $139.70–$451.97 | 32% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine monovalent 1 mL *CRH* | $290.92 | $484.87 | $131.88–$426.69 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine monovalent 1 mL *CRH* | $290.92 | $484.87 | $131.88–$426.69 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE LIVE MONOVALENT ORAL 1 ML | $290.93 | $484.88 | $131.89–$426.69 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE LIVE MONOVALENT ORAL 1 ML | $290.93 | $484.88 | $131.89–$426.69 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vacc PF 1.5 mL Oral Susp | $293.33 | $488.89 | $132.98–$430.22 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vacc PF 1.5 mL Oral Susp | $293.33 | $488.89 | $132.98–$430.22 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE MONOVALENT 1.5 ML ORAL SUSP | $308.16 | $513.60 | $139.70–$451.97 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE MONOVALENT 1.5 ML ORAL SUSP | $308.16 | $513.60 | $139.70–$451.97 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 TRAVEL CLINIC ZOSTER VACCINE INACT ADJUVANTED (SHINGRIX) INJ | $194.40 | $324.00 | $88.13–$285.12 | 19% below | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 TRAVEL CLINIC ZOSTER VACCINE INACT ADJUVANTED (SHINGRIX) INJ | $194.40 | $324.00 | $88.13–$285.12 | 19% below | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster Vaccine Inact Adjuvanted (SHINGRIX) Inj | $485.12 | $808.53 | $219.92–$711.51 | 102% above | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster Vaccine Inact Adjuvanted (SHINGRIX) Inj | $485.12 | $808.53 | $219.92–$711.51 | 102% above | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 TRAVEL CLINIC ZOSTER VACCINE INACT ADJUVANTED (SHINGRIX) INJ | $194.40 | $324.00 | $88.13–$285.12 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 TRAVEL CLINIC ZOSTER VACCINE INACT ADJUVANTED (SHINGRIX) INJ | $194.40 | $324.00 | $88.13–$285.12 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster Vaccine Inact Adjuvanted (SHINGRIX) Inj | $485.12 | $808.53 | $219.92–$711.51 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster Vaccine Inact Adjuvanted (SHINGRIX) Inj | $485.12 | $808.53 | $219.92–$711.51 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TRAVEL CLINIC TETANUS/DIPHTH TOX (ADSB) ADULT 0.5 ML SYR INJ | $48.00 | $80.00 | $21.76–$70.40 | 35% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TRAVEL CLINIC TETANUS/DIPHTH TOX (ADSB) ADULT 0.5 ML SYR INJ | $48.00 | $80.00 | $21.76–$70.40 | 35% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus/diphth tox (adsb) Adult 0.5 mL Inj | $118.65 | $197.75 | $53.79–$174.02 | 62% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus/diphth tox (adsb) Adult 0.5 mL Inj | $118.65 | $197.75 | $53.79–$174.02 | 62% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TRAVEL CLINIC TETANUS/DIPHTH TOX (ADSB) ADULT 0.5 ML SYR INJ | $48.00 | $80.00 | $21.76–$70.40 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TRAVEL CLINIC TETANUS/DIPHTH TOX (ADSB) ADULT 0.5 ML SYR INJ | $48.00 | $80.00 | $21.76–$70.40 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus/diphth tox (adsb) Adult 0.5 mL Inj | $118.65 | $197.75 | $53.79–$174.02 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus/diphth tox (adsb) Adult 0.5 mL Inj | $118.65 | $197.75 | $53.79–$174.02 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TRAVEL CLINIC TDAP (ADACEL) 0.5 ML INJ | $45.00 | $75.00 | $20.40–$66.00 | 54% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TRAVEL CLINIC TDAP (ADACEL) 0.5 ML INJ | $45.00 | $75.00 | $20.40–$66.00 | 54% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TRAVEL CLINIC TDAP (BOOSTRIX) 0.5 ML INJ | $51.00 | $85.00 | $23.12–$74.80 | 48% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TRAVEL CLINIC TDAP (BOOSTRIX) 0.5 ML INJ | $51.00 | $85.00 | $23.12–$74.80 | 48% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tet/diph/pert acel (ADACEL Tdap) 0.5 mL Inj | $111.63 | $186.05 | $50.61–$163.72 | 13% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tet/diph/pert acel (ADACEL Tdap) 0.5 mL Inj | $111.63 | $186.05 | $50.61–$163.72 | 13% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) | $127.13 | $211.89 | $57.63–$186.46 | 29% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) | $127.13 | $211.89 | $57.63–$186.46 | 29% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TRAVEL CLINIC TDAP (ADACEL) 0.5 ML INJ | $45.00 | $75.00 | $20.40–$66.00 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TRAVEL CLINIC TDAP (ADACEL) 0.5 ML INJ | $45.00 | $75.00 | $20.40–$66.00 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TRAVEL CLINIC TDAP (BOOSTRIX) 0.5 ML INJ | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TRAVEL CLINIC TDAP (BOOSTRIX) 0.5 ML INJ | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tet/diph/pert acel (ADACEL Tdap) 0.5 mL Inj | $111.63 | $186.05 | $50.61–$163.72 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tet/diph/pert acel (ADACEL Tdap) 0.5 mL Inj | $111.63 | $186.05 | $50.61–$163.72 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) | $127.13 | $211.89 | $57.63–$186.46 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria/pertussis acel (Tdap) | $127.13 | $211.89 | $57.63–$186.46 | — | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TRAVEL CLINIC TYPHOID POLYSACCHARIDE VACCINE 0.5 ML INJ | $136.20 | $227.00 | $61.74–$199.76 | 27% above | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TRAVEL CLINIC TYPHOID POLYSACCHARIDE VACCINE 0.5 ML INJ | $136.20 | $227.00 | $61.74–$199.76 | 27% above | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid Vi polysaccharide Vaccine 0.5 mL Inj | $339.39 | $565.65 | $153.86–$497.77 | 217% above | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid Vi polysaccharide Vaccine 0.5 mL Inj | $339.39 | $565.65 | $153.86–$497.77 | 217% above | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TRAVEL CLINIC TYPHOID POLYSACCHARIDE VACCINE 0.5 ML INJ | $136.20 | $227.00 | $61.74–$199.76 | — | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TRAVEL CLINIC TYPHOID POLYSACCHARIDE VACCINE 0.5 ML INJ | $136.20 | $227.00 | $61.74–$199.76 | — | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid Vi polysaccharide Vaccine 0.5 mL Inj | $339.39 | $565.65 | $153.86–$497.77 | — | 40% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid Vi polysaccharide Vaccine 0.5 mL Inj | $339.39 | $565.65 | $153.86–$497.77 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TRAVEL CLINIC TYPHOID EC ORAL VACCINE CAPSULES | $33.00 | $55.00 | $14.96–$48.40 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 TRAVEL CLINIC TYPHOID EC ORAL VACCINE CAPSULES | $33.00 | $55.00 | $14.96–$48.40 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 typhoid EC ORAL vaccine capsule live | $81.71 | $136.18 | $37.04–$119.84 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 typhoid EC ORAL vaccine capsule live | $81.71 | $136.18 | $37.04–$119.84 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TRAVEL CLINIC TYPHOID EC ORAL VACCINE CAPSULES | $33.00 | $55.00 | $14.96–$48.40 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 TRAVEL CLINIC TYPHOID EC ORAL VACCINE CAPSULES | $33.00 | $55.00 | $14.96–$48.40 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 typhoid EC ORAL vaccine capsule live | $81.71 | $136.18 | $37.04–$119.84 | — | 40% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 typhoid EC ORAL vaccine capsule live | $81.71 | $136.18 | $37.04–$119.84 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-NFM | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AIUK | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-HVCK | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OBTR | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CSJC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EFCC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OCJC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AIU | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-7E | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-7PCT | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-WRIM | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OBC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SPGP | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PESC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SPFM | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MFCC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FV | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JPCU | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JSS | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FAY | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FUL | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JOBS | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CAC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JICU | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JMDS | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MEDI | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MS | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JSCM | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DHFC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JPOD | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MED | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EFOU | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EAC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FIPS | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SS | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-HBVC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-TSBW | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AMS | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OPU | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-IM | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EDOU | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CIDE | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DTVC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PICC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CHPC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CBCC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PC | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CS | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MPEO | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DTSP | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-LAD | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MCLN | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-NSOB | $51.00 | $85.00 | $29.75–$74.80 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE -JPED | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JOB | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JMOI | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JIMC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JDHC | $51.00 | $85.00 | $67.67–$70.30 | 11% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUCJ | $61.20 | $102.00 | $35.70–$89.76 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JER | $61.20 | $102.00 | $67.67–$70.30 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUCX | $61.20 | $102.00 | $67.67–$70.30 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUC | $61.20 | $102.00 | $35.70–$89.76 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EC | $61.20 | $102.00 | $35.70–$89.76 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JUTR | $61.20 | $102.00 | $35.70–$89.76 | 7% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMV | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-NSOB | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-NFM | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-TCOP | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AIUK | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MVJC | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-HVCK | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OBTR | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CSJC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OCJC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-7PCT | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OBC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PESC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MFCC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JPCU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JSS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JOBS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JICU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JMDS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JIGC | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JSCM | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JPOD | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE -JPED | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JOB | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JMOI | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JIMC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JDHC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMO | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFML | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMD | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMB | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMM | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFME | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JFMC | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-LAD | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DTSP | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MPEO | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FMCK | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MFMC | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FMCJ | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CBCC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CHPC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-PICC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DTVC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CIDE | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-BAMB | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EDOU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-IM | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FFH | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AFM | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-OPU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AMS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-TSBW | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-HBVC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-TCA | $51.00 | $85.00 | $23.12–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MED | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MEDI | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-7E | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MCLN | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FIPS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EAC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EFOU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-DHFC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MS | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-CAC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FUL | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FAY | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-FV | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SPFM | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-SPGP | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-WRIM | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-AIU | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EFCC | $51.00 | $85.00 | $29.75–$74.80 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUC | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JUTR | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUCJ | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-MUCX | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-EC | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE-JER | $61.20 | $102.00 | $35.70–$89.