Butler Memorial Hospital
Listed in its price file as “Butler Healthcare Providers_ DBA Butler Memorial Hospital”.
Butler Memorial Hospital in Butler, PA publishes cash prices for 361 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 203 of 357 procedures and above it for 144. By typical cash price it ranks #53 of 108 Pennsylvania hospitals and #9 of 26 hospitals in the Pittsburgh, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
1 Hospital Way, Butler PA 16001 Collected Oct 26, 2026 Source price file Check a bill from this hospital
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Scan AbdomenComb | $1,879.50 | $2,685.00 | $502.10–$2,819.25 | at median | 30% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Scan AbdomenComb | $1,879.50 | $2,685.00 | $1,074.00–$2,416.50 | — | 30% |
| Abdominal X-ray, 2 views CPT 74019 Abdomen Xray 2V | $267.40 | $382.00 | $71.43–$401.10 | 18% below | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen Xray 2V | $267.40 | $382.00 | $152.80–$343.80 | — | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Xray Min 3V Lt | $275.10 | $393.00 | $73.49–$412.65 | 24% below | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Xray Min 3Vs rt | $275.10 | $393.00 | $73.49–$412.65 | 24% below | 30% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Xray Min 3V Lt | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Xray Min 3Vs rt | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Arterial Eval Single Level | $283.50 | $405.00 | $75.74–$425.25 | 37% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP Art Physiologic Limited UP | $283.50 | $405.00 | $75.74–$425.25 | 37% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP Art Physiologic Limited LO | $283.50 | $405.00 | $75.74–$425.25 | 37% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOP Art Physiologic Limited LO | $283.50 | $405.00 | $162.00–$364.50 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Arterial Eval Single Level | $283.50 | $405.00 | $162.00–$364.50 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOP Art Physiologic Limited UP | $283.50 | $405.00 | $162.00–$364.50 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Scan Upper Ext wo | $1,379.00 | $1,970.00 | $368.39–$2,068.50 | 17% above | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Scan Upper Ext wo | $1,379.00 | $1,970.00 | $788.00–$1,773.00 | — | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagram Study | $396.20 | $566.00 | $105.84–$594.30 | 14% below | 30% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophagram Study | $396.20 | $566.00 | $226.40–$509.40 | — | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Bone Scan Wb | $920.50 | $1,315.00 | $245.90–$1,380.75 | 25% below | 30% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Scan Wb | $920.50 | $1,315.00 | $526.00–$1,183.50 | — | 30% |
| Breast ultrasound, complete, one breast CPT 76641 US Breast Screening Bil Comp | $757.40 | $1,082.00 | $202.33–$1,136.10 | 39% above | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Screening RT Comp | $757.40 | $1,082.00 | $202.33–$1,136.10 | 39% above | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Screening LT Comp | $757.40 | $1,082.00 | $202.33–$1,136.10 | 39% above | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt Complete | $757.40 | $1,082.00 | $202.33–$1,136.10 | 39% above | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt Complete | $757.40 | $1,082.00 | $202.33–$1,136.10 | 39% above | 30% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US Breast Screening Bil Comp | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Screening LT Comp | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Screening RT Comp | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Lt Complete | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Rt Complete | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Screening Bil Limit | $757.40 | $1,082.00 | $202.33–$1,136.10 | 64% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Screening RT Limit | $757.40 | $1,082.00 | $202.33–$1,136.10 | 64% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Screening LT Limit | $757.40 | $1,082.00 | $202.33–$1,136.10 | 64% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Rt Limited | $757.40 | $1,082.00 | $202.33–$1,136.10 | 64% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Lt Limited | $757.40 | $1,082.00 | $202.33–$1,136.10 | 64% above | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Screening Bil Limit | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Screening RT Limit | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Rt Limited | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Lt Limited | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Screening LT Limit | $757.40 | $1,082.00 | $432.80–$973.80 | — | 30% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen Pelvis 74174 | $3,385.20 | $4,836.00 | $904.33–$5,077.80 | 13% above | 30% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen Pelvis 74174 | $3,385.20 | $4,836.00 | $1,934.40–$4,352.40 | — | 30% |
| CT angiography (CTA) of the head CPT 70496 CTA Head Enhanced | $1,897.00 | $2,710.00 | $506.77–$2,845.50 | 11% above | 30% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Head Enhanced | $1,897.00 | $2,710.00 | $1,084.00–$2,439.00 | — | 30% |
| CT angiography (CTA) of the neck CPT 70498 CTA Neck Enhanced 70498 | $2,030.00 | $2,900.00 | $542.30–$3,045.00 | 22% above | 30% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck Enhanced 70498 | $2,030.00 | $2,900.00 | $1,160.00–$2,610.00 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest Enhanced 71275 | $2,221.80 | $3,174.00 | $593.54–$3,332.70 | 16% above | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest Enhanced 71275 | $2,221.80 | $3,174.00 | $1,269.60–$2,856.60 | — | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Coronary Angiography | $1,528.10 | $2,183.00 | $408.22–$2,292.15 | 23% below | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA Coronary Angiography | $1,528.10 | $2,183.00 | $873.20–$1,964.70 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CTA Card Calcium Scoring G | $385.00 | $550.00 | $102.85–$577.50 | 118% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CTA Card Calcium Scoring G | $385.00 | $550.00 | $220.00–$495.00 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Unenhanced | $1,531.60 | $2,188.00 | $409.16–$2,297.40 | 26% below | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Unenhanced | $1,531.60 | $2,188.00 | $875.20–$1,969.20 | — | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis Enhanced | $2,100.00 | $3,000.00 | $561.00–$3,150.00 | 30% below | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis Enhanced | $2,100.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urography 74178 | $3,201.10 | $4,573.00 | $855.15–$4,801.65 | 7% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis Comb 74178 | $3,201.10 | $4,573.00 | $855.15–$4,801.65 | 7% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis Comb 74178 | $3,201.10 | $4,573.00 | $1,829.20–$4,115.70 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urography 74178 | $3,201.10 | $4,573.00 | $1,829.20–$4,115.70 | — | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT Scan AbdomenEnhanced | $947.80 | $1,354.00 | $253.20–$1,421.70 | 43% below | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Scan AbdomenEnhanced | $947.80 | $1,354.00 | $541.60–$1,218.60 | — | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT Scan AbdomenUnenhanced | $839.30 | $1,199.00 | $224.21–$1,258.95 | 26% below | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Scan AbdomenUnenhanced | $839.30 | $1,199.00 | $479.60–$1,079.10 | — | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxilfacial wo Contrast | $1,085.00 | $1,550.00 | $289.85–$1,627.50 | 4% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Scan Parn Sinuses Unehn | $1,085.00 | $1,550.00 | $289.85–$1,627.50 | 4% below | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Scan Parn Sinuses Unehn | $1,085.00 | $1,550.00 | $620.00–$1,395.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxilfacial wo Contrast | $1,085.00 | $1,550.00 | $620.00–$1,395.00 | — | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Brain wo Contrast | $807.80 | $1,154.00 | $215.80–$1,211.70 | 25% below | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Brain wo Contrast | $807.80 | $1,154.00 | $461.60–$1,038.60 | — | 30% |
| CT scan of the head with contrast CPT 70460 CT Scan HeadEnhanced | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 22% below | 30% |
| CT scan of the head with contrast inpatient CPT 70460 CT Scan HeadEnhanced | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| CT scan of the head without and with contrast CPT 70470 CT Scan HeadComb | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 37% below | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Scan HeadComb | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Scan Lumbar SpineUnenh | $1,356.60 | $1,938.00 | $362.41–$2,034.90 | 18% above | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Scan Lumbar SpineUnenh | $1,356.60 | $1,938.00 | $775.20–$1,744.20 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Scan Cervical SpineUnenh | $1,356.60 | $1,938.00 | $362.41–$2,034.90 | 15% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Scan Cervical SpineUnenh | $1,356.60 | $1,938.00 | $775.20–$1,744.20 | — | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Scan PelvisEnhanced | $700.00 | $1,000.00 | $187.00–$1,050.00 | 59% below | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Scan PelvisEnhanced | $700.00 | $1,000.00 | $400.00–$900.00 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid Duplex Doppler | $703.50 | $1,005.00 | $187.94–$1,055.25 | 13% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DOP Carotid Duplex CV | $703.50 | $1,005.00 | $187.94–$1,055.25 | 13% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid Duplex Doppler | $703.50 | $1,005.00 | $402.00–$904.50 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DOP Carotid Duplex CV | $703.50 | $1,005.00 | $402.00–$904.50 | — | 30% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/wo Contrast | $1,400.00 | $2,000.00 | $374.00–$2,100.00 | 13% below | 30% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/wo Contrast | $1,400.00 | $2,000.00 | $800.00–$1,800.00 | — | 30% |
| Chest X-ray, 2 views CPT 71046 Chest Xray 2V | $192.50 | $275.00 | $51.42–$288.75 | 40% below | 30% |
| Chest X-ray, 2 views CPT 71046 Chest Xray Cv Access 71010 | $192.50 | $275.00 | $51.42–$288.75 | 40% below | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest Xray Cv Access 71010 | $192.50 | $275.00 | $110.00–$247.50 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest Xray 2V | $192.50 | $275.00 | $110.00–$247.50 | — | 30% |
| Chest X-ray, single view CPT 71045 Chest Xray Single View | $144.20 | $206.00 | $38.52–$216.30 | 23% below | 30% |
| Chest X-ray, single view inpatient CPT 71045 Chest Xray Single View | $144.20 | $206.00 | $82.40–$185.40 | — | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Xray Rt | $140.00 | $200.00 | $37.40–$210.00 | 51% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Xray Lt | $140.00 | $200.00 | $37.40–$210.00 | 51% below | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Xray Rt | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Xray Lt | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $455.00 | $650.00 | $121.55–$682.50 | 37% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Limited | $455.00 | $650.00 | $121.55–$682.50 | 37% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $455.00 | $650.00 | $260.00–$585.00 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Limited | $455.00 | $650.00 | $260.00–$585.00 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Va Bone Density | $265.30 | $379.00 | $70.87–$397.95 | 2% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Density Dexa Lumbar/Hip | $265.30 | $379.00 | $70.87–$397.95 | 2% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Va Bone Density | $265.30 | $379.00 | $151.60–$341.10 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Density Dexa Lumbar/Hip | $265.30 | $379.00 | $151.60–$341.10 | — | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Density Dexa Wrist | $169.40 | $242.00 | $45.25–$254.10 | 6% below | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Bone Density Dexa Wrist | $169.40 | $242.00 | $96.80–$217.80 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Detailed Mfm | $1,151.50 | $1,645.00 | $307.62–$1,727.25 | 8% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Detailed | $1,151.50 | $1,645.00 | $307.62–$1,727.25 | 8% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg Detailed | $1,151.50 | $1,645.00 | $658.00–$1,480.50 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Preg Detailed Mfm | $1,151.50 | $1,645.00 | $658.00–$1,480.50 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Thorax wo Contrast | $911.40 | $1,302.00 | $243.47–$1,367.10 | 17% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Thorax wo Contrast | $911.40 | $1,302.00 | $520.80–$1,171.80 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Scan ChestEnhanced | $1,358.70 | $1,941.00 | $362.97–$2,038.05 | 5% below | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Scan ChestEnhanced | $1,358.70 | $1,941.00 | $776.40–$1,746.90 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Digital Bilateral G0204 | $364.00 | $520.00 | $97.24–$546.00 | — | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammo Digital Bilateral G0204 | $364.00 | $520.00 | $208.00–$468.00 | — | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Study Digital Rt G0206 | $245.00 | $350.00 | $65.45–$367.50 | 23% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Study Digital Lt G0206 | $245.00 | $350.00 | $65.45–$367.50 | 23% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Study Dig Lt Sp G0206 | $348.60 | $498.00 | $93.13–$522.90 | 10% above | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Study Digital Lt G0206 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Study Digital Rt G0206 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 Mammo Study Dig Lt Sp G0206 | $348.60 | $498.00 | $199.20–$448.20 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 PV Art Img Lower BI CV | $445.20 | $636.00 | $118.93–$667.80 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Dup Art Imag Lower Ext Bil CV | $445.20 | $636.00 | $118.93–$667.80 | 46% below | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Duplex Art Image Lower Ext Uni | $445.20 | $636.00 | $118.93–$667.80 | 46% below | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Duplex Lower Ext Bil | $445.20 | $636.00 | $118.93–$667.80 | 46% below | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 PV Art Img Lower Ext UN CV | $445.20 | $636.00 | $118.93–$667.80 | 46% below | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 PV Art Img Lower BI CV | $445.20 | $636.00 | $254.40–$572.40 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Duplex Art Image Lower Ext Uni | $445.20 | $636.00 | $254.40–$572.40 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Duplex Lower Ext Bil | $445.20 | $636.00 | $254.40–$572.40 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 PV Art Img Lower Ext UN CV | $445.20 | $636.00 | $254.40–$572.40 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Dup Art Imag Lower Ext Bil CV | $445.20 | $636.00 | $254.40–$572.40 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PV Insufficiency Study, BI CV | $819.00 | $1,170.00 | $218.79–$1,228.50 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PV Ven Img Lower BI CV | $819.00 | $1,170.00 | $218.79–$1,228.50 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 PV Ven Img Upper BI CV | $819.00 | $1,170.00 | $218.79–$1,228.50 | — | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 PV Ven Img Lower UN | $519.40 | $742.00 | $138.75–$779.10 | 40% below | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 PV Ven Img Upper UN | $519.40 | $742.00 | $138.75–$779.10 | 40% below | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Imaging | $819.00 | $1,170.00 | $218.79–$1,228.50 | 6% below | 30% |
| Duplex ultrasound of the leg veins, both legs one side CPT 93970 US Venous Imag Unilat | $519.40 | $742.00 | $138.75–$779.10 | 40% below | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 PV Ven Img Upper BI CV | $819.00 | $1,170.00 | $468.00–$1,053.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 PV Insufficiency Study, BI CV | $819.00 | $1,170.00 | $468.00–$1,053.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 PV Ven Img Lower BI CV | $819.00 | $1,170.00 | $468.00–$1,053.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 PV Ven Img Upper UN | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 PV Ven Img Lower UN | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Imaging | $819.00 | $1,170.00 | $468.00–$1,053.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient one side CPT 93970 US Venous Imag Unilat | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocard/Doppler/Colorflow | $1,558.90 | $2,227.00 | $416.45–$2,338.35 | 17% below | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocard/Doppler/Colorflow | $1,558.90 | $2,227.00 | $890.80–$2,004.30 | — | 30% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow Xray 2V Lt | $267.40 | $382.00 | $71.43–$401.10 | 12% below | 30% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow Xray 2V rt | $267.40 | $382.00 | $71.43–$401.10 | 12% below | 30% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Xray 2V Lt | $267.40 | $382.00 | $152.80–$343.80 | — | 30% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Xray 2V rt | $267.40 | $382.00 | $152.80–$343.80 | — | 30% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Xray Min 3V Rt | $366.10 | $523.00 | $97.80–$549.15 | 6% above | 30% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Xray Min 3V Lt | $366.10 | $523.00 | $97.80–$549.15 | 6% above | 30% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Xray Min 3V Lt | $366.10 | $523.00 | $209.20–$470.70 | — | 30% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Xray Min 3V Rt | $366.10 | $523.00 | $209.20–$470.70 | — | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Scan Temporal Bone Unenh | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 3% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit wo Contrast | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 3% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Iacs wo Contrast 70480 | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 3% below | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit wo Contrast | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Iacs wo Contrast 70480 | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Scan Temporal Bone Unenh | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bone Complete Min 3V | $175.00 | $250.00 | $46.75–$262.50 | 57% below | 30% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bone Complete Min 3V | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Xray Min 2V Lt | $275.10 | $393.00 | $73.49–$412.65 | 2% below | 30% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Xray Min 2V | $275.10 | $393.00 | $73.49–$412.65 | 2% below | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Xray Min 2V Lt | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Xray Min 2V | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary Scan 78226 | $628.60 | $898.00 | $167.93–$942.90 | 49% below | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary Scan 78226 | $628.60 | $898.00 | $359.20–$808.20 | — | 30% |
| Hand X-ray, 2 views one side CPT 73120 Hand Xray 2V | $210.00 | $300.00 | $56.10–$315.00 | 25% below | 30% |
| Hand X-ray, 2 views one side CPT 73120 Hand Xray Lt Min 2V | $275.10 | $393.00 | $73.49–$412.65 | 2% below | 30% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand Xray 2V | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand Xray Lt Min 2V | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Oscalcis Xray Min 2V Lt | $249.20 | $356.00 | $66.57–$373.80 | 6% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis Xray Min 2V Rt | $249.20 | $356.00 | $66.57–$373.80 | 6% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis Xray Min 2V Rt | $249.20 | $356.00 | $142.40–$320.40 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Oscalcis Xray Min 2V Lt | $249.20 | $356.00 | $142.40–$320.40 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Polysomnography 4 Chan Slp Sty | $979.30 | $1,399.00 | $261.61–$1,468.95 | 61% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Study | $979.30 | $1,399.00 | $261.61–$1,468.95 | 61% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 4 Channel Sleep Study | $979.30 | $1,399.00 | $261.61–$1,468.95 | 61% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Polysomnography 4 Chan Slp Sty | $979.30 | $1,399.00 | $559.60–$1,259.10 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Study | $979.30 | $1,399.00 | $559.60–$1,259.10 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 4 Channel Sleep Study | $979.30 | $1,399.00 | $559.60–$1,259.10 | — | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography/Cpap Initiate | $3,821.30 | $5,459.00 | $1,020.83–$5,731.95 | 22% above | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography/Cpap Initiate | $3,821.30 | $5,459.00 | $2,183.60–$4,913.10 | — | 30% |
| Knee X-ray, 3 views one side CPT 73562 Knee Xray 3V rt | $312.20 | $446.00 | $83.40–$468.30 | 22% below | 30% |
