Hospital Pittsburgh, PA

Excela Health Latrobe Hospital

Listed in its price file as “Independence Health System Latrobe Area Hospital”.

Excela Health Latrobe Hospital in Latrobe, PA publishes cash prices for 368 common procedures listed here, from its own machine-readable price file updated Dec 17, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 333 of 362 procedures and above it for 22. By typical cash price it ranks #14 of 106 Pennsylvania hospitals and #5 of 26 hospitals in the Pittsburgh, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1 Mellon Way, Latrobe, PA 15650 Collected Oct 26, 2026 Source price file Check a bill from this hospital (724) 832-4000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 390219 · CMS hospital register NPI 1821015462

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Abdominal CT scan without and with contrast CPT 74170 CT KIDNEYS W&W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	35% below	40%
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W & W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	35% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT KIDNEYS W&W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W & W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	—	40%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS	$216.60	$361.00	$30.98–$363.31	34% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS	$216.60	$361.00	$30.98–$363.31	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE BIL 3+ VIEWS	$225.60	$376.00	$16.89–$300.80	41% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE RIGHT 3+ VIEWS	$150.00	$250.00	$16.89–$226.62	61% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE LEFT 3+ VIEWS	$150.00	$250.00	$16.89–$226.62	61% below	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE BIL 3+ VIEWS	$225.60	$376.00	$16.89–$300.80	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE LEFT 3+ VIEWS	$150.00	$250.00	$16.89–$226.62	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE RIGHT 3+ VIEWS	$150.00	$250.00	$16.89–$226.62	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US DOPPLER ART ABI LMTED BILAT	$172.20	$287.00	$40.10–$346.47	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US DOPPLER ART ABI LMTED BILAT	$172.20	$287.00	$40.10–$346.47	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT SHOULDER W/O CONTRAST	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT WO CONTRAST	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT WO CONTRAST	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRAST-LT	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER W/O CONTRAST-LT	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER W/O CONTRAST-RT	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRAST-RT	$871.20	$1,452.00	$99.40–$1,161.60	26% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT SHOULDER W/O CONTRAST	$871.20	$1,452.00	$99.40–$1,161.60	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRAST-LT	$871.20	$1,452.00	$99.40–$1,161.60	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRAST-RT	$871.20	$1,452.00	$99.40–$1,161.60	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER W/O CONTRAST-RT	$871.20	$1,452.00	$99.40–$1,161.60	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER W/O CONTRAST-LT	$871.20	$1,452.00	$99.40–$1,161.60	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR BARIUM SWALLOW	$257.40	$429.00	$42.79–$456.75	45% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR BARIUM SWALLOW	$257.40	$429.00	$42.79–$456.75	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$456.60	$761.00	$121.78–$1,041.02	63% below	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST SONOGRAM RT COMPLETE	$132.00	$220.00	$99.40–$347.38	76% below	40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST SONOGRAM LT COMPLETE	$132.00	$220.00	$99.40–$347.38	76% below	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST SONOGRAM RT COMPLETE	$132.00	$220.00	$99.40–$347.38	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST SONOGRAM LT COMPLETE	$132.00	$220.00	$99.40–$347.38	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ED US BREAST LIMITED	$132.00	$220.00	$82.13–$226.62	71% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST SONOGRAM LT LIMITED	$132.00	$220.00	$82.13–$226.62	71% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RIGHT LIMITED	$132.00	$220.00	$82.13–$226.62	71% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST SONOGRAM RT LIMITED	$132.00	$220.00	$82.13–$226.62	71% below	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ED US BREAST LIMITED	$132.00	$220.00	$82.13–$226.62	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RIGHT LIMITED	$132.00	$220.00	$82.13–$226.62	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST SONOGRAM LT LIMITED	$132.00	$220.00	$82.13–$226.62	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST SONOGRAM RT LIMITED	$132.00	$220.00	$82.13–$226.62	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN & PELVIS.	$1,482.00	$2,470.00	$331.69–$3,032.66	50% below	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN & PELVIS	$1,482.00	$2,470.00	$331.69–$3,032.66	50% below	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD & PELVIS GI BLEED	$1,482.00	$2,470.00	$331.69–$3,032.66	50% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABDOMEN & PELVIS.	$1,482.00	$2,470.00	$331.69–$3,032.66	—	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABDOMEN & PELVIS	$1,482.00	$2,470.00	$331.69–$3,032.66	—	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD	$587.40	$979.00	$166.76–$899.58	66% below	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD.	$587.40	$979.00	$166.76–$899.58	66% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD	$587.40	$979.00	$166.76–$899.58	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD.	$587.40	$979.00	$166.76–$899.58	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK	$635.40	$1,059.00	$166.76–$992.33	62% below	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK.	$635.40	$1,059.00	$166.76–$992.33	62% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK	$635.40	$1,059.00	$166.76–$992.33	—	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK.	$635.40	$1,059.00	$166.76–$992.33	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$587.40	$979.00	$166.76–$803.44	70% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST.	$587.40	$979.00	$166.76–$803.44	70% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST.	$587.40	$979.00	$166.76–$803.44	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$587.40	$979.00	$166.76–$803.44	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO CORONARY ARTERIES, CMPLT	$552.60	$921.00	$331.69–$1,174.40	72% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CTA CORON COMPLETE GLOBAL SP	$885.00	$1,475.00	$331.69–$1,180.00	55% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL ORAL CONTRAST ONLY	$1,213.20	$2,022.00	$201.95–$1,617.60	42% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT LOW DOSE RENAL	$1,213.20	$2,022.00	$201.95–$1,617.60	42% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CONTRAST	$1,213.20	$2,022.00	$201.95–$1,617.60	42% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL ORAL CONTRAST ONLY	$1,213.20	$2,022.00	$201.95–$1,617.60	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CONTRAST	$1,213.20	$2,022.00	$201.95–$1,617.60	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT LOW DOSE RENAL	$1,213.20	$2,022.00	$201.95–$1,617.60	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS IV CONTRAST ONLY	$1,491.00	$2,485.00	$315.79–$1,988.00	50% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS IV & ORAL CONTRAST	$1,491.00	$2,485.00	$315.79–$1,988.00	50% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY	$1,491.00	$2,485.00	$315.79–$1,988.00	50% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS IV & ORAL CONTRAST	$1,491.00	$2,485.00	$315.79–$1,988.00	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY	$1,491.00	$2,485.00	$315.79–$1,988.00	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM	$1,831.80	$3,053.00	$331.69–$3,615.83	39% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT CYSTOGRAM	$1,831.80	$3,053.00	$331.69–$3,615.83	39% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN PELVIS W&W/O CONT	$1,831.80	$3,053.00	$331.69–$3,615.83	39% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM	$1,831.80	$3,053.00	$331.69–$3,615.83	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN PELVIS W&W/O CONT	$1,831.80	$3,053.00	$331.69–$3,615.83	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT CYSTOGRAM	$1,831.80	$3,053.00	$331.69–$3,615.83	—	40%
CT scan of the abdomen with contrast CPT 74160 CT LIVER CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	40% below	40%
CT scan of the abdomen with contrast CPT 74160 CT PANCREAS CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	40% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN IV & ORAL CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	40% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN IV CONTRAST ONLY	$993.60	$1,656.00	$166.76–$1,324.80	40% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT LIVER CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN IV & ORAL CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT PANCREAS CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN ORAL CONTRAST ONLY	$808.80	$1,348.00	$99.40–$1,078.40	28% below	40%
CT scan of the abdomen without contrast CPT 74150 CT PANCREAS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	28% below	40%
CT scan of the abdomen without contrast CPT 74150 CT KIDNEYS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	28% below	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	28% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT PANCREAS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN ORAL CONTRAST ONLY	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT KIDNEYS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O CONTRAST	$855.60	$1,426.00	$99.40–$1,140.80	24% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES NO CONTRAST	$855.60	$1,426.00	$99.40–$1,140.80	24% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES NO CONTRAST	$855.60	$1,426.00	$99.40–$1,140.80	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL W/O CONTRAST	$855.60	$1,426.00	$99.40–$1,140.80	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN STROKE ALERT ER	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN STROKE ALERT ER	$736.20	$1,227.00	$99.40–$981.60	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	—	40%
CT scan of the head with contrast CPT 70460 CT BRAIN W/CONTRAST	$847.20	$1,412.00	$160.80–$1,129.60	37% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/CONTRAST	$847.20	$1,412.00	$160.80–$1,129.60	—	40%
CT scan of the head without and with contrast CPT 70470 CT OH BRAIN W&W/O CONTRAST	$1,591.80	$2,653.00	$166.76–$2,122.40	5% below	40%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W&W/O CONTRAST	$1,591.80	$2,653.00	$166.76–$2,122.40	5% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT OH BRAIN W&W/O CONTRAST	$1,591.80	$2,653.00	$166.76–$2,122.40	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W&W/O CONTRAST	$1,591.80	$2,653.00	$166.76–$2,122.40	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR NO CONTRAST	$839.40	$1,399.00	$99.40–$1,119.20	26% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR NO CONTRAST	$839.40	$1,399.00	$99.40–$1,119.20	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	31% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	41% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX COMP/BILAT	$346.80	$578.00	$90.06–$621.32	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUPLEX COMP/BILAT	$346.80	$578.00	$90.06–$621.32	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W & W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	27% below	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONT + HI RES	$1,221.60	$2,036.00	$166.76–$1,628.80	27% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W & W/O CONTRAST	$1,221.60	$2,036.00	$166.76–$1,628.80	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONT + HI RES	$1,221.60	$2,036.00	$166.76–$1,628.80	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST PA LAT	$151.20	$252.00	$28.37–$226.62	53% below	40%
Chest X-ray, 2 views CPT 71046 XR CHEST STROKE 2 VIEWS PA LAT	$151.20	$252.00	$28.37–$226.62	53% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST STROKE 2 VIEWS PA LAT	$151.20	$252.00	$28.37–$226.62	—	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA LAT	$151.20	$252.00	$28.37–$226.62	—	40%
Chest X-ray, single view CPT 71045 XR INFANT CHEST ABD 1 VIEW	$120.00	$200.00	$18.58–$226.62	36% below	40%
Chest X-ray, single view CPT 71045 XR CHEST AP OR PA 1 VIEW	$120.00	$200.00	$18.58–$226.62	36% below	40%
Chest X-ray, single view CPT 71045 XR CHEST STROKE 1 VIEW	$120.00	$200.00	$18.58–$226.62	36% below	40%
Chest X-ray, single view inpatient CPT 71045 XR INFANT CHEST ABD 1 VIEW	$120.00	$200.00	$18.58–$226.62	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST STROKE 1 VIEW	$120.00	$200.00	$18.58–$226.62	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST AP OR PA 1 VIEW	$120.00	$200.00	$18.58–$226.62	—	40%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE BILATERAL	$190.20	$317.00	$19.52–$253.60	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RIGHT	$126.60	$211.00	$19.52–$226.62	57% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LEFT	$126.60	$211.00	$19.52–$226.62	57% below	40%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR CLAVICLE BILATERAL	$190.20	$317.00	$19.52–$253.60	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RIGHT	$126.60	$211.00	$19.52–$226.62	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LEFT	$126.60	$211.00	$19.52–$226.62	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$333.60	$556.00	$74.77–$444.80	53% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$333.60	$556.00	$74.77–$444.80	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 MM BONE DENSITY SPINE/HIP	$214.80	$358.00	$72.13–$286.40	20% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 MM BONE DENSITY SPINE/HIP	$214.80	$358.00	$72.13–$286.40	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 MM BONE DENSITY EXTREMITY	$127.20	$212.00	$32.98–$226.62	29% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 MM BONE DENSITY EXTREMITY	$127.20	$212.00	$32.98–$226.62	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT FOLLOW UP ADVANCED LUNG CENTE	$808.80	$1,348.00	$99.40–$1,078.40	26% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST NO CONT + HI RES	$808.80	$1,348.00	$99.40–$1,078.40	26% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST NAV BRONCH	$808.80	$1,348.00	$99.40–$1,078.40	26% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	26% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT FOLLOW UP ADVANCED LUNG CENTE	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST FOR PE	$993.60	$1,656.00	$166.76–$1,324.80	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONT + HI RES	$993.60	$1,656.00	$166.76–$1,324.80	32% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRAST	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST FOR PE	$993.60	$1,656.00	$166.76–$1,324.80	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO FFDM POST PRCD BILAT	$184.80	$308.00	$134.74–$530.38	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO FFDM DIAG BILAT	$184.80	$308.00	$134.74–$530.38	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO FFDM POST PRCD BILAT	$184.80	$308.00	$134.74–$530.38	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO FFDM DIAG BILAT	$184.80	$308.00	$134.74–$530.38	—	40%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO FFDM DIAG LEFT	$145.80	$243.00	$106.97–$287.38	54% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO FFDM DIAG RIGHT	$145.80	$243.00	$106.97–$287.38	54% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO FFDM POST PRCD LEFT	$145.80	$243.00	$106.97–$287.38	54% below	40%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO