Hospital

Ocean Beach Hospital

Listed in its price file as “Public-Hospital-District-3-of-Pacific-County”.

Ocean Beach Hospital in Ilwaco, WA publishes cash prices for 357 common procedures listed here, from its own machine-readable price file updated Oct 23, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Washington median for 211 of 354 procedures and below it for 132. By typical cash price it ranks #41 of 60 Washington hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

174 1st Avenue North, Ilwaco, WA, 98624 Collected Oct 25, 2026 Source price file Check a bill from this hospital (360) 642-3181

Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CMS star rating 2 of 5 CCN 501314 · CMS hospital register NPI 1295771376

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Ocean Beach Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

State law

This state limits hospital bills for lower-income patients

Washington law (RCW 70.170.060) requires hospital charity care: patients with family income up to 300% of the federal poverty level owe nothing at hospitals in large health systems (200% at other hospitals), with 75% and 50% discounts up to 400% (300% at other hospitals). It covers the part of the bill a patient owes, insured or not. Ask the hospital for its charity care application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,556.75	$3,409.00	$1,465.87–$3,374.91	23% above	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST	$2,556.75	$3,409.00	$1,465.87–$3,374.91	—	25%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$291.75	$389.00	$167.27–$385.11	10% below	25%
Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS	$291.75	$389.00	$167.27–$385.11	—	25%
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	12% below	25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$287.25	$383.00	$164.69–$379.17	24% below	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$287.25	$383.00	$164.69–$379.17	—	25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,527.00	$2,036.00	$875.48–$2,015.64	8% above	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST	$1,527.00	$2,036.00	$875.48–$2,015.64	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST	$455.25	$607.00	$261.01–$600.93	25% below	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST	$455.25	$607.00	$261.01–$600.93	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,622.25	$2,163.00	$930.09–$2,141.37	9% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM	$1,622.25	$2,163.00	$930.09–$2,141.37	—	25%
Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE	$315.00	$420.00	$180.60–$415.80	27% below	25%
Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE	$315.00	$420.00	$180.60–$415.80	—	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED	$315.00	$420.00	$180.60–$415.80	7% below	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED	$315.00	$420.00	$180.60–$415.80	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$3,335.25	$4,447.00	$1,912.21–$4,402.53	7% below	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS	$3,335.25	$4,447.00	$1,912.21–$4,402.53	—	25%
CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,894.25	$3,859.00	$1,659.37–$3,820.41	37% above	25%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST	$2,894.25	$3,859.00	$1,659.37–$3,820.41	—	25%
CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,865.75	$3,821.00	$1,643.03–$3,782.79	27% above	25%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST	$2,865.75	$3,821.00	$1,643.03–$3,782.79	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,851.50	$3,802.00	$1,634.86–$3,763.98	19% above	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST	$2,851.50	$3,802.00	$1,634.86–$3,763.98	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$150.00	$200.00	$86.00–$198.00	13% above	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST	$150.00	$200.00	$86.00–$198.00	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,644.50	$3,526.00	$1,516.18–$3,490.74	5% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST	$2,644.50	$3,526.00	$1,516.18–$3,490.74	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,632.25	$4,843.00	$2,082.49–$4,794.57	18% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST	$3,632.25	$4,843.00	$2,082.49–$4,794.57	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,672.50	$6,230.00	$2,678.90–$6,167.70	25% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST	$4,672.50	$6,230.00	$2,678.90–$6,167.70	—	25%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST	$2,103.00	$2,804.00	$1,205.72–$2,775.96	12% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST	$2,103.00	$2,804.00	$1,205.72–$2,775.96	—	25%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,663.50	$2,218.00	$953.74–$2,195.82	16% above	25%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST	$1,663.50	$2,218.00	$953.74–$2,195.82	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,590.75	$2,121.00	$912.03–$2,099.79	44% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST	$1,590.75	$2,121.00	$912.03–$2,099.79	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,650.00	$2,200.00	$946.00–$2,178.00	24% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST	$1,650.00	$2,200.00	$946.00–$2,178.00	—	25%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,619.25	$2,159.00	$928.37–$2,137.41	11% above	25%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST	$1,619.25	$2,159.00	$928.37–$2,137.41	—	25%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,989.00	$2,652.00	$1,140.36–$2,625.48	15% above	25%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST	$1,989.00	$2,652.00	$1,140.36–$2,625.48	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$2,160.00	$2,880.00	$1,238.40–$2,851.20	50% above	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST	$2,160.00	$2,880.00	$1,238.40–$2,851.20	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST	$2,025.00	$2,700.00	$1,161.00–$2,673.00	35% above	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST	$2,025.00	$2,700.00	$1,161.00–$2,673.00	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST	$2,088.75	$2,785.00	$1,197.55–$2,757.15	16% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST	$2,088.75	$2,785.00	$1,197.55–$2,757.15	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$986.25	$1,315.00	$565.45–$1,301.85	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$986.25	$1,315.00	$565.45–$1,301.85	—	25%
Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,598.75	$3,465.00	$1,489.95–$3,430.35	25% above	25%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST	$2,598.75	$3,465.00	$1,489.95–$3,430.35	—	25%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS	$273.00	$364.00	$156.52–$360.36	6% below	25%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW	$246.75	$329.00	$141.47–$325.71	3% above	25%
Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$296.25	$395.00	$169.85–$391.05	24% above	25%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW	$246.75	$329.00	$141.47–$325.71	—	25%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW	$296.25	$395.00	$169.85–$391.05	—	25%
Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE	$255.75	$341.00	$146.63–$337.59	7% below	25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE	$255.75	$341.00	$146.63–$337.59	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$611.25	$815.00	$350.45–$806.85	2% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$611.25	$815.00	$350.45–$806.85	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$361.50	$482.00	$207.26–$477.18	14% below	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL	$361.50	$482.00	$207.26–$477.18	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$123.75	$165.00	$70.95–$163.35	29% below	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON	$123.75	$165.00	$70.95–$163.35	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,716.75	$2,289.00	$984.27–$2,266.11	15% above	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,716.75	$2,289.00	$984.27–$2,266.11	15% above	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING	$1,716.75	$2,289.00	$984.27–$2,266.11	—	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$1,716.75	$2,289.00	$984.27–$2,266.11	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$2,127.75	$2,837.00	$1,219.91–$2,808.63	12% above	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$2,127.75	$2,837.00	$1,219.91–$2,808.63	—	25%
Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD	$467.25	$623.00	$267.89–$616.77	3% above	25%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD	$467.25	$623.00	$267.89–$616.77	—	25%
Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD	$388.50	$518.00	$222.74–$512.82	1% above	25%
Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD	$388.50	$518.00	$222.74–$512.82	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,057.50	$1,410.00	$606.30–$1,395.90	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY	$1,057.50	$1,410.00	$606.30–$1,395.90	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,161.00	$1,548.00	$665.64–$1,532.52	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX SCAN XTR VEINS COMPLETE BILATERAL STUDY	$1,161.00	$1,548.00	$665.64–$1,532.52	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$1,678.50	$2,238.00	$962.34–$2,215.62	at median	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE	$1,678.50	$2,238.00	$962.34–$2,215.62	—	25%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS	$211.50	$282.00	$121.26–$279.18	21% below	25%
Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED	$211.50	$282.00	$121.26–$279.18	21% below	25%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS	$211.50	$282.00	$121.26–$279.18	—	25%
Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW LIMITED	$211.50	$282.00	$121.26–$279.18	—	25%
Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	14% below	25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,719.75	$2,293.00	$985.99–$2,270.07	41% above	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST	$1,719.75	$2,293.00	$985.99–$2,270.07	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$317.25	$423.00	$181.89–$418.77	14% below	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS	$317.25	$423.00	$181.89–$418.77	—	25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS	$255.75	$341.00	$146.63–$337.59	7% below	25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS	$255.75	$341.00	$146.63–$337.59	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM	$1,828.50	$2,438.00	$1,048.34–$2,413.62	55% above	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM	$1,828.50	$2,438.00	$1,048.34–$2,413.62	—	25%
Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS	$203.25	$271.00	$116.53–$268.29	29% below	25%
Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS	$203.25	$271.00	$116.53–$268.29	—	25%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS	$220.50	$294.00	$126.42–$291.06	15% below	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS	$220.50	$294.00	$126.42–$291.06	—	25%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS	$273.00	$364.00	$156.52–$360.36	12% below	25%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS	$317.25	$423.00	$181.89–$418.77	24% below	25%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS	$317.25	$423.00	$181.89–$418.77	—	25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,682.25	$2,243.00	$964.49–$2,220.57	25% above	25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST	$1,682.25	$2,243.00	$964.49–$2,220.57	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$578.25	$771.00	$331.53–$763.29	14% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$578.25	$771.00	$331.53–$763.29	—	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$444.75	$593.00	$254.99–$587.07	40% above	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM	$444.75	$593.00	$254.99–$587.07	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$1,541.25	$2,055.00	$883.65–$2,034.45	551% above	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM	$1,541.25	$2,055.00	$883.65–$2,034.45	—	25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS	$246.75	$329.00	$141.47–$325.71	11% below	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS	$246.75	$329.00	$141.47–$325.71	—	25%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST	$2,274.00	$3,032.00	$1,303.76–$3,001.68	15% above	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST	$2,274.00	$3,032.00	$1,303.76–$3,001.68	—	25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,036.25	$2,715.00	$1,167.45–$2,687.85	7% above	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST	$2,036.25	$2,715.00	$1,167.45–$2,687.85	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$3,552.75	$4,737.00	$2,036.91–$4,689.63	21% above	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST	$3,552.75	$4,737.00	$2,036.91–$4,689.63	—	25%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,301.00	$3,068.00	$1,319.24–$3,037.32	10% above	25%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST	$2,301.00	$3,068.00	$1,319.24–$3,037.32	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$3,517.50	$4,690.00	$2,016.70–$4,643.10	13% above	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST	$3,517.50	$4,690.00	$2,016.70–$4,643.10	—	25%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE	$2,238.75	$2,985.00	$1,283.55–$2,955.15	16% above	25%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE	$2,238.75	$2,985.00	$1,283.55–$2,955.15	—	25%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE	$3,729.00	$4,972.00	$652.97–$4,922.28	28% above	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE	$3,729.00	$4,972.00	$652.97–$4,922.28	—	25%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,335.50	$3,114.00	$1,339.02–$3,082.86	11% above	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE	$2,335.50	$3,114.00	$1,339.02–$3,082.86	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$3,782.25	$5,043.00	$2,168.49–$4,992.57	25% above	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE	$3,782.25	$5,043.00	$2,168.49–$4,992.57	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE	$2,397.75	$3,197.00	$1,374.71–$3,165.03	13% above	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE	$2,397.75	$3,197.00	$1,374.71–$3,165.03	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$4,319.25	$5,759.00	$2,476.37–$5,701.41	47% above	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE	$4,319.25	$5,759.00	$2,476.37–$5,701.41	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$2,353.50	$3,138.00	$1,349.34–$3,106.62	17% above	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE	$2,353.50	$3,138.00	$1,349.34–$3,106.62	—	25%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,729.00	$4,972.00	$2,137.96–$4,922.28	23% above	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST	$3,729.00	$4,972.00	$2,137.96–$4,922.28	—	25%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST	$2,125.50	$2,834.00	$1,218.62–$2,805.66	11% above	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST	$2,125.50	$2,834.00	$1,218.62–$2,805.66	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,160.00	$2,880.00	$1,238.40–$2,851.20	13% above	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST	$2,160.00	$2,880.00	$1,238.40–$2,851.20	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$414.00	$552.00	$237.36–$546.48	7% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS	$414.00	$552.00	$237.36–$546.48	—	25%
Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,911.75	$2,549.00	$1,096.07–$2,523.51	14% above	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST	$1,911.75	$2,549.00	$1,096.07–$2,523.51	—	25%
Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,635.75	$2,181.00	$937.83–$2,159.19	23% above	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST	$1,635.75	$2,181.00	$937.83–$2,159.19	—	25%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE	$220.50	$294.00	$126.42–$291.06	7% below	25%
Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE	$220.50	$294.00	$126.42–$291.06	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$4,110.00	$5,480.00	$2,356.40–$5,425.20	16% above	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE	$4,110.00	$5,480.00	$2,356.40–$5,425.20	—	25%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST	$1,842.00	$2,456.00	$1,056.08–$2,431.44	28% above	25%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST	$1,842.00	$2,456.00	$1,056.08–$2,431.44	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED	$375.75	$501.00	$215.43–$495.99	18% below	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED	$375.75	$501.00	$215.43–$495.99	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE	$625.50	$834.00	$358.62–$825.66	5% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE	$625.50	$834.00	$358.62–$825.66	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$708.75	$945.00	$406.35–$935.55	10% above	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS	$708.75	$945.00	$406.35–$935.55	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$750.00	$1,000.00	$430.00–$990.00	50% above	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM	$750.00	$1,000.00	$430.00–$990.00	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM	$159.00	$212.00	$91.16–$209.88	64% below	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM	$159.00	$212.00	$91.16–$209.88	—	25%
Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS	$264.75	$353.00	$151.79–$349.47	10% below	25%
Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS	$264.75	$353.00	$151.79–$349.47	—	25%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$319.50	$426.00	$183.18–$421.74	13% below	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS	$319.50	$426.00	$183.18–$421.74	—	25%
Screening mammogram, both breasts both sides CPT 77067 HC SCREEN MAMMO BI INCL CAD	$375.00	$500.00	$131.47–$495.00	—	25%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD	$375.00	$500.00	$131.47–$495.00	11% above	25%
Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$375.00	$500.00	$131.47–$495.00	11% above	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREEN MAMMO BI INCL CAD	$375.00	$500.00	$131.47–$495.00	—	25%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD	$375.00	$500.00	$131.47–$495.00	—	25%
Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD	$375.00	$500.00	$131.47–$495.00	—	25%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$299.25	$399.00	$171.57–$395.01	9% below	25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS	$299.25	$399.00	$171.57–$395.01	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$361.50	$482.00	$207.26–$477.18	12% above	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS	$361.50	$482.00	$207.26–$477.18	—	25%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS	$246.75	$329.00	$141.47–$325.71	15% below	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS	$246.75	$329.00	$141.47–$325.71	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$467.25	$623.00	$267.89–$616.77	13% below	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY	$467.25	$623.00	$267.89–$616.77	—	25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS	$273.00	$364.00	$156.52–$360.36	5% above	25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST	$2,058.00	$2,744.00	$1,179.92–$2,716.56	42% above	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST	$2,058.00	$2,744.00	$1,179.92–$2,716.56	—	25%
Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$242.25	$323.00	$138.89–$319.77	1% below	25%
Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS	$242.25	$323.00	$138.89–$319.77	—	25%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB	$462.75	$617.00	$265.31–$610.83	7% below	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB	$462.75	$617.00	$265.31–$610.83	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM	$596.25	$795.00	$341.85–$787.05	40% above	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM	$596.25	$795.00	$341.85–$787.05	—	25%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$757.50	$1,010.00	$434.30–$999.90	9% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$757.50	$1,010.00	$434.30–$999.90	—	25%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS	$672.75	$897.00	$385.71–$888.03	17% above	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS	$672.75	$897.00	$385.71–$888.03	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK	$440.25	$587.00	$252.41–$581.13	21% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK	$440.25	$587.00	$252.41–$581.13	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$433.50	$578.00	$248.54–$572.22	37% below	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM	$433.50	$578.00	$248.54–$572.22	—	25%
Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$246.75	$329.00	$141.47–$325.71	11% below	25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS	$246.75	$329.00	$141.47–$325.71	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$661.50	$882.00	$379.26–$873.18	2% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$661.50	$882.00	$379.26–$873.18	—	25%
Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS	$203.25	$271.00	$116.53–$268.29	19% below	25%
Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS	$203.25	$271.00	$116.53–$268.29	—	25%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	13% below	25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$336.00	$448.00	$192.64–$443.52	4% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS	$336.00	$448.00	$192.64–$443.52	—	25%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW	$229.50	$306.00	$131.58–$302.94	11% below	25%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$274.50	$366.00	$157.38–$362.34	6% above	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW	$229.50	$306.00	$131.58–$302.94	—	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW	$274.50	$366.00	$157.38–$362.34	—	25%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS	$238.50	$318.00	$136.74–$314.82	6% below	25%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS	$238.50	$318.00	$136.74–$314.82	—	25%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$246.75	$329.00	$141.47–$325.71	7% below	25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS	$246.75	$329.00	$141.47–$325.71	—	25%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS	$203.25	$271.00	$116.53–$268.29	27% below	25%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS	$203.25	$271.00	$116.53–$268.29	—	25%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS	$264.75	$353.00	$151.79–$349.47	12% below	25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS	$264.75	$353.00	$151.79–$349.47	—	25%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	12% below	25%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS	$273.00	$364.00	$156.52–$360.36	—	25%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS	$220.50	$294.00	$126.42–$291.06	23% below	25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS	$220.50	$294.00	$126.42–$291.06	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$309.00	$412.00	$177.16–$407.88	17% below	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS	$309.00	$412.00	$177.16–$407.88	—	25%
X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$450.75	$601.00	$258.43–$594.99	at median	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS	$450.75	$601.00	$258.43–$594.99	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$317.25	$423.00	$181.89–$418.77	at median	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS	$317.25	$423.00	$181.89–$418.77	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$249.00	$332.00	$142.76–$328.68	3% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS	$249.00	$332.00	$142.76–$328.68	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$291.75	$389.00	$167.27–$385.11	9% below	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS	$291.75	$389.00	$167.27–$385.11	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$246.75	$329.00	$141.47–$325.71	14% below	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS	$246.75	$329.00	$141.47–$325.71	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$291.75	$389.00	$167.27–$385.11	3% above	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS	$291.75	$389.00	$167.27–$385.11	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$271.50	$362.00	$38.62–$358.38	23% above	25%
ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM	$271.50	$362.00	$38.62–$358.38	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT)	$52.50	$70.00	$5.30–$69.30	11% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT)	$52.50	$70.00	$5.30–$69.30	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST)	$66.00	$88.00	$5.18–$87.12	56% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST)	$66.00	$88.00	$5.18–$87.12	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$330.75	$441.00	$47.63–$436.59	34% above	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL	$330.75	$441.00	$47.63–$436.59	—	25%
Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN	$34.50	$46.00	$4.95–$45.54	3% below	25%
Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$63.00	$84.00	$4.95–$83.16	77% above	25%
Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN	$34.50	$46.00	$4.95–$45.54	—	25%
Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD CDM	$63.00	$84.00	$4.95–$83.16	—	25%
Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD	$264.00	$352.00	$40.75–$348.48	57% above	25%
Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD	$264.00	$352.00	$40.75–$348.48	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS	$32.25	$43.00	$5.18–$42.57	15% below	25%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALK PHOS TOTAL	$32.25	$43.00	$5.18–$42.57	15% below	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS	$32.25	$43.00	$5.18–$42.57	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALK PHOS TOTAL	$32.25	$43.00	$5.18–$42.57	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$43.50	$58.00	$5.22–$57.42	63% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$43.50	$58.00	$5.22–$57.42	63% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE	$43.50	$58.00	$5.22–$57.42	63% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$43.50	$58.00	$5.22–$57.42	63% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE PANEL EACH ALLERGEN	$43.50	$58.00	$5.22–$57.42	63% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM	$43.50	$58.00	$5.22–$57.42	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$43.50	$58.00	$5.22–$57.42	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE	$43.50	$58.00	$5.22–$57.42	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE - IGE QUANT	$43.50	$58.00	$5.22–$57.42	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE PANEL EACH ALLERGEN	$43.50	$58.00	$5.22–$57.42	—	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$66.00	$88.00	$16.77–$87.12	21% below	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM	$66.00	$88.00	$16.77–$87.12	—	25%
Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA CDM	$132.75	$177.00	$14.57–$175.23	16% above	25%
Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA CDM	$132.75	$177.00	$14.57–$175.23	—	25%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE CDM	$114.75	$153.00	$6.48–$151.47	84% above	25%
Amylase blood test CPT 82150 HC ASSAY OF AMYLASE	$114.75	$153.00	$6.48–$151.47	84% above	25%
Amylase blood test CPT 82150 HC AMYLASE	$114.75	$153.00	$6.48–$151.47	84% above	25%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$114.75	$153.00	$6.48–$151.47	—	25%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE CDM	$114.75	$153.00	$6.48–$151.47	—	25%
Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE	$114.75	$153.00	$6.48–$151.47	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP ANTIBODY	$145.50	$194.00	$12.95–$192.06	87% above	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY CDM	$145.50	$194.00	$12.95–$192.06	87% above	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY CDM	$145.50	$194.00	$12.95–$192.06	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP ANTIBODY	$145.50	$194.00	$12.95–$192.06	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$105.75	$141.00	$12.09–$139.59	51% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES	$105.75	$141.00	$12.09–$139.59	51% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA CDM	$105.75	$141.00	$12.09–$139.59	51% above	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA	$105.75	$141.00	$12.09–$139.59	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA CDM	$105.75	$141.00	$12.09–$139.59	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES	$105.75	$141.00	$12.09–$139.59	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE CDM	$159.00	$212.00	$39.26–$209.88	18% below	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE	$159.00	$212.00	$39.26–$209.88	18% below	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE	$159.00	$212.00	$39.26–$209.88	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE CDM	$159.00	$212.00	$39.26–$209.88	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$87.00	$116.00	$8.62–$114.84	at median	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER	$155.25	$207.00	$8.62–$204.93	78% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIA OTHER - SPUTUM	$182.25	$243.00	$8.62–$240.57	109% above	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM	$87.00	$116.00	$8.62–$114.84	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER	$155.25	$207.00	$8.62–$204.93	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE BACTERIA OTHER - SPUTUM	$182.25	$243.00	$8.62–$240.57	—	25%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$88.50	$118.00	$8.46–$116.82	18% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL	$88.50	$118.00	$8.46–$116.82	—	25%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL CDM	$30.75	$41.00	$5.02–$40.59	30% below	25%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$30.75	$41.00	$5.02–$40.59	30% below	25%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL	$30.75	$41.00	$5.02–$40.59	—	25%
Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL CDM	$30.75	$41.00	$5.02–$40.59	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG LEVEL 4	$78.00	$104.00	$60.22–$102.96	55% below	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM CDM	$370.50	$494.00	$60.22–$489.06	112% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG LEVEL 4	$78.00	$104.00	$60.22–$102.96	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM CDM	$370.50	$494.00	$60.22–$489.06	—	25%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$168.00	$224.00	$10.32–$221.76	13% above	25%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$168.00	$224.00	$10.32–$221.76	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$18.75	$25.00	$3.00–$24.75	25% below	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM	$18.75	$25.00	$3.00–$24.75	—	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$34.50	$46.00	$3.93–$45.54	8% below	25%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$34.50	$46.00	$3.93–$45.54	8% below	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP	$34.50	$46.00	$3.93–$45.54	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP)	$34.50	$46.00	$3.93–$45.54	—	25%
Blood lead test CPT 83655 HC HVY MET BLD - LEAD	$90.00	$120.00	$12.11–$118.80	42% above	25%
Blood lead test CPT 83655 HC ASSAY OF LEAD CDM	$90.00	$120.00	$12.11–$118.80	42% above	25%
Blood lead test CPT 83655 HC LEAD BLOOD	$90.00	$120.00	$12.11–$118.80	42% above	25%
Blood lead test inpatient CPT 83655 HC LEAD BLOOD	$90.00	$120.00	$12.11–$118.80	—	25%
Blood lead test inpatient CPT 83655 HC HVY MET BLD - LEAD	$90.00	$120.00	$12.11–$118.80	—	25%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD CDM	$90.00	$120.00	$12.11–$118.80	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$92.25	$123.00	$7.52–$121.77	24% above	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM	$92.25	$123.00	$7.52–$121.77	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$75.75	$101.00	$2.99–$99.99	17% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO CDM	$75.75	$101.00	$2.99–$99.99	—	25%
C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$152.25	$203.00	$20.81–$200.97	38% above	25%
C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE CDM	$152.25	$203.00	$20.81–$200.97	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$64.50	$86.00	$5.18–$85.14	10% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN CDM	$64.50	$86.00	$5.18–$85.14	10% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN CDM	$64.50	$86.00	$5.18–$85.14	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$64.50	$86.00	$5.18–$85.14	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$207.00	$276.00	$37.27–$273.24	18% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE	$207.00	$276.00	$37.27–$273.24	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$168.75	$225.00	$20.81–$222.75	53% above	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9	$168.75	$225.00	$20.81–$222.75	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$105.75	$141.00	$20.81–$139.59	12% below	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 CDM	$105.75	$141.00	$20.81–$139.59	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$112.50	$150.00	$51.31–$148.50	7% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM	$112.50	$150.00	$51.31–$148.50	—	25%
Calcium blood test, total CPT 82310 HC CALCIUM TOTAL CDM	$66.75	$89.00	$5.16–$88.11	57% above	25%
Calcium blood test, total CPT 82310 HC CALCIUM SERUM	$66.75	$89.00	$5.16–$88.11	57% above	25%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL CDM	$66.75	$89.00	$5.16–$88.11	—	25%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM	$66.75	$89.00	$5.16–$88.11	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$154.50	$206.00	$18.96–$203.94	19% above	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM	$154.50	$206.00	$18.96–$203.94	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$113.25	$151.00	$12.88–$149.49	43% above	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG	$113.25	$151.00	$12.88–$149.49	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$62.25	$83.00	$35.09–$82.17	54% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ CDM	$62.25	$83.00	$35.09–$82.17	54% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$62.25	$83.00	$35.09–$82.17	54% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$194.25	$259.00	$35.09–$256.41	45% above	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$62.25	$83.00	$35.09–$82.17	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ CDM	$62.25	$83.00	$35.09–$82.17	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ	$62.25	$83.00	$35.09–$82.17	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR	$194.25	$259.00	$35.09–$256.41	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL CDM	$193.50	$258.00	$13.39–$255.42	118% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL CDM	$193.50	$258.00	$13.39–$255.42	—	25%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO	$81.75	$109.00	$7.77–$107.91	21% above	25%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$123.00	$164.00	$7.77–$162.36	82% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO	$81.75	$109.00	$7.77–$107.91	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC	$123.00	$164.00	$7.77–$162.36	—	25%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$55.50	$74.00	$6.47–$73.26	8% above	25%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED	$55.50	$74.00	$6.47–$73.26	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$112.50	$150.00	$10.56–$148.50	23% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$112.50	$150.00	$10.56–$148.50	—	25%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL CDM	$115.50	$154.00	$16.30–$152.46	9% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL	$115.50	$154.00	$16.30–$152.46	9% above	25%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$115.50	$154.00	$16.30–$152.46	9% above	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL	$115.50	$154.00	$16.30–$152.46	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL CDM	$115.50	$154.00	$16.30–$152.46	—	25%