| Knee X-ray, 3 views one side CPT 73562 Knee Xray 3V Lt | $312.20 | $446.00 | $83.40–$468.30 | 22% below | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee Xray 3V rt | $312.20 | $446.00 | $178.40–$401.40 | — | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee Xray 3V Lt | $312.20 | $446.00 | $178.40–$401.40 | — | 30% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Xray 5V Rt | $389.20 | $556.00 | $103.97–$583.80 | 11% below | 30% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Xray 4V Min Lt | $389.20 | $556.00 | $103.97–$583.80 | 11% below | 30% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Xray 4V Min Rt | $389.20 | $556.00 | $103.97–$583.80 | 11% below | 30% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Xray 5V Lt | $389.20 | $556.00 | $103.97–$583.80 | 11% below | 30% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Xray 6V Rt | $389.20 | $556.00 | $103.97–$583.80 | 11% below | 30% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Xray 6V Rt | $389.20 | $556.00 | $222.40–$500.40 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Xray 5V Rt | $389.20 | $556.00 | $222.40–$500.40 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Xray 4V Min Lt | $389.20 | $556.00 | $222.40–$500.40 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Xray 4V Min Rt | $389.20 | $556.00 | $222.40–$500.40 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Xray 5V Lt | $389.20 | $556.00 | $222.40–$500.40 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Scan Low Ext wo | $1,008.70 | $1,441.00 | $269.47–$1,513.05 | 5% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Scan Low Ext wo | $1,008.70 | $1,441.00 | $576.40–$1,296.90 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Upper Abdominal Limited | $575.40 | $822.00 | $153.71–$863.10 | 5% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdominal Limited | $575.40 | $822.00 | $153.71–$863.10 | 5% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Soft Tissue Limited | $575.40 | $822.00 | $153.71–$863.10 | 5% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Soft Tissue Limited | $575.40 | $822.00 | $328.80–$739.80 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Upper Abdominal Limited | $575.40 | $822.00 | $328.80–$739.80 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdominal Limited | $575.40 | $822.00 | $328.80–$739.80 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue Upper Ext | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue Mass Extr 76882 | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue Leg Limited | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tiss Knee Limit 76882 | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue ArmLimit 76822 | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tiss Wrist Limit 76882 | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tiss Ankle Limit 76882 | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Lower Ext Rt | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Lower Ext Lt | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Upper Ext Lt | $210.00 | $300.00 | $56.10–$315.00 | 47% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue Upper Ext | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tiss Knee Limit 76882 | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tiss Wrist Limit 76882 | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tiss Ankle Limit 76882 | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue Mass Extr 76882 | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue Leg Limited | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue ArmLimit 76822 | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Upper Ext Lt | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Lower Ext Rt | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Lower Ext Lt | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Ca Screen Progr | $219.80 | $314.00 | $58.72–$329.70 | 45% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Ca Screen | $219.80 | $314.00 | $58.72–$329.70 | 45% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Ca Screen Progr | $219.80 | $314.00 | $125.60–$282.60 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Ca Screen | $219.80 | $314.00 | $125.60–$282.60 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib Xray 2V rt | $331.80 | $474.00 | $88.64–$497.70 | 1% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib Xray 2V lt | $331.80 | $474.00 | $88.64–$497.70 | 1% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib Xray 2V lt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib Xray 2V rt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head wo Gad Recon | $3,549.00 | $5,070.00 | $948.09–$5,323.50 | 97% above | 30% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head wo Gad Recon | $3,549.00 | $5,070.00 | $2,028.00–$4,563.00 | — | 30% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast Bilat w/wo Gad | $2,038.40 | $2,912.00 | $544.54–$3,057.60 | — | 30% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast Bilat w/wo Gad | $2,038.40 | $2,912.00 | $1,164.80–$2,620.80 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extr Jt wo Contrast | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 36% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lower Extr Jt wo Contrast | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Ext Jt w/wo Contrast | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | at median | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lower Ext Jt w/wo Contrast | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen/Mrcp Recon | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 40% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen wo Contrast | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 40% above | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen wo Contrast | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen/Mrcp Recon | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/wo Gad | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | at median | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/wo Gad | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain/Brain St wo Gad | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 52% above | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain/Brain St wo Gad | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brn/Brn St w/wo Gad | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | 22% above | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brn/Brn St w/wo Gad | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine wo Gad | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 55% above | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine wo Gad | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 Lumbar Pelvis Plexus w/wo Gad | $2,100.00 | $3,000.00 | $561.00–$3,150.00 | 36% below | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumb Spine w/wo Gad | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | 8% above | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Lumbar Pelvis Plexus w/wo Gad | $2,100.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumb Spine w/wo Gad | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine wo Gad | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 34% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic Spine wo Gad | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Cerv Spine w/wo Gad | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | 21% above | 30% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Cerv Spine w/wo Gad | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Cervical Spine wo Gad | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 58% above | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Cervical Spine wo Gad | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/wo Contrast | $3,524.50 | $5,035.00 | $941.54–$5,286.75 | at median | 30% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/wo Contrast | $3,524.50 | $5,035.00 | $2,014.00–$4,531.50 | — | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis wo Contrast | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 41% above | 30% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis wo Contrast | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Extr Jt wo Contrast | $2,766.40 | $3,952.00 | $739.02–$4,149.60 | 30% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Extr Jt wo Contrast | $2,766.40 | $3,952.00 | $1,580.80–$3,556.80 | — | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Spine Cervical 4-5V | $470.40 | $672.00 | $125.66–$705.60 | 7% above | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Spine Cervical 4-5V | $470.40 | $672.00 | $268.80–$604.80 | — | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Scan Soft Tis NeckEnh | $700.00 | $1,000.00 | $187.00–$1,050.00 | 48% below | 30% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Scan Soft Tis NeckEnh | $700.00 | $1,000.00 | $400.00–$900.00 | — | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tis Neck wo Contrast | $595.00 | $850.00 | $158.95–$892.50 | 45% below | 30% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tis Neck wo Contrast | $595.00 | $850.00 | $340.00–$765.00 | — | 30% |
| Neck soft tissue X-ray CPT 70360 Soft Tissue Neck | $140.00 | $200.00 | $37.40–$210.00 | 50% below | 30% |
| Neck soft tissue X-ray inpatient CPT 70360 Soft Tissue Neck | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myo Perf Spect R/S w/Wm Ef | $4,003.30 | $5,719.00 | $1,069.45–$6,004.95 | 2% above | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myo Perf Spect R/S w/Wm Ef | $4,003.30 | $5,719.00 | $2,287.60–$5,147.10 | — | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT Skul Bas Thig Sb 78815 | $10,641.40 | $15,202.00 | $2,842.77–$15,962.10 | 47% above | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT Skul Bas/Mid Thgh 78815 | $10,641.40 | $15,202.00 | $2,842.77–$15,962.10 | 47% above | 30% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT Skul Bas Thig Sb 78815 | $10,641.40 | $15,202.00 | $6,080.80–$13,681.80 | — | 30% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT Skul Bas/Mid Thgh 78815 | $10,641.40 | $15,202.00 | $6,080.80–$13,681.80 | — | 30% |
| Pelvic CT scan without contrast CPT 72192 CT Scan PelvisUnenhanced | $630.00 | $900.00 | $168.30–$945.00 | 42% below | 30% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Scan PelvisUnenhanced | $630.00 | $900.00 | $360.00–$810.00 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited 76857 | $433.30 | $619.00 | $115.75–$649.95 | 3% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited | $433.30 | $619.00 | $115.75–$649.95 | 3% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Limited 76857 | $433.30 | $619.00 | $247.60–$557.10 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Limited | $433.30 | $619.00 | $247.60–$557.10 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $868.70 | $1,241.00 | $232.07–$1,303.05 | 49% above | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Complete | $868.70 | $1,241.00 | $496.40–$1,116.90 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg 14+Wks Sing Gest Mfm | $851.90 | $1,217.00 | $227.58–$1,277.85 | 39% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg 14+Wks Sing Gest 76805 | $851.90 | $1,217.00 | $227.58–$1,277.85 | 39% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg 14+Wks Sing Gest 76805 | $851.90 | $1,217.00 | $486.80–$1,095.30 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg 14+Wks Sing Gest Mfm | $851.90 | $1,217.00 | $486.80–$1,095.30 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg<14 Wks Sing Gest Mfm | $851.90 | $1,217.00 | $227.58–$1,277.85 | 52% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg <14 Wks Sing Gest | $851.90 | $1,217.00 | $227.58–$1,277.85 | 52% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg<14 Wks Sing Gest Mfm | $851.90 | $1,217.00 | $486.80–$1,095.30 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg <14 Wks Sing Gest | $851.90 | $1,217.00 | $486.80–$1,095.30 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited Mfm | $431.90 | $617.00 | $115.38–$647.85 | 19% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited | $431.90 | $617.00 | $115.38–$647.85 | 19% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited | $431.90 | $617.00 | $115.38–$647.85 | 19% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited Mfm | $431.90 | $617.00 | $246.80–$555.30 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited | $431.90 | $617.00 | $246.80–$555.30 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited | $431.90 | $617.00 | $246.80–$555.30 | — | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilateral 2V | $353.50 | $505.00 | $94.44–$530.25 | 5% above | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Unilateral 2V | $353.50 | $505.00 | $202.00–$454.50 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Unilat w/Pa Chest 3V Min | $504.70 | $721.00 | $134.83–$757.05 | 23% above | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs Unilat w/Pa Chest 3V Min | $504.70 | $721.00 | $288.40–$648.90 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 Mammo Screen Digital Bilat | $298.90 | $427.00 | $79.85–$448.35 | — | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Mammo Screen Digital Bilat | $298.90 | $427.00 | $170.80–$384.30 | — | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 3V Lt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 2 or More Lt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 4V Rt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 4V Lt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 3V Rt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Xray 2 or More Rt | $331.80 | $474.00 | $88.64–$497.70 | 2% below | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 2 or More Rt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 2 or More Lt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 4V Lt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 4V Rt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 3V Lt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Xray 3V Rt | $331.80 | $474.00 | $189.60–$426.60 | — | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Paranasal Sinus Xray Min 3V | $210.00 | $300.00 | $56.10–$315.00 | 51% below | 30% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Paranasal Sinus Xray Min 3V | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 Skull Xray <4V | $175.00 | $250.00 | $46.75–$262.50 | 51% below | 30% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull Xray <4V | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography | $3,462.90 | $4,947.00 | $925.09–$5,194.35 | at median | 30% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography | $3,462.90 | $4,947.00 | $1,978.80–$4,452.30 | — | 30% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Echocardiography 93351 | $837.90 | $1,197.00 | $223.84–$1,256.85 | 54% below | 30% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Echocardiography 93351 | $837.90 | $1,197.00 | $478.80–$1,077.30 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallow Function w/Video Mbs | $283.50 | $405.00 | $75.74–$425.25 | 52% below | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallow Function w/Video Mbs | $283.50 | $405.00 | $162.00–$364.50 | — | 30% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Xray 2V Lt | $247.10 | $353.00 | $66.01–$370.65 | 38% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Xray 2V Min rt | $247.10 | $353.00 | $66.01–$370.65 | 38% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Xray 2V Min rt | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Xray 2V Lt | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Scan Thoracic SpineUnenh | $1,473.50 | $2,105.00 | $393.64–$2,210.25 | 26% above | 30% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Scan Thoracic SpineUnenh | $1,473.50 | $2,105.00 | $842.00–$1,894.50 | — | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Pelvic | $281.40 | $402.00 | $75.17–$422.10 | 50% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US Pelvic Transvaginal 76830 | $524.30 | $749.00 | $140.06–$786.45 | 6% below | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Pelvic | $281.40 | $402.00 | $160.80–$361.80 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic Transvaginal 76830 | $524.30 | $749.00 | $299.60–$674.10 | — | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal Mfm | $535.50 | $765.00 | $143.06–$803.25 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US Preg Transvaginal | $535.50 | $765.00 | $143.06–$803.25 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal Mfm | $535.50 | $765.00 | $306.00–$688.50 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Transvaginal | $535.50 | $765.00 | $306.00–$688.50 | — | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US Upper Abdominal | $715.40 | $1,022.00 | $191.11–$1,073.10 | 9% below | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Upper Abdominal | $715.40 | $1,022.00 | $408.80–$919.80 | — | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US Testicular | $646.80 | $924.00 | $172.79–$970.20 | 5% above | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular | $646.80 | $924.00 | $369.60–$831.60 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Mass Head/Neck Port | $196.70 | $281.00 | $52.55–$295.05 | 66% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Mass Head/Neck | $196.70 | $281.00 | $52.55–$295.05 | 66% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head/Neck | $653.10 | $933.00 | $174.47–$979.65 | 14% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Mass Head/Neck Port | $196.70 | $281.00 | $112.40–$252.90 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Mass Head/Neck | $196.70 | $281.00 | $112.40–$252.90 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head/Neck | $653.10 | $933.00 | $373.20–$839.70 | — | 30% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Xray Min 2V rt | $308.00 | $440.00 | $82.28–$462.00 | 11% above | 30% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Xray Min 2V Lt | $308.00 | $440.00 | $82.28–$462.00 | 11% above | 30% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Xray Min 2V Lt | $308.00 | $440.00 | $176.00–$396.00 | — | 30% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Xray Min 2V rt | $308.00 | $440.00 | $176.00–$396.00 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study both sides CPT 93971 Limited Venous Image Lower BI | $519.40 | $742.00 | $138.75–$779.10 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study both sides CPT 93971 Limited Venous Image Upper BI | $519.40 | $742.00 | $138.75–$779.10 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PV Insufficiency Study UN CV | $519.40 | $742.00 | $138.75–$779.10 | 19% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient both sides CPT 93971 Limited Venous Image Upper BI | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient both sides CPT 93971 Limited Venous Image Lower BI | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PV Insufficiency Study UN CV | $519.40 | $742.00 | $296.80–$667.80 | — | 30% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist Xray 2V Lt | $275.10 | $393.00 | $73.49–$412.65 | at median | 30% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist Xray 2V Rt | $275.10 | $393.00 | $73.49–$412.65 | at median | 30% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist Xray 2V Lt | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist Xray 2V Rt | $275.10 | $393.00 | $157.20–$353.70 | — | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Xray 4V Trauma Lt | $136.50 | $195.00 | $36.47–$204.75 | 58% below | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Xray Lt Min 3V | $280.00 | $400.00 | $74.80–$420.00 | 13% below | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Xray Min 3V Rt | $280.00 | $400.00 | $74.80–$420.00 | 13% below | 30% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Xray 4V Trauma Lt | $136.50 | $195.00 | $78.00–$175.50 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Xray Min 3V Rt | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Xray Lt Min 3V | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Lt w/Pelvis 2-3V | $247.10 | $353.00 | $66.01–$370.65 | 30% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip rt w/Pelvis 2-3V | $247.10 | $353.00 | $66.01–$370.65 | 30% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip rt w/Pelvis 2-3V | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Lt w/Pelvis 2-3V | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen Xray 1V | $267.40 | $382.00 | $71.43–$401.10 | 4% below | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Xray 1V | $267.40 | $382.00 | $152.80–$343.80 | — | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle Xray 2V Lt | $254.10 | $363.00 | $67.88–$381.15 | 25% below | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle Xray 2V rt | $254.10 | $363.00 | $67.88–$381.15 | 25% below | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle Xray 2V Lt | $254.10 | $363.00 | $145.20–$326.70 | — | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle Xray 2V rt | $254.10 | $363.00 | $145.20–$326.70 | — | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 Finger Xray 2V Min | $259.00 | $370.00 | $69.19–$388.50 | 7% above | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 Finger Xray 2V Min | $259.00 | $370.00 | $148.00–$333.00 | — | 30% |
| X-ray of the foot, 2 views one side CPT 73620 Foot Xray 2V | $254.10 | $363.00 | $67.88–$381.15 | 22% below | 30% |
| X-ray of the foot, 2 views one side CPT 73620 Foot Xray 2V Lt | $254.10 | $363.00 | $67.88–$381.15 | 22% below | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Xray 2V | $254.10 | $363.00 | $145.20–$326.70 | — | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot Xray 2V Lt | $254.10 | $363.00 | $145.20–$326.70 | — | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Xray 3V Min | $310.80 | $444.00 | $83.03–$466.20 | 15% below | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Xray 3V Lt Min 3V | $310.80 | $444.00 | $83.03–$466.20 | 15% below | 30% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Xray 3V Lt Min 3V | $310.80 | $444.00 | $177.60–$399.60 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Xray 3V Min | $310.80 | $444.00 | $177.60–$399.60 | — | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Xray Lateral Lt Min 3V | $310.80 | $444.00 | $83.03–$466.20 | 4% above | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Xray 3V Minimum | $310.80 | $444.00 | $83.03–$466.20 | 4% above | 30% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Xray Lateral Lt Min 3V | $310.80 | $444.00 | $177.60–$399.60 | — | 30% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Xray 3V Minimum | $310.80 | $444.00 | $177.60–$399.60 | — | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 1V Ctr rt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 1 or 2V Lt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 1V Ctr Lt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 2V Lt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 1V Lt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Xray 1V Rt | $259.70 | $371.00 | $69.38–$389.55 | 8% below | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 1V Ctr Lt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 1V Rt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 1V Lt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 2V Lt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 1V Ctr rt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Xray 1 or 2V Lt | $259.70 | $371.00 | $148.40–$333.90 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Xray Lumbosacral F + E | $175.00 | $250.00 | $46.75–$262.50 | 52% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Spine Xray Lumbar 2 3V | $406.70 | $581.00 | $108.65–$610.05 | 12% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Spine Xray Lumbosacral F + E | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Spine Xray Lumbar 2 3V | $406.70 | $581.00 | $232.40–$522.90 | — | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 Spine Xray Lumbosac Min 4V | $453.60 | $648.00 | $121.18–$680.40 | at median | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine Xray Lumbosac Min 4V | $453.60 | $648.00 | $259.20–$583.20 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Spine Xray Dorsal 2V | $175.00 | $250.00 | $46.75–$262.50 | 52% below | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Spine Xray Dorsal 2V | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bone Complete 3V Min | $175.00 | $250.00 | $46.75–$262.50 | 36% below | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bone Complete 3V Min | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical 3V or Less | $140.00 | $200.00 | $37.40–$210.00 | 58% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical Trauma f/u 3V | $140.00 | $200.00 | $37.40–$210.00 | 58% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Cervical Trauma 3V | $140.00 | $200.00 | $37.40–$210.00 | 58% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Spine Xray-Cervical Flex Ext | $140.00 | $200.00 | $37.40–$210.00 | 58% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical Trauma 3V | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical Trauma f/u 3V | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical 3V or Less | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Xray-Cervical Flex Ext | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Xray 1-2V | $168.00 | $240.00 | $44.88–$252.00 | 43% below | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis Xray 1-2V | $168.00 | $240.00 | $96.00–$216.00 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum Coccyx Xray Min 2V | $370.30 | $529.00 | $98.92–$555.45 | 10% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum Coccyx Xray Min 2V | $370.30 | $529.00 | $211.60–$476.10 | — | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Acth | $251.30 | $359.00 | $67.13–$376.95 | 13% above | 30% |
| ACTH blood test inpatient CPT 82024 Acth | $251.30 | $359.00 | $143.60–$323.10 | — | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt Alt | $36.40 | $52.00 | $9.72–$54.60 | at median | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Sgpt Alt | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot Ast | $36.40 | $52.00 | $9.72–$54.60 | 1% above | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Sgot Ast | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel | $233.10 | $333.00 | $62.27–$349.65 | 25% below | 30% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel | $233.10 | $333.00 | $133.20–$299.70 | — | 30% |
| Albumin blood test CPT 82040 Albumin, Serum - Syn/Index | $34.30 | $49.00 | $9.16–$51.45 | 7% above | 30% |
| Albumin blood test CPT 82040 Albumin Serum | $34.30 | $49.00 | $9.16–$51.45 | 7% above | 30% |
| Albumin blood test CPT 82040 Protein Bound Glucose Albumin | $34.30 | $49.00 | $9.16–$51.45 | 7% above | 30% |
| Albumin blood test inpatient CPT 82040 Albumin Serum | $34.30 | $49.00 | $19.60–$44.10 | — | 30% |
| Albumin blood test inpatient CPT 82040 Protein Bound Glucose Albumin | $34.30 | $49.00 | $19.60–$44.10 | — | 30% |
| Albumin blood test inpatient CPT 82040 Albumin, Serum - Syn/Index | $34.30 | $49.00 | $19.60–$44.10 | — | 30% |
| Aldosterone blood test CPT 82088 Aldosterone-Urine | $265.30 | $379.00 | $70.87–$397.95 | 27% above | 30% |
| Aldosterone blood test CPT 82088 Aldosterone Serum | $265.30 | $379.00 | $70.87–$397.95 | 27% above | 30% |