FFDM POST PRCD RIGHT	$145.80	$243.00	$106.97–$287.38	54% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO FFDM POST PRCD RIGHT	$145.80	$243.00	$106.97–$287.38	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO FFDM DIAG LEFT	$145.80	$243.00	$106.97–$287.38	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO FFDM DIAG RIGHT	$145.80	$243.00	$106.97–$287.38	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO FFDM POST PRCD LEFT	$145.80	$243.00	$106.97–$287.38	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ART DUPLEX LOW EXT BILATERAL	$517.20	$862.00	$77.26–$689.60	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS COMPRSN-BILAT LOWER	$378.60	$631.00	$85.58–$621.32	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS COMPRSN-BILAT UPPER	$378.60	$631.00	$85.58–$621.32	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS REFLUX BILATERAL	$378.60	$631.00	$85.58–$621.32	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS REFLUX BILATERAL	$378.60	$631.00	$85.58–$621.32	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS COMPRSN-BILAT LOWER	$378.60	$631.00	$85.58–$621.32	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS COMPRSN-BILAT UPPER	$378.60	$631.00	$85.58–$621.32	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D W/DOPPLER & COLOR FLOW	$730.20	$1,217.00	$169.22–$1,422.88	61% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO 2D W/DOPPLER & COLOR FLOW	$730.20	$1,217.00	$169.22–$1,422.88	—	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW LEFT 2 VIEWS	$81.00	$135.00	$16.45–$226.62	75% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW RIGHT 2 VIEWS	$81.00	$135.00	$16.45–$226.62	75% below	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW LEFT 2 VIEWS	$81.00	$135.00	$16.45–$226.62	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW RIGHT 2 VIEWS	$81.00	$135.00	$16.45–$226.62	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW BIL 3+ VIEWS	$185.40	$309.00	$17.98–$247.20	49% below	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW LEFT 3+ VIEWS	$124.20	$207.00	$17.98–$226.62	66% below	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW RIGHT 3+ VIEWS	$124.20	$207.00	$17.98–$226.62	66% below	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW LEFT 3+ VIEWS	$124.20	$207.00	$17.98–$226.62	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW RIGHT 3+ VIEWS	$124.20	$207.00	$17.98–$226.62	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONES -W/O CONT	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA TURCICA NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT POSTERIOR FOSSA NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	32% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA TURCICA NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT POSTERIOR FOSSA NO CONTRAST	$736.20	$1,227.00	$99.40–$981.60	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONES -W/O CONT	$736.20	$1,227.00	$99.40–$981.60	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR ZYGOMATIC ARCHES-3 VIEWS +	$202.20	$337.00	$26.64–$272.24	51% below	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3+ VIEWS	$202.20	$337.00	$26.64–$272.24	51% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR ZYGOMATIC ARCHES-3 VIEWS +	$202.20	$337.00	$26.64–$272.24	—	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 3+ VIEWS	$202.20	$337.00	$26.64–$272.24	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM BILATERAL	$187.20	$312.00	$19.86–$249.60	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM LEFT 2 VIEWS	$125.40	$209.00	$19.86–$226.62	56% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM RIGHT 2 VIEWS	$125.40	$209.00	$19.86–$226.62	56% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR FOREARM BILATERAL	$187.20	$312.00	$19.86–$249.60	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM RIGHT 2 VIEWS	$125.40	$209.00	$19.86–$226.62	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM LEFT 2 VIEWS	$125.40	$209.00	$19.86–$226.62	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HB SCAN	$1,022.40	$1,704.00	$290.47–$1,363.20	17% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HB SCAN WITH STIMULATION	$1,022.40	$1,704.00	$290.47–$1,363.20	17% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HB SCAN WITH STIMULATION	$1,022.40	$1,704.00	$290.47–$1,363.20	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HB SCAN	$1,022.40	$1,704.00	$290.47–$1,363.20	—	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND RIGHT 2 VIEWS	$154.80	$258.00	$19.15–$272.24	45% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND LEFT 2 VIEWS	$154.80	$258.00	$19.15–$272.24	45% below	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND LEFT 2 VIEWS	$154.80	$258.00	$19.15–$272.24	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND RIGHT 2 VIEWS	$154.80	$258.00	$19.15–$272.24	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR CALCANEUS BILATERAL 2 VIEWS	$183.60	$306.00	$18.43–$244.80	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS LEFT 2 VIEWS	$125.40	$209.00	$18.43–$226.62	53% below	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS RIGHT 2 VIEWS	$125.40	$209.00	$18.43–$226.62	53% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR CALCANEUS BILATERAL 2 VIEWS	$183.60	$306.00	$18.43–$244.80	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS LEFT 2 VIEWS	$125.40	$209.00	$18.43–$226.62	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS RIGHT 2 VIEWS	$125.40	$209.00	$18.43–$226.62	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY/CPAP	$1,292.40	$2,154.00	$312.45–$2,236.17	60% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY/CPAP	$1,292.40	$2,154.00	$312.45–$2,236.17	—	40%
Knee X-ray, 3 views CPT 73562 XR KNEE BIL 3 VIEWS	$254.40	$424.00	$21.72–$339.20	36% below	40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE LEFT 3 VIEWS	$169.20	$282.00	$21.72–$226.62	58% below	40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE RIGHT 3 VIEWS	$169.20	$282.00	$21.72–$226.62	58% below	40%
Knee X-ray, 3 views inpatient CPT 73562 XR KNEE BIL 3 VIEWS	$254.40	$424.00	$21.72–$339.20	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE LEFT 3 VIEWS	$169.20	$282.00	$21.72–$226.62	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE RIGHT 3 VIEWS	$169.20	$282.00	$21.72–$226.62	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE ORTHO EVAL BILATERAL	$278.40	$464.00	$24.15–$371.20	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE BIL 4+ VIEWS.	$278.40	$464.00	$24.15–$371.20	36% below	40%
Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE BIL 4+ VIEWS	$278.40	$464.00	$24.15–$371.20	36% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE LEFT 4 + VIEWS	$185.40	$309.00	$24.15–$272.24	58% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE RIGHT 4+ VIEWS	$185.40	$309.00	$24.15–$272.24	58% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE ORTHO EVAL LEFT	$185.40	$309.00	$24.15–$272.24	58% below	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE ORTHO EVAL RIGHT	$185.40	$309.00	$24.15–$272.24	58% below	40%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE ORTHO EVAL BILATERAL	$278.40	$464.00	$24.15–$371.20	—	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE BIL 4+ VIEWS	$278.40	$464.00	$24.15–$371.20	—	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE BIL 4+ VIEWS.	$278.40	$464.00	$24.15–$371.20	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE RIGHT 4+ VIEWS	$185.40	$309.00	$24.15–$272.24	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE LEFT 4 + VIEWS	$185.40	$309.00	$24.15–$272.24	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE ORTHO EVAL RIGHT	$185.40	$309.00	$24.15–$272.24	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE ORTHO EVAL LEFT	$185.40	$309.00	$24.15–$272.24	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXT W/O CONTRAST	$760.20	$1,267.00	$99.40–$1,013.60	29% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP W/O CONTRAST-LT	$760.20	$1,267.00	$99.40–$1,013.60	29% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAST-RT	$760.20	$1,267.00	$99.40–$1,013.60	29% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP W/O CONTRAST-RT	$760.20	$1,267.00	$99.40–$1,013.60	29% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAST-LT	$760.20	$1,267.00	$99.40–$1,013.60	29% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXT W/O CONTRAST	$760.20	$1,267.00	$99.40–$1,013.60	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT W/O CONTRAST-RT	$760.20	$1,267.00	$99.40–$1,013.60	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP W/O CONTRAST-RT	$760.20	$1,267.00	$99.40–$1,013.60	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP W/O CONTRAST-LT	$760.20	$1,267.00	$99.40–$1,013.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US BILIARY	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 IR US ABDOMEN, LIMITED	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US FAST ABD SCAN LIMITED	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-PYLORIC STENOSIS	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US S T ABD-LOW BACK	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US ABD WALL	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US LOWER BACK	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US RT UPPER QUAD/LMTD ABD	$289.20	$482.00	$53.44–$385.60	51% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US LOWER BACK	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US FAST ABD SCAN LIMITED	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US ABD WALL	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US BILIARY	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 IR US ABDOMEN, LIMITED	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$289.20	$482.00	$53.44–$385.60	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US S T ABD-LOW BACK	$289.20	$482.00	$53.44–$385.60	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US LOWER EXTREMITY	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SOFT TISSUE SONOGRAM	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US MUSCULOSKELETAL EXTREMITY	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US UPPER EXTREMITY	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 IR US SOFT TISSUE EXTREMITY LTD	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US AXILLA	$121.20	$202.00	$28.55–$272.24	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ED US LOWER EXTREMITY	$121.20	$202.00	$28.55–$272.24	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SOFT TISSUE SONOGRAM	$121.20	$202.00	$28.55–$272.24	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 IR US SOFT TISSUE EXTREMITY LTD	$121.20	$202.00	$28.55–$272.24	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ED US UPPER EXTREMITY	$121.20	$202.00	$28.55–$272.24	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ED US AXILLA	$121.20	$202.00	$28.55–$272.24	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ED US MUSCULOSKELETAL EXTREMITY	$121.20	$202.00	$28.55–$272.24	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING,NON LUNG CENTER	$157.20	$262.00	$99.40–$286.58	71% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT ADVANCED LUNG CENTER LDCT	$157.20	$262.00	$99.40–$286.58	71% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT ADVANCED LUNG CENTER LDCT	$157.20	$262.00	$99.40–$286.58	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING,NON LUNG CENTER	$157.20	$262.00	$99.40–$286.58	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBIA FIBULA BIL	$205.20	$342.00	$17.04–$273.60	39% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA RIGHT 2 VIEWS	$136.20	$227.00	$17.04–$226.62	59% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA FIBULA LEFT 2 VIEWS	$136.20	$227.00	$17.04–$226.62	59% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBIA FIBULA BIL	$205.20	$342.00	$17.04–$273.60	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA LEFT 2 VIEWS	$136.20	$227.00	$17.04–$226.62	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA FIBULA RIGHT 2 VIEWS	$136.20	$227.00	$17.04–$226.62	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MR MRA BRAIN WO CONTRAST	$1,181.40	$1,969.00	$226.85–$1,575.20	34% below	40%
MR angiography (MRA) of the head without contrast CPT 70544 MR MRV BRAIN WO CONTRAST	$1,181.40	$1,969.00	$226.85–$1,575.20	34% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR MRV BRAIN WO CONTRAST	$1,181.40	$1,969.00	$226.85–$1,575.20	—	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR MRA BRAIN WO CONTRAST	$1,181.40	$1,969.00	$226.85–$1,575.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	45% below	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR HIP RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR KNEE LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR HIP LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR KNEE RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR HIP LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR KNEE LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR HIP RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR KNEE RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR HIP LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR HIP RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR KNEE LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR KNEE RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ANKLE LT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR ANKLE RT W/WO CONTRAST	$1,854.60	$3,091.00	$331.69–$2,472.80	—	40%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	43% below	40%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN W SECRETIN	$1,120.80	$1,868.00	$226.85–$1,494.40	43% below	40%
MRI of the abdomen without contrast CPT 74181 MR MRCP	$1,120.80	$1,868.00	$226.85–$1,494.40	43% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR MRCP	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN W SECRETIN	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W/WO CONTRAST	$1,225.20	$2,042.00	$331.69–$1,633.60	66% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W/WO CONTRAST	$1,225.20	$2,042.00	$331.69–$1,633.60	—	40%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	40% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W/WO CONTRAST	$1,362.00	$2,270.00	$331.69–$2,995.34	53% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W/WO CONTRAST	$1,362.00	$2,270.00	$331.69–$2,995.34	—	40%
MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	34% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR LUMBAR WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR W/WO CONTRAST	$1,602.60	$2,671.00	$331.69–$2,981.62	52% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR LUMBAR W/WO CONTRAST	$1,602.60	$2,671.00	$331.69–$2,981.62	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	43% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL W/WO CONTRAST	$1,377.00	$2,295.00	$331.69–$3,012.68	53% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL W/WO CONTRAST	$1,377.00	$2,295.00	$331.69–$3,012.68	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	33% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR CERVICAL WO CONTRAST	$1,178.40	$1,964.00	$226.85–$1,571.20	—	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS POST BIOPSY PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	65% below	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS SCREENING PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	65% below	40%
MRI of the pelvis without and with contrast CPT 72197 MR MRI PELVIS W/WO CONTRAST	$1,225.20	$2,042.00	$294.26–$1,633.60	65% below	40%