Cortisol blood test, total inpatient CPT 82533 HC CORTISOL	$115.50	$154.00	$16.30–$152.46	—	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL	$79.50	$106.00	$6.51–$104.94	20% above	25%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM	$105.00	$140.00	$6.51–$138.60	58% above	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL	$79.50	$106.00	$6.51–$104.94	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM	$105.00	$140.00	$6.51–$138.60	—	25%
Creatinine blood test CPT 82565 HC ASSAY CREATININE	$37.50	$50.00	$5.12–$49.50	13% below	25%
Creatinine blood test CPT 82565 HC CREATININE BLOOD CDM	$73.50	$98.00	$5.12–$97.02	70% above	25%
Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE	$37.50	$50.00	$5.12–$49.50	—	25%
Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD CDM	$73.50	$98.00	$5.12–$97.02	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$124.50	$166.00	$14.39–$164.34	63% above	25%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV ANTIBODY	$124.50	$166.00	$14.39–$164.34	63% above	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV ANTIBODY	$124.50	$166.00	$14.39–$164.34	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV CDM	$124.50	$166.00	$14.39–$164.34	—	25%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT	$141.00	$188.00	$10.18–$186.12	19% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT	$141.00	$188.00	$10.18–$186.12	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$97.50	$130.00	$22.23–$128.70	24% below	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE CDM	$97.50	$130.00	$22.23–$128.70	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$160.50	$214.00	$62.14–$211.86	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE URINE	$160.50	$214.00	$62.14–$211.86	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$160.50	$214.00	$62.14–$211.86	at median	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$160.50	$214.00	$62.14–$211.86	at median	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM	$160.50	$214.00	$62.14–$211.86	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS	$160.50	$214.00	$62.14–$211.86	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE URINE	$160.50	$214.00	$62.14–$211.86	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$160.50	$214.00	$62.14–$211.86	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$62.25	$83.00	$7.01–$82.17	14% above	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL	$62.25	$83.00	$7.01–$82.17	—	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$129.75	$173.00	$18.14–$171.27	37% above	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA CDM	$129.75	$173.00	$18.14–$171.27	37% above	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EPSTEIN-BARR ANTIBODY - VIRAL CAPSID	$129.75	$173.00	$18.14–$171.27	—	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA CDM	$129.75	$173.00	$18.14–$171.27	—	25%
Estradiol blood test CPT 82670 HC ESTRADIOL	$139.50	$186.00	$27.94–$184.14	at median	25%
Estradiol blood test CPT 82670 HC ASSAY OF TOTAL ESTRADIOL CDM	$139.50	$186.00	$27.94–$184.14	at median	25%
Estradiol blood test inpatient CPT 82670 HC ESTRADIOL	$139.50	$186.00	$27.94–$184.14	—	25%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF TOTAL ESTRADIOL CDM	$139.50	$186.00	$27.94–$184.14	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$88.50	$118.00	$18.58–$116.82	6% below	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE CDM	$88.50	$118.00	$18.58–$116.82	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$280.50	$374.00	$19.63–$370.26	41% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM	$280.50	$374.00	$19.63–$370.26	—	25%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM	$128.25	$171.00	$13.63–$169.29	30% above	25%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM	$128.25	$171.00	$13.63–$169.29	—	25%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$153.00	$204.00	$9.72	90% above	25%
Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN	$153.00	$204.00	$9.72	—	25%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$132.75	$177.00	$14.70–$175.23	26% above	25%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM	$132.75	$177.00	$14.70–$175.23	—	25%
Free T3 thyroid hormone test CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$154.50	$206.00	$16.94–$203.94	72% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 HC ASSAY OF TRIIODOTHYRONINE T3 FREE CDM	$154.50	$206.00	$16.94–$203.94	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$101.25	$135.00	$9.02–$133.65	46% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM	$101.25	$135.00	$9.02–$133.65	—	25%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE CDM	$179.25	$239.00	$25.47–$236.61	41% above	25%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$179.25	$239.00	$25.47–$236.61	41% above	25%
Free testosterone test CPT 84402 HC TESTOSTERONE FREE	$179.25	$239.00	$25.47–$236.61	41% above	25%
Free testosterone test inpatient CPT 84402 HC TESTOSTERONE FREE	$179.25	$239.00	$25.47–$236.61	—	25%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE	$179.25	$239.00	$25.47–$236.61	—	25%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE CDM	$179.25	$239.00	$25.47–$236.61	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL	$52.50	$70.00	$7.20–$69.30	3% below	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL	$52.50	$70.00	$7.20–$69.30	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$66.00	$88.00	$4.75–$87.12	60% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE CDM	$66.00	$88.00	$4.75–$87.12	60% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$66.00	$88.00	$4.75–$87.12	60% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE CDM	$66.00	$88.00	$4.75–$87.12	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$66.00	$88.00	$4.75–$87.12	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR	$66.00	$88.00	$4.75–$87.12	—	25%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$84.00	$112.00	$12.87–$110.88	15% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC)	$84.00	$112.00	$12.87–$110.88	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$66.00	$88.00	$35.09–$87.12	48% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$66.00	$88.00	$35.09–$87.12	48% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$66.00	$88.00	$35.09–$87.12	48% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE DNA AMPLIFIED PROBE	$66.00	$88.00	$35.09–$87.12	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$66.00	$88.00	$35.09–$87.12	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM	$66.00	$88.00	$35.09–$87.12	—	25%
H. pylori antibody blood test CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$143.25	$191.00	$16.85–$189.09	66% above	25%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI	$143.25	$191.00	$16.85–$189.09	66% above	25%
H. pylori antibody blood test inpatient CPT 86677 HC ANTIBODY HELICOBACTER PYLORI CDM	$143.25	$191.00	$16.85–$189.09	—	25%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI	$143.25	$191.00	$16.85–$189.09	—	25%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$138.75	$185.00	$14.38–$183.15	3% below	25%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM	$138.75	$185.00	$14.38–$183.15	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 DNA QUANTIFICATION	$501.75	$669.00	$85.10–$662.31	30% above	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV ULTRA SENSITIVE PCR	$529.50	$706.00	$85.10–$698.94	37% above	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION CDM	$529.50	$706.00	$85.10–$698.94	37% above	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 DNA QUANTIFICATION	$501.75	$669.00	$85.10–$662.31	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV ULTRA SENSITIVE PCR	$529.50	$706.00	$85.10–$698.94	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION CDM	$529.50	$706.00	$85.10–$698.94	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$134.25	$179.00	$24.08–$177.21	37% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$135.00	$180.00	$24.08–$178.20	38% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG	$134.25	$179.00	$24.08–$177.21	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB	$135.00	$180.00	$24.08–$178.20	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT CDM	$168.75	$225.00	$35.09–$222.75	19% above	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$168.75	$225.00	$35.09–$222.75	19% above	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$168.75	$225.00	$35.09–$222.75	—	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT CDM	$168.75	$225.00	$35.09–$222.75	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$79.50	$106.00	$9.71–$104.94	13% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM	$79.50	$106.00	$9.71–$104.94	—	25%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$8.25	$11.00	$2.37–$10.89	72% below	25%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$30.75	$41.00	$2.37–$40.59	5% above	25%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB)	$30.75	$41.00	$2.37–$40.59	5% above	25%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$8.25	$11.00	$2.37–$10.89	—	25%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM	$30.75	$41.00	$2.37–$40.59	—	25%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB)	$30.75	$41.00	$2.37–$40.59	—	25%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$66.00	$88.00	$12.05–$87.12	4% below	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM	$66.00	$88.00	$12.05–$87.12	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$81.75	$109.00	$10.74–$107.91	10% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM	$81.75	$109.00	$10.74–$107.91	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$75.75	$101.00	$10.33–$99.99	at median	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM	$75.75	$101.00	$10.33–$99.99	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM	$84.00	$112.00	$14.27–$110.88	2% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$88.50	$118.00	$14.27–$116.82	3% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM	$84.00	$112.00	$14.27–$110.88	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY	$88.50	$118.00	$14.27–$116.82	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$413.25	$551.00	$42.84–$545.49	23% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C QUANTITATIVE PCR	$415.50	$554.00	$42.84–$548.46	24% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$415.50	$554.00	$42.84–$548.46	24% above	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM	$413.25	$551.00	$42.84–$545.49	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C RNA QUANTIFICATION	$415.50	$554.00	$42.84–$548.46	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C QUANTITATIVE PCR	$415.50	$554.00	$42.84–$548.46	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$111.00	$148.00	$13.19–$146.52	61% above	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG	$111.00	$148.00	$13.19–$146.52	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 ANTIBODY IGG	$110.25	$147.00	$19.35–$145.53	25% above	25%
Herpes blood test, HSV-2 antibody CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$111.00	$148.00	$19.35–$146.52	26% above	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 ANTIBODY IGG	$110.25	$147.00	$19.35–$145.53	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC ANTIBODY HERPES SMPLX TYPE 2 CDM	$111.00	$148.00	$19.35–$146.52	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$78.75	$105.00	$12.95–$103.95	6% above	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM	$78.75	$105.00	$12.95–$103.95	—	25%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE CDM	$66.00	$88.00	$17.92–$87.12	46% below	25%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE CDM	$66.00	$88.00	$17.92–$87.12	—	25%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$79.50	$106.00	$11.43–$104.94	4% below	25%