| Aldosterone blood test CPT 82088 Aldosterone Urine 24 hr | $265.30 | $379.00 | $70.87–$397.95 | 27% above | 30% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone-Urine | $265.30 | $379.00 | $151.60–$341.10 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Serum | $265.30 | $379.00 | $151.60–$341.10 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Urine 24 hr | $265.30 | $379.00 | $151.60–$341.10 | — | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Bone Spec | $36.40 | $52.00 | $9.72–$54.60 | at median | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Total Iso | $36.40 | $52.00 | $9.72–$54.60 | at median | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phos Serum | $36.40 | $52.00 | $9.72–$54.60 | at median | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Total Iso | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alk Phos Serum | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Bone Spec | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cockroach | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sunflower Seed IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Whey Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Mold Complete | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit (f213) Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit Epithelia (382) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 House Dust (Greer) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Guinea Pig Epithelia IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Willow IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Blueberry IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mosquito IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Trichophyton Rubrum IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allerg Spec IgE Fusarium Solan | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tea IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Plum IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Celery IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cauliflower IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Goat Milk (f300) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sole (rf337) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Turkey Meat (f294) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mushroom IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl G IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl V IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sweet Vernal Grass IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Guar Bean Gum IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bumble Bee Venom IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tomato | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Apple IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Strawberry IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Avocado IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Broccoli IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Garlic IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Onion IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cucumber IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dill IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cocoa IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Orange IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grape IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE Red Oak | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Trout IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tilapia IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mackerel IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Halibut IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Gulf Flounder IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oyster IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Blue Mussel IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cocklebur IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Red Top Grass IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sweet Gum IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Yellow Hornet IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Paper Wasp IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen White Face Hornet IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Honey Bee IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Yolk IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken Meat | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Beef IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Banana IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pork IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Potato IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sweet Potato IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lobster IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pea IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Helminthosporium Halo | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Epicoccum Purpurascen | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Orris Root IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pecan Nut IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Coconut IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pistachio IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Candida Albicans IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Duck Feathers IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Goose Feather IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken Feathers IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen White Pine Tree IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Goldenrod IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree of Heaven | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Scallop IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Tuna Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Hazelnut Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Cashew Nut Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen White Bean IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lettuce IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Parsley IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Salmon Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Almond Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine Prot Ige 86003 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mint IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Coffee IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut Allergy | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rice F9 Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oat F7 Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Buckwheat Fll Igz | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Peach (f95) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Pteronyssinus | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Farinae (d2) | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cows Milk (f2) | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium Herbarum (m2) | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata (m6) | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lamb IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander e3 IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Niger IgE Allergen | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Panel 15 Cereal Group | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Gluten Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Almond F20 Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Brazilnut F18 Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut F17Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Orchard Grass Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allerg Spec IgE Annatto Seed | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cochineal Extr Dactyl Cocc IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Yellow Jacket IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Coriander Cilantro | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pineapple IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Paprika IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Green Pepper IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grapefruit IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Yeast IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Carrot IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Eggplant IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Blackberry IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chili Pepper | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Black Pepper | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rabbit Serum Proteins | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bovine Gelatin IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cayenne Pepper IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cinnamon Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lime Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pine Nut Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lupine Seed Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sunflower IGE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mango Fruit | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lemon | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Milk Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Niger 86606 | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Flaxseed (f333) IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Caraway (Carum Carvi)(f26S)IgE | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Thistle Russian | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast-Allergens Each | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast Allergens Additional Rout | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rast-Latex Allergy | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Perennial Rye, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Meadow Fescue, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Timothy, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dpteronyssinus, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dermato Farinae, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, House Dust, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cladospor Herb, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Alternaria Tenuis,Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Maple Box Elder, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oak White, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Elm, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sycamore, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dog Dander, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cat Dander, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Ragweed Common, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Ragweed Giant, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, English Plant, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lambs Quarters, Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sheep Sorrel | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cacremonium Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cotton Fibers | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Birch Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Corn Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Clam Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Ash Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bermuda Grass Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Papaya | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mandarin | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Johnson Grass Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, June Grass Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pecan Tree Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Walnut Tree Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Walnut Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Scallop Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Codfish Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Shrimp Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Sesame Seed Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Rough,Pigweed,Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Penicillium,Notatum | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mulberry Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mugwort Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Mountain Cedar Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Cottonwoood Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Wheat Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Soybean Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut Ige | $28.00 | $40.00 | $7.48–$42.00 | 13% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Sugar Cane IgE | $36.40 | $52.00 | $9.72–$54.60 | 13% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Afumigatus Ige | $43.40 | $62.00 | $11.59–$65.10 | 34% above | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Scallop IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sunflower Seed IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Whey Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Mold Complete | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rabbit (f213) Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rabbit Epithelia (382) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust (Greer) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Guinea Pig Epithelia IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Willow IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Blueberry IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mosquito IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Trichophyton Rubrum IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allerg Spec IgE Fusarium Solan | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tea IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Plum IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Celery IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cauliflower IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goat Milk (f300) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sole (rf337) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey Meat (f294) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mushroom IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl G IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl V IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sweet Vernal Grass IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Guar Bean Gum IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bumble Bee Venom IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tomato | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Apple IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Strawberry IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Avocado IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Broccoli IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Garlic IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Onion IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cucumber IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dill IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cocoa IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Orange IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grape IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE Red Oak | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Trout IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tilapia IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mackerel IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Halibut IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Gulf Flounder IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oyster IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Blue Mussel IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cocklebur IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Red Top Grass IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sweet Gum IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Yellow Hornet IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Paper Wasp IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen White Face Hornet IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Honey Bee IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Yolk IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken Meat | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Beef IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Banana IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pork IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Potato IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sweet Potato IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lobster IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pea IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Helminthosporium Halo | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Epicoccum Purpurascen | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Orris Root IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pecan Nut IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Coconut IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pistachio IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Candida Albicans IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Duck Feathers IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Goose Feather IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken Feathers IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen White Pine Tree IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Goldenrod IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree of Heaven | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Tuna Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Hazelnut Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Cashew Nut Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen White Bean IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lettuce IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Parsley IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Salmon Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Almond Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mouse Urine Prot Ige 86003 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mint IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coffee IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Macadamia Nut Allergy | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rice F9 Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oat F7 Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Buckwheat Fll Igz | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peach (f95) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dermatophagoides Pteronyssinus | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dermatophagoides Farinae (d2) | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cows Milk (f2) | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium Herbarum (m2) | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alternata (m6) | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lamb IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Horse Dander e3 IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Niger IgE Allergen | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Panel 15 Cereal Group | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond F20 Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brazilnut F18 Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazelnut F17Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allerg Spec IgE Annatto Seed | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cochineal Extr Dactyl Cocc IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Yellow Jacket IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Coriander Cilantro | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pineapple IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Paprika IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Green Pepper IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grapefruit IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Yeast IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Carrot IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Eggplant IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Blackberry IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chili Pepper | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Black Pepper | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rabbit Serum Proteins | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bovine Gelatin IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cayenne Pepper IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cinnamon Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lime Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pine Nut Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lupine Seed Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sunflower IGE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mango Fruit | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lemon | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Papaya | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mandarin | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Sesame Seed Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Rough,Pigweed,Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Penicillium,Notatum | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mulberry Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mugwort Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Mountain Cedar Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Cottonwoood Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Wheat Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Soybean Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Corn Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Milk Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Clam Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Shrimp Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Codfish Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Scallop Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Walnut Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Walnut Tree Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pecan Tree Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, June Grass Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Johnson Grass Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bermuda Grass Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Ash Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Orchard Grass Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cockroach | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Birch Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cotton Fibers | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cacremonium Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sheep Sorrel | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lambs Quarters, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, English Plant, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Ragweed Giant, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Ragweed Common, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cat Dander, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dog Dander, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sycamore, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Elm, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oak White, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Maple Box Elder, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Alternaria Tenuis,Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cladospor Herb, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, House Dust, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dermato Farinae, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dpteronyssinus, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Timothy, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Meadow Fescue, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Perennial Rye, Ige | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast-Latex Allergy | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Allergens Additional Rout | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast-Allergens Each | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Thistle Russian | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Caraway (Carum Carvi)(f26S)IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Flaxseed (f333) IgE | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Niger 86606 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sugar Cane IgE | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Afumigatus Ige | $43.40 | $62.00 | $24.80–$55.80 | — | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Serum 82105 | $111.30 | $159.00 | $29.73–$166.95 | 1% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Feto Protein | $111.30 | $159.00 | $29.73–$166.95 | 1% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Feto Pro-Maternal | $111.30 | $159.00 | $29.73–$166.95 | 1% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Mate Alfa Feto Protein | $111.30 | $159.00 | $29.73–$166.95 | 1% above | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Serum 82105 | $111.30 | $159.00 | $63.60–$143.10 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Feto Protein | $111.30 | $159.00 | $63.60–$143.10 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Feto Pro-Maternal | $111.30 | $159.00 | $63.60–$143.10 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Mate Alfa Feto Protein | $111.30 | $159.00 | $63.60–$143.10 | — | 30% |
| Ammonia blood test CPT 82140 Ammonia | $97.30 | $139.00 | $25.99–$145.95 | 7% above | 30% |
