Hospital Natchitoches, LA

Louisiana Extended Care of Natchitoches

Listed in its price file as “LLC-I, LLC”.

Louisiana Extended Care of Natchitoches in Natchitoches, LA publishes cash prices for 385 common procedures listed here, from its own machine-readable price file updated Oct 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Louisiana median for 353 of 385 procedures and below it for 30. By typical cash price it ranks #58 of 63 Louisiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

501 Keyser Ave 4th Floor, Natchitoches, LA 71457 Collected Oct 26, 2026 Source price file Check a bill from this hospital (318) 214-4200

Acute care hospital Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 190007 · CMS hospital register

The price file shows no self-pay discount

For 1842 of the 1842 prices listed here, the cash price in Louisiana Extended Care of Natchitoches's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Financial assistance

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONTRAST	$2,305.00	$2,305.00	—	133% above	—
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST	$2,305.00	$2,305.00	—	—	—
Abdominal X-ray, 2 views CPT 74019 ABDOMEN XRAY 2 VIEWS	$136.00	$136.00	—	22% below	—
Abdominal X-ray, 2 views CPT 74019 ABDOMEN	$382.00	$382.00	—	119% above	—
Abdominal X-ray, 2 views CPT 74019 LECH ABDOMEN	$566.00	$566.00	—	225% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN XRAY 2 VIEWS	$136.00	$136.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN	$382.00	$382.00	—	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 LECH ABDOMEN	$566.00	$566.00	—	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3+ VIEW LEFT	$293.00	$293.00	—	158% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3+ VIEW RIGHT	$293.00	$293.00	—	158% above	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3+ VIEW RIGHT	$293.00	$293.00	—	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3+ VIEW LEFT	$293.00	$293.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$381.00	$381.00	—	132% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT ART/VENOUS LIMITED - WCC	$714.00	$714.00	—	334% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$381.00	$381.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT ART/VENOUS LIMITED - WCC	$714.00	$714.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT; U EXTR WO CONTRAST LEFT	$1,574.00	$1,574.00	—	150% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT; U EXTR WO CONTRAST RIGHT	$1,574.00	$1,574.00	—	150% above	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT; U EXTR WO CONTRAST LEFT	$1,574.00	$1,574.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT; U EXTR WO CONTRAST RIGHT	$1,574.00	$1,574.00	—	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$566.00	$566.00	—	165% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 LECH ESOPHAGUS	$840.00	$840.00	—	293% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$566.00	$566.00	—	—	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 LECH ESOPHAGUS	$840.00	$840.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 WHOLE BODY BONE SCAN	$1,693.00	$1,693.00	—	208% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 WHOLE BODY BONE SCAN	$1,693.00	$1,693.00	—	—	—
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$317.00	$317.00	—	89% above	—
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE	$359.00	$359.00	—	115% above	—
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$317.00	$317.00	—	—	—
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE	$359.00	$359.00	—	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642 US EXAM,BREAST (S) - LTD	$450.00	$450.00	—	169% above	—
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US EXAM,BREAST (S) - LTD	$450.00	$450.00	—	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD & PELV W/O&W/DYEM	$997.00	$997.00	—	12% above	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD & PELV W/O&W/DYEM	$997.00	$997.00	—	—	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$2,052.00	$2,052.00	—	211% above	—
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD	$2,052.00	$2,052.00	—	—	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$2,052.00	$2,052.00	—	211% above	—