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS SCREEN/DIAG PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	65% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS SCREENING PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS POST BIOPSY PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS SCREEN/DIAG PROSTATE	$1,225.20	$2,042.00	$294.26–$1,633.60	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR MRI PELVIS W/WO CONTRAST	$1,225.20	$2,042.00	$294.26–$1,633.60	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS POST BIO PROSTATE WO C	$1,120.80	$1,868.00	$226.85–$1,494.40	44% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS SCREEN PROSTATE WO CON	$1,120.80	$1,868.00	$226.85–$1,494.40	44% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	44% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS SCREEN PROSTATE WO CON	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS POST BIO PROSTATE WO C	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR AC JOINTS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR SC JOINTS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPR EXT (W/JT-NO CONTRAST)-RT	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPR EXT (W/JT-NO CONTRAST)-LT	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	47% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR SC JOINTS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR AC JOINTS WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR WRIST RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR ELBOW RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR ELBOW LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPR EXT (W/JT-NO CONTRAST)-RT	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR SHOULDER RT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPR EXT (W/JT-NO CONTRAST)-LT	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR SHOULDER LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR WRIST LT WO CONTRAST	$1,120.80	$1,868.00	$226.85–$1,494.40	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERVICAL 4 OR 5 VIEWS	$284.40	$474.00	$30.74–$379.20	35% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL 4 OR 5 VIEWS	$284.40	$474.00	$30.74–$379.20	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT LARYNX CONTRAST	$993.60	$1,656.00	$165.00–$1,324.80	27% below	40%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK CONTRAST	$993.60	$1,656.00	$165.00–$1,324.80	27% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK CONTRAST	$993.60	$1,656.00	$165.00–$1,324.80	—	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT LARYNX CONTRAST	$993.60	$1,656.00	$165.00–$1,324.80	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	25% below	40%
Neck soft tissue CT scan without contrast CPT 70490 CT LARYNX NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	25% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK W/O CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT LARYNX NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$130.20	$217.00	$17.70–$226.62	54% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 VIABILITY MULTI SPECT	$1,884.00	$3,140.00	$408.96–$3,371.30	51% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF MULTI SPECT	$1,884.00	$3,140.00	$408.96–$3,371.30	51% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 VIABILITY MULTI SPECT	$1,884.00	$3,140.00	$408.96–$3,371.30	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF MULTI SPECT	$1,884.00	$3,140.00	$408.96–$3,371.30	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	26% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS NO CONTRAST	$808.80	$1,348.00	$99.40–$1,078.40	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED	$111.60	$186.00	$37.22–$272.24	75% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ED US PELVIC WALL	$111.60	$186.00	$37.22–$272.24	75% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED	$111.60	$186.00	$37.22–$272.24	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ED US PELVIC WALL	$111.60	$186.00	$37.22–$272.24	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS-ALL	$295.80	$493.00	$59.70–$394.40	49% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS-ALL	$295.80	$493.00	$59.70–$394.40	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG COMP	$266.40	$444.00	$86.96–$382.62	56% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG COMP	$266.40	$444.00	$86.96–$382.62	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG <14 WKS SINGLE	$266.40	$444.00	$87.65–$385.66	53% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG <14 WKS SINGLE	$266.40	$444.00	$87.65–$385.66	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ED US PREG TRANSABDOMINAL	$219.60	$366.00	$58.56–$292.80	59% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PREGNANCY-LIMITED	$219.60	$366.00	$58.56–$292.80	59% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ED US PREG TRANSABDOMINAL	$219.60	$366.00	$58.56–$292.80	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PREGNANCY-LIMITED	$219.60	$366.00	$58.56–$292.80	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LEFT UNILATERAL	$149.40	$249.00	$22.79–$226.62	56% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS RIGHT UNILATERAL	$149.40	$249.00	$22.79–$226.62	56% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RIGHT UNILATERAL	$149.40	$249.00	$22.79–$226.62	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LEFT UNILATERAL	$149.40	$249.00	$22.79–$226.62	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS LEFT UNI PA CHEST 3+VWS	$154.80	$258.00	$25.45–$272.24	62% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS RT UNI & PA CHEST 3+ VWS	$154.80	$258.00	$25.45–$272.24	62% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS LEFT UNI PA CHEST 3+VWS	$154.80	$258.00	$25.45–$272.24	—	40%
Screening mammogram, both breasts both sides CPT 77067 MM MAMMO FFDM SCREEN BILAT	$180.00	$300.00	$109.09–$433.27	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM MAMMO FFDM SCREEN BILAT	$180.00	$300.00	$109.09–$433.27	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULDER EVAL BILAT	$147.00	$245.00	$18.39–$226.62	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER BIL 2+ VIEWS	$219.00	$365.00	$18.39–$292.00	36% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RIGHT 2+ VIEWS	$147.00	$245.00	$18.39–$226.62	57% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER EVAL RIGHT	$147.00	$245.00	$18.39–$226.62	57% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER EVAL LEFT	$147.00	$245.00	$18.39–$226.62	57% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LEFT 2+ VIEWS	$147.00	$245.00	$18.39–$226.62	57% below	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR SHOULDER EVAL BILAT	$147.00	$245.00	$18.39–$226.62	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER BIL 2+ VIEWS	$219.00	$365.00	$18.39–$292.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LEFT 2+ VIEWS	$147.00	$245.00	$18.39–$226.62	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RIGHT 2+ VIEWS	$147.00	$245.00	$18.39–$226.62	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER EVAL LEFT	$147.00	$245.00	$18.39–$226.62	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER EVAL RIGHT	$147.00	$245.00	$18.39–$226.62	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3+ VIEWS	$276.60	$461.00	$26.44–$368.80	35% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES 3+ VIEWS	$276.60	$461.00	$26.44–$368.80	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1-3 VIEWS	$129.60	$216.00	$27.62–$272.24	64% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 1-3 VIEWS	$129.60	$216.00	$27.62–$272.24	—	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY	$1,292.40	$2,154.00	$168.61–$2,236.17	63% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY	$1,292.40	$2,154.00	$168.61–$2,236.17	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR COOKIE SWALLOW	$257.40	$429.00	$48.82–$456.75	56% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR COOKIE SWALLOW	$257.40	$429.00	$48.82–$456.75	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR FEMUR BILATERAL 2 VIEWS+	$140.40	$234.00	$29.54–$226.62	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR RIGHT 2 VIEWS	$93.60	$156.00	$29.54–$226.62	77% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR LEFT 2 VIEWS	$93.60	$156.00	$29.54–$226.62	77% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR FEMUR BILATERAL 2 VIEWS+	$140.40	$234.00	$29.54–$226.62	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR LEFT 2 VIEWS	$93.60	$156.00	$29.54–$226.62	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RIGHT 2 VIEWS	$93.60	$156.00	$29.54–$226.62	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC W/O CONTRAST	$839.40	$1,399.00	$99.40–$1,119.20	28% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC W/O CONTRAST	$839.40	$1,399.00	$99.40–$1,119.20	—	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOES RIGHT 2+ VIEWS	$80.40	$134.00	$12.95–$226.62	71% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOES LEFT 2+ VIEWS	$80.40	$134.00	$12.95–$226.62	71% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES RIGHT 2+ VIEWS	$80.40	$134.00	$12.95–$226.62	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES LEFT 2+ VIEWS	$80.40	$134.00	$12.95–$226.62	—	40%
Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL	$267.00	$445.00	$62.60–$356.00	52% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL PREG	$266.40	$444.00	$90.59–$398.60	52% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL PREG	$266.40	$444.00	$90.59–$398.60	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN, COMPLETE	$307.80	$513.00	$74.31–$410.40	60% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN, COMPLETE	$307.80	$513.00	$74.31–$410.40	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR SCAN	$394.20	$657.00	$57.65–$525.60	35% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR SCAN	$394.20	$657.00	$57.65–$525.60	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ED US NECK	$388.80	$648.00	$55.47–$518.40	31% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID OR S T NECK	$388.80	$648.00	$55.47–$518.40	31% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 IR US THYROID	$388.80	$648.00	$55.47–$518.40	31% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID OR S T NECK	$388.80	$648.00	$55.47–$518.40	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ED US NECK	$388.80	$648.00	$55.47–$518.40	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI WITH KUB	$256.20	$427.00	$58.07–$456.75	61% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI NO KUB	$256.20	$427.00	$58.07–$456.75	61% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI NO KUB	$256.20	$427.00	$58.07–$456.75	—	40%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS BILATERAL	$193.20	$322.00	$18.02–$257.60	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUSRIGHT 2 VIEWS	$129.00	$215.00	$18.02–$226.62	58% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS LEFT 2 VIEWS	$129.00	$215.00	$18.02–$226.62	58% below	40%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR HUMERUS BILATERAL	$193.20	$322.00	$18.02–$257.60	—	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUSRIGHT 2 VIEWS	$129.00	$215.00	$18.02–$226.62	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS LEFT 2 VIEWS	$129.00	$215.00	$18.02–$226.62	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED US DVT LIMITED	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS COMPRSN UNI-LT UPPER	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS REFLUX RIGHT-UNI	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS REFLUX LEFT-UNI	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS COMPRSN UNI-RT UPPER	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS COMPRSN-UNI LT LOWER	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS COMPRSN-UNI RT LOWER	$259.80	$433.00	$59.83–$346.40	57% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 ED US DVT LIMITED	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS COMPRSN-UNI RT LOWER	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS COMPRSN-UNI LT LOWER	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS REFLUX LEFT-UNI	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS COMPRSN UNI-RT UPPER	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS REFLUX RIGHT-UNI	$259.80	$433.00	$59.83–$346.40	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS COMPRSN UNI-LT UPPER	$259.80	$433.00	$59.83–$346.40	—	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST RIGHT 2 VIEWS	$81.00	$135.00	$19.11–$226.62	71% below	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST LEFT 2 VIEWS	$81.00	$135.00	$19.11–$226.62	71% below	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST RIGHT 2 VIEWS	$81.00	$135.00	$19.11–$226.62	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST LEFT 2 VIEWS	$81.00	$135.00	$19.11–$226.62	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST BIL 3+ VIEWS	$173.40	$289.00	$19.89–$231.20	46% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RIGHT 3+ VIEWS	$115.20	$192.00	$19.89–$226.62	64% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LEFT 3+ VIEWS	$115.20	$192.00	$19.89–$226.62	64% below	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST BIL 3+ VIEWS	$173.40	$289.00	$19.89–$231.20	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LEFT 3+ VIEWS	$115.20	$192.00	$19.89–$226.62	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RIGHT 3+ VIEWS	$115.20	$192.00	$19.89–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP ORTHO EVAL RIGHT	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT 2-3 VIEWS W PELVIS	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RIGHT 2-3 VIEWS	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT AP-FRG<16 2-3 VW W PE	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP ORTHO EVAL LEFT	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT 2-3 VIEWS	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT AP-FRG<16 2-3 VW W PE	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR W PEL	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR W PEL.	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RIGHT 2-3 VIEWS W PELVIS	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT AP-FRG<16 YR 2-3 VW	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RIGHT 2-3 VWS IN OR W PEL	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RIGHT 2-3 VWS IN OR	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT AP-FRG<16 YR 2-3 VW	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR	$93.60	$156.00	$37.61–$226.62	74% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP ORTHO EVAL RIGHT	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP ORTHO EVAL LEFT	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT AP-FRG<16 YR 2-3 VW	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT AP-FRG<16 YR 2-3 VW	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RIGHT 2-3 VWS IN OR	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RIGHT 2-3 VIEWS	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR W PEL.	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LEFT 2-3 VIEWS	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LEFT 2-3 VWS IN OR W PEL	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LEFT 2-3 VIEWS W PELVIS	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RIGHT 2-3 VIEWS W PELVIS	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT AP-FRG<16 2-3 VW W PE	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT AP-FRG<16 2-3 VW W PE	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RIGHT 2-3 VWS IN OR W PEL	$93.60	$156.00	$37.61–$226.62	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$174.60	$291.00	$25.37–$232.80	40% below	40%
X-ray of the abdomen, 1 view CPT 74018 XR COLON TRANSIT STUDY	$174.60	$291.00	$25.37–$232.80	40% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$174.60	$291.00	$25.37–$232.80	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR COLON TRANSIT STUDY	$174.60	$291.00	$25.37–$232.80	—	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE RIGHT 2 VIEWS	$136.20	$227.00	$15.96–$226.62	60% below	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LEFT 2 VIEWS	$136.20	$227.00	$15.96–$226.62	60% below	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE LEFT 2 VIEWS	$136.20	$227.00	$15.96–$226.62	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE RIGHT 2 VIEWS	$136.20	$227.00	$15.96–$226.62	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RIGHT 2+ VIEWS	$80.40	$134.00	$16.32–$226.62	68% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LEFT 2+ VIEWS	$80.40	$134.00	$16.32–$226.62	68% below	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LEFT 2+ VIEWS	$80.40	$134.00	$16.32–$226.62	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RIGHT 2+ VIEWS	$80.40	$134.00	$16.32–$226.62	—	40%