Insulin blood test CPT 83525 HC INSULIN LEVEL ASSAY	$79.50	$106.00	$11.43–$104.94	4% below	25%
Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL ASSAY	$79.50	$106.00	$11.43–$104.94	—	25%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM	$79.50	$106.00	$11.43–$104.94	—	25%
Iron blood test (serum iron) CPT 83540 HC IRON	$71.25	$95.00	$6.47–$94.05	51% above	25%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM	$71.25	$95.00	$6.47–$94.05	51% above	25%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM	$71.25	$95.00	$6.47–$94.05	—	25%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$71.25	$95.00	$6.47–$94.05	—	25%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM	$75.75	$101.00	$8.74–$99.99	26% above	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM	$75.75	$101.00	$8.74–$99.99	—	25%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM	$71.25	$95.00	$8.68–$94.05	6% below	25%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM	$71.25	$95.00	$8.68–$94.05	—	25%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$105.75	$141.00	$18.52–$139.59	10% above	25%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE CDM	$105.75	$141.00	$18.52–$139.59	—	25%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE CDM	$111.00	$148.00	$11.57–$146.52	11% above	25%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE	$111.00	$148.00	$11.57–$146.52	11% above	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE CDM	$111.00	$148.00	$11.57–$146.52	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE	$111.00	$148.00	$11.57–$146.52	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$54.75	$73.00	$6.04–$72.27	27% above	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM	$57.75	$77.00	$6.04–$76.23	34% above	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM	$54.75	$73.00	$6.04–$72.27	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM	$57.75	$77.00	$6.04–$76.23	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM	$111.00	$148.00	$6.89–$146.52	32% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM	$111.00	$148.00	$6.89–$146.52	—	25%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$79.50	$106.00	$8.17–$104.94	21% above	25%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM	$79.50	$106.00	$8.17–$104.94	—	25%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY	$114.75	$153.00	$17.03–$151.47	19% above	25%
Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE CDM	$153.75	$205.00	$17.03–$202.95	60% above	25%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY	$114.75	$153.00	$17.03–$151.47	—	25%
Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE CDM	$153.75	$205.00	$17.03–$202.95	—	25%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM	$66.00	$88.00	$6.70–$87.12	22% above	25%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM	$66.00	$88.00	$6.70–$87.12	—	25%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA ANTIBODY - IGG	$66.00	$88.00	$12.88–$87.12	7% below	25%
Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA CDM	$66.00	$88.00	$12.88–$87.12	7% below	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA CDM	$66.00	$88.00	$12.88–$87.12	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA ANTIBODY - IGG	$66.00	$88.00	$12.88–$87.12	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES	$66.00	$88.00	$5.18–$87.12	15% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES	$66.00	$88.00	$5.18–$87.12	—	25%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM	$95.25	$127.00	$13.05–$125.73	32% above	25%
Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS	$95.25	$127.00	$13.05–$125.73	32% above	25%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS	$95.25	$127.00	$13.05–$125.73	—	25%
Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM	$95.25	$127.00	$13.05–$125.73	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$98.25	$131.00	$18.39–$129.69	at median	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE CDM	$98.25	$131.00	$18.39–$129.69	at median	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$98.25	$131.00	$18.39–$129.69	—	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE CDM	$98.25	$131.00	$18.39–$129.69	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$93.00	$124.00	$18.39–$122.76	16% below	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM	$93.00	$124.00	$18.39–$122.76	—	25%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS CDM	$129.00	$172.00	$26.61–$170.28	41% above	25%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$129.00	$172.00	$26.61–$170.28	41% above	25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS	$129.00	$172.00	$26.61–$170.28	—	25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS CDM	$129.00	$172.00	$26.61–$170.28	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP-THIN PREP SCREENING	$113.25	$151.00	$20.26–$149.49	36% above	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM	$113.25	$151.00	$20.26–$149.49	36% above	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SUREPATH DIAGNOSTIC	$113.25	$151.00	$20.26–$149.49	36% above	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM	$113.25	$151.00	$20.26–$149.49	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SUREPATH DIAGNOSTIC	$113.25	$151.00	$20.26–$149.49	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP-THIN PREP SCREENING	$113.25	$151.00	$20.26–$149.49	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE CDM	$176.25	$235.00	$41.28–$232.65	17% below	25%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$176.25	$235.00	$41.28–$232.65	17% below	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE CDM	$176.25	$235.00	$41.28–$232.65	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE)	$176.25	$235.00	$41.28–$232.65	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD CDM	$84.00	$112.00	$6.01–$110.88	104% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$84.00	$112.00	$6.01–$110.88	104% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD CDM	$84.00	$112.00	$6.01–$110.88	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL	$84.00	$112.00	$6.01–$110.88	—	25%
Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS	$41.25	$55.00	$4.74–$54.45	3% above	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS	$41.25	$55.00	$4.74–$54.45	—	25%
Potassium blood test CPT 84132 HC POTASSIUM	$41.25	$55.00	$4.76–$54.45	at median	25%
Potassium blood test inpatient CPT 84132 HC POTASSIUM	$41.25	$55.00	$4.76–$54.45	—	25%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM	$111.00	$148.00	$20.86–$146.52	14% above	25%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM	$111.00	$148.00	$20.86–$146.52	—	25%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM	$135.75	$181.00	$19.38–$179.19	25% above	25%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM	$135.75	$181.00	$19.38–$179.19	—	25%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A SCREEN	$71.25	$95.00	$16.55–$94.05	5% above	25%
Rapid flu test (influenza antigen) CPT 87804 HC IAADIADOO INFLUENZA CDM	$71.25	$95.00	$16.55–$94.05	5% above	25%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA B SCREEN	$71.25	$95.00	$16.55–$94.05	5% above	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA A SCREEN	$71.25	$95.00	$16.55–$94.05	—	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC IAADIADOO INFLUENZA CDM	$71.25	$95.00	$16.55–$94.05	—	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA B SCREEN	$71.25	$95.00	$16.55–$94.05	—	25%
Renin blood test CPT 84244 HC RENIN	$168.75	$225.00	$21.99–$222.75	29% above	25%
Renin blood test CPT 84244 HC ASSAY OF RENIN CDM	$168.75	$225.00	$21.99–$222.75	29% above	25%
Renin blood test inpatient CPT 84244 HC RENIN	$168.75	$225.00	$21.99–$222.75	—	25%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM	$168.75	$225.00	$21.99–$222.75	—	25%
Rh blood typing CPT 86901 HC RH TYPE	$57.75	$77.00	$2.99–$76.23	21% above	25%
Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$57.75	$77.00	$2.99–$76.23	21% above	25%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) CDM	$57.75	$77.00	$2.99–$76.23	—	25%
Rh blood typing inpatient CPT 86901 HC RH TYPE	$57.75	$77.00	$2.99–$76.23	—	25%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT	$71.25	$95.00	$5.67–$94.05	78% above	25%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE CDM	$71.25	$95.00	$5.67–$94.05	78% above	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT	$71.25	$95.00	$5.67–$94.05	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE CDM	$71.25	$95.00	$5.67–$94.05	—	25%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$57.75	$77.00	$14.39–$76.23	16% below	25%
Rubella antibody test (immunity check) CPT 86762 HC ANTIBODY RUBELLA CDM	$101.25	$135.00	$14.39–$133.65	47% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$57.75	$77.00	$14.39–$76.23	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 HC ANTIBODY RUBELLA CDM	$101.25	$135.00	$14.39–$133.65	—	25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED	$42.00	$56.00	$2.70–$55.44	17% above	25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED	$42.00	$56.00	$2.70–$55.44	—	25%
Sodium blood test CPT 84295 HC SODIUM	$41.25	$55.00	$4.81–$54.45	2% below	25%
Sodium blood test inpatient CPT 84295 HC SODIUM	$41.25	$55.00	$4.81–$54.45	—	25%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$84.00	$112.00	$8.90–$110.88	25% above	25%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS	$84.00	$112.00	$8.90–$110.88	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$105.00	$140.00	$13.24–$138.60	54% above	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM	$105.00	$140.00	$13.24–$138.60	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$72.00	$96.00	$4.27–$95.04	123% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$72.00	$96.00	$4.27–$95.04	123% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL	$72.00	$96.00	$4.27–$95.04	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL CDM	$72.00	$96.00	$4.27–$95.04	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$261.75	$349.00	$61.98–$345.51	26% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$261.75	$349.00	$61.98–$345.51	26% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD	$261.75	$349.00	$61.98–$345.51	26% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QUANTIFERON TB GOLD	$261.75	$349.00	$61.98–$345.51	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM	$261.75	$349.00	$61.98–$345.51	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON	$261.75	$349.00	$61.98–$345.51	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE -TOTAL	$135.75	$181.00	$25.81–$179.19	6% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL	$135.75	$181.00	$25.81–$179.19	6% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$135.75	$181.00	$25.81–$179.19	6% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE	$135.75	$181.00	$25.81–$179.19	6% above	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL CDM	$135.75	$181.00	$25.81–$179.19	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE	$135.75	$181.00	$25.81–$179.19	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE -TOTAL	$135.75	$181.00	$25.81–$179.19	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL	$135.75	$181.00	$25.81–$179.19	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$66.00	$88.00	$14.55–$87.12	18% below	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM	$66.00	$88.00	$14.55–$87.12	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4	$132.75	$177.00	$16.80–$175.23	26% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$132.75	$177.00	$16.80–$175.23	26% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH CDM	$132.75	$177.00	$16.80–$175.23	26% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH	$132.75	$177.00	$16.80–$175.23	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4	$132.75	$177.00	$16.80–$175.23	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH CDM	$132.75	$177.00	$16.80–$175.23	—	25%