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK	$2,052.00	$2,052.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$2,488.00	$2,488.00	—	207% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST	$2,488.00	$2,488.00	—	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,361.00	$2,361.00	—	401% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$2,361.00	$2,361.00	—	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CAL TEST	$2,127.00	$2,127.00	—	2493% above	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$2,361.00	$2,361.00	—	2778% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CAL TEST	$2,127.00	$2,127.00	—	—	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$2,361.00	$2,361.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$3,275.00	$3,275.00	—	196% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 LECH CT ABD & PELVIS W/O CONTR	$4,864.00	$4,864.00	—	340% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$3,275.00	$3,275.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 LECH CT ABD & PELVIS W/O CONTR	$4,864.00	$4,864.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST M	$3,742.00	$3,742.00	—	240% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 LECH CT ABD & PELVIS W/CONTRAS	$5,556.00	$5,556.00	—	404% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST M	$3,742.00	$3,742.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 LECH CT ABD & PELVIS W/CONTRAS	$5,556.00	$5,556.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS WW/O CO 1+REGIOM	$4,207.00	$4,207.00	—	196% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS WW/O CON 1+REGIO	$4,207.00	$4,207.00	—	196% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 LECH CT ABD&PELVIS WW/O CON 1+	$6,248.00	$6,248.00	—	340% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PELVIS WW/O CON 1+REGIO	$4,207.00	$4,207.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PELVIS WW/O CO 1+REGIOM	$4,207.00	$4,207.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 LECH CT ABD&PELVIS WW/O CON 1+	$6,248.00	$6,248.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$2,095.00	$2,095.00	—	152% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$2,095.00	$2,095.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,854.00	$1,854.00	—	150% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,854.00	$1,854.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL,SIN. W/O CONT	$1,491.00	$1,491.00	—	139% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL,SIN. W/O CONT	$1,491.00	$1,491.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CODE PURPLE	$1,588.00	$1,588.00	—	142% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN/HEAD W/O CONTRAST	$1,588.00	$1,588.00	—	142% above	—
CT scan of the head or brain, no contrast dye CPT 70450 LECH CT BRAIN/HEAD W/O CONTRAS	$2,358.00	$2,358.00	—	260% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN/HEAD W/O CONTRAST	$1,588.00	$1,588.00	—	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CODE PURPLE	$1,588.00	$1,588.00	—	—	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 LECH CT BRAIN/HEAD W/O CONTRAS	$2,358.00	$2,358.00	—	—	—
CT scan of the head with contrast CPT 70460 CT BRAIN/HEAD W/CONTRAST	$1,823.00	$1,823.00	—	154% above	—
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN/HEAD W/CONTRAST	$1,823.00	$1,823.00	—	—	—
CT scan of the head without and with contrast CPT 70470 CT BRAIN/HEAD W/WO CONTRAST	$2,016.00	$2,016.00	—	125% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN/HEAD W/WO CONTRAST	$2,016.00	$2,016.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CAT SCAN-LUMBAR	$869.00	$869.00	—	16% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,966.00	$1,966.00	—	162% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 LECH CT LUMBAR SPINE W/O CONTR	$2,918.00	$2,918.00	—	289% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CAT SCAN-LUMBAR	$869.00	$869.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,966.00	$1,966.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 LECH CT LUMBAR SPINE W/O CONTR	$2,918.00	$2,918.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,343.00	$1,343.00	—	91% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 LECH CT CERVICAL SPINE W/O CON	$2,188.00	$2,188.00	—	211% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,343.00	$1,343.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 LECH CT CERVICAL SPINE W/O CON	$2,188.00	$2,188.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONT	$1,926.00	$1,926.00	—	141% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONT	$1,926.00	$1,926.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DOPPLER ULTRASOUND BI	$877.00	$877.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DUPLEX COMPLETE	$877.00	$877.00	—	88% above	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 LECH CAROTID DOPPLER ULTRASOUN	$1,302.00	$1,302.00	—	179% above	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DOPPLER ULTRASOUND BI	$877.00	$877.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DUPLEX COMPLETE	$877.00	$877.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 LECH CAROTID DOPPLER ULTRASOUN	$1,302.00	$1,302.00	—	—	—