| Ammonia blood test CPT 82140 Ammonia, 24 Hour Urine | $97.30 | $139.00 | $25.99–$145.95 | 7% above | 30% |
| Ammonia blood test inpatient CPT 82140 Ammonia, 24 Hour Urine | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| Ammonia blood test inpatient CPT 82140 Ammonia | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| Amylase blood test CPT 82150 Amylase Urine | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Serum | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Peritoneal Fluid | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Pleural Fluid 82150 | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Pancreatic Cyst | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Body Fluid | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test CPT 82150 Amylase Urine 2 hr | $45.50 | $65.00 | $12.16–$68.25 | 4% above | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Urine | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Urine 2 hr | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Serum | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Body Fluid | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Pancreatic Cyst | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Pleural Fluid 82150 | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Amylase blood test inpatient CPT 82150 Amylase Peritoneal Fluid | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrulline Peptide Igg | $84.70 | $121.00 | $22.63–$127.05 | 1% below | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrulline Peptide Igg | $84.70 | $121.00 | $48.40–$108.90 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody AnaRout | $80.50 | $115.00 | $21.50–$120.75 | 8% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Multiplex W/Reflex Anti Ca | $80.50 | $115.00 | $21.50–$120.75 | 8% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Pnl 1 w/ANA IFA w/ Rflx | $80.50 | $115.00 | $21.50–$120.75 | 8% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Choice Screen w/Rfx Ds Dna | $80.50 | $115.00 | $21.50–$120.75 | 8% above | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Choice Screen w/Rfx Ds Dna | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lupus Pnl 1 w/ANA IFA w/ Rflx | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody AnaRout | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Multiplex W/Reflex Anti Ca | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide-Bnp | $170.10 | $243.00 | $45.44–$255.15 | 15% below | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pro Bnp N Terminal 83880 | $170.10 | $243.00 | $45.44–$255.15 | 15% below | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide-Bnp | $170.10 | $243.00 | $97.20–$218.70 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Pro Bnp N Terminal 83880 | $170.10 | $243.00 | $97.20–$218.70 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Routine 87070 | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture 87070 | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Post-Op Culture | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nose And Throat Culture | $85.40 | $122.00 | $22.81–$128.10 | 64% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture, Routine 87070 | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture 87070 | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nose And Throat Culture | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Post-Op Culture | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic 8 Panel | $44.80 | $64.00 | $11.97–$67.20 | 42% below | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic 8 Panel | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total Serum | $30.80 | $44.00 | $8.23–$46.20 | 4% below | 30% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Serum | $30.80 | $44.00 | $17.60–$39.60 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate Needle Biopsy 88305 | $193.20 | $276.00 | $51.61–$289.80 | 9% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Gr+Micro+STRATA | $193.20 | $276.00 | $51.61–$289.80 | 9% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cell Block 88305 | $193.20 | $276.00 | $51.61–$289.80 | 9% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path, Gr+Micro, Level Iv | $193.20 | $276.00 | $51.61–$289.80 | 9% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Prostate Needle Biopsy 88305 | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path, Gr+Micro, Level Iv | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path Gr+Micro+STRATA | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Cell Block 88305 | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Blood culture for bacteria CPT 87040 Misc Microbiology | $85.40 | $122.00 | $22.81–$128.10 | 1% above | 30% |
| Blood culture for bacteria CPT 87040 Blood Culture 87040 | $169.40 | $242.00 | $45.25–$254.10 | 100% above | 30% |
| Blood culture for bacteria inpatient CPT 87040 Misc Microbiology | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture 87040 | $169.40 | $242.00 | $96.80–$217.80 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Collection | $17.50 | $25.00 | $4.68–$26.25 | 17% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PN expanded new consult 25-39m | $17.50 | $25.00 | $4.68–$26.25 | 17% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $17.50 | $25.00 | $4.68–$26.25 | 17% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Lead Collection | $17.50 | $25.00 | $4.68–$26.25 | 17% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Collection | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Lead Collection | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose Serum | $23.10 | $33.00 | $6.17–$34.65 | 10% below | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose Serum Timed | $23.10 | $33.00 | $6.17–$34.65 | 10% below | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose Tolerance--Fasting | $23.10 | $33.00 | $6.17–$34.65 | 10% below | 30% |
| Blood glucose (sugar) test CPT 82947 Protein Bound Glucose Glucose | $23.10 | $33.00 | $6.17–$34.65 | 10% below | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose Poc By Flex | $23.10 | $33.00 | $6.17–$34.65 | 10% below | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Serum | $23.10 | $33.00 | $13.20–$29.70 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 Protein Bound Glucose Glucose | $23.10 | $33.00 | $13.20–$29.70 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Tolerance--Fasting | $23.10 | $33.00 | $13.20–$29.70 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Serum Timed | $23.10 | $33.00 | $13.20–$29.70 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Poc By Flex | $23.10 | $33.00 | $13.20–$29.70 | — | 30% |
| Blood lead test CPT 83655 Lead Urine | $80.50 | $115.00 | $21.50–$120.75 | 3% above | 30% |
| Blood lead test CPT 83655 Lead | $80.50 | $115.00 | $21.50–$120.75 | 3% above | 30% |
| Blood lead test CPT 83655 Lead Blood | $80.50 | $115.00 | $21.50–$120.75 | 3% above | 30% |
| Blood lead test CPT 83655 Lead - Blood Hm | $80.50 | $115.00 | $21.50–$120.75 | 3% above | 30% |
| Blood lead test CPT 83655 Lead - Urine Hmu | $80.50 | $115.00 | $21.50–$120.75 | 3% above | 30% |
| Blood lead test inpatient CPT 83655 Lead - Urine Hmu | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Blood lead test inpatient CPT 83655 Lead - Blood Hm | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Blood lead test inpatient CPT 83655 Lead | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Blood lead test inpatient CPT 83655 Lead Blood | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Blood lead test inpatient CPT 83655 Lead Urine | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg, Beta, Qualitative | $44.80 | $64.00 | $11.97–$67.20 | 10% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test-Urine | $44.80 | $64.00 | $11.97–$67.20 | 10% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg, Beta, Qualitative | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test-Urine | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Reflex, Blood Typing Abo | $34.30 | $49.00 | $9.16–$51.45 | 74% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo | $248.50 | $355.00 | $66.39–$372.75 | 87% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Rh | $248.50 | $355.00 | $66.39–$372.75 | 87% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Reflex, Blood Typing Abo | $34.30 | $49.00 | $19.60–$44.10 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Rh | $248.50 | $355.00 | $142.00–$319.50 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo | $248.50 | $355.00 | $142.00–$319.50 | — | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Serum | $28.00 | $40.00 | $7.48–$42.00 | 4% above | 30% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Serum | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| C-peptide blood test CPT 84681 C-Peptide, Ser | $136.50 | $195.00 | $36.47–$204.75 | 26% above | 30% |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Ser | $136.50 | $195.00 | $78.00–$175.50 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein | $36.40 | $52.00 | $9.72–$54.60 | 2% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Crp Quantitative | $36.40 | $52.00 | $9.72–$54.60 | 2% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Synovasure Crp Sf | $36.40 | $52.00 | $9.72–$54.60 | 2% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Synovasure Crp Sf | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Crp Quantitative | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Cdifficile Dna Toxin Assay | $149.80 | $214.00 | $40.02–$224.70 | 28% below | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Cdifficile Dna Toxin Assay | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca-19-9 Antigen | $82.60 | $118.00 | $22.07–$123.90 | 38% below | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca-19-9 Antigen | $82.60 | $118.00 | $47.20–$106.20 | — | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Ca-125Ovarian Cancer Antigen | $114.10 | $163.00 | $30.48–$171.15 | 13% below | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca-125Ovarian Cancer Antigen | $114.10 | $163.00 | $65.20–$146.70 | — | 30% |
| Calcium blood test, total CPT 82310 Calcium Of Para C | $36.40 | $52.00 | $9.72–$54.60 | 8% above | 30% |
| Calcium blood test, total CPT 82310 Calcium Of Parai | $36.40 | $52.00 | $9.72–$54.60 | 8% above | 30% |
| Calcium blood test, total CPT 82310 Calcium | $36.40 | $52.00 | $9.72–$54.60 | 8% above | 30% |
| Calcium blood test, total inpatient CPT 82310 Calcium Of Para C | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 Calcium Of Parai | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 Calcium | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Cea By Abbott | $124.60 | $178.00 | $33.29–$186.90 | 5% above | 30% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea By Abbott | $124.60 | $178.00 | $71.20–$160.20 | — | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 Herpes Zoster Igm Varicella | $106.40 | $152.00 | $28.42–$159.60 | 26% above | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Herpes Zoster Igm Varicella | $106.40 | $152.00 | $60.80–$136.80 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Gc/Ct Urine Female 87491 | $149.80 | $214.00 | $40.02–$224.70 | 24% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis | $149.80 | $214.00 | $40.02–$224.70 | 24% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Gcctuf | $149.80 | $214.00 | $40.02–$224.70 | 24% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Gc/Ct Urine Female 87491 | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Gcctuf | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cardio Iq Adv Lipid Panel | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cardio Iq Adv Lipid Panel | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| Complete blood count (CBC) with differential CPT 85025 Cbc And Differential 85025 | $52.50 | $75.00 | $14.02–$78.75 | 3% above | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cbc And Differential 85025 | $52.50 | $75.00 | $30.00–$67.50 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 Cbc 85027 | $44.80 | $64.00 | $11.97–$67.20 | 4% above | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Cbc 85027 | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comp Metabolic Panel | $56.00 | $80.00 | $14.96–$84.00 | 37% below | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comp Metabolic Panel | $56.00 | $80.00 | $32.00–$72.00 | — | 30% |
| Cortisol blood test, total CPT 82533 Cortisol - Plasma | $107.80 | $154.00 | $28.80–$161.70 | 5% above | 30% |
| Cortisol blood test, total CPT 82533 Dexamethasone Suppression Cor | $107.80 | $154.00 | $28.80–$161.70 | 5% above | 30% |
| Cortisol blood test, total CPT 82533 Cortisol Total 82533 | $107.80 | $154.00 | $28.80–$161.70 | 5% above | 30% |
| Cortisol blood test, total inpatient CPT 82533 Dexamethasone Suppression Cor | $107.80 | $154.00 | $61.60–$138.60 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Total 82533 | $107.80 | $154.00 | $61.60–$138.60 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol - Plasma | $107.80 | $154.00 | $61.60–$138.60 | — | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 Total Ck For Isoenzymes | $45.50 | $65.00 | $12.16–$68.25 | 1% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 Cpk Serum | $45.50 | $65.00 | $12.16–$68.25 | 1% above | 30% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Cpk Serum | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Total Ck For Isoenzymes | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Creatinine blood test CPT 82565 Creat Ser/Cex | $35.00 | $50.00 | $9.35–$52.50 | 4% above | 30% |
| Creatinine blood test CPT 82565 Creat/Est Glomerular Filt | $35.00 | $50.00 | $9.35–$52.50 | 4% above | 30% |
| Creatinine blood test CPT 82565 Creatinine Serum | $35.00 | $50.00 | $9.35–$52.50 | 4% above | 30% |
| Creatinine blood test inpatient CPT 82565 Creat Ser/Cex | $35.00 | $50.00 | $20.00–$45.00 | — | 30% |
| Creatinine blood test inpatient CPT 82565 Creat/Est Glomerular Filt | $35.00 | $50.00 | $20.00–$45.00 | — | 30% |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum | $35.00 | $50.00 | $20.00–$45.00 | — | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG Avidity | $44.80 | $64.00 | $11.97–$67.20 | 48% below | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Igg Ab | $44.80 | $64.00 | $11.97–$67.20 | 48% below | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG Avidity | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Igg Ab | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quant | $50.40 | $72.00 | $13.46–$75.60 | 26% below | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 Quantitative D-Dimer 85379 | $50.40 | $72.00 | $13.46–$75.60 | 26% below | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Quant | $50.40 | $72.00 | $28.80–$64.80 | — | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 Quantitative D-Dimer 85379 | $50.40 | $72.00 | $28.80–$64.80 | — | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate | $144.90 | $207.00 | $38.71–$217.35 | 8% above | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea Sulfate | $144.90 | $207.00 | $82.80–$186.30 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetaminophen | $133.00 | $190.00 | $35.53–$199.50 | 27% below | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol Screen Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Screen 7 Serum | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monit 4 w/Conf Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring MDMA/MDA | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Urine Phencyclidine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Cotinine, Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monit Alco Metabo Con | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Gamma Hydro Butyric Acid Scr U | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ketamine Qualitative Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monit Panel 6 w/Conf Urin | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring PNL 3 Screen | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Panl 8 w/conf uri | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 8 W Confirma | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Single Drug Class Method Dsb | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Analgesics Non-Opioid 80329 | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Scr/Confirm Ur | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scrn Meconium 80301 | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Monit w Conf Oral Flu | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Single Drug Class Method Dsu | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Nos 7 OR More Dsu 80377 | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Barabiturate Screen - Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Qualitative DAU | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring PN 1 Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol Screen Dpuc | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Single Drug Class Method Dpuc | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring Panel7 w/Conf | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monit Buprenorp w Confirm | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Oxy Confirm Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Propoxyphene Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Sed Hypnotics Non BenzoDsu | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Skeletal Muscle Relaxants Dsu | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Pcp Screen - Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tox Opiates w/Conf Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Single Drug Class Tox 2 | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PDM Fentanyl W Confirm Urine | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines ScrMethamph Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Scr/Ma 6-10-Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid Screen - Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Screen - Dau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Scr Morph/CodeineDau | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Ur Screen | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tricyclic Eval, Qualitative | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monit Antipsych w Conf Ur | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol Urine Ethyl | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monit Alco Meta Conf Urin | $227.50 | $325.00 | $60.78–$341.25 | 25% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Common Drug Screen | $280.00 | $400.00 | $74.80–$420.00 | 54% above | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Acetaminophen | $133.00 | $190.00 | $76.00–$171.00 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Scr/Ma 6-10-Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Qualitative DAU | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring PN 1 Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tramadol Screen Dpuc | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Single Drug Class Method Dpuc | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring Panel7 w/Conf | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monit Buprenorp w Confirm | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Oxy Confirm Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Propoxyphene Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Sed Hypnotics Non BenzoDsu | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Skeletal Muscle Relaxants Dsu | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Nos 7 OR More Dsu 80377 | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Single Drug Class Method Dsu | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Scrn Meconium 80301 | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine Scr/Confirm Ur | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Analgesics Non-Opioid 80329 | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Single Drug Class Method Dsb | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel 8 W Confirma | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Panl 8 w/conf uri | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monit w Conf Oral Flu | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring PNL 3 Screen | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monit Panel 6 w/Conf Urin | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ketamine Qualitative Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Gamma Hydro Butyric Acid Scr U | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monit Alco Metabo Con | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Cotinine, Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Urine Phencyclidine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitoring MDMA/MDA | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Monit 4 w/Conf Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Screen 7 Serum | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tramadol Screen Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monit Alco Meta Conf Urin | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol Urine Ethyl | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monit Antipsych w Conf Ur | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tricyclic Eval, Qualitative | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine Ur Screen | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PDM Fentanyl W Confirm Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Pcp Screen - Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Scr Morph/CodeineDau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Screen - Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid Screen - Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barabiturate Screen - Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines ScrMethamph Dau | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tox Opiates w/Conf Urine | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Single Drug Class Tox 2 | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Common Drug Screen | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolye 4 Panel | $36.40 | $52.00 | $9.72–$54.60 | 31% below | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolye 4 Panel | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epsteinbarr Virus Capsid Agigg | $120.40 | $172.00 | $32.16–$180.60 | 5% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgG | $120.40 | $172.00 | $32.16–$180.60 | 5% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epsteinbarr Virus Capsid Agigm | $120.40 | $172.00 | $32.16–$180.60 | 5% above | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epsteinbarr Virus Capsid Agigm | $120.40 | $172.00 | $68.80–$154.80 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IgG | $120.40 | $172.00 | $68.80–$154.80 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epsteinbarr Virus Capsid Agigg | $120.40 | $172.00 | $68.80–$154.80 | — | 30% |
| Estradiol blood test CPT 82670 Estradiol 82670 | $183.40 | $262.00 | $48.99–$275.10 | 10% above | 30% |
| Estradiol blood test CPT 82670 Estradiol Ultrasensitive | $183.40 | $262.00 | $48.99–$275.10 | 10% above | 30% |
| Estradiol blood test CPT 82670 Estradiol Free 82670 | $183.40 | $262.00 | $48.99–$275.10 | 10% above | 30% |
| Estradiol blood test inpatient CPT 82670 Estradiol Free 82670 | $183.40 | $262.00 | $104.80–$235.80 | — | 30% |
| Estradiol blood test inpatient CPT 82670 Estradiol 82670 | $183.40 | $262.00 | $104.80–$235.80 | — | 30% |
| Estradiol blood test inpatient CPT 82670 Estradiol Ultrasensitive | $183.40 | $262.00 | $104.80–$235.80 | — | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH Pediatric | $121.80 | $174.00 | $32.54–$182.70 | 2% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh - Serum | $121.80 | $174.00 | $32.54–$182.70 | 2% above | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Fsh - Serum | $121.80 | $174.00 | $69.60–$156.60 | — | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH Pediatric | $121.80 | $174.00 | $69.60–$156.60 | — | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool 83993 | $61.60 | $88.00 | $16.46–$92.40 | 52% below | 30% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool 83993 | $61.60 | $88.00 | $35.20–$79.20 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $91.00 | $130.00 | $24.31–$136.50 | 5% above | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $91.00 | $130.00 | $52.00–$117.00 | — | 30% |
| Fibrinogen blood test CPT 85384 Fibrinogen | $112.70 | $161.00 | $30.11–$169.05 | 70% above | 30% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen | $112.70 | $161.00 | $64.40–$144.90 | — | 30% |