X-ray of the foot, 2 views CPT 73620 XR FOOT BIL 2 VIEWS	$205.20	$342.00	$18.49–$273.60	39% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT LEFT 2 VIEWS	$136.20	$227.00	$18.49–$226.62	59% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT RIGHT 2 VIEWS	$136.20	$227.00	$18.49–$226.62	59% below	40%
X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT BIL 2 VIEWS	$205.20	$342.00	$18.49–$273.60	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT LEFT 2 VIEWS	$136.20	$227.00	$18.49–$226.62	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT RIGHT 2 VIEWS	$136.20	$227.00	$18.49–$226.62	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT BIL 3+ VIEWS	$225.60	$376.00	$20.10–$300.80	38% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LEFT 3+ VIEWS	$150.00	$250.00	$20.10–$226.62	59% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RIGHT 3+ VIEWS	$150.00	$250.00	$20.10–$226.62	59% below	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT BIL 3+ VIEWS	$225.60	$376.00	$20.10–$300.80	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RIGHT 3+ VIEWS	$150.00	$250.00	$20.10–$226.62	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LEFT 3+ VIEWS	$150.00	$250.00	$20.10–$226.62	—	40%
X-ray of the hand, 3 or more views CPT 73130 XR HAND BIL 3+ VIEWS	$187.20	$312.00	$17.22–$249.60	37% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LEFT 3+ VIEWS	$125.40	$209.00	$17.22–$226.62	58% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RIGHT 3+ VIEWS	$125.40	$209.00	$17.22–$226.62	58% below	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND BIL 3+ VIEWS	$187.20	$312.00	$17.22–$249.60	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LEFT 3+ VIEWS	$125.40	$209.00	$17.22–$226.62	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RIGHT 3+ VIEWS	$125.40	$209.00	$17.22–$226.62	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE BIL 1-2 VIEWS	$205.20	$342.00	$19.41–$273.60	28% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LEFT 1- 2 VIEWS	$136.20	$227.00	$19.41–$226.62	52% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RIGHT 1-2 VIEWS	$136.20	$227.00	$19.41–$226.62	52% below	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE BIL 1-2 VIEWS	$205.20	$342.00	$19.41–$273.60	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RIGHT 1-2 VIEWS	$136.20	$227.00	$19.41–$226.62	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LEFT 1- 2 VIEWS	$136.20	$227.00	$19.41–$226.62	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SP FLEX/EXT NEURO EVAL	$157.20	$262.00	$22.06–$272.24	61% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR 2-3 VIEWS/AP-LAT	$157.20	$262.00	$22.06–$272.24	61% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR 2-3 VIEWS/AP-LAT	$157.20	$262.00	$22.06–$272.24	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SP FLEX/EXT NEURO EVAL	$157.20	$262.00	$22.06–$272.24	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR 4+ VIEWS	$223.80	$373.00	$34.29–$298.40	51% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR 4+ VIEWS	$223.80	$373.00	$34.29–$298.40	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC AP LAT	$157.20	$262.00	$24.75–$272.24	59% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC AP LAT	$157.20	$262.00	$24.75–$272.24	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES	$125.40	$209.00	$21.30–$226.62	54% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES	$125.40	$209.00	$21.30–$226.62	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL 2-3 VIEWS	$150.00	$250.00	$23.58–$226.62	55% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERV SP FLEX/EXT NEURO EVAL	$150.00	$250.00	$23.58–$226.62	55% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERV SP FLEX/EXT NEURO EVAL	$150.00	$250.00	$23.58–$226.62	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VIEWS	$129.00	$215.00	$19.76–$272.24	56% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2 VIEWS	$129.00	$215.00	$19.76–$272.24	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX 2+ VIEWS	$190.20	$317.00	$21.67–$253.60	43% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM COCCYX 2+ VIEWS	$190.20	$317.00	$21.67–$253.60	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ACTH blood test CPT 82024 A.C.T.H.	$87.60	$146.00	$35.94–$164.16	63% below	40%
ACTH blood test inpatient CPT 82024 A.C.T.H.	$87.60	$146.00	$35.94–$164.16	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SPGT	$29.40	$49.00	$4.93–$39.20	19% below	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SPGT	$29.40	$49.00	$4.93–$39.20	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$19.80	$33.00	$3.54–$26.40	45% below	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$19.80	$33.00	$3.54–$26.40	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PROFILE	$145.80	$243.00	$44.32–$282.61	53% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PROFILE	$145.80	$243.00	$44.32–$282.61	—	40%
Albumin blood test CPT 82040 ALBUMIN IGG INDEX	$19.80	$33.00	$4.38–$26.75	38% below	40%
Albumin blood test CPT 82040 ALBUMIN	$19.80	$33.00	$4.38–$26.75	38% below	40%
Albumin blood test inpatient CPT 82040 ALBUMIN	$19.80	$33.00	$4.38–$26.75	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN IGG INDEX	$19.80	$33.00	$4.38–$26.75	—	40%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$61.20	$102.00	$31.20–$174.37	71% below	40%
Aldosterone blood test CPT 82088 ALDOSTREONE URINE	$144.60	$241.00	$31.20–$192.80	31% below	40%
Aldosterone blood test CPT 82088 ALDOSTERONE, BLOOD	$144.60	$241.00	$31.20–$192.80	31% below	40%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$61.20	$102.00	$31.20–$174.37	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTREONE URINE	$144.60	$241.00	$31.20–$192.80	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, BLOOD	$144.60	$241.00	$31.20–$192.80	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$19.80	$33.00	$3.62–$26.40	46% below	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$19.80	$33.00	$3.62–$26.40	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN,EACH	$18.60	$31.00	$4.86–$37.14	43% below	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN,EACH	$18.60	$31.00	$4.86–$37.14	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL AFP	$61.80	$103.00	$15.07–$82.40	43% below	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MA	$61.80	$103.00	$15.07–$82.40	43% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR MA	$61.80	$103.00	$15.07–$82.40	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL AFP	$61.80	$103.00	$15.07–$82.40	—	40%
Ammonia blood test CPT 82140 AMMONIA	$52.80	$88.00	$6.00–$70.40	42% below	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$52.80	$88.00	$6.00–$70.40	—	40%
Amylase blood test CPT 82150 AMYLASE	$29.40	$49.00	$6.00–$39.20	33% below	40%
Amylase blood test CPT 82150 URINE AMYLASE	$29.40	$49.00	$6.00–$39.20	33% below	40%
Amylase blood test inpatient CPT 82150 URINE AMYLASE	$29.40	$49.00	$6.00–$39.20	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$29.40	$49.00	$6.00–$39.20	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CITRULLINE (PLASMA)	$77.40	$129.00	$12.05–$103.20	9% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CITRULLINE (PLASMA)	$77.40	$129.00	$12.05–$103.20	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, QUAL	$76.80	$128.00	$10.34–$102.40	3% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA, QUAL	$76.80	$128.00	$10.34–$102.40	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BNP)	$107.40	$179.00	$23.20–$143.20	46% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP (B TYPE NATRIURETIC)	$107.40	$179.00	$23.20–$143.20	46% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE (BNP)	$107.40	$179.00	$23.20–$143.20	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP (B TYPE NATRIURETIC)	$107.40	$179.00	$23.20–$143.20	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL, OTHER	$13.20	$22.00	$6.90–$30.84	76% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL, OTHER	$13.20	$22.00	$6.90–$30.84	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE	$27.00	$45.00	$7.87–$43.16	66% below	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE	$27.00	$45.00	$7.87–$43.16	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN,TOTAL	$19.80	$33.00	$4.67–$35.51	38% below	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN,TOTAL	$19.80	$33.00	$4.67–$35.51	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 RENAL BIOPSY SO	$120.60	$201.00	$17.88–$160.80	29% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV, GROSS & MICRO	$120.60	$201.00	$17.88–$160.80	29% below	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 RENAL BIOPSY SO	$120.60	$201.00	$17.88–$160.80	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV, GROSS & MICRO	$120.60	$201.00	$17.88–$160.80	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$15.60	$26.00	$9.60–$50.47	82% below	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$15.60	$26.00	$9.60–$50.47	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, ESL	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI NURSING HOME	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI HOME PHLEBOTOMY	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, WCIM	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ZZ IR BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, BLVS DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI COVID CLINIC	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, LIGONIER DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, SALTSBURG DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, NORVELT DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI PENN TOWNSHIP	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, MT VIEW DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, UNIT DRAWN	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, TSH	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, BLVS TOWN	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, OP HOSPITAL DIAG	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, DOWNTOWN	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENI, DERRY	$4.80	$8.00	$1.08–$21.36	68% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LABCORP VENI FEE	$5.40	$9.00	$1.08–$21.36	64% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 AMBRY GEN KIT COLLECT	$9.00	$15.00	$1.08–$21.36	40% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 NXGEN KIT COLLECT/PROCESS	$12.00	$20.00	$1.08–$21.36	20% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BIOREFERENCE LAB FEE	$15.00	$25.00	$1.08–$21.36	at median	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, WCIM	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ZZ IR BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, BLVS DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, LIGONIER DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, SALTSBURG DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, NORVELT DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, MT VIEW DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, UNIT DRAWN	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, TSH	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, BLVS TOWN	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, DERRY	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, DOWNTOWN	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, OP HOSPITAL DIAG	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI COVID CLINIC	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI, ESL	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI PENN TOWNSHIP	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI HOME PHLEBOTOMY	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENI NURSING HOME	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE BLOOD DRAW	$4.80	$8.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LABCORP VENI FEE	$5.40	$9.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 AMBRY GEN KIT COLLECT	$9.00	$15.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 NXGEN KIT COLLECT/PROCESS	$12.00	$20.00	$1.08–$21.36	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BIOREFERENCE LAB FEE	$15.00	$25.00	$1.08–$21.36	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE-FASTING	$13.80	$23.00	$3.66–$23.85	47% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE, 2 HR. PP	$13.80	$23.00	$3.66–$23.85	47% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$13.80	$23.00	$3.66–$23.85	47% below	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-FASTING	$13.80	$23.00	$3.66–$23.85	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, 2 HR. PP	$13.80	$23.00	$3.66–$23.85	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$13.80	$23.00	$3.66–$23.85	—	40%
Blood lead test CPT 83655 LEAD, WHOLE BLOOD CAPILLARY	$43.80	$73.00	$11.27–$59.97	44% below	40%
Blood lead test CPT 83655 LEAD 24 HR-UA	$43.80	$73.00	$11.27–$59.97	44% below	40%
Blood lead test CPT 83655 BLOOD LEAD	$43.80	$73.00	$11.27–$59.97	44% below	40%
Blood lead test inpatient CPT 83655 LEAD, WHOLE BLOOD CAPILLARY	$43.80	$73.00	$11.27–$59.97	—	40%
Blood lead test inpatient CPT 83655 BLOOD LEAD	$43.80	$73.00	$11.27–$59.97	—	40%
Blood lead test inpatient CPT 83655 LEAD 24 HR-UA	$43.80	$73.00	$11.27–$59.97	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, SERUM	$27.00	$45.00	$5.78–$36.00	47% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST, SERUM	$27.00	$45.00	$5.78–$36.00	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/REVERSE	$116.40	$194.00	$4.17–$346.47	14% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF 86900 (ABO TYPE)	$116.40	$194.00	$4.17–$346.47	14% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 REF 86900 (ABO TYPE)	$116.40	$194.00	$4.17–$346.47	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/REVERSE	$116.40	$194.00	$4.17–$346.47	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN (UREA NITROGEN)	$18.60	$31.00	$3.68–$24.80	32% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (UREA NITROGEN)	$18.60	$31.00	$3.68–$24.80	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$76.20	$127.00	$19.30–$101.60	31% below	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$76.20	$127.00	$19.30–$101.60	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP QNT	$15.00	$25.00	$3.60–$28.16	58% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP QNT	$15.00	$25.00	$3.60–$28.16	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$91.80	$153.00	$34.68–$122.40	56% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$91.80	$153.00	$34.68–$122.40	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$58.80	$98.00	$15.70–$78.40	56% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$58.80	$98.00	$15.70–$78.40	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$55.80	$93.00	$14.65–$74.40	58% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$55.80	$93.00	$14.65–$74.40	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV 2 (COVID19) IH-EMPLOYEE	$30.00	$50.00	$40.00–$128.28	68% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV 2 (COVID19)-IN HOUSE	$76.80	$128.00	$42.59–$128.28	19% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV 2 (COVID19) IH-EMPLOYEE	$30.00	$50.00	$40.00–$128.28	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV 2 (COVID19)-IN HOUSE	$76.80	$128.00	$42.59–$128.28	—	40%
Calcium blood test, total CPT 82310 CALCIUM	$22.20	$37.00	$3.54–$29.60	34% below	40%