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST	$2,299.00	$2,299.00	—	123% above	—
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST	$2,299.00	$2,299.00	—	—	—
Chest X-ray, 2 views CPT 71046 CHEST,CROSS-TAB LAT	$236.00	$236.00	—	87% above	—
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$242.00	$242.00	—	92% above	—
Chest X-ray, 2 views CPT 71046 CHEST,DECUBITUS	$245.00	$245.00	—	94% above	—
Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 VIEW	$299.00	$299.00	—	137% above	—
Chest X-ray, 2 views CPT 71046 LECH CHEST 2 VIEWS	$355.00	$355.00	—	182% above	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST,CROSS-TAB LAT	$236.00	$236.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$242.00	$242.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST,DECUBITUS	$245.00	$245.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST XRAY 2 VIEW	$299.00	$299.00	—	—	—
Chest X-ray, 2 views inpatient CPT 71046 LECH CHEST 2 VIEWS	$355.00	$355.00	—	—	—
Chest X-ray, single view CPT 71045 CONAGRA EPA CHEST (1) VIEW	$192.00	$192.00	—	86% above	—
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$242.00	$242.00	—	134% above	—
Chest X-ray, single view CPT 71045 CHEST XRAY 1 VIEW	$299.00	$299.00	—	190% above	—
Chest X-ray, single view CPT 71045 LECH CHEST SINGLE VIEW	$307.00	$307.00	—	197% above	—
Chest X-ray, single view inpatient CPT 71045 CONAGRA EPA CHEST (1) VIEW	$192.00	$192.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$242.00	$242.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 CHEST XRAY 1 VIEW	$299.00	$299.00	—	—	—
Chest X-ray, single view inpatient CPT 71045 LECH CHEST SINGLE VIEW	$307.00	$307.00	—	—	—
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$299.00	$299.00	—	162% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE,LEFT	$301.00	$301.00	—	164% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE,RIGHT	$301.00	$301.00	—	164% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 LECH CLAVICLE,LEFT	$446.00	$446.00	—	291% above	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$299.00	$299.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE,LEFT	$301.00	$301.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE,RIGHT	$301.00	$301.00	—	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 LECH CLAVICLE,LEFT	$446.00	$446.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 KIDNEY'S & BLADDER:COMPLETE	$361.00	$361.00	—	32% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL,COMP	$478.00	$478.00	—	74% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 LECH US EXAM ABDO BACK WALL,CO	$709.00	$709.00	—	159% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 KIDNEY'S & BLADDER:COMPLETE	$361.00	$361.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL,COMP	$478.00	$478.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 LECH US EXAM ABDO BACK WALL,CO	$709.00	$709.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA,AXIAL SKELETON	$529.00	$529.00	—	265% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA,AXIAL SKELETON	$529.00	$529.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 APPEND SKELETON (PERIPHERAL)	$165.00	$165.00	—	108% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY (PERIPHERAL)	$192.00	$192.00	—	142% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 APPEND SKELETON (PERIPHERAL)	$165.00	$165.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY (PERIPHERAL)	$192.00	$192.00	—	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$682.00	$682.00	—	157% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS	$682.00	$682.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$2,021.00	$2,021.00	—	201% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 LECH CT CHEST W/O CONTRAST	$3,001.00	$3,001.00	—	347% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$2,021.00	$2,021.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 LECH CT CHEST W/O CONTRAST	$3,001.00	$3,001.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$2,210.00	$2,210.00	—	163% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 LECH CT CHEST W/CONTRAST	$3,282.00	$3,282.00	—	290% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST	$2,210.00	$2,210.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 LECH CT CHEST W/CONTRAST	$3,282.00	$3,282.00	—	—	—
Diagnostic mammogram, both breasts CPT 77066 3-D MAMMOGRAM DIAGNOSTIC BIL	$560.00	$560.00	—	281% above	—
Diagnostic mammogram, both breasts CPT 77066 MAMMOGRAM DIAGNOSTIC BIL	$655.00	$655.00	—	345% above	—
Diagnostic mammogram, both breasts CPT 77066 MAMMOGRAM DIAGNOSTIC BIL M	$655.00	$655.00	—	345% above	—
Diagnostic mammogram, both breasts inpatient CPT 77066 3-D MAMMOGRAM DIAGNOSTIC BIL	$560.00	$560.00	—	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMOGRAM DIAGNOSTIC BIL	$655.00	$655.00	—	—	—
Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMOGRAM DIAGNOSTIC BIL M	$655.00	$655.00	—	—	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM-UNILATERAL RT/DIAG	$420.00	$420.00	—	245% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM-UNILATERAL LT/DIAG	$420.00	$420.00	—	245% above	—
Diagnostic mammogram, one breast one side CPT 77065 3-D MAMMO-UNILATERAL RT/DIAG	$560.00	$560.00	—	360% above	—
Diagnostic mammogram, one breast one side CPT 77065 3-D MAMMO-UNILATERAL LT/DIAG	$560.00	$560.00	—	360% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAM-UNILATERAL RT/DIAG	$420.00	$420.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAM-UNILATERAL LT/DIAG	$420.00	$420.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 3-D MAMMO-UNILATERAL LT/DIAG	$560.00	$560.00	—	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 3-D MAMMO-UNILATERAL RT/DIAG	$560.00	$560.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DPLX BILATERAL LOWER EXT	$927.00	$927.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LECH ART DPLX BILATERAL LOW EX	$1,375.00	$1,375.00	—	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 ART DPLX BLE	$766.00	$766.00	—	69% above	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ART DPLX BILATERAL LOWER EXT	$927.00	$927.00	—	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LECH ART DPLX BILATERAL LOW EX	$1,375.00	$1,375.00	—	—	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 ART DPLX BLE	$766.00	$766.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DOPPLER BILATERAL UPPER	$1,049.00	$1,049.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS DOPPLER BILATERAL LOWER	$1,111.00	$1,111.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LECH VENOUS DOPPLER BILAT LOWE	$1,649.00	$1,649.00	—	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DPLX COMPLT	$912.00	$912.00	—	118% above	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DOPPLER BILATERAL UPPER	$1,049.00	$1,049.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS DOPPLER BILATERAL LOWER	$1,111.00	$1,111.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LECH VENOUS DOPPLER BILAT LOWE	$1,649.00	$1,649.00	—	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DPLX COMPLT	$912.00	$912.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE	$1,762.00	$1,762.00	—	145% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE	$1,762.00	$1,762.00	—	—	—
Elbow X-ray, 2 views CPT 73070 ELBOW XRAY 2 VIEWS	$299.00	$299.00	—	163% above	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW, 2 VIEWS RIGHT	$323.00	$323.00	—	184% above	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW, 2 VIEWS LEFT	$323.00	$323.00	—	184% above	—
Elbow X-ray, 2 views one side CPT 73070 LECH ELBOW, 2 VIEWS RIGHT	$479.00	$479.00	—	321% above	—
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW XRAY 2 VIEWS	$299.00	$299.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW, 2 VIEWS LEFT	$323.00	$323.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW, 2 VIEWS RIGHT	$323.00	$323.00	—	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 LECH ELBOW, 2 VIEWS RIGHT	$479.00	$479.00	—	—	—
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW XRAY 3+ VIEWS	$299.00	$299.00	—	128% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3+ VIEW LEFT	$346.00	$346.00	—	164% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3+ VIEW RIGHT	$372.00	$372.00	—	184% above	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW XRAY 3+ VIEWS	$299.00	$299.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3+ VIEW LEFT	$346.00	$346.00	—	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3+ VIEW RIGHT	$372.00	$372.00	—	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS,SELLA,I/O EAR W/O CO	$1,491.00	$1,491.00	—	146% above	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS,SELLA,I/O EAR W/O CO	$1,491.00	$1,491.00	—	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 XRAY OF FACIAL BONES 3+ VIEWS	$105.00	$105.00	—	29% below	—