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN; EA ADDTL VACCINE-TSBW | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-FV | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-OBC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JDHC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-AIU | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-NFM | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JSS | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-EFCC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-SS | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE MORE THAN ONE VACCINE-OBTR | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN MORE THAN 1 NOT FLU/PNEUMO | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD'L VACCINE | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-SPGP | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATIN ADMIN EACH ADD'L-OCJC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-SPFM | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 OB/GYN ADMIN IMMUN NO FLU/PNEU/ 8+ YRS; EA ADD VAC -NSOB | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JPCU | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU-DHFC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC.FUL | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-HVCK | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-EDOU | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JIMC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-FAY | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE MORE THAN ONE VACCINE-AIUK | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CBCC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CAC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CHPC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JOB | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CIDE | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JOBS | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JMDS | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-MFCC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU M.S. | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU-SC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE -JPED | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-PESC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-PC | $31.20 | $52.00 | $14.14–$45.76 | 30% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION, TWO OR MORE-MUC | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATIN ADMIN EACH ADD'L-EC | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION TWO OR MORE-MUCJ | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION TWO OR MORE-MUCX | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION; TWO OR MORE-JUTR | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JER | $37.80 | $63.00 | $17.14–$55.44 | 16% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JOBS | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-NFM | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE MORE THAN ONE VACCINE-AIUK | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-HVCK | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE MORE THAN ONE VACCINE-OBTR | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD'L VACCINE | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-PC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-FMCJ | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-MFMC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CBCC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CHPC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CIDE | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-BAMB | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-EDOU | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-FFH | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-AFM | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN; EA ADDTL VACCINE-TSBW | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-AIU | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE, MORE THAN ONE VACCINE-EFCC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-SS | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATIN ADMIN EACH ADD'L-OCJC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-FMCK | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFME | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMM | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMB | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMD | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFML | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMO | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JFMV | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JDHC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-OBC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-PESC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JIMC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JOB | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-MFCC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE -JPED | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JIGC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JPCU | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JMDS | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-SPGP | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN MORE THAN 1 NOT FLU/PNEUMO | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JSS | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-SPFM | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-FV | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC-FAY | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN. EA ADD VAC.FUL | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-CAC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU-SC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU M.S. | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC. ADMIN. MORE THAN 1 VACC. NOT FLU/PNEU-DHFC | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 OB/GYN ADMIN IMMUN NO FLU/PNEU/ 8+ YRS; EA ADD VAC -NSOB | $31.20 | $52.00 | $14.14–$45.76 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE-JER | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATIN ADMIN EACH ADD'L-EC | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION TWO OR MORE-MUCJ | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION, TWO OR MORE-MUC | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION; TWO OR MORE-JUTR | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION TWO OR MORE-MUCX | $37.80 | $63.00 | $17.14–$55.44 | — | 40% |
| Yellow fever vaccine, live CPT 90717 TRAVEL CLINIC YELLOW FEVER VACCINE 0.5 ML INJ | $195.60 | $326.00 | $88.67–$286.88 | at median | 40% |
| Yellow fever vaccine, live CPT 90717 TRAVEL CLINIC YELLOW FEVER VACCINE 0.5 ML INJ | $195.60 | $326.00 | $88.67–$286.88 | at median | 40% |
| Yellow fever vaccine, live CPT 90717 yellow fever Vaccine 0.5 mL Inj | $488.49 | $814.15 | $221.45–$716.45 | 150% above | 40% |
| Yellow fever vaccine, live CPT 90717 yellow fever Vaccine 0.5 mL Inj | $488.49 | $814.15 | $221.45–$716.45 | 150% above | 40% |
| Yellow fever vaccine, live inpatient CPT 90717 TRAVEL CLINIC YELLOW FEVER VACCINE 0.5 ML INJ | $195.60 | $326.00 | $88.67–$286.88 | — | 40% |
| Yellow fever vaccine, live inpatient CPT 90717 TRAVEL CLINIC YELLOW FEVER VACCINE 0.5 ML INJ | $195.60 | $326.00 | $88.67–$286.88 | — | 40% |
| Yellow fever vaccine, live inpatient CPT 90717 yellow fever Vaccine 0.5 mL Inj | $488.49 | $814.15 | $221.45–$716.45 | — | 40% |
| Yellow fever vaccine, live inpatient CPT 90717 yellow fever Vaccine 0.5 mL Inj | $488.49 | $814.15 | $221.45–$716.45 | — | 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.
Source file: https://www.muhealth.org/sites/default/files/finance/436003859_university-of-missouri-health-care_standardcharges.csv