Total IgE blood test CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$141.00	$188.00	$16.46–$186.12	47% above	25%
Total IgE blood test inpatient CPT 82785 HC ASSAY OF GAMMAGLOBULIN IGE CDM	$141.00	$188.00	$16.46–$186.12	—	25%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL	$36.00	$48.00	$4.35–$47.52	1% below	25%
Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL	$36.00	$48.00	$4.35–$47.52	—	25%
Total thyroxine (T4) blood test CPT 84436 HC THYROXINE T4	$71.25	$95.00	$6.87–$94.05	26% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE T4	$71.25	$95.00	$6.87–$94.05	—	25%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$141.00	$188.00	$14.18–$186.12	55% above	25%
Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$141.00	$188.00	$14.18–$186.12	55% above	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3 CDM	$141.00	$188.00	$14.18–$186.12	—	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3	$141.00	$188.00	$14.18–$186.12	—	25%
Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN	$52.50	$70.00	$12.76–$69.30	41% below	25%
Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN	$52.50	$70.00	$12.76–$69.30	—	25%
Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES CDM	$44.25	$59.00	$5.74–$58.41	at median	25%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES	$44.25	$59.00	$5.74–$58.41	at median	25%
Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES CDM	$44.25	$59.00	$5.74–$58.41	—	25%
Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES	$44.25	$59.00	$5.74–$58.41	—	25%
Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE CDM	$136.50	$182.00	$12.47–$180.18	at median	25%
Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE	$136.50	$182.00	$12.47–$180.18	at median	25%
Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE CDM	$136.50	$182.00	$12.47–$180.18	—	25%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE	$136.50	$182.00	$12.47–$180.18	—	25%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$52.50	$70.00	$3.17–$69.30	33% above	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM	$52.50	$70.00	$3.17–$69.30	—	25%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$42.00	$56.00	$2.25–$55.44	46% above	25%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY CDM	$42.00	$56.00	$2.25–$55.44	46% above	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY CDM	$42.00	$56.00	$2.25–$55.44	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$42.00	$56.00	$2.25–$55.44	—	25%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$32.25	$43.00	$3.48–$42.57	58% above	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM	$32.25	$43.00	$3.48–$42.57	—	25%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT	$132.75	$177.00	$8.07–$175.23	57% above	25%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$132.75	$177.00	$8.07–$175.23	57% above	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE/COLONY COUNT	$132.75	$177.00	$8.07–$175.23	—	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE CDM	$132.75	$177.00	$8.07–$175.23	—	25%
Urine microalbumin (albumin) test CPT 82043 HC URINE ALBUMIN QUANTITATIVE CDM	$52.50	$70.00	$5.78–$69.30	at median	25%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE	$52.50	$70.00	$5.78–$69.30	at median	25%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE	$52.50	$70.00	$5.78–$69.30	—	25%
Urine microalbumin (albumin) test inpatient CPT 82043 HC URINE ALBUMIN QUANTITATIVE CDM	$52.50	$70.00	$5.78–$69.30	—	25%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$66.00	$88.00	$8.61–$87.12	32% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$66.00	$88.00	$8.61–$87.12	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN-B12	$111.00	$148.00	$15.08–$146.52	12% above	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN-B12	$111.00	$148.00	$15.08–$146.52	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$105.75	$141.00	$29.60–$139.59	22% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM	$105.75	$141.00	$29.60–$139.59	—	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VIT D 1 25-DIHYDROXY	$273.75	$365.00	$38.50–$361.35	57% above	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VIT D 1 25-DIHYDROXY	$273.75	$365.00	$38.50–$361.35	—	25%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM	$84.00	$112.00	$11.39–$110.88	11% above	25%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM	$84.00	$112.00	$11.39–$110.88	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$88.50	$118.00	$15.05–$116.82	18% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$88.50	$118.00	$15.05–$116.82	18% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC (HCG) QUANTITATIVE	$88.50	$118.00	$15.05–$116.82	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM	$88.50	$118.00	$15.05–$116.82	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$528.00	$704.00	$302.72–$696.96	19% below	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM	$528.00	$704.00	$302.72–$696.96	—	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$485.25	$647.00	$278.21–$640.53	15% below	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM	$485.25	$647.00	$278.21–$640.53	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,296.00	$1,728.00	$743.04–$1,710.72	18% above	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,296.00	$1,728.00	$743.04–$1,710.72	—	25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$579.00	$772.00	$331.96–$764.28	6% below	25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM	$579.00	$772.00	$331.96–$764.28	—	25%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC PR 58120 DILATION AND CURETTAGE RHC	$432.00	$576.00	$247.68–$570.24	85% below	25%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,587.00	$6,116.00	$2,629.88–$6,054.84	55% above	25%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC PR 58120 DILATION AND CURETTAGE RHC	$432.00	$576.00	$247.68–$570.24	—	25%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM	$4,587.00	$6,116.00	$2,629.88–$6,054.84	—	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$229.50	$306.00	$131.58–$302.94	24% above	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM	$229.50	$306.00	$131.58–$302.94	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$105.75	$141.00	$60.63–$139.59	5% below	25%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT RHC	$25.50	$34.00	$14.62–$33.66	77% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM	$105.75	$141.00	$60.63–$139.59	—	25%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PR 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT RHC	$25.50	$34.00	$14.62–$33.66	—	25%
Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$370.50	$494.00	$212.42–$489.06	117% above	25%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM	$370.50	$494.00	$212.42–$489.06	—	25%
IUD insertion (the device itself billed separately) CPT 58300 HC PR 58300 INSERTION INTRAUTERINE DEVICE IUD RHC	$93.75	$125.00	$53.75–$123.75	67% below	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC PR 58300 INSERTION INTRAUTERINE DEVICE IUD RHC	$93.75	$125.00	$53.75–$123.75	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$271.50	$362.00	$155.66–$358.38	28% below	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM	$271.50	$362.00	$155.66–$358.38	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$784.50	$1,046.00	$449.78–$1,035.54	159% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM	$784.50	$1,046.00	$449.78–$1,035.54	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US RHC	$84.75	$113.00	$48.59–$111.87	83% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$973.50	$1,298.00	$558.14–$1,285.02	101% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$973.50	$1,298.00	$558.14–$1,285.02	101% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PR 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US RHC	$84.75	$113.00	$48.59–$111.87	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM	$973.50	$1,298.00	$558.14–$1,285.02	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$973.50	$1,298.00	$558.14–$1,285.02	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC PR 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT RHC	$2,107.50	$2,810.00	$1,208.30–$2,781.90	663% above	25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC PR 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT RHC	$2,107.50	$2,810.00	$1,208.30–$2,781.90	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$721.50	$962.00	$413.66–$952.38	58% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE	$721.50	$962.00	$413.66–$952.38	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$867.75	$1,157.00	$497.51–$1,145.43	129% above	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE	$867.75	$1,157.00	$497.51–$1,145.43	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$1,323.00	$1,764.00	$758.52–$1,746.36	101% above	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM	$1,323.00	$1,764.00	$758.52–$1,746.36	—	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$2,808.00	$3,744.00	$1,609.92–$3,706.56	281% above	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM	$2,808.00	$3,744.00	$1,609.92–$3,706.56	—	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/OR LESS CDM	$2,004.00	$2,672.00	$1,148.96–$2,645.28	167% above	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/OR LESS CDM	$2,004.00	$2,672.00	$1,148.96–$2,645.28	—	25%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$210.00	$280.00	$120.40–$277.20	25% below	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM	$210.00	$280.00	$120.40–$277.20	—	25%
Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$1,079.25	$1,439.00	$618.77–$1,424.61	63% above	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM	$1,079.25	$1,439.00	$618.77–$1,424.61	—	25%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$1,322.25	$1,763.00	$758.09–$1,745.37	at median	25%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM	$1,322.25	$1,763.00	$758.09–$1,745.37	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$330.00	$440.00	$189.20–$435.60	51% below	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM	$330.00	$440.00	$189.20–$435.60	—	25%
Removal of a breast lump, open surgery CPT 19120 HC EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION CDM	$5,696.25	$7,595.00	$3,265.85–$7,519.05	17% above	25%
Removal of a breast lump, open surgery inpatient CPT 19120 HC EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION CDM	$5,696.25	$7,595.00	$3,265.85–$7,519.05	—	25%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$354.75	$473.00	$203.39–$468.27	32% below	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM	$354.75	$473.00	$203.39–$468.27	—	25%
Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$378.00	$504.00	$216.72–$498.96	14% below	25%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM	$378.00	$504.00	$216.72–$498.96	—	25%
Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$365.25	$487.00	$209.41–$482.13	32% above	25%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM	$365.25	$487.00	$209.41–$482.13	—	25%
Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$434.25	$579.00	$248.97–$573.21	25% above	25%
Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM	$434.25	$579.00	$248.97–$573.21	—	25%
Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$382.50	$510.00	$219.30–$504.90	8% above	25%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM	$382.50	$510.00	$219.30–$504.90	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$450.75	$601.00	$258.43–$594.99	33% above	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM	$450.75	$601.00	$258.43–$594.99	—	25%
Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION RHC	$98.25	$131.00	$56.33–$129.69	71% below	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION RHC	$98.25	$131.00	$56.33–$129.69	—	25%
Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$1,989.75	$2,653.00	$1,140.79–$2,626.47	814% above	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM	$1,989.75	$2,653.00	$1,140.79–$2,626.47	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$705.00	$940.00	$404.20–$930.60	29% below	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$705.00	$940.00	$404.20–$930.60	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$462.00	$616.00	$264.88–$609.84	12% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM	$462.00	$616.00	$264.88–$609.84	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$444.75	$593.00	$254.99–$587.07	10% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM	$444.75	$593.00	$254.99–$587.07	—	25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION RHC	$78.75	$105.00	$45.15–$103.95	70% below	25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION RHC	$78.75	$105.00	$45.15–$103.95	—	25%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$963.75	$1,285.00	$552.55–$1,272.15	27% below	25%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$963.75	$1,285.00	$552.55–$1,272.15	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$736.50	$982.00	$422.26–$972.18	104% above	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM	$736.50	$982.00	$422.26–$972.18	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,401.75	$1,869.00	$803.67–$1,850.31	44% below	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG	$1,401.75	$1,869.00	$803.67–$1,850.31	—	25%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,410.75	$1,881.00	$808.83–$1,862.19	494% above	25%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM	$1,410.75	$1,881.00	$808.83–$1,862.19	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$1,767.75	$2,357.00	$1,013.51–$2,333.43	175% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM	$1,767.75	$2,357.00	$1,013.51–$2,333.43	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$1,185.75	$1,581.00	$679.83–$1,565.19	21% above	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM	$1,185.75	$1,581.00	$679.83–$1,565.19	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PR 94640 NEBULIZER SMALL VOLUME	$36.00	$48.00	$20.64–$47.52	82% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PR 94640 NEBULIZER SMALL VOLUME RHC	$36.00	$48.00	$20.64–$47.52	82% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY	$222.00	$296.00	$127.28–$293.04	11% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM	$372.75	$497.00	$213.71–$492.03	86% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PR 94640 NEBULIZER SMALL VOLUME RHC	$36.00	$48.00	$20.64–$47.52	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC PR 94640 NEBULIZER SMALL VOLUME	$36.00	$48.00	$20.64–$47.52	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY	$222.00	$296.00	$127.28–$293.04	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM	$372.75	$497.00	$213.71–$492.03	—	25%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$905.25	$1,207.00	$519.01–$1,194.93	16% above	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM	$905.25	$1,207.00	$519.01–$1,194.93	—	25%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$1,926.00	$2,568.00	$337.67–$2,542.32	40% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM	$1,926.00	$2,568.00	$337.67–$2,542.32	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY	$293.25	$391.00	$168.13–$387.09	57% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY	$293.25	$391.00	$168.13–$387.09	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$56.25	$75.00	$32.25–$74.25	77% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM	$56.25	$75.00	$32.25–$74.25	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$108.75	$145.00	$62.35–$143.55	76% below	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM	$108.75	$145.00	$62.35–$143.55	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$177.00	$236.00	$57.92–$233.64	78% below	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM	$177.00	$236.00	$57.92–$233.64	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$305.25	$407.00	$107.16–$402.93	77% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM	$305.25	$407.00	$107.16–$402.93	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$471.00	$628.00	$159.79–$621.72	79% below	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM	$471.00	$628.00	$159.79–$621.72	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$1,170.00	$1,560.00	$670.80–$1,544.40	97% above	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY	$1,170.00	$1,560.00	$670.80–$1,544.40	—	25%
Family therapy with the patient, 50 minutes CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$79.50	$106.00	$45.58–$104.94	61% below	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC	$79.50	$106.00	$45.58–$104.94	—	25%
Family therapy without the patient, 50 minutes CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$76.50	$102.00	$43.86–$100.98	58% below	25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC	$76.50	$102.00	$43.86–$100.98	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM	$306.00	$408.00	$175.44–$403.92	9% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$306.00	$408.00	$175.44–$403.92	9% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM	$306.00	$408.00	$175.44–$403.92	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM	$306.00	$408.00	$175.44–$403.92	—	25%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$405.00	$540.00	$232.20–$534.60	at median	25%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM	$405.00	$540.00	$232.20–$534.60	at median	25%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM	$405.00	$540.00	$232.20–$534.60	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM	$405.00	$540.00	$232.20–$534.60	—	25%
IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$246.75	$329.00	$141.47–$325.71	5% above	25%
IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$246.75	$329.00	$141.47–$325.71	5% above	25%
IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM	$246.75	$329.00	$141.47–$325.71	—	25%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM	$246.75	$329.00	$141.47–$325.71	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC PR 96372 THER/PROPH/DIAG INJ SC/IM	$42.00	$56.00	$24.08–$55.44	57% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM	$97.50	$130.00	$55.90–$128.70	at median	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$97.50	$130.00	$55.90–$128.70	at median	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC PR 96372 THER/PROPH/DIAG INJ SC/IM	$42.00	$56.00	$24.08–$55.44	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM	$97.50	$130.00	$55.90–$128.70	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM	$97.50	$130.00	$55.90–$128.70	—	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC	$305.25	$407.00	$175.01–$402.93	28% above	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC	$305.25	$407.00	$175.01–$402.93	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$96.75	$129.00	$55.47–$127.71	2% below	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN	$96.75	$129.00	$55.47–$127.71	—	25%
New patient office visit, about 30 minutes CPT 99203 HC PR 99203 OFFICE OUTPATIENT NEW RHC	$189.00	$252.00	$89.14–$249.48	5% above	25%
New patient office visit, about 30 minutes inpatient CPT 99203 HC PR 99203 OFFICE OUTPATIENT NEW RHC	$189.00	$252.00	$89.14–$249.48	—	25%
New patient office visit, about 45 minutes CPT 99204 HC PR 99204 OFFICE OUTPATIENT NEW RHC	$284.25	$379.00	$107.13–$375.21	13% above	25%
New patient office visit, about 45 minutes inpatient CPT 99204 HC PR 99204 OFFICE OUTPATIENT NEW RHC	$284.25	$379.00	$107.13–$375.21	—	25%
New patient office visit, about 60 minutes CPT 99205 HC PR 99205 OFFICE OUTPATIENT NEW RHC	$364.50	$486.00	$170.99–$481.14	10% above	25%
New patient office visit, about 60 minutes inpatient CPT 99205 HC PR 99205 OFFICE OUTPATIENT NEW RHC	$364.50	$486.00	$170.99–$481.14	—	25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PR 99202 OFFICE OUTPATIENT NEW RHC	$151.50	$202.00	$60.86–$199.98	3% above	25%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PR 99202 OFFICE OUTPATIENT NEW RHC	$151.50	$202.00	$60.86–$199.98	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$45.00	$60.00	$25.80	29% below	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM	$45.00	$60.00	$25.80	—	25%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX	$246.75	$329.00	$141.47–$325.71	14% above	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX	$246.75	$329.00	$141.47–$325.71	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX	$246.75	$329.00	$141.47–$325.71	11% below	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX	$246.75	$329.00	$141.47–$325.71	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$246.75	$329.00	$141.47–$325.71	12% above	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM	$246.75	$329.00	$141.47–$325.71	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$246.75	$329.00	$141.47–$325.71	at median	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM	$246.75	$329.00	$141.47–$325.71	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$96.75	$129.00	$23.55–$127.71	14% above	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES	$96.75	$129.00	$23.55–$127.71	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$96.75	$129.00	$25.25–$127.71	1% above	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN	$96.75	$129.00	$25.25–$127.71	—	25%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC	$99.75	$133.00	$57.19–$131.67	62% below	25%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC	$99.75	$133.00	$57.19–$131.67	—	25%
Psychotherapy session, 30 minutes CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC	$135.00	$180.00	$77.40–$178.20	2% below	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC	$135.00	$180.00	$77.40–$178.20	—	25%
Psychotherapy session, 45 minutes CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC	$177.75	$237.00	$101.91–$234.63	2% below	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC	$177.75	$237.00	$101.91–$234.63	—	25%
Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC	$263.25	$351.00	$150.93–$347.49	at median	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC	$263.25	$351.00	$150.93–$347.49	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PR 99215 OFFICE OUTPATIENT VISIT RHC	$216.75	$289.00	$92.73–$286.11	11% below	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PR 99215 OFFICE OUTPATIENT VISIT RHC	$216.75	$289.00	$92.73–$286.11	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 OFFICE OUTPATIENT VISIT RHC	$123.00	$164.00	$58.84–$162.36	14% below	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 OFFICE OUTPATIENT VISIT RHC	$123.00	$164.00	$58.84–$162.36	—	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PR 99214 OFFICE OUTPATIENT VISIT RHC	$175.50	$234.00	$88.44–$231.66	2% below	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PR 99214 OFFICE OUTPATIENT VISIT RHC	$175.50	$234.00	$88.44–$231.66	—	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PR 99212 OFFICE OUTPATIENT VISIT RHC	$94.50	$126.00	$36.53–$124.74	9% below	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PR 99212 OFFICE OUTPATIENT VISIT RHC	$94.50	$126.00	$36.53–$124.74	—	25%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$342.75	$457.00	$196.51–$452.43	38% above	25%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ	$342.75	$457.00	$196.51–$452.43	—	25%
Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$629.25	$839.00	$360.77–$830.61	50% above	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM	$629.25	$839.00	$360.77–$830.61	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$96.75	$129.00	$55.47–$127.71	8% below	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$96.75	$129.00	$55.47–$127.71	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY	$234.00	$312.00	$134.16–$308.88	16% above	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY	$234.00	$312.00	$134.16–$308.88	—	25%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$795.75	$1,061.00	$456.23–$1,050.39	234% above	25%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT	$795.75	$1,061.00	$456.23–$1,050.39	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Washington	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC PR RX VARICELLA VACCINE LIVE SQ 0.5 ML	$271.50	$362.00	$307.70–$358.38	34% above	25%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC PR RX VARICELLA VACCINE LIVE SQ 0.5 ML	$271.50	$362.00	$307.70–$358.38	—	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP	$11.65	$15.54	$13.21–$15.38	75% below	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC PR RX DIPHTH TETANUS TOX ACELL PERTUSSIS VACC/YOUNGER THAN 7 YRS/IM	$105.75	$141.00	$119.85–$139.59	127% above	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTH-ACELL PERTUSSIS-TETANUS 15-23-5 LF-MCG/0.5 IM SUSP	$11.65	$15.54	$13.21–$15.38	—	25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 HC PR RX DIPHTH TETANUS TOX ACELL PERTUSSIS VACC/YOUNGER THAN 7 YRS/IM	$105.75	$141.00	$119.85–$139.59	—	25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC PR RX INFLUENZA TRIVALENT IIV3 SPLIT VIRUS PF IM 0.5 ML	$27.00	$36.00	$23.89–$35.64	6% below	25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$91.34	$121.78	$23.89–$120.56	217% above	25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC PR RX INFLUENZA TRIVALENT IIV3 SPLIT VIRUS PF IM 0.5 ML	$27.00	$36.00	$23.89–$35.64	—	25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$91.34	$121.78	$23.89–$120.56	—	25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC PR RX 9VHPV VACCINE 2/3 DOSE IM 0.5 ML	$363.00	$484.00	$411.40–$479.16	33% above	25%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC PR RX 9VHPV VACCINE 2/3 DOSE IM 0.5 ML	$363.00	$484.00	$411.40–$479.16	—	25%
Hepatitis A vaccine, adult dose CPT 90632 HC PR RX HEPATITIS A VACCINE ADULT IM 1 ML	$164.25	$219.00	$74.92–$216.81	113% above	25%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC PR RX HEPATITIS A VACCINE ADULT IM 1 ML	$164.25	$219.00	$74.92–$216.81	—	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC PR RX HEPATITIS A VACCINE PEDIATRIC 2 DOSE IM 0.5 ML	$103.50	$138.00	$117.30–$136.62	232% above	25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HC PR RX HEPATITIS A VACCINE PEDIATRIC 2 DOSE IM 0.5 ML	$103.50	$138.00	$117.30–$136.62	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML INJECTION SUSP/SUSY (WRAPPER)	$52.12	$69.49	$59.07–$75.14	33% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC PR RX HEPB VACCINE ADULT 3 DOSE IM 1 ML	$164.25	$219.00	$75.14–$216.81	111% above	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML INJECTION SUSP/SUSY (WRAPPER)	$52.12	$69.49	$59.07–$75.14	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC PR RX HEPB VACCINE ADULT 3 DOSE IM 1 ML	$164.25	$219.00	$75.14–$216.81	—	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC PR RX HEPB VACCINE PED/ADOLESC 3 DOSE IM 0.5 ML	$129.00	$172.00	$33.22–$170.28	129% above	25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HC PR RX HEPB VACCINE PED/ADOLESC 3 DOSE IM 0.5 ML	$129.00	$172.00	$33.22–$170.28	—	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC PR RX HIB PRP-T VACCINE 4 DOSE IM 1 EA	$120.00	$160.00	$136.00–$158.40	281% above	25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HC PR RX HIB PRP-T VACCINE 4 DOSE IM 1 EA	$120.00	$160.00	$136.00–$158.40	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC PR RX IIV VACCINE PF INCREASED AG CONTENT IM 1 EA	$106.50	$142.00	$120.70–$140.58	27% above	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$176.72	$235.63	$122.52–$233.27	111% above	25%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC PR RX IIV VACCINE PF INCREASED AG CONTENT IM 1 EA	$106.50	$142.00	$120.70–$140.58	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY	$176.72	$235.63	$122.52–$233.27	—	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC PR RX MEASLES MUMPS RUBELLA VACCINE LIVE SQ 1 EA	$174.00	$232.00	$197.20–$229.68	1% above	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC PR RX MEASLES MUMPS RUBELLA VACCINE LIVE SQ 1 EA	$174.00	$232.00	$197.20–$229.68	—	25%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC PR RX MEASLES MUMPS RUBELLA VARICELLA VACCINE LIVE SQ 0.5 ML	$330.75	$441.00	$374.85–$436.59	75% above	25%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 HC PR RX MEASLES MUMPS RUBELLA VARICELLA VACCINE LIVE SQ 0.5 ML	$330.75	$441.00	$374.85–$436.59	—	25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC PR RX MENACWYD/MENACWY-CRM CONJ VACCINE GRPS ACYW IM 0.5 ML	$373.50	$498.00	$423.30–$493.02	136% above	25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC PR RX MENACWYD/MENACWY-CRM CONJ VACCINE GRPS ACYW IM 0.5 ML	$373.50	$498.00	$423.30–$493.02	—	25%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC PR RX MENINGOCOCCAL CONJ QUADRIVALENT (MENQUADFI) IM 1 EA	$123.00	$164.00	$139.40–$162.36	20% below	25%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 HC PR RX MENINGOCOCCAL CONJ QUADRIVALENT (MENQUADFI) IM 1 EA	$123.00	$164.00	$139.40–$162.36	—	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC PR RX MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM 0.5 ML	$166.50	$222.00	$188.70–$219.78	52% below	25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC PR RX MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM 0.5 ML	$166.50	$222.00	$188.70–$219.78	—	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP	$279.46	$372.61	—	26% above	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC PR RX PNEUMOCOCCAL VACCINE 13 VALENT IM 0.5 ML	$510.00	$680.00	$578.00–$673.20	130% above	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP	$279.46	$372.61	—	—	25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC PR RX PNEUMOCOCCAL VACCINE 13 VALENT IM 0.5 ML	$510.00	$680.00	$578.00–$673.20	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC PR RX PNEUMOCOCCAL CONJ 20 VALENT VACCINE (PCV20) IM 1 EA	$558.00	$744.00	$361.42–$736.56	18% above	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HC PR RX PNEUMOCOCCAL CONJ 20 VALENT VACCINE (PCV20) IM 1 EA	$558.00	$744.00	$361.42–$736.56	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PR RX PNEUMOCOCCAL VACCINE 23 VALENT 2 YRS OR OLDER SQ/IM 0.5	$270.00	$360.00	$133.47–$356.40	88% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PR RX PNEUMOCOCCAL VACCINE 23 VALENT 2 YRS OR OLDER SQ/IM 0.5	$270.00	$360.00	$133.47–$356.40	—	25%
Polio vaccine, inactivated (IPV) CPT 90713 HC PR RX POLIOVIRUS VACCINE INACTIVATED SQ/IM 0.5 ML	$114.00	$152.00	$129.20–$150.48	53% above	25%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 HC PR RX POLIOVIRUS VACCINE INACTIVATED SQ/IM 0.5 ML	$114.00	$152.00	$129.20–$150.48	—	25%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC PR RX ROTOVIRUS VACCINE (RV5) 3 DOSE ORAL 2 ML	$59.25	$79.00	$67.15–$78.21	21% below	25%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 HC PR RX ROTOVIRUS VACCINE (RV5) 3 DOSE ORAL 2 ML	$59.25	$79.00	$67.15–$78.21	—	25%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC PR RX HZV ZOSTER VACCINE RECOMBINANT ADJUVANTED IM 0.5 ML	$332.25	$443.00	$376.55–$438.57	52% above	25%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC PR RX HZV ZOSTER VACCINE RECOMBINANT ADJUVANTED IM 0.5 ML	$332.25	$443.00	$376.55–$438.57	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC PR RX TD VACCINE PF 7 YRS OR OLDER IM 0.5 ML	$121.50	$162.00	$39.57–$160.38	115% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP	$150.67	$200.89	$39.57–$198.88	167% above	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC PR RX TD VACCINE PF 7 YRS OR OLDER IM 0.5 ML	$121.50	$162.00	$39.57–$160.38	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP	$150.67	$200.89	$39.57–$198.88	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$155.58	$207.44	$40.07–$205.37	88% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP/SUSY (WRAPPER)	$174.63	$232.84	$40.07–$230.51	111% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC PR RX TDAP VACCINE 7 YRS OR OLDER IM 0.5 ML	$185.25	$247.00	$40.07–$244.53	124% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$155.58	$207.44	$40.07–$205.37	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP/SUSY (WRAPPER)	$174.63	$232.84	$40.07–$230.51	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC PR RX TDAP VACCINE 7 YRS OR OLDER IM 0.5 ML	$185.25	$247.00	$40.07–$244.53	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR 90471 VFC IMMUNIZATION ADMIN INITIAL	$17.25	$23.00	$19.11–$22.89	59% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE INITIAL VFC CDM	$18.00	$24.00	$19.11–$23.76	57% below	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$55.50	$74.00	$19.11–$73.26	32% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM	$55.50	$74.00	$19.11–$73.26	32% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$55.50	$74.00	$19.11–$73.26	32% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$55.50	$74.00	$19.11–$73.26	32% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE INITIAL CDM	$55.50	$74.00	$19.11–$73.26	32% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE HEPATITIS B CDM	$63.75	$85.00	$19.11–$84.15	52% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE INFLUENZA CDM	$75.75	$101.00	$19.11–$99.99	80% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR ADMIN VACCINE PNEUMONIA CDM	$78.75	$105.00	$19.11–$103.95	87% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC PR 90471 IMMUNIZATION ADMIN	$96.00	$128.00	$19.11–$126.72	128% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR 90471 VFC IMMUNIZATION ADMIN INITIAL	$17.25	$23.00	$19.11–$22.89	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE INITIAL VFC CDM	$18.00	$24.00	$19.11–$23.76	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE INITIAL CDM	$55.50	$74.00	$19.11–$73.26	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM	$55.50	$74.00	$19.11–$73.26	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM	$55.50	$74.00	$19.11–$73.26	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM	$55.50	$74.00	$19.11–$73.26	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM	$55.50	$74.00	$19.11–$73.26	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE HEPATITIS B CDM	$63.75	$85.00	$19.11–$84.15	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE INFLUENZA CDM	$75.75	$101.00	$19.11–$99.99	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR ADMIN VACCINE PNEUMONIA CDM	$78.75	$105.00	$19.11–$103.95	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC PR 90471 IMMUNIZATION ADMIN	$96.00	$128.00	$19.11–$126.72	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR 90472 VFC IMMUNIZATION ADMIN EACH ADDL	$17.25	$23.00	$16.58–$22.77	52% below	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR ADMIN VACCINE EA ADDL VFC CDM	$18.00	$24.00	$16.58–$23.76	50% below	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$55.50	$74.00	$16.58–$73.26	54% above	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR 90472 IMMUNIZATION ADMIN EACH ADD	$63.75	$85.00	$16.58–$84.15	76% above	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC PR 90472 ADMIN VACCINE EA ADDL CDM	$63.75	$85.00	$16.58–$84.15	76% above	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR 90472 VFC IMMUNIZATION ADMIN EACH ADDL	$17.25	$23.00	$16.58–$22.77	—	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR ADMIN VACCINE EA ADDL VFC CDM	$18.00	$24.00	$16.58–$23.76	—	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM	$55.50	$74.00	$16.58–$73.26	—	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR 90472 IMMUNIZATION ADMIN EACH ADD	$63.75	$85.00	$16.58–$84.15	—	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC PR 90472 ADMIN VACCINE EA ADDL CDM	$63.75	$85.00	$16.58–$84.15	—	25%

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://hospitalpricetransparencyfiles.com/public-hospital-district-3-of-pacific-county/916001012_Public-Hospital-District-3-of-Pacific-County_standardcharges.csv