Calcium blood test, total CPT 82310 CALCIUM, URINE, RANDOM	$22.20	$37.00	$3.54–$29.60	34% below	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$22.20	$37.00	$3.54–$29.60	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM, URINE, RANDOM	$22.20	$37.00	$3.54–$29.60	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$54.00	$90.00	$17.64–$89.36	55% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$54.00	$90.00	$17.64–$89.36	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB	$61.80	$103.00	$11.99–$82.40	26% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG	$61.80	$103.00	$11.99–$82.40	26% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB	$61.80	$103.00	$11.99–$82.40	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG	$61.80	$103.00	$11.99–$82.40	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE-AMP	$97.80	$163.00	$23.19–$194.52	52% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE-AMP	$97.80	$163.00	$23.19–$194.52	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$42.60	$71.00	$12.46–$56.80	52% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$42.60	$71.00	$12.46–$56.80	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC/W AUTOMATED DIFF	$24.00	$40.00	$7.20–$38.85	52% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC/W AUTOMATED DIFF	$24.00	$40.00	$7.20–$38.85	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF	$18.00	$30.00	$4.70–$24.00	57% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF	$18.00	$30.00	$4.70–$24.00	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROFILE	$36.00	$60.00	$9.83–$56.63	61% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PROFILE	$36.00	$60.00	$9.83–$56.63	—	40%
Cortisol blood test, total CPT 82533 CORTISOL, SERUM	$51.60	$86.00	$12.00–$77.44	50% below	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SERUM	$51.60	$86.00	$12.00–$77.44	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK, TOTAL	$19.80	$33.00	$6.06–$33.57	56% below	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK, TOTAL	$19.80	$33.00	$6.06–$33.57	—	40%
Creatinine blood test CPT 82565 CREATININE	$18.60	$31.00	$3.70–$24.80	45% below	40%
Creatinine blood test inpatient CPT 82565 CREATININE	$18.60	$31.00	$3.70–$24.80	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV, IGG ANTIBODIES	$49.80	$83.00	$12.64–$66.40	43% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV TESTING OF PRODUCT	$49.80	$83.00	$12.64–$66.40	43% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV TESTING OF PRODUCT	$49.80	$83.00	$12.64–$66.40	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV, IGG ANTIBODIES	$49.80	$83.00	$12.64–$66.40	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$68.40	$114.00	$9.09–$91.20	at median	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$68.40	$114.00	$9.09–$91.20	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$91.80	$153.00	$20.69–$122.40	34% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$91.80	$153.00	$20.69–$122.40	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITUATE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRYCYCLIC SCREENING	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DALMANE N-DELALKYL (FLURAZEPAM	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUTABARBITAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCP UA QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ABUSE PANEL 9, SERUM	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, HIGH COMPLX,SND OUT	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN,MULTI DRUG CLASS	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GOLD	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN, EIA HIGH COMPLEX/PT	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BLOOD ALCOHOL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL URINE	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE,SERUM	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES-UA-QUAL	$162.00	$270.00	$57.83–$326.88	13% below	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN,MULTI DRUG CLASS	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OPIATES-UA-QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DALMANE N-DELALKYL (FLURAZEPAM	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUTABARBITAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, EIA HIGH COMPLEX/PT	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ABUSE PANEL 9, SERUM	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BARBITUATE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRYCYCLIC SCREENING	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL URINE	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BLOOD ALCOHOL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GOLD	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE-UA-QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCP UA QUAL	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN, HIGH COMPLX,SND OUT	$162.00	$270.00	$57.83–$326.88	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE,SERUM	$162.00	$270.00	$57.83–$326.88	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PROFILE	$44.40	$74.00	$6.52–$59.20	19% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PROFILE	$44.40	$74.00	$6.52–$59.20	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV, IGM, QUAL, V. CAPSID	$125.40	$209.00	$16.53–$167.20	7% above	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV, IGG, QUAL, V. CAPSID	$125.40	$209.00	$16.53–$167.20	7% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV, IGM, QUAL, V. CAPSID	$125.40	$209.00	$16.53–$167.20	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV, IGG, QUAL, V. CAPSID	$125.40	$209.00	$16.53–$167.20	—	40%
Estradiol blood test CPT 82670 ESTRADIOL FRACT TOTAL	$87.60	$146.00	$21.50–$129.14	49% below	40%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$87.60	$146.00	$21.50–$129.14	49% below	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL	$87.60	$146.00	$21.50–$129.14	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL FRACT TOTAL	$87.60	$146.00	$21.50–$129.14	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$119.40	$199.00	$17.16–$159.20	at median	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$119.40	$199.00	$17.16–$159.20	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$51.60	$86.00	$18.27–$81.22	60% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$51.60	$86.00	$18.27–$81.22	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$28.80	$48.00	$12.15–$53.46	67% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$28.80	$48.00	$12.15–$53.46	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN SCREENING	$21.00	$35.00	$9.05–$43.87	69% below	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN SCREENING	$21.00	$35.00	$9.05–$43.87	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$33.60	$56.00	$13.68–$70.44	62% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$33.60	$56.00	$13.68–$70.44	—	40%
Free T3 thyroid hormone test CPT 84481 FREE T3	$49.20	$82.00	$15.76–$79.77	55% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$49.20	$82.00	$15.76–$79.77	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 EQUILIBRIUM DIALYSIS	$48.60	$81.00	$8.39–$64.80	19% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$48.60	$81.00	$8.39–$64.80	19% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 EQUILIBRIUM DIALYSIS	$48.60	$81.00	$8.39–$64.80	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$48.60	$81.00	$8.39–$64.80	—	40%
Free testosterone test CPT 84402 TESTOSTERONE (FREE)	$68.40	$114.00	$23.70–$120.74	57% below	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE (FREE)	$68.40	$114.00	$23.70–$120.74	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRNSTPTDSE	$18.60	$31.00	$5.47–$24.80	61% below	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRNSTPTDSE	$18.60	$31.00	$5.47–$24.80	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR SCREEN	$23.40	$39.00	$4.42–$31.20	37% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$23.40	$39.00	$4.42–$31.20	37% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HR SCREEN	$23.40	$39.00	$4.42–$31.20	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$23.40	$39.00	$4.42–$31.20	—	40%
Glucose tolerance test, 3 samples CPT 82951 82951 GTT (3 SPECIMENS)	$58.20	$97.00	$11.98–$77.60	28% below	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, 3 SPECIMENS	$58.20	$97.00	$11.98–$77.60	28% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 82951 GTT (3 SPECIMENS)	$58.20	$97.00	$11.98–$77.60	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, 3 SPECIMENS	$58.20	$97.00	$11.98–$77.60	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE DNA PROBE-AMP	$97.80	$163.00	$23.19–$195.32	49% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE DNA PROBE-AMP	$97.80	$163.00	$23.19–$195.32	—	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGA	$65.40	$109.00	$13.23–$87.20	43% below	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGG	$65.40	$109.00	$13.23–$87.20	43% below	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI IGG	$65.40	$109.00	$13.23–$87.20	—	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI IGA	$65.40	$109.00	$13.23–$87.20	—	40%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG	$75.00	$125.00	$11.39–$100.00	21% below	40%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG	$75.00	$125.00	$11.39–$100.00	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1, VIRAL LOAD, QNT	$238.80	$398.00	$79.19–$513.39	54% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1, VIRAL LOAD, QNT	$238.80	$398.00	$79.19–$513.39	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 ANTIBODY	$36.00	$60.00	$12.76–$93.06	65% below	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 ANTIBODY	$36.00	$60.00	$12.76–$93.06	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$51.60	$86.00	$22.41–$77.18	64% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB	$51.60	$86.00	$22.41–$77.18	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOL RSLT	$105.60	$176.00	$32.65–$249.83	51% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HI-RISK TYP POOL RSLT	$105.60	$176.00	$32.65–$249.83	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN AIC	$30.00	$50.00	$8.40–$53.42	44% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN AIC	$30.00	$50.00	$8.40–$53.42	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN BY RESP	$6.60	$11.00	$2.21–$14.96	62% below	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$6.60	$11.00	$2.21–$14.96	62% below	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN BY RESP	$6.60	$11.00	$2.21–$14.96	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$6.60	$11.00	$2.21–$14.96	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE, IGG AND IGM	$51.00	$85.00	$11.21–$68.00	39% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE, IGG AND IGM	$51.00	$85.00	$11.21–$68.00	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 ANTI HEP B SURFACE AB	$33.60	$56.00	$9.99–$67.85	54% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 ANTI HEP B SURFACE AB	$33.60	$56.00	$9.99–$67.85	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$32.40	$54.00	$9.61–$52.49	53% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG	$32.40	$54.00	$9.61–$52.49	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$43.80	$73.00	$13.28–$76.38	56% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$43.80	$73.00	$13.28–$76.38	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C PCR QNT	$156.00	$260.00	$39.65–$261.32	45% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C PCR QNT	$156.00	$260.00	$39.65–$261.32	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX VIRUS I IGM	$52.80	$88.00	$12.27–$70.40	34% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 GLYCOPROTEIN IGG AB	$52.80	$88.00	$12.27–$70.40	34% below	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 GLYCOPROTEIN IGG AB	$52.80	$88.00	$12.27–$70.40	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX VIRUS I IGM	$52.80	$88.00	$12.27–$70.40	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 GLYCOPROTEIN IGG AB	$52.80	$88.00	$16.05–$70.62	51% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX II IGM	$52.80	$88.00	$16.05–$70.62	51% below	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX II IGM	$52.80	$88.00	$16.05–$70.62	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 GLYCOPROTEIN IGG AB	$52.80	$88.00	$16.05–$70.62	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HI SENSITIVITY	$49.20	$82.00	$11.51–$65.60	38% below	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HI SENSITIVITY	$49.20	$82.00	$11.51–$65.60	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$70.20	$117.00	$16.68–$93.60	41% below	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE, URINE, QNT	$70.20	$117.00	$16.68–$93.60	41% below	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE, URINE, QNT	$70.20	$117.00	$16.68–$93.60	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$70.20	$117.00	$16.68–$93.60	—	40%
Insulin blood test CPT 83525 INSULIN, 60 MINUTES	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test CPT 83525 INSULIN, 30 MINUTES	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test CPT 83525 INSULIN	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test CPT 83525 INSULIN, TOTAL (BOUND)	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test CPT 83525 INSULIN, 120 MINUTES	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test CPT 83525 INSULIN, 90 MINUTES	$42.00	$70.00	$9.82–$56.00	42% below	40%
Insulin blood test inpatient CPT 83525 INSULIN	$42.00	$70.00	$9.82–$56.00	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, 60 MINUTES	$42.00	$70.00	$9.82–$56.00	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, TOTAL (BOUND)	$42.00	$70.00	$9.82–$56.00	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, 120 MINUTES	$42.00	$70.00	$9.82–$56.00	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, 30 MINUTES	$42.00	$70.00	$9.82–$56.00	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, 90 MINUTES	$42.00	$70.00	$9.82–$56.00	—	40%
Iron blood test (serum iron) CPT 83540 IRON, TISSUE QUANT	$15.00	$25.00	$4.81–$21.16	67% below	40%
Iron blood test (serum iron) CPT 83540 IRON	$15.00	$25.00	$4.81–$21.16	67% below	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON, TISSUE QUANT	$15.00	$25.00	$4.81–$21.16	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$15.00	$25.00	$4.81–$21.16	—	40%
Iron-binding capacity (TIBC) test CPT 83550 UIBC	$24.00	$40.00	$6.00–$43.56	60% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 UIBC	$24.00	$40.00	$6.00–$43.56	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$47.40	$79.00	$8.08–$63.20	31% below	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$47.40	$79.00	$8.08–$63.20	—	40%
LH (luteinizing hormone) test CPT 83002 LH LUTEIN HORMONE	$119.40	$199.00	$17.00–$159.20	at median	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH LUTEIN HORMONE	$119.40	$199.00	$17.00–$159.20	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE ANALYSIS	$39.00	$65.00	$9.60–$71.10	49% below	40%
Lactate (lactic acid) blood test CPT 83605 CSF LACTATE	$39.00	$65.00	$9.60–$71.10	49% below	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$39.00	$65.00	$9.60–$71.10	49% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$39.00	$65.00	$9.60–$71.10	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 CSF LACTATE	$39.00	$65.00	$9.60–$71.10	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE ANALYSIS	$39.00	$65.00	$9.60–$71.10	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$15.00	$25.00	$4.37–$20.00	59% below	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$15.00	$25.00	$4.37–$20.00	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$12.00	$20.00	$6.00–$34.80	74% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$12.00	$20.00	$6.00–$34.80	—	40%
Liver function blood test panel CPT 80076 HEPATIC (LIVER) PROFILE	$24.00	$40.00	$7.60–$43.08	70% below	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC (LIVER) PROFILE	$24.00	$40.00	$7.60–$43.08	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE IGG AB	$50.40	$84.00	$15.32–$67.41	47% below	40%
Lyme disease antibody test CPT 86618 LYMES AB SCREENING	$50.40	$84.00	$15.32–$67.41	47% below	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGG AB	$50.40	$84.00	$15.32–$67.41	—	40%
Lyme disease antibody test inpatient CPT 86618 LYMES AB SCREENING	$50.40	$84.00	$15.32–$67.41	—	40%
Magnesium blood test CPT 83735 MAGNESIUM	$15.00	$25.00	$4.82–$21.21	64% below	40%