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES	$387.00	$387.00	—	163% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150 ZYGOMATIC ARCHES	$387.00	$387.00	—	163% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XRAY OF FACIAL BONES 3+ VIEWS	$105.00	$105.00	—	—	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES	$387.00	$387.00	—	—	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 ZYGOMATIC ARCHES	$387.00	$387.00	—	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM XRAY 2 VIEWS	$299.00	$299.00	—	166% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM,2 VIEWS RIGHT	$323.00	$323.00	—	187% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM,2 VIEWS LEFT	$323.00	$323.00	—	187% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 LECH FOREARM,2 VIEWS RIGHT	$479.00	$479.00	—	325% above	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM XRAY 2 VIEWS	$299.00	$299.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM,2 VIEWS RIGHT	$323.00	$323.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM,2 VIEWS LEFT	$323.00	$323.00	—	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 LECH FOREARM,2 VIEWS RIGHT	$479.00	$479.00	—	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,352.00	$1,352.00	—	138% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,352.00	$1,352.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL XRAY 2+ VIEWS	$299.00	$299.00	—	174% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL,LEFT	$251.00	$251.00	—	130% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL,RIGHT	$251.00	$251.00	—	130% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL XRAY 2+ VIEWS	$299.00	$299.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL,LEFT	$251.00	$251.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL,RIGHT	$251.00	$251.00	—	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP TEST TYPE III	$646.00	$646.00	—	196% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP TEST TYPE III	$646.00	$646.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CPAP TITRATION POLY	$6,209.00	$6,209.00	—	348% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CPAP TITRATION POLY	$6,209.00	$6,209.00	—	—	—
Knee X-ray, 3 views CPT 73562 KNEE XRAY 3 VIEWS	$299.00	$299.00	—	121% above	—
Knee X-ray, 3 views one side CPT 73562 KNEE,LEFT,3 VIEW	$352.00	$352.00	—	161% above	—
Knee X-ray, 3 views one side CPT 73562 KNEE,RIGHT,3 VIEW	$352.00	$352.00	—	161% above	—
Knee X-ray, 3 views one side CPT 73562 LECH KNEE,LEFT,3 VIEW	$522.00	$522.00	—	286% above	—
Knee X-ray, 3 views inpatient CPT 73562 KNEE XRAY 3 VIEWS	$299.00	$299.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE,LEFT,3 VIEW	$352.00	$352.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE,RIGHT,3 VIEW	$352.00	$352.00	—	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 LECH KNEE,LEFT,3 VIEW	$522.00	$522.00	—	—	—
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$326.00	$326.00	—	123% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY KNEE 4 OR MORE, LEFT	$304.00	$304.00	—	108% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY KNEE 4 OR MORE, RIGHT	$304.00	$304.00	—	108% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE;COMPLT 4/MORE VIEW-RT	$432.00	$432.00	—	196% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE;COMPLT 4/MORE VIEW-LT	$432.00	$432.00	—	196% above	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$326.00	$326.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY KNEE 4 OR MORE, LEFT	$304.00	$304.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY KNEE 4 OR MORE, RIGHT	$304.00	$304.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE;COMPLT 4/MORE VIEW-RT	$432.00	$432.00	—	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE;COMPLT 4/MORE VIEW-LT	$432.00	$432.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LWR W/O CONT RT	$1,574.00	$1,574.00	—	164% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LWR W/O CONT LT	$1,574.00	$1,574.00	—	164% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 LECH CT EXT LWR W/O CONT LT	$2,339.00	$2,339.00	—	292% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 LECH CT EXT LWR W/O CONT RT	$2,339.00	$2,339.00	—	292% above	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LWR W/O CONT RT	$1,574.00	$1,574.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LWR W/O CONT LT	$1,574.00	$1,574.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 LECH CT EXT LWR W/O CONT LT	$2,339.00	$2,339.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 LECH CT EXT LWR W/O CONT RT	$2,339.00	$2,339.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PANCREAS ULTRASOUND	$306.00	$306.00	—	22% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 G B ULTRASOUND	$330.00	$330.00	—	32% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SPLEEN ULTRASOUND	$434.00	$434.00	—	73% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$488.00	$488.00	—	95% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED	$562.00	$562.00	—	125% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PANCREAS ULTRASOUND	$306.00	$306.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 G B ULTRASOUND	$330.00	$330.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SPLEEN ULTRASOUND	$434.00	$434.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$488.00	$488.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED	$562.00	$562.