| Folate (folic acid) blood test CPT 82746 Folate Serum | $98.00 | $140.00 | $26.18–$147.00 | 13% above | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Serum | $98.00 | $140.00 | $56.00–$126.00 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 T3, Free | $130.20 | $186.00 | $34.78–$195.30 | 22% above | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3, Free | $130.20 | $186.00 | $74.40–$167.40 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine, Free 84439 | $61.60 | $88.00 | $16.46–$92.40 | 3% above | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free Direct Dialysis 84439 | $61.60 | $88.00 | $16.46–$92.40 | 3% above | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine, Free 84439 | $61.60 | $88.00 | $35.20–$79.20 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free Direct Dialysis 84439 | $61.60 | $88.00 | $35.20–$79.20 | — | 30% |
| Free testosterone test CPT 84402 Testosterone Free Of Test Tf | $167.30 | $239.00 | $44.69–$250.95 | 5% above | 30% |
| Free testosterone test inpatient CPT 84402 Testosterone Free Of Test Tf | $167.30 | $239.00 | $95.60–$215.10 | — | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Gt Serum | $49.00 | $70.00 | $13.09–$73.50 | 3% above | 30% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Gt Serum | $49.00 | $70.00 | $28.00–$63.00 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 1 hr | $33.60 | $48.00 | $8.98–$50.40 | 10% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hr Pp Glucola | $33.60 | $48.00 | $8.98–$50.40 | 10% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hr Pp Meal | $33.60 | $48.00 | $8.98–$50.40 | 10% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Pp-Cola | $33.60 | $48.00 | $8.98–$50.40 | 10% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance 1 hr | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hr Pp Glucola | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hr Pp Meal | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Pp-Cola | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2 hr | $85.40 | $122.00 | $22.81–$128.10 | 5% above | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2 hr | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Gcctuf | $149.80 | $214.00 | $40.02–$224.70 | 19% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae | $149.80 | $214.00 | $40.02–$224.70 | 19% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae Gcctuf | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Igg Aby | $97.30 | $139.00 | $25.99–$145.95 | 16% below | 30% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Iga | $97.30 | $139.00 | $25.99–$145.95 | 16% below | 30% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Igm Ab | $97.30 | $139.00 | $25.99–$145.95 | 16% below | 30% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Iga | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Igg Aby | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Igm Ab | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| H. pylori stool antigen test CPT 87338 H Pylori Ag Eia Stool 87338 | $85.40 | $122.00 | $22.81–$128.10 | 11% below | 30% |
| H. pylori stool antigen test inpatient CPT 87338 H Pylori Ag Eia Stool 87338 | $85.40 | $122.00 | $48.80–$109.80 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Quanitatative HIV1 Real Tm PCR | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Rna Pcr Quant | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant Expanded Pcr | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant 2nd Gen Pcr | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant 1st Gen Pcr | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant By Bdna | $352.80 | $504.00 | $94.25–$529.20 | 29% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv 1 Rna Pcr Quant | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Quanitatative HIV1 Real Tm PCR | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Quant 2nd Gen Pcr | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Quant Expanded Pcr | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Quant 1st Gen Pcr | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Quant By Bdna | $352.80 | $504.00 | $201.60–$453.60 | — | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 Hiv - Prenatal Iv | $91.00 | $130.00 | $24.31–$136.50 | 12% below | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv - Prenatal Iv | $91.00 | $130.00 | $52.00–$117.00 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 2 | $149.80 | $214.00 | $40.02–$224.70 | 6% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1/Hiv2 Ag/Ab Exposure | $149.80 | $214.00 | $40.02–$224.70 | 6% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Albumin Synovial Fluid | $149.80 | $214.00 | $40.02–$224.70 | 6% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB 4th GEN | $149.80 | $214.00 | $40.02–$224.70 | 6% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB 4th GEN | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 2 | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Albumin Synovial Fluid | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1/Hiv2 Ag/Ab Exposure | $149.80 | $214.00 | $85.60–$192.60 | — | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papilloma mRNA High Risk | $175.00 | $250.00 | $46.75–$262.50 | 16% below | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv Dna Low/High Risk | $175.00 | $250.00 | $46.75–$262.50 | 16% below | 30% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Human Papilloma mRNA High Risk | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv Dna Low/High Risk | $175.00 | $250.00 | $100.00–$225.00 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C Mpg 83036 | $46.90 | $67.00 | $12.53–$70.35 | 8% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycohemoglobin A1C | $46.90 | $67.00 | $12.53–$70.35 | 8% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C Mpg 83036 | $46.90 | $67.00 | $26.80–$60.30 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycohemoglobin A1C | $46.90 | $67.00 | $26.80–$60.30 | — | 30% |
| Hemoglobin blood test CPT 85018 Hemoglobin 85018 | $18.20 | $26.00 | $4.86–$27.30 | 6% above | 30% |
| Hemoglobin blood test CPT 85018 Hgb Eval Hemoglobin | $18.20 | $26.00 | $4.86–$27.30 | 6% above | 30% |
| Hemoglobin blood test inpatient CPT 85018 Hgb Eval Hemoglobin | $18.20 | $26.00 | $10.40–$23.40 | — | 30% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin 85018 | $18.20 | $26.00 | $10.40–$23.40 | — | 30% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibod 86704 | $80.50 | $115.00 | $21.50–$120.75 | 5% below | 30% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibod 86704 | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surf Antibody | $72.10 | $103.00 | $19.26–$108.15 | 2% below | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surf Antibody | $72.10 | $103.00 | $41.20–$92.70 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surf Antigen 87340 | $70.00 | $100.00 | $18.70–$105.00 | 1% above | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surf Antigen 87340 | $70.00 | $100.00 | $40.00–$90.00 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody 86803 | $94.50 | $135.00 | $25.24–$141.75 | 5% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hcv Ab w/Reflex Hcv Qn | $94.50 | $135.00 | $25.24–$141.75 | 5% below | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody 86803 | $94.50 | $135.00 | $54.00–$121.50 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hcv Ab w/Reflex Hcv Qn | $94.50 | $135.00 | $54.00–$121.50 | — | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C Rna Viral Load | $360.50 | $515.00 | $96.30–$540.75 | 27% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Quantitative Rna | $360.50 | $515.00 | $96.30–$540.75 | 27% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Rna Quant By Bdna | $360.50 | $515.00 | $96.30–$540.75 | 27% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Reflex Hcv Pcr Quant | $360.50 | $515.00 | $96.30–$540.75 | 27% above | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep C Rna Viral Load | $360.50 | $515.00 | $206.00–$463.50 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hcv Rna Quant By Bdna | $360.50 | $515.00 | $206.00–$463.50 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hcv Quantitative Rna | $360.50 | $515.00 | $206.00–$463.50 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Reflex Hcv Pcr Quant | $360.50 | $515.00 | $206.00–$463.50 | — | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 Hsv1 Igm Titer | $49.70 | $71.00 | $13.28–$74.55 | 38% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 Hsv1 Igm Screen | $49.70 | $71.00 | $13.28–$74.55 | 38% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Abs Type I Igg | $49.70 | $71.00 | $13.28–$74.55 | 38% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Abs Igm | $49.70 | $71.00 | $13.28–$74.55 | 38% below | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv1 Igm Titer | $49.70 | $71.00 | $28.40–$63.90 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv1 Igm Screen | $49.70 | $71.00 | $28.40–$63.90 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Abs Igm | $49.70 | $71.00 | $28.40–$63.90 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Abs Type I Igg | $49.70 | $71.00 | $28.40–$63.90 | — | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 Hsv2 Igm Titer | $127.40 | $182.00 | $34.03–$191.10 | 19% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Inhibin | $127.40 | $182.00 | $34.03–$191.10 | 19% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Abs Type II Igg | $127.40 | $182.00 | $34.03–$191.10 | 19% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igm Screen | $127.40 | $182.00 | $34.03–$191.10 | 19% above | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv 2 Igm Screen | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Inhibin | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Abs Type II Igg | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv2 Igm Titer | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Cardio Crp Ultrasensitive | $154.70 | $221.00 | $41.33–$232.05 | 97% above | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Cardio Crp Ultrasensitive | $154.70 | $221.00 | $88.40–$198.90 | — | 30% |
| Homocysteine blood test CPT 83090 Homocysteine Serum 83090 | $182.00 | $260.00 | $48.62–$273.00 | 52% above | 30% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine Serum 83090 | $182.00 | $260.00 | $104.00–$234.00 | — | 30% |
| Insulin blood test CPT 83525 5th Hr Insulin Tol 83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 Fasting Insulin 83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 Insulin, Fasting 83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 1st Hr InsulinTolerance83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 2nd Hr InsulinTolerance83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 3rd Hr InsulinTolerance83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test CPT 83525 4th Hr Insulin Tol 83525 | $76.30 | $109.00 | $20.38–$114.45 | 5% above | 30% |
| Insulin blood test inpatient CPT 83525 Insulin, Fasting 83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 Fasting Insulin 83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 5th Hr Insulin Tol 83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 4th Hr Insulin Tol 83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 3rd Hr InsulinTolerance83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 2nd Hr InsulinTolerance83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Insulin blood test inpatient CPT 83525 1st Hr InsulinTolerance83525 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Iron blood test (serum iron) CPT 83540 Iron 24 Hr Urine | $44.80 | $64.00 | $11.97–$67.20 | 2% below | 30% |
| Iron blood test (serum iron) CPT 83540 Iron Serum | $44.80 | $64.00 | $11.97–$67.20 | 2% below | 30% |
| Iron blood test (serum iron) CPT 83540 Liver Tissue, Iron | $44.80 | $64.00 | $11.97–$67.20 | 2% below | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Serum | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 Liver Tissue, Iron | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron 24 Hr Urine | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Ibc | $59.50 | $85.00 | $15.90–$89.25 | at median | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Ibc | $59.50 | $85.00 | $34.00–$76.50 | — | 30% |
| Kidney function blood test panel CPT 80069 Renal Function 10 Panel | $45.50 | $65.00 | $12.16–$68.25 | 33% below | 30% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function 10 Panel | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| LH (luteinizing hormone) test CPT 83002 LH Pediactric | $121.80 | $174.00 | $32.54–$182.70 | 2% above | 30% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Lh | $121.80 | $174.00 | $32.54–$182.70 | 2% above | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH Pediactric | $121.80 | $174.00 | $69.60–$156.60 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone Lh | $121.80 | $174.00 | $69.60–$156.60 | — | 30% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $72.10 | $103.00 | $19.26–$108.15 | 6% below | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $72.10 | $103.00 | $41.20–$92.70 | — | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pleural Fluid | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Serum | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Peritoneal Fluid | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Synovial Fluid | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Body Fluid Ldh | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Pericardial Fluid | $42.00 | $60.00 | $11.22–$63.00 | 14% above | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pleural Fluid | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh Serum | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Peritoneal Fluid | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Pericardial Fluid | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Synovial Fluid | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Body Fluid Ldh | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Peritoneal Fluid | $46.90 | $67.00 | $12.53–$70.35 | at median | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $46.90 | $67.00 | $12.53–$70.35 | at median | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Peritoneal Fluid | $46.90 | $67.00 | $26.80–$60.30 | — | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase | $46.90 | $67.00 | $26.80–$60.30 | — | 30% |
| Liver function blood test panel CPT 80076 Hepatic Function 7 Panel | $42.00 | $60.00 | $11.22–$63.00 | 46% below | 30% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function 7 Panel | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Lyme disease antibody test CPT 86618 Lyme Igm-Csf 86618 | $112.70 | $161.00 | $30.11–$169.05 | 19% above | 30% |
| Lyme disease antibody test CPT 86618 Lyme Disease Eia 86618 | $112.70 | $161.00 | $30.11–$169.05 | 19% above | 30% |
| Lyme disease antibody test CPT 86618 Lyme Abs-Csf 86618 | $112.70 | $161.00 | $30.11–$169.05 | 19% above | 30% |
| Lyme disease antibody test CPT 86618 Lyme Igg-Csf | $112.70 | $161.00 | $30.11–$169.05 | 19% above | 30% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Eia 86618 | $112.70 | $161.00 | $64.40–$144.90 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Abs-Csf 86618 | $112.70 | $161.00 | $64.40–$144.90 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Igg-Csf | $112.70 | $161.00 | $64.40–$144.90 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Igm-Csf 86618 | $112.70 | $161.00 | $64.40–$144.90 | — | 30% |
| Magnesium blood test CPT 83735 Urorisk Magnesium 83735 | $46.20 | $66.00 | $12.34–$69.30 | 11% above | 30% |
| Magnesium blood test CPT 83735 Magnesium Serum | $46.20 | $66.00 | $12.34–$69.30 | 11% above | 30% |
| Magnesium blood test CPT 83735 Magnesium 24 Hr Urine | $46.20 | $66.00 | $12.34–$69.30 | 11% above | 30% |
| Magnesium blood test CPT 83735 Magnesium Rbc 83735 | $46.20 | $66.00 | $12.34–$69.30 | 11% above | 30% |
| Magnesium blood test inpatient CPT 83735 Magnesium Rbc 83735 | $46.20 | $66.00 | $26.40–$59.40 | — | 30% |
| Magnesium blood test inpatient CPT 83735 Magnesium 24 Hr Urine | $46.20 | $66.00 | $26.40–$59.40 | — | 30% |
| Magnesium blood test inpatient CPT 83735 Magnesium Serum | $46.20 | $66.00 | $26.40–$59.40 | — | 30% |
| Magnesium blood test inpatient CPT 83735 Urorisk Magnesium 83735 | $46.20 | $66.00 | $26.40–$59.40 | — | 30% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Measles Igm 86765 | $37.80 | $54.00 | $10.10–$56.70 | 53% below | 30% |
| Measles (rubeola) antibody test CPT 86765 Measles Antibody Rubeola | $37.80 | $54.00 | $10.10–$56.70 | 53% below | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody Rubeola | $37.80 | $54.00 | $21.60–$48.60 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Measles Igm 86765 | $37.80 | $54.00 | $21.60–$48.60 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Poc Mono 86308 | $16.80 | $24.00 | $4.49–$25.20 | 55% below | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mono Poc | $36.40 | $52.00 | $9.72–$54.60 | 2% below | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Slide | $36.40 | $52.00 | $9.72–$54.60 | 2% below | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Poc Mono 86308 | $16.80 | $24.00 | $9.60–$21.60 | — | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile Slide | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Poc | $36.40 | $52.00 | $20.80–$46.80 | — | 30% |
| Mumps immunity blood test CPT 86735 Mumps Ab Igg | $86.80 | $124.00 | $23.19–$130.20 | 7% above | 30% |
| Mumps immunity blood test CPT 86735 Mumps Ab Igm | $86.80 | $124.00 | $23.19–$130.20 | 7% above | 30% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Ab Igm | $86.80 | $124.00 | $49.60–$111.60 | — | 30% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Ab Igg | $86.80 | $124.00 | $49.60–$111.60 | — | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa, Free | $121.10 | $173.00 | $32.35–$181.65 | 6% above | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa, Free | $121.10 | $173.00 | $69.20–$155.70 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen-Diag | $121.10 | $173.00 | $32.35–$181.65 | 10% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Post Prostatectomy | $121.10 | $173.00 | $32.35–$181.65 | 10% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Psa, Total | $121.10 | $173.00 | $32.35–$181.65 | 10% above | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen-Diag | $121.10 | $173.00 | $69.20–$155.70 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa, Total | $121.10 | $173.00 | $69.20–$155.70 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Post Prostatectomy | $121.10 | $173.00 | $69.20–$155.70 | — | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Imaged Thin Prep Pap Dia Lvl 2 | $116.90 | $167.00 | $31.23–$175.35 | 43% above | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Imaged Thin Prep Pap Dia Lvl 1 | $116.90 | $167.00 | $31.23–$175.35 | 43% above | 30% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Imaged Thin Prep Pap Dia Lvl 2 | $116.90 | $167.00 | $66.80–$150.30 | — | 30% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Imaged Thin Prep Pap Dia Lvl 1 | $116.90 | $167.00 | $66.80–$150.30 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Intact Of Parai | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intraop | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact without Calcium | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth, Mid Region C Of Parac | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth Intact Fine Needle Aspirat | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone, Intact | $193.20 | $276.00 | $51.61–$289.80 | 12% below | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Intact Of Parai | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Pth, Mid Region C Of Parac | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact without Calcium | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone, Intact | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Pth Intact Fine Needle Aspirat | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intraop | $193.20 | $276.00 | $110.40–$248.40 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Test 85730 | $33.60 | $48.00 | $8.98–$50.40 | 19% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Part Thrombo Time Ptt | $33.60 | $48.00 | $8.98–$50.40 | 19% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anti Ptt/Interpretation | $33.60 | $48.00 | $8.98–$50.40 | 19% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT LA Reflex Hex Phase Confir | $33.60 | $48.00 | $8.98–$50.40 | 19% below | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT LA Reflex Hex Phase Confir | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Test 85730 | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Part Thrombo Time Ptt | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anti Ptt/Interpretation | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum | $33.60 | $48.00 | $8.98–$50.40 | 3% above | 30% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum | $33.60 | $48.00 | $19.20–$43.20 | — | 30% |
| Potassium blood test CPT 84132 Potassium Plasma | $32.20 | $46.00 | $8.60–$48.30 | 1% above | 30% |
| Potassium blood test CPT 84132 Potassium RBC | $32.20 | $46.00 | $8.60–$48.30 | 1% above | 30% |
| Potassium blood test CPT 84132 Potassium Serum 84132 | $32.20 | $46.00 | $8.60–$48.30 | 1% above | 30% |
| Potassium blood test CPT 84132 Potassium Serum | $32.20 | $46.00 | $8.60–$48.30 | 1% above | 30% |
| Potassium blood test CPT 84132 Potassium K Plasma | $32.20 | $46.00 | $8.60–$48.30 | 1% above | 30% |
| Potassium blood test inpatient CPT 84132 Potassium Plasma | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Potassium blood test inpatient CPT 84132 Potassium RBC | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Potassium blood test inpatient CPT 84132 Potassium Serum | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Potassium blood test inpatient CPT 84132 Potassium Serum 84132 | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Potassium blood test inpatient CPT 84132 Potassium K Plasma | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Qnatal Advanced | $1,969.10 | $2,813.00 | $526.03–$2,953.65 | 16% below | 30% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Qnatal Advanced | $1,969.10 | $2,813.00 | $1,125.20–$2,531.70 | — | 30% |
| Progesterone blood test CPT 84144 Progesterone | $136.50 | $195.00 | $36.47–$204.75 | 1% below | 30% |
| Progesterone blood test inpatient CPT 84144 Progesterone | $136.50 | $195.00 | $78.00–$175.50 | — | 30% |
| Prolactin blood test CPT 84146 Prolactin | $127.40 | $182.00 | $34.03–$191.10 | 2% above | 30% |
| Prolactin blood test CPT 84146 Prolactin Total 84146 | $127.40 | $182.00 | $34.03–$191.10 | 2% above | 30% |
| Prolactin blood test CPT 84146 Prolactin Monomeric 84146 | $127.40 | $182.00 | $34.03–$191.10 | 2% above | 30% |
| Prolactin blood test inpatient CPT 84146 Prolactin Monomeric 84146 | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Prolactin blood test inpatient CPT 84146 Prolactin | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Prolactin blood test inpatient CPT 84146 Prolactin Total 84146 | $127.40 | $182.00 | $72.80–$163.80 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time 85610 | $28.00 | $40.00 | $7.48–$42.00 | 2% below | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time 85610 | $28.00 | $40.00 | $16.00–$36.00 | — | 30% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen | $97.30 | $139.00 | $25.99–$145.95 | 77% above | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Group A Strep Test | $63.00 | $90.00 | $16.83–$94.50 | at median | 30% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Group A Strep Test | $63.00 | $90.00 | $36.00–$81.00 | — | 30% |
| Renin blood test CPT 84244 Plasma Renin Activity | $105.00 | $150.00 | $28.05–$157.50 | 27% below | 30% |
| Renin blood test inpatient CPT 84244 Plasma Renin Activity | $105.00 | $150.00 | $60.00–$135.00 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant | $45.50 | $65.00 | $12.16–$68.25 | 16% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 Islet Cell Antibody | $45.50 | $65.00 | $12.16–$68.25 | 16% above | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Islet Cell Antibody | $45.50 | $65.00 | $26.00–$58.50 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Screen | $95.20 | $136.00 | $25.43–$142.80 | 13% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Ab Igm 86762 | $95.20 | $136.00 | $25.43–$142.80 | 13% above | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab Igm 86762 | $95.20 | $136.00 | $54.40–$122.40 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen | $95.20 | $136.00 | $54.40–$122.40 | — | 30% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis-Complete | $80.50 | $115.00 | $21.50–$120.75 | 9% below | 30% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis-Complete | $80.50 | $115.00 | $46.00–$103.50 | — | 30% |
| Sodium blood test CPT 84295 Sodium Na Serum | $25.20 | $36.00 | $6.73–$37.80 | 22% below | 30% |
| Sodium blood test inpatient CPT 84295 Sodium Na Serum | $25.20 | $36.00 | $14.40–$32.40 | — | 30% |
| Stool ova and parasites exam CPT 87177 Ova And Parasites Dir | $63.00 | $90.00 | $16.83–$94.50 | 7% above | 30% |