Magnesium blood test CPT 83735 MAGNESIUM, 24 HOUR	$15.00	$25.00	$4.82–$21.21	64% below	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, 24 HOUR	$15.00	$25.00	$4.82–$21.21	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$15.00	$25.00	$4.82–$21.21	—	40%
Measles (rubeola) antibody test CPT 86765 MEASLES RUBEOLA, IGM	$38.40	$64.00	$10.40–$51.20	53% below	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$38.40	$64.00	$10.40–$51.20	53% below	40%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES RUBEOLA, IGM	$38.40	$64.00	$10.40–$51.20	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$38.40	$64.00	$10.40–$51.20	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$19.20	$32.00	$3.36–$25.60	49% below	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$19.20	$32.00	$3.36–$25.60	—	40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$30.00	$50.00	$12.14–$63.10	63% below	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$30.00	$50.00	$12.14–$63.10	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PRENATAL PACKAGE	$182.40	$304.00	$14.40–$243.20	41% below	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PRENATAL PACKAGE	$182.40	$304.00	$14.40–$243.20	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE RATIO	$51.00	$85.00	$17.11–$104.76	56% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE RATIO	$51.00	$85.00	$17.11–$104.76	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, DIAGNOSTIC	$58.20	$97.00	$16.88–$77.60	47% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, DIAGNOSTIC	$58.20	$97.00	$16.88–$77.60	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP SMEAR DIAG THIN W/COMPUTER	$76.80	$128.00	$19.40–$102.40	5% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP SMEAR DIAG THIN W/COMPUTER	$76.80	$128.00	$19.40–$102.40	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 DIAG PAP SMEAR LIQUID	$46.80	$78.00	$16.00–$106.30	24% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 DIAG PAP SMEAR LIQUID	$46.80	$78.00	$16.00–$106.30	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$94.20	$157.00	$38.42–$176.13	56% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$213.60	$356.00	$38.42–$284.80	1% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$94.20	$157.00	$38.42–$176.13	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$213.60	$356.00	$38.42–$284.80	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PART THROMBOPLASTIN TIME	$15.00	$25.00	$4.52–$20.00	64% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PART THROMBOPLASTIN TIME	$15.00	$25.00	$4.52–$20.00	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$9.00	$15.00	$2.88–$12.67	72% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$9.00	$15.00	$2.88–$12.67	—	40%
Potassium blood test CPT 84132 POTASSIUM BY RESP	$12.00	$20.00	$2.95–$16.00	63% below	40%
Potassium blood test CPT 84132 POTASSIUM	$12.00	$20.00	$2.95–$16.00	63% below	40%
Potassium blood test inpatient CPT 84132 POTASSIUM	$12.00	$20.00	$2.95–$16.00	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM BY RESP	$12.00	$20.00	$2.95–$16.00	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY	$1,203.60	$2,006.00	$607.24–$2,915.18	48% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY	$1,203.60	$2,006.00	$607.24–$2,915.18	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$48.00	$80.00	$17.00–$84.35	65% below	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$48.00	$80.00	$17.00–$84.35	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$28.80	$48.00	$18.04–$91.17	77% below	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$28.80	$48.00	$18.04–$91.17	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$9.60	$16.00	$2.32–$12.80	66% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$9.60	$16.00	$2.32–$12.80	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 OPIATE(S), EX. DEMEROL, EACH	$121.80	$203.00	$11.73–$162.40	120% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 OPIATE(S), EX. DEMEROL, EACH	$121.80	$203.00	$11.73–$162.40	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DIRECT OPTICAL OB	$29.40	$49.00	$12.50–$55.00	48% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA IA W DIRECT OPTICAL OB	$29.40	$49.00	$12.50–$55.00	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$29.40	$49.00	$6.37–$39.20	54% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$29.40	$49.00	$6.37–$39.20	—	40%
Renin blood test CPT 84244 RENIN ACTIVITY	$75.00	$125.00	$14.40–$102.21	48% below	40%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY	$75.00	$125.00	$14.40–$102.21	—	40%
Rh blood typing CPT 86901 REF 86901 (RH TYPE)	$44.40	$74.00	$5.00–$97.25	22% below	40%
Rh blood typing CPT 86901 BLOOD TYPING, RH	$44.40	$74.00	$5.00–$97.25	22% below	40%
Rh blood typing CPT 86901 DU FACTOR	$44.40	$74.00	$5.00–$97.25	22% below	40%
Rh blood typing inpatient CPT 86901 REF 86901 (RH TYPE)	$44.40	$74.00	$5.00–$97.25	—	40%
Rh blood typing inpatient CPT 86901 DU FACTOR	$44.40	$74.00	$5.00–$97.25	—	40%
Rh blood typing inpatient CPT 86901 BLOOD TYPING, RH	$44.40	$74.00	$5.00–$97.25	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUM FACTOR, QNT	$22.20	$37.00	$5.28–$31.02	43% below	40%
Rheumatoid factor (RF) test CPT 86431 RF, FLUID	$22.20	$37.00	$5.28–$31.02	43% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RF, FLUID	$22.20	$37.00	$5.28–$31.02	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FACTOR, QNT	$22.20	$37.00	$5.28–$31.02	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$38.40	$64.00	$11.96–$52.62	55% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$38.40	$64.00	$11.96–$52.62	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE	$16.20	$27.00	$2.51–$29.96	24% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE	$16.20	$27.00	$2.51–$29.96	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SPERM ANALYSIS COMPLETE W/DIFF	$49.20	$82.00	$11.46–$65.60	45% below	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SPERM ANALYSIS COMPLETE W/DIFF	$49.20	$82.00	$11.46–$65.60	—	40%
Sodium blood test CPT 84295 SODIUM (NA) BY RESP	$15.00	$25.00	$4.48–$27.24	54% below	40%
Sodium blood test CPT 84295 SODIUM	$15.00	$25.00	$4.48–$27.24	54% below	40%
Sodium blood test inpatient CPT 84295 SODIUM (NA) BY RESP	$15.00	$25.00	$4.48–$27.24	—	40%
Sodium blood test inpatient CPT 84295 SODIUM	$15.00	$25.00	$4.48–$27.24	—	40%
Stool ova and parasites exam CPT 87177 OVA + PARASITES, SCREEN	$31.80	$53.00	$8.28–$42.86	46% below	40%
Stool ova and parasites exam inpatient CPT 87177 OVA + PARASITES, SCREEN	$31.80	$53.00	$8.28–$42.86	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 2 SPEC SCREENING	$17.40	$29.00	$0.81–$23.20	15% below	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN 1-3 CONSEC	$17.40	$29.00	$0.81–$23.20	15% below	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 3 SPEC SCREENING	$17.40	$29.00	$0.81–$23.20	15% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN 1-3 CONSEC	$17.40	$29.00	$0.81–$23.20	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 2 SPEC SCREENING	$17.40	$29.00	$0.81–$23.20	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 3 SPEC SCREENING	$17.40	$29.00	$0.81–$23.20	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FHG, IA, DX	$36.00	$60.00	$3.36–$48.00	at median	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FHG, IA, DX	$36.00	$60.00	$3.36–$48.00	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB PA	$18.60	$31.00	$12.32–$79.20	75% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB, IGM	$76.80	$128.00	$12.32–$102.40	2% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA, ABS	$76.80	$128.00	$12.32–$102.40	2% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA - AB (CSF)	$76.80	$128.00	$12.32–$102.40	2% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB PA	$18.60	$31.00	$12.32–$79.20	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB, IGM	$76.80	$128.00	$12.32–$102.40	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA - AB (CSF)	$76.80	$128.00	$12.32–$102.40	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA, ABS	$76.80	$128.00	$12.32–$102.40	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR MONITOR WRFLX TITER	$6.00	$10.00	$2.54–$11.18	79% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, QUALITATIVE	$22.20	$37.00	$2.54–$29.60	21% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, QUAL	$22.20	$37.00	$2.54–$29.60	21% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR MONITOR WRFLX TITER	$6.00	$10.00	$2.54–$11.18	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, QUAL	$22.20	$37.00	$2.54–$29.60	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, QUALITATIVE	$22.20	$37.00	$2.54–$29.60	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST, CELL IMMUN MEASURE	$196.20	$327.00	$57.68–$282.52	37% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST, CELL IMMUN MEASURE	$196.20	$327.00	$57.68–$282.52	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$51.60	$86.00	$24.02–$107.93	69% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$51.60	$86.00	$24.02–$107.93	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIV/KID MICROSOM AUTO ABS	$32.40	$54.00	$9.49–$46.20	59% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$32.40	$54.00	$9.49–$46.20	59% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROXIDASE MICROS	$32.40	$54.00	$9.49–$46.20	59% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID PEROXIDASE MICROS	$32.40	$54.00	$9.49–$46.20	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$32.40	$54.00	$9.49–$46.20	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIV/KID MICROSOM AUTO ABS	$32.40	$54.00	$9.49–$46.20	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$39.00	$65.00	$15.63–$79.60	61% below	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$39.00	$65.00	$15.63–$79.60	—	40%
Total IgE blood test CPT 82785 IGE	$52.20	$87.00	$15.32–$79.07	50% below	40%
Total IgE blood test inpatient CPT 82785 IGE	$52.20	$87.00	$15.32–$79.07	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$19.80	$33.00	$4.05–$26.40	34% below	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$19.80	$33.00	$4.05–$26.40	—	40%
Total thyroxine (T4) blood test CPT 84436 T4	$30.60	$51.00	$5.21–$40.80	32% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$30.60	$51.00	$5.21–$40.80	—	40%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$49.20	$82.00	$9.60–$65.60	49% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$49.20	$82.00	$9.60–$65.60	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$33.60	$56.00	$11.87–$62.96	62% below	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$33.60	$56.00	$11.87–$62.96	—	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG, AMP PROBE	$73.80	$123.00	$32.65–$264.26	62% below	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG, AMP PROBE	$73.80	$123.00	$32.65–$264.26	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$34.20	$57.00	$5.34–$45.60	13% below	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$34.20	$57.00	$5.34–$45.60	—	40%
Troponin test, quantitative CPT 84484 TROPONIN I	$27.00	$45.00	$10.27–$45.19	67% below	40%
Troponin test, quantitative CPT 84484 TROPONIN T, QUANT.	$140.40	$234.00	$10.27–$187.20	72% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$27.00	$45.00	$10.27–$45.19	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T, QUANT.	$140.40	$234.00	$10.27–$187.20	—	40%
Uric acid blood test CPT 84550 URIC ACID	$19.80	$33.00	$4.21–$26.40	37% below	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$19.80	$33.00	$4.21–$26.40	—	40%
Urinalysis with microscope exam, automated CPT 81001 UA MACRO AND MICRO	$9.00	$15.00	$2.45–$12.00	73% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA MACRO AND MICRO	$9.00	$15.00	$2.45–$12.00	—	40%
Urinalysis without microscope exam, automated CPT 81003 SPEC GRAVITY URINE	$18.60	$31.00	$2.09–$24.80	5% above	40%
Urinalysis without microscope exam, automated CPT 81003 PH, URINE	$18.60	$31.00	$2.09–$24.80	5% above	40%
Urinalysis without microscope exam, automated CPT 81003 UA MACROSCOPIC DIPSTICK	$18.60	$31.00	$2.09–$24.80	5% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA MACROSCOPIC DIPSTICK	$18.60	$31.00	$2.09–$24.80	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPEC GRAVITY URINE	$18.60	$31.00	$2.09–$24.80	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH, URINE	$18.60	$31.00	$2.09–$24.80	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINE BILIRUBIN ICTOTEST	$21.00	$35.00	$3.24–$28.00	at median	40%
Urinalysis without microscope exam, manual CPT 81002 GLUCOSE,URINE,QUAL REDUCING SUB	$21.00	$35.00	$3.24–$28.00	at median	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE BILIRUBIN ICTOTEST	$21.00	$35.00	$3.24–$28.00	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 GLUCOSE,URINE,QUAL REDUCING SUB	$21.00	$35.00	$3.24–$28.00	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, URINE, QNT	$24.00	$40.00	$7.51–$38.85	57% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, URINE, QNT	$24.00	$40.00	$7.51–$38.85	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR UA QUANT	$27.00	$45.00	$5.38–$36.00	32% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR UA QUANT	$27.00	$45.00	$5.38–$36.00	—	40%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY, QUAL, URINE, VISUAL	$27.00	$45.00	$4.00–$43.74	27% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY, QUAL, URINE, VISUAL	$27.00	$45.00	$4.00–$43.74	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$33.00	$55.00	$13.60–$59.84	65% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$33.00	$55.00	$13.60–$59.84	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY VITAMIN D	$67.80	$113.00	$27.55–$136.88	55% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXY VITAMIN D	$67.80	$113.00	$27.55–$136.88	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 1,25 DIHYDROXY VITAMIN D	$229.80	$383.00	$35.83–$306.40	5% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1,25 DIHYDROXY VITAMIN D	$229.80	$383.00	$35.83–$306.40	—	40%
Zinc blood test CPT 84630 ZINC	$47.40	$79.00	$10.60–$63.20	35% below	40%
Zinc blood test inpatient CPT 84630 ZINC	$47.40	$79.00	$10.60–$63.20	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG	$49.20	$82.00	$14.01–$65.60	46% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG TRIPLE SCREEN	$49.20	$82.00	$14.01–$65.60	46% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG	$49.20	$82.00	$14.01–$65.60	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG TRIPLE SCREEN	$49.20	$82.00	$14.01–$65.60	—	40%

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 CPT 19081 MM STEREOTACTIC BR BX 1ST	$1,700.40	$2,834.00	$177.96–$4,300.81	57% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 TX DIST FIBULAR FX W/O MAN	$524.40	$874.00	$142.20–$1,360.92	21% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 TX DIST FIBULAR FX W/O MAN	$524.40	$874.00	$142.20–$1,360.92	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470/CL TX METATARS FX WO MANIP	$199.20	$332.00	$74.98–$642.33	62% below	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470/CL TX METATARS FX WO MANIP	$199.20	$332.00	$74.98–$642.33	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	60% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	60% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ELECTIVE/CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	60% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ELECTIVE/CARDIOVERSION	$603.60	$1,006.00	$104.40–$1,721.10	—	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY POLYPECTOMY SNARE	$1,500.00	$2,500.00	$410.27–$3,116.07	40% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY POLYPECTOMY SNARE	$1,500.00	$2,500.00	$410.27–$3,116.07	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY	$1,500.00	$2,500.00	$384.00–$3,116.07	31% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY	$1,500.00	$2,500.00	$384.00–$3,116.07	—	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY/DIAGNOSTIC	$1,170.00	$1,950.00	$413.50–$2,421.64	22% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY/DIAGNOSTIC	$1,170.00	$1,950.00	$413.50–$2,421.64	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000/CYSTOURETHROSCOPY	$1,001.40	$1,669.00	$90.00–$1,815.77	42% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000/CYSTOURETHROSCOPY	$1,001.40	$1,669.00	$90.00–$1,815.77	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209/REM CERUMEN, LAV UNI	$78.00	$130.00	$11.52–$153.62	46% below	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM CERUMEN, LAV UNI	$78.00	$130.00	$11.52–$153.62	46% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209/REM CERUMEN, LAV UNI	$78.00	$130.00	$11.52–$153.62	—	40%