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LTD NONVAS STRUX JT SP OR S	$254.00	$254.00	—	46% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LTD NONVAS STRUX JT SP OR S	$254.00	$254.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT SCAN FOR LUNG CANC	$445.00	$445.00	—	200% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT SCAN FOR LUNG CANC	$445.00	$445.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LOWER LEG XRAY 2 VIEWS	$299.00	$299.00	—	161% above	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 ANKLE XRAY 3 + VIEWS	$299.00	$299.00	—	161% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG,LOWER,LEFT	$293.00	$293.00	—	155% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG,LOWER,RIGHT	$293.00	$293.00	—	155% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LECH LEG,LOWER,RIGHT	$435.00	$435.00	—	279% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LOWER LEG XRAY 2 VIEWS	$299.00	$299.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 ANKLE XRAY 3 + VIEWS	$299.00	$299.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG,LOWER,LEFT	$293.00	$293.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG,LOWER,RIGHT	$293.00	$293.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LECH LEG,LOWER,RIGHT	$435.00	$435.00	—	—	—
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIO HEAD W/O CONTRAST	$2,510.00	$2,510.00	—	199% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIO HEAD W/O CONTRAST	$2,510.00	$2,510.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 EXT LWR JOINT W/O CONTRAST LT	$2,969.00	$2,969.00	—	242% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 EXT LWR JOINT W/O CONTRAST RT	$2,969.00	$2,969.00	—	242% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 EXT LWR JOINT W/O CONTRAST LT	$2,969.00	$2,969.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 EXT LWR JOINT W/O CONTRAST RT	$2,969.00	$2,969.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 EXT LWR JOINT W/WO CONTRAST LT	$3,548.00	$3,548.00	—	186% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 EXT LWR JOINT W/WO CONTRAST RT	$3,548.00	$3,548.00	—	186% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 EXT LWR JOINT W/WO CONTRAST LT	$3,548.00	$3,548.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 EXT LWR JOINT W/WO CONTRAST RT	$3,548.00	$3,548.00	—	—	—
MRI of the abdomen without contrast CPT 74181 ABDOMEN W/O CONTRAST	$2,969.00	$2,969.00	—	231% above	—
MRI of the abdomen without contrast CPT 74181 MRCP	$3,811.00	$3,811.00	—	325% above	—
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN W/O CONTRAST	$2,969.00	$2,969.00	—	—	—
MRI of the abdomen without contrast inpatient CPT 74181 MRCP	$3,811.00	$3,811.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W/WO CONTRAST	$3,853.00	$3,853.00	—	208% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W/WO CONTRAST	$3,853.00	$3,853.00	—	—	—
MRI of the brain, no contrast dye CPT 70551 BRAIN W/O CONTRAST	$2,929.00	$2,929.00	—	198% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN W/O CONTRAST	$2,929.00	$2,929.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W/WO CONTRAST	$4,045.00	$4,045.00	—	210% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W/WO CONTRAST	$4,045.00	$4,045.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148 LUMBAR W/O CONTRAST	$3,202.00	$3,202.00	—	210% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR W/O CONTRAST	$3,202.00	$3,202.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR W/WO CONTRAST	$4,218.00	$4,218.00	—	209% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR W/WO CONTRAST	$4,218.00	$4,218.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC W/O CONTRAST	$2,753.00	$2,753.00	—	216% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC W/O CONTRAST	$2,753.00	$2,753.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL W/WO CONTRAST	$4,658.00	$4,658.00	—	246% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL W/WO CONTRAST	$4,658.00	$4,658.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL W/O CONTRAST	$3,226.00	$3,226.00	—	245% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL W/O CONTRAST	$3,226.00	$3,226.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE	$1,050.00	$1,050.00	—	2% above	—
MRI of the pelvis without and with contrast CPT 72197 PELVIS W/WO CONTRAST	$3,812.00	$3,812.00	—	272% above	—
MRI of the pelvis without and with contrast CPT 72197 PROSTATE MRI W/O & W/DYE	$4,896.00	$4,896.00	—	378% above	—