| Stool ova and parasites exam CPT 87177 Ova And Parasites Conc | $107.80 | $154.00 | $28.80–$161.70 | 84% above | 30% |
| Stool ova and parasites exam inpatient CPT 87177 Ova And Parasites Dir | $63.00 | $90.00 | $36.00–$81.00 | — | 30% |
| Stool ova and parasites exam inpatient CPT 87177 Ova And Parasites Conc | $107.80 | $154.00 | $61.60–$138.60 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool Occult | $14.00 | $20.00 | $3.74–$21.00 | 31% below | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool Occult Blood Screening | $14.00 | $20.00 | $3.74–$21.00 | 31% below | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool Occult | $14.00 | $20.00 | $8.00–$18.00 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool Occult Blood Screening | $14.00 | $20.00 | $8.00–$18.00 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Globin By Immunochem | $37.80 | $54.00 | $10.10–$56.70 | 5% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Globin By Immunochem | $37.80 | $54.00 | $21.60–$48.60 | — | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Panel IFA | $87.50 | $125.00 | $23.38–$131.25 | 17% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Antibody | $87.50 | $125.00 | $23.38–$131.25 | 17% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Fta - Abs | $87.50 | $125.00 | $23.38–$131.25 | 17% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Trepon Palli Anti Part Aggluti | $87.50 | $125.00 | $23.38–$131.25 | 17% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis AB Cascading | $87.50 | $125.00 | $23.38–$131.25 | 17% above | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Trepon Palli Anti Part Aggluti | $87.50 | $125.00 | $50.00–$112.50 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Antibody | $87.50 | $125.00 | $50.00–$112.50 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis AB Cascading | $87.50 | $125.00 | $50.00–$112.50 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fta - Abs | $87.50 | $125.00 | $50.00–$112.50 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Panel IFA | $87.50 | $125.00 | $50.00–$112.50 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Serology Rpr | $16.80 | $24.00 | $4.49–$25.20 | 40% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Quest Rpr w/Reflex 86592 | $16.80 | $24.00 | $4.49–$25.20 | 40% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Spinal/Body Fluid | $16.80 | $24.00 | $4.49–$25.20 | 40% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Serum 86592 | $16.80 | $24.00 | $4.49–$25.20 | 40% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Serology Rpr | $16.80 | $24.00 | $9.60–$21.60 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Quest Rpr w/Reflex 86592 | $16.80 | $24.00 | $9.60–$21.60 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl Spinal/Body Fluid | $16.80 | $24.00 | $9.60–$21.60 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl Serum 86592 | $16.80 | $24.00 | $9.60–$21.60 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Gold | $197.40 | $282.00 | $52.73–$296.10 | 36% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quanitferon Tb Gold 4 Tubes | $197.40 | $282.00 | $52.73–$296.10 | 36% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Gold Plus | $408.10 | $583.00 | $109.02–$612.15 | 32% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Tb Gold | $197.40 | $282.00 | $112.80–$253.80 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quanitferon Tb Gold 4 Tubes | $197.40 | $282.00 | $112.80–$253.80 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Tb Gold Plus | $408.10 | $583.00 | $233.20–$524.70 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone,Total Female/Peds | $169.40 | $242.00 | $45.25–$254.10 | 4% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total-Serum | $169.40 | $242.00 | $45.25–$254.10 | 4% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Of Test Tf | $169.40 | $242.00 | $45.25–$254.10 | 4% above | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total Of Test Tf | $169.40 | $242.00 | $96.80–$217.80 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone,Total Female/Peds | $169.40 | $242.00 | $96.80–$217.80 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total-Serum | $169.40 | $242.00 | $96.80–$217.80 | — | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thy Perox Ab Of Thyab/Per Ab | $38.50 | $55.00 | $10.28–$57.75 | 49% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Lkm-1 AbIgg Liver Kidney | $97.30 | $139.00 | $25.99–$145.95 | 29% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Microso Ab | $97.30 | $139.00 | $25.99–$145.95 | 29% above | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thy Perox Ab Of Thyab/Per Ab | $38.50 | $55.00 | $22.00–$49.50 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Microso Ab | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Lkm-1 AbIgg Liver Kidney | $97.30 | $139.00 | $55.60–$125.10 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh 3rd Generation | $81.20 | $116.00 | $21.69–$121.80 | 19% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Pediatric/Adolescent | $81.20 | $116.00 | $21.69–$121.80 | 19% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh | $112.00 | $160.00 | $29.92–$168.00 | 12% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh 3rd Generation | $81.20 | $116.00 | $46.40–$104.40 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Pediatric/Adolescent | $81.20 | $116.00 | $46.40–$104.40 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh | $112.00 | $160.00 | $64.00–$144.00 | — | 30% |
| Total IgE blood test CPT 82785 Immunoglobulin E Ige | $109.20 | $156.00 | $29.17–$163.80 | 5% above | 30% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E Ige | $109.20 | $156.00 | $62.40–$140.40 | — | 30% |
| Total cholesterol blood test CPT 82465 Cholesterol Serum | $31.50 | $45.00 | $8.41–$47.25 | 4% above | 30% |
| Total cholesterol blood test CPT 82465 Cholesterol/Lipo Electro | $31.50 | $45.00 | $8.41–$47.25 | 4% above | 30% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Serum | $31.50 | $45.00 | $18.00–$40.50 | — | 30% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol/Lipo Electro | $31.50 | $45.00 | $18.00–$40.50 | — | 30% |
| Total thyroxine (T4) blood test CPT 84436 T4 | $46.90 | $67.00 | $12.53–$70.35 | 4% above | 30% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 | $46.90 | $67.00 | $26.80–$60.30 | — | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 T3, Total | $94.50 | $135.00 | $25.24–$141.75 | 2% below | 30% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3, Total | $94.50 | $135.00 | $54.00–$121.50 | — | 30% |
| Transferrin blood test CPT 84466 Transferrin | $84.70 | $121.00 | $22.63–$127.05 | 2% below | 30% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $84.70 | $121.00 | $48.40–$108.90 | — | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Naa | $184.80 | $264.00 | $49.37–$277.20 | at median | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna Ql | $184.80 | $264.00 | $49.37–$277.20 | at median | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna | $184.80 | $264.00 | $49.37–$277.20 | at median | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Males | $184.80 | $264.00 | $49.37–$277.20 | at median | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Rna Ql | $184.80 | $264.00 | $105.60–$237.60 | — | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Rna | $184.80 | $264.00 | $105.60–$237.60 | — | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Males | $184.80 | $264.00 | $105.60–$237.60 | — | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Naa | $184.80 | $264.00 | $105.60–$237.60 | — | 30% |
| Triglycerides blood test CPT 84478 Triglyceride/Lipo Electro | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test CPT 84478 Triglycerides Pleural Fluid | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test CPT 84478 Vap Cholesterol Triglycende | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test CPT 84478 Triglyceride Body Fluid 84478 | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test CPT 84478 Triglycerides Serum | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test CPT 84478 Triglycerides Peritoneal Fluid | $39.90 | $57.00 | $10.66–$59.85 | 1% above | 30% |
| Triglycerides blood test inpatient CPT 84478 Vap Cholesterol Triglycende | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid 84478 | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Peritoneal Fluid | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Serum | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride/Lipo Electro | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Pleural Fluid | $39.90 | $57.00 | $22.80–$51.30 | — | 30% |
| Troponin test, quantitative CPT 84484 Troponin I | $59.50 | $85.00 | $15.90–$89.25 | 28% below | 30% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I | $59.50 | $85.00 | $34.00–$76.50 | — | 30% |
| Uric acid blood test CPT 84550 Uric Acid Serum | $32.20 | $46.00 | $8.60–$48.30 | 2% above | 30% |
| Uric acid blood test inpatient CPT 84550 Uric Acid Serum | $32.20 | $46.00 | $18.40–$41.40 | — | 30% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Reflex 5M/Ed | $22.40 | $32.00 | $5.98–$33.60 | 32% below | 30% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Rout + Micro | $22.40 | $32.00 | $5.98–$33.60 | 32% below | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Reflex 5M/Ed | $22.40 | $32.00 | $12.80–$28.80 | — | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Rout + Micro | $22.40 | $32.00 | $12.80–$28.80 | — | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Without Microscopy | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Glucose Qual | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Specific Gravity | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ketones | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urobilinogen | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Protein Qual | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Bilirubin Qual | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Blood Qual | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Ph | $17.50 | $25.00 | $4.68–$26.25 | 2% below | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urobilinogen | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Protein Qual | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Bilirubin Qual | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Blood Qual | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Glucose Qual | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Specific Gravity | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ketones | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Ph | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Without Microscopy | $17.50 | $25.00 | $10.00–$22.50 | — | 30% |
| Urinalysis without microscope exam, manual CPT 81002 Reducing Subs Urine | $19.60 | $28.00 | $5.24–$29.40 | 7% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 Poc Urine Dip 81002 | $19.60 | $28.00 | $5.24–$29.40 | 7% below | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Subs Urine | $19.60 | $28.00 | $11.20–$25.20 | — | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Poc Urine Dip 81002 | $19.60 | $28.00 | $11.20–$25.20 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $54.60 | $78.00 | $14.59–$81.90 | 4% below | 30% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Bacterial Culture 87086 | $54.60 | $78.00 | $14.59–$81.90 | 4% below | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Bacterial Culture 87086 | $54.60 | $78.00 | $31.20–$70.20 | — | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $54.60 | $78.00 | $31.20–$70.20 | — | 30% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin, 24 hr Micur | $42.00 | $60.00 | $11.22–$63.00 | 6% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Rand Urine Misp | $42.00 | $60.00 | $11.22–$63.00 | 6% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 Urine Albumin Excretion Rate | $42.00 | $60.00 | $11.22–$63.00 | 6% above | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Rand Urine Misp | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Urine Albumin Excretion Rate | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin, 24 hr Micur | $42.00 | $60.00 | $24.00–$54.00 | — | 30% |
| Urine pregnancy test, read by color change CPT 81025 Urine Hcg Qual/Point Of Care | $44.80 | $64.00 | $11.97–$67.20 | 21% above | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Hcg Qual/Point Of Care | $44.80 | $64.00 | $25.60–$57.60 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 | $100.10 | $143.00 | $26.74–$150.15 | 7% above | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 | $100.10 | $143.00 | $57.20–$128.70 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy | $145.60 | $208.00 | $38.90–$218.40 | 3% below | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 250H Total 82306 | $145.60 | $208.00 | $38.90–$218.40 | 3% below | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy | $145.60 | $208.00 | $83.20–$187.20 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 250H Total 82306 | $145.60 | $208.00 | $83.20–$187.20 | — | 30% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D, 1, 25-Dihydroxyrout | $250.60 | $358.00 | $66.95–$375.90 | 4% above | 30% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D, 1, 25-Dihydroxyrout | $250.60 | $358.00 | $143.20–$322.20 | — | 30% |
| Zinc blood test CPT 84630 Zinc Rbc 84630 | $76.30 | $109.00 | $20.38–$114.45 | 6% above | 30% |
| Zinc blood test CPT 84630 Zinc | $76.30 | $109.00 | $20.38–$114.45 | 6% above | 30% |
| Zinc blood test inpatient CPT 84630 Zinc Rbc 84630 | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| Zinc blood test inpatient CPT 84630 Zinc | $76.30 | $109.00 | $43.60–$98.10 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg, Beta, Quantitative | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Mate Hcg, Quant | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Total Quantitative Male | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Serum 84702 | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Serum Quant | $89.60 | $128.00 | $23.94–$134.40 | at median | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg, Beta, Quantitative | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Serum 84702 | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Mate Hcg, Quant | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Total Quantitative Male | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Serum Quant | $89.60 | $128.00 | $51.20–$115.20 | — | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Bx Breast w/wo Clip Lt 1 Site | $4,700.50 | $6,715.00 | $1,255.70–$7,050.75 | 20% above | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Bx Breast w/wo Clip Rt 1 Site | $4,700.50 | $6,715.00 | $1,255.70–$7,050.75 | 20% above | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Bx Breast w/wo Clip Lt 1 Site | $4,700.50 | $6,715.00 | $2,686.00–$6,043.50 | — | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 Bx Breast w/wo Clip Rt 1 Site | $4,700.50 | $6,715.00 | $2,686.00–$6,043.50 | — | 30% |
| Cardiac catheterization with coronary angiogram CPT 93458 Lhc,Cors, w/Wolv, w/Wo Cd | $8,818.60 | $12,598.00 | $2,355.83–$13,227.90 | at median | 30% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 Lhc,Cors, w/Wolv, w/Wo Cd | $8,818.60 | $12,598.00 | $5,039.20–$11,338.20 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Ext | $1,047.20 | $1,496.00 | $279.75–$1,570.80 | 29% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion | $1,047.20 | $1,496.00 | $279.75–$1,570.80 | 29% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Iha Cardioversion | $1,047.20 | $1,496.00 | $279.75–$1,570.80 | 29% below | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Iha Cardioversion | $1,047.20 | $1,496.00 | $598.40–$1,346.40 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion | $1,047.20 | $1,496.00 | $598.40–$1,346.40 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Ext | $1,047.20 | $1,496.00 | $598.40–$1,346.40 | — | 30% |
| Catheter ablation for atrial fibrillation CPT 93656 Comp Ep Eval w/Abl A Fib 93656 | $45,273.20 | $64,676.00 | $12,094.41–$67,909.80 | 46% above | 30% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 Comp Ep Eval w/Abl A Fib 93656 | $45,273.20 | $64,676.00 | $25,870.40–$58,208.40 | — | 30% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision | $1,491.00 | $2,130.00 | $852.00–$1,917.00 | — | 30% |
| Coronary stent placement, one artery CPT 92928 Stent, Bare Metal Major | $12,600.00 | $18,000.00 | $3,366.00–$18,900.00 | 38% below | 30% |
| Coronary stent placement, one artery inpatient CPT 92928 Stent, Bare Metal Major | $12,600.00 | $18,000.00 | $7,200.00–$16,200.00 | — | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Premal Lesion 1 | $245.00 | $350.00 | $65.45–$367.50 | 43% below | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruction Premal Lesion 1 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Earwax removal with instruments, one ear CPT 69210 Remove Impacted Cerumen | $105.00 | $150.00 | $28.05–$157.50 | 22% below | 30% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Cerumen | $105.00 | $150.00 | $60.00–$135.00 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Cerv/Thoracic Epid Steroid | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 56% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Cervical/Thoracic Single | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 56% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PN paravertebral sympath. bloc | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 56% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PN c-spine epidural steroid in | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 56% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Inj Cervical/Thoracic Single | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PN paravertebral sympath. bloc | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 PN c-spine epidural steroid in | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Inj Cerv/Thoracic Epid Steroid | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 Inj Para Facet Lum/Sac Sin R | $1,435.00 | $2,050.00 | $383.35–$2,152.50 | at median | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 Parafacet L/S Single Lev Rt | $1,435.00 | $2,050.00 | $383.35–$2,152.50 | at median | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 Parafacet L/S Single Lev Lt | $1,435.00 | $2,050.00 | $383.35–$2,152.50 | at median | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 Inj Para Facet Lum/Sac Sin L | $1,435.00 | $2,050.00 | $383.35–$2,152.50 | at median | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 Inj Para Facet Lum/Sac Sin L | $1,435.00 | $2,050.00 | $820.00–$1,845.00 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 Inj Para Facet Lum/Sac Sin R | $1,435.00 | $2,050.00 | $820.00–$1,845.00 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 Parafacet L/S Single Lev Lt | $1,435.00 | $2,050.00 | $820.00–$1,845.00 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 Parafacet L/S Single Lev Rt | $1,435.00 | $2,050.00 | $820.00–$1,845.00 | — | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Sonohysterography Sis 58340 | $228.90 | $327.00 | $61.15–$343.35 | 40% below | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Sonohysterography Sis 58340 | $228.90 | $327.00 | $130.80–$294.30 | — | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision/Drain Abscess Simple | $301.70 | $431.00 | $80.60–$452.55 | 41% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Incision of Abcess | $301.70 | $431.00 | $80.60–$452.55 | 41% below | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Incision of Abcess | $301.70 | $431.00 | $172.40–$387.90 | — | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision/Drain Abscess Simple | $301.70 | $431.00 | $172.40–$387.90 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection Single Tendon Sheath | $452.90 | $647.00 | $120.99–$679.35 | 21% below | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Single Tendon Sheath | $452.90 | $647.00 | $120.99–$679.35 | 21% below | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Single Tendon Sheath Inj | $452.90 | $647.00 | $120.99–$679.35 | 21% below | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Single Tendon Sheath Inj | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection Single Tendon Sheath | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Single Tendon Sheath | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/Inj Large Joint 20610 | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Large Joint | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Major Joint/Bursa Inj | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration Inj Large Joint | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp LG JT Shoulder/HIp/Knee | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Large Joint Asp/Injection Rt | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Large Joint Asp/Inj Lt 20610 | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Large Joint Asp/Inj Rt 20610 | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Wrist Arthrogram Inj Lt 20610 | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Large Joint Asp/Inj Lt 20605 | $452.90 | $647.00 | $120.99–$679.35 | 3% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Large Joint | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Major Joint/Bursa Inj | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Asp LG JT Shoulder/HIp/Knee | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration Inj Large Joint | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Asp/Inj Large Joint 20610 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Large Joint Asp/Injection Rt | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Large Joint Asp/Inj Lt 20605 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Large Joint Asp/Inj Lt 20610 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Large Joint Asp/Inj Rt 20610 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Wrist Arthrogram Inj Lt 20610 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp Inter Joint Wrist/Ankle | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PN lumbar sympathetic block | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Asp/Inj Intermediate Joint | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Intermediate Joint/Bursa Inj | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Med Joint | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Intermediate Joint Asp/Inj Rt | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Intermediate Joint Asp/Inj Rt | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Intermediate Joint Asp/Inj Lt | $452.90 | $647.00 | $120.99–$679.35 | 28% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp/Inj Intermediate Joint | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Med Joint | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Intermediate Joint/Bursa Inj | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Asp Inter Joint Wrist/Ankle | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PN lumbar sympathetic block | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Intermediate Joint Asp/Inj Lt | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Intermediate Joint Asp/Inj Rt | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Intermediate Joint Asp/Inj Rt | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP SM Joint Fingers/Toes | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Small Joint 20600 | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Small Joint/Bursa Inj | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Small Joint | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PN transforam. add l-sp level | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Small Joint Asp/Inj Lt 20605 | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Small Joint Asp/Inj Rt 20600 | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Small Joint Asp/Inj Lt 20600 | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 Small Joint Asp/Inj Rt | $452.90 | $647.00 | $120.99–$679.35 | 10% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PN transforam. add l-sp level | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis Small Joint | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP SM Joint Fingers/Toes | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Small Joint/Bursa Inj | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/Inj Small Joint 20600 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Small Joint Asp/Inj Lt 20605 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Small Joint Asp/Inj Lt 20600 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Small Joint Asp/Inj Rt 20600 | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 Small Joint Asp/Inj Rt | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Interm Trunk Ext 25cm | $607.60 | $868.00 | $162.32–$911.40 | 4% above | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Interm Trunk Ext 25cm | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Left heart catheterization, diagnostic CPT 93452 L Heart Cath w/Wo Lv | $4,550.00 | $6,500.00 | $1,215.50–$6,825.00 | 30% below | 30% |