Earwax removal with instruments, one ear CPT 69210 69210/REM IMPACTED CERUMEN	$72.60	$121.00	$8.71–$153.62	46% below	40%
Earwax removal with instruments, one ear CPT 69210 69210/REM IMPACTED CERUMEN	$77.40	$129.00	$8.71–$153.62	43% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 69210/REM IMPACTED CERUMEN	$77.40	$129.00	$8.71–$153.62	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR INJECT EPIDURAL C/T W/IMAGING	$862.20	$1,437.00	$107.04–$1,838.14	64% below	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT INJ PARAVERT F JNT L/S 1LEV	$843.00	$1,405.00	$86.41–$2,303.18	41% below	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR INJ PARAVERT F JNT L/S 1 LEV	$843.00	$1,405.00	$86.41–$2,303.18	41% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,170.00	$1,950.00	$187.00–$2,421.64	1% above	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,170.00	$1,950.00	$187.00–$2,421.64	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 ZZ XR HYSTEROGRAM INJECTION	$278.40	$464.00	$62.40–$371.20	32% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 ZZ US INJ HYSTEROSONO	$278.40	$464.00	$62.40–$371.20	32% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION DRAINAGE-SIMPLE	$190.20	$317.00	$28.20–$522.46	63% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I&D SIMPLE/SINGLE	$190.20	$317.00	$28.20–$522.46	63% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 10060/I&D SIMPLE/SINGLE	$190.20	$317.00	$28.20–$522.46	63% below	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060/I&D SIMPLE/SINGLE	$190.20	$317.00	$28.20–$522.46	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION DRAINAGE-SIMPLE	$190.20	$317.00	$28.20–$522.46	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550/INJECT SINGL TENDON SHTH	$297.00	$495.00	$38.40–$799.31	48% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ZZ IR INJ TEND SHEA/LIGAMENT	$297.00	$495.00	$38.40–$799.31	48% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550/INJECT SINGL TENDON SHTH	$297.00	$495.00	$38.40–$799.31	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ZZ CT ARTHROCENTESIS MAJOR JT	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 DRAIN/INJ MAJOR JNT/BURSA	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610/ARTHROCENTESIS MAJOR JOINT	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ZZ IR ARTHROCENT/MAJOR	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ZZ XR ARTHROCENTESIS MAJOR JOINT	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ZZ XR ARTHRO ASP INJ MJR JT	$354.60	$591.00	$11.87–$1,008.80	24% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610/ARTHROCENTESIS MAJOR JOINT	$354.60	$591.00	$11.87–$1,008.80	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ZZ XR ARTHROCENT/INTERMEDIATE	$354.60	$591.00	$11.63–$799.31	1% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ZZ IR ARTHROCENT/INTERMEDIATE	$354.60	$591.00	$11.63–$799.31	1% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605/ARTHROCENTESIS INTER JOINT	$354.60	$591.00	$11.63–$799.31	1% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 D* 20605/ARTHROCENTESIS INTERMED	$368.24	$613.73	$11.63–$799.31	5% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605/ARTHROCENTESIS INTER JOINT	$354.60	$591.00	$11.63–$799.31	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ZZ IR ASPIRATE/INJECT SMALL JOINT	$354.60	$591.00	$21.60–$799.31	14% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ZZ XR ASPIRATE/INJECT SMALL JNT	$354.60	$591.00	$21.60–$799.31	14% below	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER CAPSULOTOMY	$798.00	$1,330.00	$259.81–$1,819.36	23% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031/SUTURE REP INTERMED <2.5CM	$375.00	$625.00	$29.40–$1,058.57	36% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031/SUTURE REP INTERMED <2.5CM	$375.00	$625.00	$29.40–$1,058.57	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 IR INJECT EPIDURAL L/S W/IMAGING	$843.00	$1,405.00	$97.58–$1,838.14	60% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CT INJECT EPIDURAL L/S W/IMAGING	$843.00	$1,405.00	$97.58–$1,838.14	60% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 XR INJECT EPIDURAL L/S W/IMAGING	$843.00	$1,405.00	$97.58–$1,838.14	60% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NM LUMBAR PUNCT/CISTERNOGRAM	$843.00	$1,405.00	$97.58–$1,838.14	60% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 IR CISTERNOGRAM PUNCTURE L/S	$843.00	$1,405.00	$97.58–$1,838.14	60% below	40%
Lower-back epidural injection, without imaging guidance CPT 62322 LS EPIDURAL INJECT W/O IMAGIN	$843.00	$1,405.00	$85.38–$2,303.18	57% below	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT INJ TRANSFRMN EPI L/S 1ST	$843.00	$1,405.00	$113.66–$2,303.18	57% below	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR TRANS.EPI L/S FIRST LEVEL	$1,285.20	$2,142.00	$113.66–$2,303.18	34% below	40%
Miscarriage treatment with D&C, first trimester CPT 59820 59820 TRMT MISCARRIAGE-1ST TRIMES	$2,173.80	$3,623.00	$322.98–$8,429.54	60% below	40%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 59820 TRMT MISCARRIAGE-1ST TRIMES	$2,173.80	$3,623.00	$322.98–$8,429.54	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 EXC BGN LES TRK,A/L <=.5CM	$501.60	$836.00	$45.00–$1,843.99	63% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400 EXC BGN LES TRK,A/L <=.5CM	$501.60	$836.00	$45.00–$1,843.99	—	40%
Nail removal (partial or complete), one nail CPT 11730 11730/AVULSION NAIL	$142.20	$237.00	$30.90–$522.46	70% below	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730/AVULSION NAIL	$142.20	$237.00	$30.90–$522.46	—	40%
Paracentesis with imaging guidance CPT 49083 XR PARACENTESIS W/IMAGING	$1,208.40	$2,014.00	$822.12–$2,437.29	28% below	40%
Paracentesis with imaging guidance CPT 49083 US PARACENT W/IMAGING	$1,208.40	$2,014.00	$822.12–$2,437.29	28% below	40%
Paracentesis with imaging guidance CPT 49083 CT PARACENTESIS W/IMAGING	$1,208.40	$2,014.00	$822.12–$2,437.29	28% below	40%
Paracentesis with imaging guidance CPT 49083 49083/PARACENTESIS W/IMAGING	$1,208.40	$2,014.00	$822.12–$2,437.29	28% below	40%
Paracentesis with imaging guidance CPT 49083 IR PARACENTESIS W/IMAGING	$1,353.00	$2,255.00	$822.12–$2,437.29	20% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 49083/PARACENTESIS W/IMAGING	$1,208.40	$2,014.00	$822.12–$2,437.29	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750/EXCISION OF NAIL	$501.60	$836.00	$120.00–$1,058.57	40% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750/EXCISION OF NAIL	$501.60	$836.00	$120.00–$1,058.57	—	40%
Removal of a foreign object under the skin, simple CPT 10120 10120/I&D FB SIMPLE	$401.40	$669.00	$36.60–$1,058.57	23% below	40%
Removal of a foreign object under the skin, simple CPT 10120 10120/I&D FB SIMPLE	$401.40	$669.00	$36.60–$1,058.57	23% below	40%
Removal of a foreign object under the skin, simple CPT 10120 ZZ IR FOREIGN BODY INCS & REMOVE	$401.40	$669.00	$36.60–$1,058.57	23% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120/I&D FB SIMPLE	$401.40	$669.00	$36.60–$1,058.57	—	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY/SCREENING NOT HI RSK	$1,198.80	$1,998.00	$541.69–$2,421.64	21% below	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY/SCREENING NOT HI RSK	$1,198.80	$1,998.00	$541.69–$2,421.64	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY/SCREENING HIGH RISK	$1,198.80	$1,998.00	$685.34–$2,421.64	27% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY/SCREENING HIGH RISK	$1,198.80	$1,998.00	$685.34–$2,421.64	—	40%
Short arm cast (elbow to hand) CPT 29075 29075/APPLY SHORT ARM CAST	$331.20	$552.00	$53.93–$728.33	20% below	40%
Short arm splint (forearm and hand) CPT 29125 29125/APPLIC SHORT ARM SPLINT	$142.20	$237.00	$31.20–$346.47	55% below	40%
Short arm splint (forearm and hand) CPT 29125 29125/APPLY SHORT ARM SPLINT	$142.20	$237.00	$31.20–$346.47	55% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 29125/APPLIC SHORT ARM SPLINT	$142.20	$237.00	$31.20–$346.47	—	40%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST	$161.40	$269.00	$60.60–$728.33	70% below	40%
Short leg cast (below the knee) CPT 29405 29405/APPLICATION SHORT LEG CAST	$161.40	$269.00	$60.60–$728.33	70% below	40%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST	$161.40	$269.00	$60.60–$728.33	—	40%
Short leg cast (below the knee) inpatient CPT 29405 29405/APPLICATION SHORT LEG CAST	$161.40	$269.00	$60.60–$728.33	—	40%
Short leg splint (calf to foot) CPT 29515 29515/APPLIC SHORT LEG SPLINT	$142.80	$238.00	$42.00–$423.15	69% below	40%
Short leg splint (calf to foot) inpatient CPT 29515 29515/APPLIC SHORT LEG SPLINT	$142.80	$238.00	$42.00–$423.15	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001/SUTURE REP <2.5 CM TRUNK	$210.60	$351.00	$29.40–$522.46	59% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001/SUTURE REP <2.5 CM TRUNK	$210.60	$351.00	$29.40–$522.46	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SINGLE LESION	$239.40	$399.00	$48.52–$1,058.57	64% below	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SINGLE LESION	$239.40	$399.00	$48.52–$1,058.57	—	40%
Skin tag removal, up to 15 tags CPT 11200 11200 REM SKIN TABS 1-15 ANY	$217.20	$362.00	$37.20–$522.46	64% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REM SKIN TABS 1-15 ANY	$217.20	$362.00	$37.20–$522.46	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DX W/O IMAGE	$631.80	$1,053.00	$50.40–$1,838.14	49% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270/LUMBAR PUNCT DX W/O IMAGE	$631.80	$1,053.00	$50.40–$1,838.14	49% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270/LUMBAR PUNCT DX W/O IMAGE	$631.80	$1,053.00	$50.40–$1,838.14	49% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270/LUMBAR PUNCT DX W/O IMAGE	$631.80	$1,053.00	$50.40–$1,838.14	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002/SUTURE REP 2.6-7.5CM TRUNK	$210.60	$351.00	$42.60–$522.46	60% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002/SUTURE REP 2.6-7.5 CM TRUNK	$210.60	$351.00	$42.60–$522.46	60% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002/SUTURE REP 2.6-7.5 CM TRUNK	$210.60	$351.00	$42.60–$522.46	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011/SUTURE REP <2.5 CM FACE	$210.60	$351.00	$37.80–$522.46	59% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011/SUTURE REP <2.5 CM FACE	$210.60	$351.00	$37.80–$522.46	—	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING	$940.80	$1,568.00	$106.44–$1,633.52	36% below	40%
Thoracentesis with imaging guidance CPT 32555 32555/THORACENTESIS W/IMAGING	$940.80	$1,568.00	$106.44–$1,633.52	36% below	40%
Thoracentesis with imaging guidance CPT 32555 IR THORACENTESIS WITH IMAGE	$940.80	$1,568.00	$106.44–$1,633.52	36% below	40%
Thoracentesis with imaging guidance CPT 32555 US THORACENTSIS W IMAGING	$940.80	$1,568.00	$106.44–$1,633.52	36% below	40%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS W/IMAGING	$940.80	$1,568.00	$106.44–$1,633.52	36% below	40%
Thoracentesis with imaging guidance inpatient CPT 32555 32555/THORACENTESIS W/IMAGING	$940.80	$1,568.00	$106.44–$1,633.52	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 IR TRIGGER PNT INJ 1 OR 2 MUSC	$297.00	$495.00	$37.27–$799.31	45% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSC	$297.00	$495.00	$37.27–$799.31	45% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 ZZ CT TRIGGER PNT INJ 1 OR 2 MUSC	$297.00	$495.00	$37.27–$799.31	45% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECT TRIG PTS 1 OR 2 MUSC	$297.00	$495.00	$37.27–$799.31	45% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJECT TRIG PTS 1 OR 2 MUSC	$297.00	$495.00	$37.27–$799.31	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US MAMMOTOME BREAST 1ST	$1,700.40	$2,834.00	$166.67–$4,300.81	52% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US PERC BX BREAST 1ST	$1,700.40	$2,834.00	$166.67–$4,300.81	52% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD W/BALLOON DILATION <30	$2,400.00	$4,000.00	$410.29–$4,996.87	30% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD W/BALLOON DILATION <30	$2,400.00	$4,000.00	$410.29–$4,996.87	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY	$1,140.00	$1,900.00	$337.20–$2,361.80	47% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY	$1,140.00	$1,900.00	$337.20–$2,361.80	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W/SUBMUCOSAL INJECTION	$1,140.00	$1,900.00	$212.32–$2,361.80	59% below	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W/SUBMUCOSAL INJECTION	$1,140.00	$1,900.00	$212.32–$2,361.80	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/POLYPECTOMY SNARE	$2,400.00	$4,000.00	$413.68–$4,996.87	23% below	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/POLYPECTOMY SNARE	$2,400.00	$4,000.00	$413.68–$4,996.87	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD W/DILATION OVER GUIDEWIRE	$1,381.80	$2,303.00	$410.26–$2,361.80	44% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD W/DILATION OVER GUIDEWIRE	$1,381.80	$2,303.00	$410.26–$2,361.80	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD W OR W/O BRUSH	$1,140.00	$1,900.00	$305.97–$2,361.80	39% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD W OR W/O BRUSH	$1,140.00	$1,900.00	$305.97–$2,361.80	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042/DEBRIDE SUBQ 1ST 20 SQ CM	$889.80	$1,483.00	$39.60–$1,820.76	17% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042/DEBRIDE SUBQ 1ST 20 SQ CM	$889.80	$1,483.00	$39.60–$1,820.76	17% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042/DEBRIDE SUBQ 1ST 20 SQ CM	$889.80	$1,483.00	$39.60–$1,820.76	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$390.00	$650.00	$33.41–$1,148.83	62% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD TRANSFUSION	$390.00	$650.00	$33.41–$1,148.83	62% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD TRANSFUSION	$390.00	$650.00	$33.41–$1,148.83	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$390.00	$650.00	$33.41–$1,148.83	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI RX	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB RX	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER RX, SUB	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER RX	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB SUBSEQUENT	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI RX, SUBSEQUENT	$250.80	$418.00	$11.83–$570.22	11% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB RX	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI RX, SUBSEQUENT	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI RX	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB SUBSEQUENT	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER RX, SUB	$250.80	$418.00	$11.83–$570.22	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER RX	$250.80	$418.00	$11.83–$570.22	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO/COMPLX DRUG INFUSE 1ST HR	$382.80	$638.00	$149.76–$860.12	52% below	40%
Chemotherapy IV infusion, first hour CPT 96413 96413/IV CHEMO 1ST HOUR	$450.00	$750.00	$149.76–$860.12	43% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO/COMPLX DRUG INFUSE 1ST HR	$382.80	$638.00	$149.76–$860.12	—	40%