| Left heart catheterization, diagnostic inpatient CPT 93452 L Heart Cath w/Wo Lv | $4,550.00 | $6,500.00 | $2,600.00–$5,850.00 | — | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Lumbar/Sacra/Epid Steroid | $1,120.00 | $1,600.00 | $299.20–$1,680.00 | 47% below | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Lumb/Sacral Epid Steroid | $1,120.00 | $1,600.00 | $299.20–$1,680.00 | 47% below | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection Lumbar/Sacral Single | $1,120.00 | $1,600.00 | $299.20–$1,680.00 | 47% below | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Lumbar/Sacra/Epid Steroid | $1,120.00 | $1,600.00 | $640.00–$1,440.00 | — | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection Lumbar/Sacral Single | $1,120.00 | $1,600.00 | $640.00–$1,440.00 | — | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Lumb/Sacral Epid Steroid | $1,120.00 | $1,600.00 | $640.00–$1,440.00 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Trans Steroi Inj Lum Sin 64483 | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PN single view spine | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 Transforam Epi L/S Sing Lev Rt | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 Inj Transf Steroid Lum Sing Lt | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 Inj Transf Steroid Lum Sing Rt | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 Transforam Epi L/S Sing Lev Lt | $1,659.70 | $2,371.00 | $443.38–$2,489.55 | 13% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PN single view spine | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Trans Steroi Inj Lum Sin 64483 | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 Transforam Epi L/S Sing Lev Rt | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 Inj Transf Steroid Lum Sing Lt | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 Inj Transf Steroid Lum Sing Rt | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 Transforam Epi L/S Sing Lev Lt | $1,659.70 | $2,371.00 | $948.40–$2,133.90 | — | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision Ben Les Trunk <05 | $1,066.80 | $1,524.00 | $284.99–$1,600.20 | 20% below | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision Ben Les Trunk <05 | $1,066.80 | $1,524.00 | $609.60–$1,371.60 | — | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excision Ben Les Face <05 | $1,066.80 | $1,524.00 | $284.99–$1,600.20 | 40% below | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excision Ben Les Face <05 | $1,066.80 | $1,524.00 | $609.60–$1,371.60 | — | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T9 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T8 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T7 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T6 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T5 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T4 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T3 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T2 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple T1 | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Simple Ta | $245.00 | $350.00 | $65.45–$367.50 | 48% below | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T2 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T8 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T7 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T6 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T5 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T4 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T3 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple Ta | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T1 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Simple T9 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 Greater Occipital Nerve Block | $560.70 | $801.00 | $149.79–$841.05 | 1% below | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Greater Occipital Nerve Block | $560.70 | $801.00 | $320.40–$720.90 | — | 30% |
| Pacemaker implant (dual chamber) CPT 33208 New/Repl Pcr W Arv Lead 33208 | $14,000.00 | $20,000.00 | $3,740.00–$21,000.00 | 10% above | 30% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 New/Repl Pcr W Arv Lead 33208 | $14,000.00 | $20,000.00 | $8,000.00–$18,000.00 | — | 30% |
| Paracentesis with imaging guidance CPT 49083 Paracentesis With Guide | $2,100.00 | $3,000.00 | $561.00–$3,150.00 | 25% above | 30% |
| Paracentesis with imaging guidance CPT 49083 Paracentesis w Guide 49083 | $2,100.00 | $3,000.00 | $561.00–$3,150.00 | 25% above | 30% |
| Paracentesis with imaging guidance CPT 49083 Paracentesis w/Guide 49083 | $2,100.00 | $3,000.00 | $561.00–$3,150.00 | 25% above | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis w/Guide 49083 | $2,100.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis w Guide 49083 | $2,100.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis With Guide | $2,100.00 | $3,000.00 | $1,200.00–$2,700.00 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T3 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent Ta | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T1 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T4 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T5 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T6 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T7 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T8 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T9 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Nail Permanent T2 | $607.60 | $868.00 | $162.32–$911.40 | 27% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T8 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T1 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T2 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T3 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T7 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T6 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T5 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T4 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent T9 | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Nail Permanent Ta | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Prostate biopsy CPT 55700 Biospy Prostate | $2,450.00 | $3,500.00 | $654.50–$3,675.00 | 36% below | 30% |
| Prostate biopsy CPT 55700 Biopsy Prostate 55700 | $2,450.00 | $3,500.00 | $654.50–$3,675.00 | 36% below | 30% |
| Prostate biopsy inpatient CPT 55700 Biospy Prostate | $2,450.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 30% |
| Prostate biopsy inpatient CPT 55700 Biopsy Prostate 55700 | $2,450.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy Facet Int Lum/Sac | $2,450.00 | $3,500.00 | $654.50–$3,675.00 | 18% below | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 Radiofrequency Ls 1St Lvl Lt | $2,450.00 | $3,500.00 | $654.50–$3,675.00 | 18% below | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 Radiofrequency Ls 1St Lvl Rt | $2,450.00 | $3,500.00 | $654.50–$3,675.00 | 18% below | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destroy Facet Int Lum/Sac | $2,450.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 Radiofrequency Ls 1St Lvl Rt | $2,450.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 Radiofrequency Ls 1St Lvl Lt | $2,450.00 | $3,500.00 | $1,400.00–$3,150.00 | — | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 Ir Fb Subcutaneous Simple | $607.60 | $868.00 | $162.32–$911.40 | 12% above | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 Removal Fb Subcuatane Simpl | $607.60 | $868.00 | $162.32–$911.40 | 12% above | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal Fb Subcuatane Simpl | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Ir Fb Subcutaneous Simple | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Short arm cast (elbow to hand) CPT 29075 Casting Short Arm | $411.60 | $588.00 | $109.96–$617.40 | 1% below | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Casting Short Arm | $411.60 | $588.00 | $235.20–$529.20 | — | 30% |
| Short arm splint (forearm and hand) CPT 29125 Application Short Arm-Static | $210.00 | $300.00 | $56.10–$315.00 | 33% below | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm-Static | $210.00 | $300.00 | $120.00–$270.00 | — | 30% |
| Short leg cast (below the knee) CPT 29405 Application Short Leg Cast | $411.60 | $588.00 | $109.96–$617.40 | 21% below | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast | $411.60 | $588.00 | $235.20–$529.20 | — | 30% |
| Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint | $244.30 | $349.00 | $65.26–$366.45 | 47% below | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Splint | $244.30 | $349.00 | $139.60–$314.10 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple,Repair Trnk Ext<26 cm | $240.10 | $343.00 | $64.14–$360.15 | 53% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple,Repair Trnk Ext<26 cm | $240.10 | $343.00 | $137.20–$308.70 | — | 30% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion | $607.60 | $868.00 | $162.32–$911.40 | 8% below | 30% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion | $607.60 | $868.00 | $347.20–$781.20 | — | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Excision Mal Les Trunk <05 | $1,066.80 | $1,524.00 | $284.99–$1,600.20 | 2% above | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Excision Mal Les Trunk <05 | $1,066.80 | $1,524.00 | $609.60–$1,371.60 | — | 30% |
| Skin tag removal, up to 15 tags CPT 11200 Ex Skin Tags Up To 1-15 Lesion | $245.00 | $350.00 | $65.45–$367.50 | 59% below | 30% |
| Skin tag removal, up to 15 tags CPT 11200 Remove Skin Tag <15 | $245.00 | $350.00 | $65.45–$367.50 | 59% below | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Ex Skin Tags Up To 1-15 Lesion | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Remove Skin Tag <15 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diag 62270 | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 14% below | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diag | $1,048.60 | $1,498.00 | $280.13–$1,572.90 | 14% below | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diag 62270 | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diag | $1,048.60 | $1,498.00 | $599.20–$1,348.20 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Repair Trnk Ext 26-75 | $262.50 | $375.00 | $70.12–$393.75 | 50% below | 30% |
| 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 Repair Trnk Ext 26-75 | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair Wnd Face Simple <25cm | $211.40 | $302.00 | $56.47–$317.10 | 59% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair Wnd Face Simple <25cm | $211.40 | $302.00 | $120.80–$271.80 | — | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Lesion | $501.90 | $717.00 | $134.08–$752.85 | 11% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Lesion | $501.90 | $717.00 | $286.80–$645.30 | — | 30% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/Imaging 32555 | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 29% below | 30% |
| Thoracentesis with imaging guidance CPT 32555 US Guide Thoracentesis 32555 | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 29% below | 30% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/Guidance 32555 | $1,050.00 | $1,500.00 | $280.50–$1,575.00 | 29% below | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/Guidance 32555 | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/Imaging 32555 | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Guide Thoracentesis 32555 | $1,050.00 | $1,500.00 | $600.00–$1,350.00 | — | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Single Mult Trig Pts Musc | $340.20 | $486.00 | $90.88–$510.30 | 37% below | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Point 1 Or 2 Muscles | $452.90 | $647.00 | $120.99–$679.35 | 16% below | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Single Mult Trig Pts Musc | $340.20 | $486.00 | $194.40–$437.40 | — | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger Point 1 Or 2 Muscles | $452.90 | $647.00 | $258.80–$582.30 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Bx Breast w/wo Clip Rt 1 Site | $2,437.40 | $3,482.00 | $651.13–$3,656.10 | 32% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Bx Breast w/wo Clip Lt 1 Site | $2,437.40 | $3,482.00 | $651.13–$3,656.10 | 32% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 Bx Breast w/wo Clip Lt 1 Site | $2,437.40 | $3,482.00 | $1,392.80–$3,133.80 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 Bx Breast w/wo Clip Rt 1 Site | $2,437.40 | $3,482.00 | $1,392.80–$3,133.80 | — | 30% |
| Vein ablation, radiofrequency, first vein CPT 36475 Endo Ven Rf Ablation Eurfa | $11,162.20 | $15,946.00 | $2,981.90–$16,743.30 | 19% above | 30% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endo Ven Rf Ablation Eurfa | $11,162.20 | $15,946.00 | $6,378.40–$14,351.40 | — | 30% |
| Wart removal, up to 14 warts CPT 17110 Destruction Benign Lesion 1-14 | $245.00 | $350.00 | $65.45–$367.50 | 56% below | 30% |
| Wart removal, up to 14 warts inpatient CPT 17110 Destruction Benign Lesion 1-14 | $245.00 | $350.00 | $140.00–$315.00 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Skin/Tissue | $1,232.70 | $1,761.00 | $329.31–$1,849.05 | 14% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Skin/Tissue | $1,232.70 | $1,761.00 | $704.40–$1,584.90 | — | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 PN thoracic epidural steroid | $660.80 | $944.00 | $176.53–$991.20 | 30% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Adminstration | $660.80 | $944.00 | $176.53–$991.20 | 30% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 PN medium joint injection | $660.80 | $944.00 | $176.53–$991.20 | 30% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 PN major joint injection | $660.80 | $944.00 | $176.53–$991.20 | 30% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 PN SI joint steroid injection | $660.80 | $944.00 | $176.53–$991.20 | 30% below | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PN medium joint injection | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 8-9 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 6-7 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 5-6-Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 5-6 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 4-5 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 3-4 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 2-3 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 1-2 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration <1Hr | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 OB Blood Administration Per Hr | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Per Hour | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration <1 Hr | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 1-2 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 2-3 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 3-4 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 4-5 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 5-6 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 6-7 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 7-8 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 8-9 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 9-10 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 10-11 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration 11-12 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PN major joint injection | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PN SI joint steroid injection | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PN thoracic epidural steroid | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Service | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Per Hr | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 11-12 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 10-11 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Adminstration 9-10 Hrs | $660.80 | $944.00 | $377.60–$849.60 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hhn Treatments | $114.10 | $163.00 | $30.48–$171.15 | 49% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction | $114.10 | $163.00 | $30.48–$171.15 | 49% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Treatment | $114.10 | $163.00 | $30.48–$171.15 | 49% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction | $114.10 | $163.00 | $65.20–$146.70 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hhn Treatments | $114.10 | $163.00 | $65.20–$146.70 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ippb Treatment | $114.10 | $163.00 | $65.20–$146.70 | — | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Op5N Chemotherapy Iv <1 Hr | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 PN thoracic facet joint inj | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Op5M Chemo-Iv 00-01Hrs | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Inf 1 Hr | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Op5M Chemo-Iv New 00-01 Hours | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Ops4N Chemotherapy Iv <1 Hr | $517.30 | $739.00 | $138.19–$775.95 | 29% below | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Ops4N Chemotherapy Iv <1 Hr | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 PN thoracic facet joint inj | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Op5M Chemo-Iv 00-01Hrs | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Op5N Chemotherapy Iv <1 Hr | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Op5M Chemo-Iv New 00-01 Hours | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Inf 1 Hr | $517.30 | $739.00 | $295.60–$665.10 | — | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 Emerg Visit Level cc >210 | $1,190.00 | $1,700.00 | $317.90–$1,785.00 | 37% below | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care | $1,190.00 | $1,700.00 | $317.90–$1,785.00 | 37% below | 30% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care | $1,190.00 | $1,700.00 | $680.00–$1,530.00 | — | 30% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Emerg Visit Level cc >210 | $1,190.00 | $1,700.00 | $680.00–$1,530.00 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG w/Rhythm Strip | $214.90 | $307.00 | $57.41–$322.35 | 23% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ER EKG | $214.90 | $307.00 | $57.41–$322.35 | 23% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 ECG 12 Lead Right | $214.90 | $307.00 | $57.41–$322.35 | 23% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge one side CPT 93005 ED ECG 12 Lead Right | $214.90 | $307.00 | $57.41–$322.35 | 23% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG w/Rhythm Strip | $214.90 | $307.00 | $122.80–$276.30 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ER EKG | $214.90 | $307.00 | $122.80–$276.30 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 ECG 12 Lead Right | $214.90 | $307.00 | $122.80–$276.30 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient one side CPT 93005 ED ECG 12 Lead Right | $214.90 | $307.00 | $122.80–$276.30 | — | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emerg Visit Level 1 0-20 | $140.00 | $200.00 | $37.40–$210.00 | 54% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emerg Visit Level 1 0-20 | $140.00 | $200.00 | $80.00–$180.00 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emerg Visit Level 2 21-35 | $280.00 | $400.00 | $74.80–$420.00 | 42% below | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emerg Visit Level 2 21-35 | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emerg Visit Level 3 36-70 | $455.00 | $650.00 | $121.55–$682.50 | 39% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emerg Visit Level 3 36-70 | $455.00 | $650.00 | $260.00–$585.00 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emerg Visit Level 4 71-140 | $595.00 | $850.00 | $158.95–$892.50 | 51% below | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emerg Visit Level 4 71-140 | $595.00 | $850.00 | $340.00–$765.00 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emerg Visit Level 5 141-210 | $1,083.60 | $1,548.00 | $289.48–$1,625.40 | 32% below | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emerg Visit Level 5 141-210 | $1,083.60 | $1,548.00 | $619.20–$1,393.20 | — | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test With Isotope | $1,226.40 | $1,752.00 | $327.62–$1,839.60 | 30% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test With Lexiscan | $1,226.40 | $1,752.00 | $327.62–$1,839.60 | 30% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test | $1,226.40 | $1,752.00 | $327.62–$1,839.60 | 30% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 St Test/Procainamide Challenge | $1,226.40 | $1,752.00 | $327.62–$1,839.60 | 30% above | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test | $1,226.40 | $1,752.00 | $700.80–$1,576.80 | — | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test With Lexiscan | $1,226.40 | $1,752.00 | $700.80–$1,576.80 | — | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 St Test/Procainamide Challenge | $1,226.40 | $1,752.00 | $700.80–$1,576.80 | — | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test With Isotope | $1,226.40 | $1,752.00 | $700.80–$1,576.80 | — | 30% |
| Family therapy with the patient, 50 minutes CPT 90847 Ft Family Therapy @30 Min | $262.50 | $375.00 | $70.12–$393.75 | 13% below | 30% |
| Family therapy with the patient, 50 minutes CPT 90847 Ftnp Coll Family Ther W Pt 15 | $262.50 | $375.00 | $70.12–$393.75 | 13% below | 30% |
| Family therapy with the patient, 50 minutes CPT 90847 Ft Family Therapy @15 Min | $262.50 | $375.00 | $70.12–$393.75 | 13% below | 30% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Ftnp Coll Family Ther W Pt 15 | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Ft Family Therapy @15 Min | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Ft Family Therapy @30 Min | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Family therapy without the patient, 50 minutes CPT 90846 Ft Collateral Fam Tx @15 Min | $247.10 | $353.00 | $66.01–$370.65 | 38% above | 30% |
| Family therapy without the patient, 50 minutes CPT 90846 Ft Collateral Fam Tx | $247.10 | $353.00 | $66.01–$370.65 | 38% above | 30% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Ft Collateral Fam Tx | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Ft Collateral Fam Tx @15 Min | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Group psychotherapy session CPT 90853 Telehlth Grp Ther Alcohol 30m | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Grp Ther Drug Per 30 Min | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Grp Ther Alcohol Per 30 Min | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Telehealth Part Hosp Drug HR | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Intensive Op Alcohol Per Hr | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Intensive Op Drug Per Hr | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Ft Group Therapy @15 Min | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Intensive Op Adol/Child | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Ft Group Therapy | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Outpatient Opiate Detox Drug | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Telehlth Intensive Alcohol HR | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session CPT 90853 Grp Ther Alcohol Per 15 Min | $177.80 | $254.00 | $47.50–$266.70 | 24% above | 30% |