Critical care, first 30 to 74 minutes CPT 99291 99291 CRITICAL CARE 30-74 MIN	$800.40	$1,334.00	$103.94–$2,151.01	62% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 CRITICAL CARE 30-74 MIN	$800.40	$1,334.00	$103.94–$2,151.01	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG, AWAKE AND DROWSY	$258.60	$431.00	$27.00–$562.28	66% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG, AWAKE AND DROWSY	$258.60	$431.00	$27.00–$562.28	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$81.00	$135.00	$10.74–$153.62	53% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 XR EKG	$81.00	$135.00	$10.74–$153.62	53% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 XR EKG	$81.00	$135.00	$10.74–$153.62	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$81.00	$135.00	$10.74–$153.62	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 EMR CATEGORY 1	$184.20	$307.00	$22.00–$245.60	43% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 EMR CATEGORY 1	$184.20	$307.00	$22.00–$245.60	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 EMR CATEGORY 2	$256.80	$428.00	$26.88–$399.83	51% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 EMR CATEGORY 2	$256.80	$428.00	$26.88–$399.83	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 EMR CATEGORY 3	$330.60	$551.00	$38.50–$710.84	58% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 EMR CATEGORY 3	$330.60	$551.00	$38.50–$710.84	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 EMR CATEGORY 4	$441.00	$735.00	$55.00–$1,086.57	65% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 EMR CATEGORY 4	$441.00	$735.00	$55.00–$1,086.57	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 EMR CATEGORY 5	$576.60	$961.00	$55.00–$1,550.78	66% below	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 EMR CATEGORY 5	$576.60	$961.00	$55.00–$1,550.78	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$484.20	$807.00	$28.36–$645.60	48% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE STRESS TEST	$484.20	$807.00	$28.36–$645.60	48% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$484.20	$807.00	$28.36–$645.60	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EXERCISE STRESS TEST	$484.20	$807.00	$28.36–$645.60	—	40%
Family therapy with the patient, 50 minutes CPT 90847 MA-FAMILY THERAPY EA 15MIN	$65.40	$109.00	$45.27–$462.20	79% below	40%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY >26 MIN	$261.60	$436.00	$45.27–$462.20	17% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 MA-FAMILY THERAPY EA 15MIN	$65.40	$109.00	$45.27–$462.20	—	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY >26 MIN	$261.60	$436.00	$45.27–$462.20	—	40%
Family therapy without the patient, 50 minutes CPT 90846 MA-FAMILY THERPY W/O PT EA 15MIN	$65.40	$109.00	$38.41–$462.20	64% below	40%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHTHPY W/O PAT 1/2 HR	$130.80	$218.00	$38.41–$462.20	27% below	40%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHTHPY W/O PAT 1 HR	$260.40	$434.00	$38.41–$462.20	45% above	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 MA-FAMILY THERPY W/O PT EA 15MIN	$65.40	$109.00	$38.41–$462.20	—	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHTHPY W/O PAT 1/2 HR	$130.80	$218.00	$38.41–$462.20	—	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHTHPY W/O PAT 1 HR	$260.40	$434.00	$38.41–$462.20	—	40%
Group psychotherapy session CPT 90853 MA-GROUP THERAPY EACH 15MIN	$36.00	$60.00	$48.00–$264.55	75% below	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 30 MIN	$72.00	$120.00	$57.78–$264.55	51% below	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 45 MIN	$108.00	$180.00	$57.78–$264.55	26% below	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 60 MIN	$144.00	$240.00	$57.78–$264.55	2% below	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 75 MIN	$180.00	$300.00	$57.78–$264.55	23% above	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 75 MIN	$180.00	$300.00	$57.78–$264.55	23% above	40%
Group psychotherapy session CPT 90853 GROUP THERAPY 90 MIN	$216.00	$360.00	$57.78–$288.00	47% above	40%
Group psychotherapy session inpatient CPT 90853 MA-GROUP THERAPY EACH 15MIN	$36.00	$60.00	$48.00–$264.55	—	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 30 MIN	$72.00	$120.00	$57.78–$264.55	—	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 45 MIN	$108.00	$180.00	$57.78–$264.55	—	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 60 MIN	$144.00	$240.00	$57.78–$264.55	—	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 75 MIN	$180.00	$300.00	$57.78–$264.55	—	40%
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 90 MIN	$216.00	$360.00	$57.78–$288.00	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IR IV HYDRATE <1 HOUR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION UP TO 1 HOUR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360/IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDR/AMB STRT/1ST ED HR	$227.40	$379.00	$37.96–$553.89	49% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360/IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDR/AMB STRT/1ST ED HR	$227.40	$379.00	$37.96–$553.89	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION UP TO 1 HOUR	$227.40	$379.00	$37.96–$553.89	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IR IV HYDRATE <1 HOUR	$227.40	$379.00	$37.96–$553.89	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION UP TO 1 HR	$227.40	$379.00	$37.96–$553.89	—	40%
IV infusion of a medicine, first hour CPT 96365 IR IV THERAPY UP TO 1 HR	$247.20	$412.00	$47.16–$553.89	50% below	40%
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUS/AMB STRT/1ST ED HR	$247.20	$412.00	$47.16–$553.89	50% below	40%
IV infusion of a medicine, first hour CPT 96365 96365 INFUSION UP TO 1 HOUR	$247.20	$412.00	$47.16–$553.89	50% below	40%
IV infusion of a medicine, first hour CPT 96365 96365/INFUSION UP TO 1 HOUR	$247.20	$412.00	$47.16–$553.89	50% below	40%
IV infusion of a medicine, first hour CPT 96365 DRUG INFUSION UP TO 1 HR	$247.20	$412.00	$47.16–$553.89	50% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365/INFUSION UP TO 1 HOUR	$247.20	$412.00	$47.16–$553.89	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUS/AMB STRT/1ST ED HR	$247.20	$412.00	$47.16–$553.89	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 DRUG INFUSION UP TO 1 HR	$247.20	$412.00	$47.16–$553.89	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 INFUSION UP TO 1 HOUR	$247.20	$412.00	$47.16–$553.89	—	40%
IV push of a medicine, first drug CPT 96374 INITIAL IV PUSH	$247.20	$412.00	$37.22–$553.89	26% below	40%
IV push of a medicine, first drug CPT 96374 96374 INITIAL IV PUSH	$247.20	$412.00	$37.22–$553.89	26% below	40%
IV push of a medicine, first drug CPT 96374 IR IVP THER/PROPH/DIAG 1/INIT	$247.20	$412.00	$37.22–$553.89	26% below	40%
IV push of a medicine, first drug inpatient CPT 96374 IR IVP THER/PROPH/DIAG 1/INIT	$247.20	$412.00	$37.22–$553.89	—	40%
IV push of a medicine, first drug inpatient CPT 96374 96374 INITIAL IV PUSH	$247.20	$412.00	$37.22–$553.89	—	40%
IV push of a medicine, first drug inpatient CPT 96374 INITIAL IV PUSH	$247.20	$412.00	$37.22–$553.89	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION SQ/IM	$84.00	$140.00	$15.24–$187.50	33% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SQ/IM INJECTION	$84.00	$140.00	$15.24–$187.50	33% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 SQ/IM INJECTION	$84.00	$140.00	$15.24–$187.50	33% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION SQ/IM	$84.00	$140.00	$15.24–$187.50	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SQ/IM INJECTION	$84.00	$140.00	$15.24–$187.50	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 SQ/IM INJECTION	$84.00	$140.00	$15.24–$187.50	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 INT PSY DIAG INTERVIEW	$173.40	$289.00	$168.76–$462.20	35% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INT PSY DIAG INTERVIEW	$173.40	$289.00	$168.76–$462.20	—	40%
New patient office visit, about 30 minutes CPT 99203 VISIT 30 MIN NEW PT LOW	$168.00	$280.00	$51.65–$227.26	38% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 VISIT 30 MIN NEW PT LOW	$168.00	$280.00	$51.65–$227.26	—	40%
New patient office visit, about 45 minutes CPT 99204 VISIT 45 MIN NEW PT MOD	$174.00	$290.00	$66.26–$291.54	55% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 VISIT 45 MIN NEW PT MOD	$174.00	$290.00	$66.26–$291.54	—	40%
New patient office visit, about 60 minutes CPT 99205 VISIT 60 MIN NEW PT HIGH	$260.40	$434.00	$72.00–$355.70	51% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 VISIT 60 MIN NEW PT HIGH	$260.40	$434.00	$72.00–$355.70	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 VISIT 15 MIN NEW PT SF	$162.00	$270.00	$42.58–$216.00	16% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 VISIT 15 MIN NEW PT SF	$162.00	$270.00	$42.58–$216.00	—	40%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC EVAL BY MD-TC	$173.40	$289.00	$168.76–$462.20	47% below	40%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC EVAL BY MD-TC	$173.40	$289.00	$168.76–$462.20	—	40%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN WO/E&M	$96.60	$161.00	$128.80–$462.20	61% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN WO/E&M	$96.60	$161.00	$128.80–$462.20	—	40%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN W/O E&M	$165.00	$275.00	$168.76–$462.20	37% below	40%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN WO/E&M	$165.00	$275.00	$168.76–$462.20	37% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN W/O E&M	$165.00	$275.00	$168.76–$462.20	—	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN WO/E&M	$165.00	$275.00	$168.76–$462.20	—	40%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN WO/E&M	$180.00	$300.00	$168.76–$462.20	40% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN WO/E&M	$180.00	$300.00	$168.76–$462.20	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 VISIT 40 MIN EST PT HIGH	$180.00	$300.00	$38.77–$240.00	38% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 VISIT 40 MIN EST PT HIGH	$180.00	$300.00	$38.77–$240.00	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 VISIT 20 MIN EST PT LOW	$168.00	$280.00	$27.83–$224.00	10% below	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 VISIT 20 MIN EST PT LOW	$168.00	$280.00	$27.83–$224.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 VISIT 30 MIN EST PT MOD	$174.00	$290.00	$33.05–$232.00	22% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 VISIT 30 MIN EST PT MOD	$174.00	$290.00	$33.05–$232.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 VISIT 30 MIN EST PT MOD	$174.00	$290.00	$33.05–$232.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 VISIT 10 MIN EST PT SF	$162.00	$270.00	$23.77–$216.00	at median	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 VISIT 10 MIN EST PT SF	$162.00	$270.00	$23.77–$216.00	—	40%
Spirometry (breathing test) CPT 94010 PR-SRIROMETRY W/GRAPHIC RECORD	$158.40	$264.00	$13.31–$562.28	51% below	40%
Spirometry (breathing test) CPT 94010 PFS-SPIROMETRY W/GRAPHIC RECORD	$158.40	$264.00	$13.31–$562.28	51% below	40%
Spirometry (breathing test) inpatient CPT 94010 PR-SRIROMETRY W/GRAPHIC RECORD	$158.40	$264.00	$13.31–$562.28	—	40%
Spirometry (breathing test) inpatient CPT 94010 PFS-SPIROMETRY W/GRAPHIC RECORD	$158.40	$264.00	$13.31–$562.28	—	40%
Spirometry before and after a bronchodilator CPT 94060 PFS-BROCHOSPASM EVAL	$263.40	$439.00	$22.80–$971.70	60% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFS-BROCHOSPASM EVAL	$263.40	$439.00	$22.80–$971.70	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 IR PHLEBOTOMY,THERAPEUTIC	$121.80	$203.00	$12.00–$346.47	48% below	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPUTIC PHLEBOTOMY	$186.60	$311.00	$12.00–$346.47	21% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPUTIC PHLEBOTOMY	$186.60	$311.00	$12.00–$346.47	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$606.06	$1,010.10	$48.00–$808.08	204% above	40%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM	$606.06	$1,010.10	$48.00–$808.08	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACCINE, TRIVAL	$92.34	$153.89	$12.00–$123.12	41% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACCINE, TRIVAL	$92.34	$153.89	$12.00–$123.12	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1ML	$184.76	$307.94	$12.00–$246.35	115% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1ML	$184.76	$307.94	$12.00–$246.35	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT 20MCG	$154.66	$257.77	$12.00–$206.22	128% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE ADULT 20MCG	$154.66	$257.77	$12.00–$206.22	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJUCATED VACCINE	$67.15	$111.92	$12.00–$89.53	115% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B CONJUCATED VACCINE	$67.15	$111.92	$12.00–$89.53	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE VACCINE TRI	$342.76	$571.26	$12.00–$457.01	281% above	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE VACCINE TRI	$342.76	$571.26	$12.00–$457.01	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACC	$165.95	$276.58	$12.00–$221.27	185% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VIRUS VACC	$165.95	$276.58	$12.00–$221.27	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO VACCINE	$254.75	$424.58	$12.00–$339.66	172% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO VACCINE	$254.75	$424.58	$12.00–$339.66	—	40%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENINGOCOCCAL VAC, TETANUS CONJUG	$1,825.01	$3,041.68	$12.00–$2,433.34	266% above	40%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL VAC, TETANUS CONJUG	$1,825.01	$3,041.68	$12.00–$2,433.34	—	40%
Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM	$837.50	$1,395.84	$12.00–$1,116.67	276% above	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENB-FHBP VACC 2/3 DOSE IM	$837.50	$1,395.84	$12.00–$1,116.67	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ 0.5ML	$1,222.28	$2,037.13	$12.00–$1,629.70	279% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ 0.5ML	$1,222.28	$2,037.13	$12.00–$1,629.70	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VALENT VACCINE	$547.94	$913.23	$12.00–$730.59	442% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VALENT VACCINE	$547.94	$913.23	$12.00–$730.59	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICK E	$553.16	$921.93	$12.00–$737.54	7% below	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, FOR IM USE	$1,015.11	$1,691.85	$12.00–$1,353.48	70% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICK E	$553.16	$921.93	$12.00–$737.54	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, FOR IM USE	$1,015.11	$1,691.85	$12.00–$1,353.48	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD)	$114.11	$190.18	$12.00–$152.14	104% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD)	$114.11	$190.18	$12.00–$152.14	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS/DIPHTHERIA/PERTUSSIS, AC	$205.11	$341.85	$12.00–$273.48	269% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS/DIPHTHERIA/PERTUSSIS, AC	$205.11	$341.85	$12.00–$273.48	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471/ADMIN VACCINE	$60.00	$100.00	$0.21–$187.50	6% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SQ/IM	$60.00	$100.00	$0.21–$187.50	6% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471/IM IMMUNIZATION WO COUNSEL	$60.00	$100.00	$0.21–$187.50	6% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471/IM IMMUNIZATION WO COUNSEL	$60.00	$100.00	$0.21–$187.50	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SQ/IM	$60.00	$100.00	$0.21–$187.50	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471/ADMIN VACCINE	$60.00	$100.00	$0.21–$187.50	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472/IM IMMUN WO COUNSL EA ADD	$42.00	$70.00	$0.10–$56.00	33% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM EACH ADD VACCINE	$42.00	$70.00	$0.10–$56.00	33% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM EACH ADD VACCINE	$42.00	$70.00	$0.10–$56.00	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472/IM IMMUN WO COUNSL EA ADD	$42.00	$70.00	$0.10–$56.00	—	40%

Dental

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 D7140/DENTAL EXTRACTION	$1,893.00	$3,155.00	$121.70–$2,524.00	at median	40%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 D7140/DENTAL EXTRACTION	$1,893.00	$3,155.00	$121.70–$2,524.00	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://wvumedicine.org/wp-content/uploads/2026/09/250965414_LatrobeAreaHospital_StandardCharges.csv