| Group psychotherapy session inpatient CPT 90853 Intensive Op Alcohol Per Hr | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Telehlth Grp Ther Alcohol 30m | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Telehlth Intensive Alcohol HR | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Outpatient Opiate Detox Drug | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Ft Group Therapy | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Intensive Op Adol/Child | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Ft Group Therapy @15 Min | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Intensive Op Drug Per Hr | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Grp Ther Alcohol Per 15 Min | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Telehealth Part Hosp Drug HR | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Grp Ther Alcohol Per 30 Min | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| Group psychotherapy session inpatient CPT 90853 Grp Ther Drug Per 30 Min | $177.80 | $254.00 | $101.60–$228.60 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Op3M Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Inf Hydration 1 Hr | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV Infusion Init | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PN brachial plexus nerve inj | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INT 31-60MN | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OpOB Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $88.08–$494.55 | 24% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Inf Hydration 1 Hr | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PN brachial plexus nerve inj | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV Infusion Init | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INT 31-60MN | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Op3M Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OB Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OpOB Iv Inf, Hydra 1 Hr | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV infusion of a medicine, first hour CPT 96365 Intraven Infusion | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Drug Therapy 1 hr | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 Iv Inf Ther/Prop New 1 Hr | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy <= 1 HR | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV THERAPY <=1 HR | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 Op3M Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 OB Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag IV Inf Init | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV Inf Remdesivir Infus 1 hour | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $93.50–$525.00 | 22% below | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag IV Inf Init | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Intraven Infusion | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Drug Therapy 1 hr | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Iv Inf Ther/Prop New 1 Hr | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy <= 1 HR | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY <=1 HR | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Op3M Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 OB Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Inf Remdesivir Infus 1 hour | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Iv Inf Ther/Prop 1 Hr | $350.00 | $500.00 | $200.00–$450.00 | — | 30% |
| IV push of a medicine, first drug CPT 96374 PN sciatic nerve injection | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Op Iv Inj, Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj IV Push | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Iv Inj Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 OpOB Iv Inj, Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 OB Iv Inj, Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Op3M Iv Inj, Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 INJECT IV PUSH SNG/INT | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Inject IV Push Sng/Int | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Iv Injection Initial | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 Intravenous Push | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug CPT 96374 NB IV PUSH MED INIT | $329.70 | $471.00 | $88.08–$494.55 | at median | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Inject IV Push Sng/Int | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Intravenous Push | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 PN sciatic nerve injection | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 NB IV PUSH MED INIT | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj IV Push | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Iv Inj Initial | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Iv Injection Initial | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 OpOB Iv Inj, Initial | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 OB Iv Inj, Initial | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 Op3M Iv Inj, Initial | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| IV push of a medicine, first drug inpatient CPT 96374 INJECT IV PUSH SNG/INT | $329.70 | $471.00 | $188.40–$423.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PN ilioguinal nerve injection | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj SC/IM | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im/Subq Inj Initial/Additional | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OpOB Im Inj, Initial | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB Im Inj, Initial | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Op3M Im Inj, Initial | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inject IV Push Sng/Int | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/Subq Inj | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im/Subq Inj New Initial | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im/Subq Inj Initial | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Subq OR Im | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OpsOB Inj Of Rhogam | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Opmt4S Inj Of Rhogam | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ops3M Inj Of Rhogam | $98.70 | $141.00 | $26.37–$148.05 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Subq OR Im | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inject IV Push Sng/Int | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB Im Inj, Initial | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OpOB Im Inj, Initial | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/Subq Inj | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Im/Subq Inj Initial/Additional | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PN ilioguinal nerve injection | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Op3M Im Inj, Initial | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj SC/IM | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Im/Subq Inj New Initial | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Im/Subq Inj Initial | $98.70 | $141.00 | $56.40–$126.90 | — | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Evaluation Drug | $247.10 | $353.00 | $66.01–$370.65 | 7% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Evaluation Psych Alcohol CRNP | $247.10 | $353.00 | $66.01–$370.65 | 7% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Evaluation Drug | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Evaluation Psych Alcohol CRNP | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re-ED @15Min | $161.00 | $230.00 | $43.01–$241.50 | 25% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Re Ed @15 Min | $161.00 | $230.00 | $43.01–$241.50 | 25% above | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Re Ed @15 Min | $161.00 | $230.00 | $92.00–$207.00 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Re-ED @15Min | $161.00 | $230.00 | $92.00–$207.00 | — | 30% |
| New patient office visit, about 30 minutes CPT 99203 Clinic Visit New 30 Minutes | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 Drug, New Pat Low Detail | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 Alchol, Op New Pat Low Detail | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 Drug, Off Visit New Pt Low | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 Consult Level 2 30 | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 New Patient Level 3 30 | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 Alcohol, Op New Pt Low Detail | $185.50 | $265.00 | $49.56–$278.25 | 22% below | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Drug, Off Visit New Pt Low | $185.50 | $265.00 | $106.00–$238.50 | — | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Alchol, Op New Pat Low Detail | $185.50 | $265.00 | $106.00–$238.50 | — | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Drug, New Pat Low Detail | $185.50 | $265.00 | $106.00–$238.50 | — | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Alcohol, Op New Pt Low Detail | $185.50 | $265.00 | $106.00–$238.50 | — | 30% |
| New patient office visit, about 45 minutes CPT 99204 Clinic Visit New 45 Minutes | $235.90 | $337.00 | $63.02–$353.85 | 21% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 New Patient Level 4 45 | $235.90 | $337.00 | $63.02–$353.85 | 21% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 Alcohol, Op New Pt Mod Complex | $235.90 | $337.00 | $63.02–$353.85 | 21% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 Alchol, Op New Pt Mod Comp | $235.90 | $337.00 | $63.02–$353.85 | 21% below | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Alcohol, Op New Pt Mod Complex | $235.90 | $337.00 | $134.80–$303.30 | — | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Alchol, Op New Pt Mod Comp | $235.90 | $337.00 | $134.80–$303.30 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Clinic Visit New up to 20 Min | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Surgical Visit New Emp Health | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Surgical Visit Estab EmpHealth | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Hepatitis B Vaccine Emp.Health | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Medical Visit Estab Emp Health | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Medication Clinic Hos | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Drug,Visit New Pt Focus Expan | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Alcohol,Op New Pt Focus Expand | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Drug, New Pat Expanded | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Patient Level 2 up to 20 | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Medical Visit New Emp Health | $159.60 | $228.00 | $42.64–$239.40 | 13% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Drug, New Pat Expanded | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Alcohol,Op New Pt Focus Expand | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Drug,Visit New Pt Focus Expan | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Medication Clinic Hos | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 105 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 75 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 60 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 45 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 30 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 90 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT Indv Init Assess @15 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Op Diet Counsel Up To 120 Min | $125.30 | $179.00 | $33.47–$187.95 | 149% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT Indv Init Assess @15 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 30 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 45 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 60 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 75 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 90 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 105 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Op Diet Counsel Up To 120 Min | $125.30 | $179.00 | $71.60–$161.10 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Complexity | $329.00 | $470.00 | $87.89–$493.50 | 3% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Complexity | $329.00 | $470.00 | $188.00–$423.00 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Reevaluation | $329.00 | $470.00 | $87.89–$493.50 | 2% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Reevaluation | $329.00 | $470.00 | $188.00–$423.00 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Tech @15Min | $147.70 | $211.00 | $39.46–$221.55 | 12% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Tech @15 Min | $147.70 | $211.00 | $39.46–$221.55 | 12% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Tech @15 Min | $147.70 | $211.00 | $84.40–$189.90 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Tech @15Min | $147.70 | $211.00 | $84.40–$189.90 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Exercise Attended @15Min | $165.20 | $236.00 | $44.13–$247.80 | 25% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Lymph Pt Ther Exercise | $165.20 | $236.00 | $44.13–$247.80 | 25% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Exercise @15 Min | $165.20 | $236.00 | $44.13–$247.80 | 25% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Exercise Attended @15Min | $165.20 | $236.00 | $94.40–$212.40 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Lymph Pt Ther Exercise | $165.20 | $236.00 | $94.40–$212.40 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Exercise @15 Min | $165.20 | $236.00 | $94.40–$212.40 | — | 30% |
| Psychiatric evaluation with medical services CPT 90792 Ft Intake Assessment | $247.10 | $353.00 | $66.01–$370.65 | 25% below | 30% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Ft Intake Assessment | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Psychotherapy session, 30 minutes CPT 90832 Indv Ther-Drug 30 Min | $247.10 | $353.00 | $66.01–$370.65 | at median | 30% |
| Psychotherapy session, 30 minutes CPT 90832 Indv Ther-Alcohol 30 Min | $247.10 | $353.00 | $66.01–$370.65 | at median | 30% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Indv Ther-Drug 30 Min | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Indv Ther-Alcohol 30 Min | $247.10 | $353.00 | $141.20–$317.70 | — | 30% |
| Psychotherapy session, 45 minutes CPT 90834 Drug, 45 Minute Individual | $262.50 | $375.00 | $70.12–$393.75 | 3% above | 30% |
| Psychotherapy session, 45 minutes CPT 90834 Alcohol, 45 Min Individual | $262.50 | $375.00 | $70.12–$393.75 | 3% above | 30% |
| Psychotherapy session, 45 minutes CPT 90834 Telehealth Drug 45 Min Indv | $262.50 | $375.00 | $70.12–$393.75 | 3% above | 30% |
| Psychotherapy session, 45 minutes CPT 90834 Telehealth Alcohol 45Min Indv | $262.50 | $375.00 | $70.12–$393.75 | 3% above | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Alcohol, 45 Min Individual | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Drug, 45 Minute Individual | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Telehealth Drug 45 Min Indv | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Telehealth Alcohol 45Min Indv | $262.50 | $375.00 | $150.00–$337.50 | — | 30% |
| Psychotherapy session, 60 minutes CPT 90837 Ft Indv Ther 60 Min | $280.00 | $400.00 | $74.80–$420.00 | 7% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 Indv Ther-Alcohol 60 Min | $280.00 | $400.00 | $74.80–$420.00 | 7% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 Ft Indv Therapy 60Min | $280.00 | $400.00 | $74.80–$420.00 | 7% below | 30% |
| Psychotherapy session, 60 minutes CPT 90837 Indv Ther-Drug 60 Min | $280.00 | $400.00 | $74.80–$420.00 | 7% below | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Indv Ther-Drug 60 Min | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Ft Indv Ther 60 Min | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Ft Indv Therapy 60Min | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Indv Ther-Alcohol 60 Min | $280.00 | $400.00 | $160.00–$360.00 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Visit Estab High Sever | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Op Wound Care Visit Level V | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Op Visit Estab 40 Min | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Drug, Estab Pt High Complexity | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Alcohol, Op Estab Pt High Comp | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Drug, Op Estab Pt High Comp | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Estab Patient Lvl 4 40 | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Alcohol, Estab Pt High Comp | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Prep Charge 40 Min EST | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Clinic Visit New 60 Min | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Clinic Visit 40 Min Est | $227.50 | $325.00 | $60.78–$341.25 | 16% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Alcohol, Estab Pt High Comp | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Alcohol, Op Estab Pt High Comp | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Drug, Estab Pt High Complexity | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Drug, Op Estab Pt High Comp | $227.50 | $325.00 | $130.00–$292.50 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Op Wound Care Visit Level III | $126.00 | $180.00 | $33.66–$189.00 | 32% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Op Visit Estab 15 Min | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Prep Charge 15 Min EST | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Op Clinic Visit Level 3 15Min | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Alcohol, Estab Pt Focu Low Com | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Drug, Estab Pt Foc Low Complex | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Alcohol, Estab Focu Low Comp | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Drug, Op Estab Low Comp | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Estab Patient Lvl 3 15 | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Clinic Visit 15 Min Est | $157.50 | $225.00 | $42.08–$236.25 | 15% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Alcohol, Estab Focu Low Comp | $157.50 | $225.00 | $90.00–$202.50 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Drug, Estab Pt Foc Low Complex | $157.50 | $225.00 | $90.00–$202.50 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Alcohol, Estab Pt Focu Low Com | $157.50 | $225.00 | $90.00–$202.50 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Drug, Op Estab Low Comp | $157.50 | $225.00 | $90.00–$202.50 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Op Wound Care Visit Level IV | $163.10 | $233.00 | $43.57–$244.65 | 19% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Op Visit Estab 25 Min | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Clinic Visit 25 Min Est | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Estab Patient Lv 4 25 | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Drug, Estab Pt Mod Complex | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Drug, Op Estab Mod Comp | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Estab Patient Lvl 4 25 | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Prep Charge 25 Min EST | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Alcohol, Op Est Pt Mod Comp | $192.50 | $275.00 | $51.42–$288.75 | 5% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Drug, Op Estab Mod Comp | $192.50 | $275.00 | $110.00–$247.50 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Drug, Estab Pt Mod Complex | $192.50 | $275.00 | $110.00–$247.50 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Alcohol, Op Est Pt Mod Comp | $192.50 | $275.00 | $110.00–$247.50 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Op Wound Care Visit Level II | $111.30 | $159.00 | $29.73–$166.95 | 31% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Estab Patient Lvl 2 10 | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Alcohol, Op Est Pt Focused | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Op Visit Estab 10 Min | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Clinic Visit 10 Minutes Est | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prep Charge 10 Min EST | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Drug, Off Op Estab Pt Focused | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Alcohol, Op Establish Pt Focus | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Drug, Estab Pat Focused | $119.70 | $171.00 | $31.98–$179.55 | 26% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Drug, Estab Pat Focused | $119.70 | $171.00 | $68.40–$153.90 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Drug, Off Op Estab Pt Focused | $119.70 | $171.00 | $68.40–$153.90 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Alcohol, Op Est Pt Focused | $119.70 | $171.00 | $68.40–$153.90 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Alcohol, Op Establish Pt Focus | $119.70 | $171.00 | $68.40–$153.90 | — | 30% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Consult Level 3 40 | $218.40 | $312.00 | $58.34–$327.60 | 18% above | 30% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Consult Level 4 60 | $306.60 | $438.00 | $81.91–$459.90 | 18% above | 30% |
| Speech therapy session, individual CPT 92507 Speech Language Treatment | $159.60 | $228.00 | $42.64–$239.40 | 48% below | 30% |
| Speech therapy session, individual CPT 92507 Voice, Treatment | $159.60 | $228.00 | $42.64–$239.40 | 48% below | 30% |
| Speech therapy session, individual CPT 92507 Laryngectomy Treatment | $159.60 | $228.00 | $42.64–$239.40 | 48% below | 30% |
| Speech therapy session, individual CPT 92507 Bedside Swallow Treatment | $240.10 | $343.00 | $64.14–$360.15 | 21% below | 30% |
| Speech therapy session, individual inpatient CPT 92507 Voice, Treatment | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Laryngectomy Treatment | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Speech Language Treatment | $159.60 | $228.00 | $91.20–$205.20 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Bedside Swallow Treatment | $240.10 | $343.00 | $137.20–$308.70 | — | 30% |
| Spirometry (breathing test) CPT 94010 Spirometry Simple | $228.20 | $326.00 | $60.96–$342.30 | 24% below | 30% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry Simple | $228.20 | $326.00 | $130.40–$293.40 | — | 30% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry w/Bronch 94060 | $480.20 | $686.00 | $128.28–$720.30 | 26% below | 30% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry w/Bronch 94060 | $480.20 | $686.00 | $274.40–$617.40 | — | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Ther Act Attended @15 Min | $147.70 | $211.00 | $39.46–$221.55 | 15% above | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Ther Act Attended @15 Min | $147.70 | $211.00 | $84.40–$189.90 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $131.60 | $188.00 | $35.16–$197.40 | 43% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy | $131.60 | $188.00 | $75.20–$169.20 | — | 30% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 Cardiovascular Stress Test | $172.90 | $247.00 | $46.19–$259.35 | 58% below | 30% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Cardiovascular Stress Test | $172.90 | $247.00 | $98.80–$222.30 | — | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Admin Tetnus/Dt/Rabies <7 Yrs | $70.70 | $101.00 | $18.89–$106.05 | 107% above | 30% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Daptacel Vaccine (DTAP) | $836.90 | $1,195.57 | $223.57–$1,255.35 | 2347% above | 30% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Daptacel Vaccine (DTAP) | $836.90 | $1,195.57 | $478.23–$1,076.01 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vacc Tri (IIV3) 0.5ml IM | $46.20 | $66.00 | $12.34–$69.30 | 31% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vacc Tri (IIV3) 0.5ml IM | $46.20 | $66.00 | $26.40–$59.40 | — | 30% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Engerix B Pedi 10mcg/0.5ml | $44.32 | $63.31 | $11.84–$66.48 | 6% below | 30% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Engerix B Pedi 10mcg/0.5ml | $44.32 | $63.31 | $25.32–$56.98 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vacc High Dose (HD-IIV3)IM | $109.20 | $156.00 | $29.17–$163.80 | 25% above | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vacc High Dose (HD-IIV3) I | $109.20 | $156.00 | $29.17–$163.80 | 25% above | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vacc High Dose (HD-IIV3) I | $109.20 | $156.00 | $62.40–$140.40 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vacc High Dose (HD-IIV3)IM | $109.20 | $156.00 | $62.40–$140.40 | — | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax Dose | $207.20 | $296.00 | $55.35–$310.80 | 61% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax Dose | $207.20 | $296.00 | $118.40–$266.40 | — | 30% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine(Pcec) Rabavert | $883.93 | $1,262.76 | $236.14–$1,325.90 | 48% above | 30% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine Human (Imovax) | $893.69 | $1,276.70 | $238.74–$1,340.54 | 49% above | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine(Pcec) Rabavert | $883.93 | $1,262.76 | $505.10–$1,136.48 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine Human (Imovax) | $893.69 | $1,276.70 | $510.68–$1,149.03 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Tetnus/Dt/Rabies >7 Yrs | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization 1 Vac/Comb | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Pneu Vaccine | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Flu Vaccine | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Smallpox Monkeypox Vac | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Adminstration | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADM 1 VACCINE | $78.40 | $112.00 | $20.94–$117.60 | 23% above | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immun Each Add Sing/Comb | $22.40 | $32.00 | $5.98–$33.60 | 17% below | 30% |
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://wvumedicine.org/wp-content/uploads/2026/09/250965274_Butler-Memorial_standardcharges.csv