MRI of the pelvis without and with contrast CPT 72197 SACRUM/COCCYX WO/W CONTRAST	$4,896.00	$4,896.00	—	378% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE	$1,050.00	$1,050.00	—	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W/WO CONTRAST	$3,812.00	$3,812.00	—	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 SACRUM/COCCYX WO/W CONTRAST	$4,896.00	$4,896.00	—	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 PROSTATE MRI W/O & W/DYE	$4,896.00	$4,896.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195 PELVIS W/O CONTRAST	$3,178.00	$3,178.00	—	292% above	—
MRI of the pelvis, no contrast dye CPT 72195 SACRUM/COCCYX WO CONTRAST	$4,076.00	$4,076.00	—	402% above	—
MRI of the pelvis, no contrast dye CPT 72195 PROSTATE MRI W/O DYE	$4,076.00	$4,076.00	—	402% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS W/O CONTRAST	$3,178.00	$3,178.00	—	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 PROSTATE MRI W/O DYE	$4,076.00	$4,076.00	—	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 SACRUM/COCCYX WO CONTRAST	$4,076.00	$4,076.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 EXT UPP JOINT W/O CONTRAST LT	$3,202.00	$3,202.00	—	302% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 EXT UPP JOINT W/O CONTRAST RT	$3,202.00	$3,202.00	—	302% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 EXT UPP JOINT W/O CONTRAST RT	$3,202.00	$3,202.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 EXT UPP JOINT W/O CONTRAST LT	$3,202.00	$3,202.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE WITH OBL	$514.00	$514.00	—	155% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE WITH OBL	$514.00	$514.00	—	—	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSUE W/CONTRAST	$1,745.00	$1,745.00	—	156% above	—
Neck soft tissue CT scan with contrast CPT 70491 LECH CT NECK SOFT TISSUE W/CON	$2,589.00	$2,589.00	—	279% above	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK, CHEST, ABD/PEL W/CONT	$7,177.00	$7,177.00	—	951% above	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TISSUE W/CONTRAST	$1,745.00	$1,745.00	—	—	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 LECH CT NECK SOFT TISSUE W/CON	$2,589.00	$2,589.00	—	—	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK, CHEST, ABD/PEL W/CONT	$7,177.00	$7,177.00	—	—	—
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE W/O CONTRA	$1,419.00	$1,419.00	—	113% above	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE W/O CONTRA	$1,419.00	$1,419.00	—	—	—
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$236.00	$236.00	—	107% above	—
Neck soft tissue X-ray CPT 70360 Xray Neck Soft Tissue	$299.00	$299.00	—	162% above	—
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$236.00	$236.00	—	—	—
Neck soft tissue X-ray inpatient CPT 70360 Xray Neck Soft Tissue	$299.00	$299.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CARD PERFUS,SPECT,MULTI	$3,834.00	$3,834.00	—	230% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 THAL/VIABILITY HEART SCAN	$4,178.00	$4,178.00	—	259% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 CARD PERFUS,SPECT,MULTI	$3,834.00	$3,834.00	—	—	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 THAL/VIABILITY HEART SCAN	$4,178.00	$4,178.00	—	—	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,703.00	$1,703.00	—	160% above	—
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,703.00	$1,703.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$123.00	$123.00	—	20% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC SOFT TISSUE LTD	$288.00	$288.00	—	88% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US SOFT TISS PELVIC WALL, BUTT	$359.00	$359.00	—	134% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON-OBSTETRICAL	$359.00	$359.00	—	134% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$123.00	$123.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC SOFT TISSUE LTD	$288.00	$288.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NON-OBSTETRICAL	$359.00	$359.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US SOFT TISS PELVIC WALL, BUTT	$359.00	$359.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM URINARY BLADDER	$756.00	$756.00	—	175% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM,PELVIC,COMPLETE	$800.00	$800.00	—	191% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 LECH US EXAM URINARY BLADDER	$1,122.00	$1,122.00	—	308% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM URINARY BLADDER	$756.00	$756.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM,PELVIC,COMPLETE	$800.00	$800.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 LECH US EXAM URINARY BLADDER	$1,122.00	$1,122.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WEEKS SINGLE FETUS	$123.00	$123.00	—	47% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB ULTRASOUND	$169.00	$169.00	—	27% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US GREATER THAN 14WK TRIPLM	$726.00	$726.00	—	213% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US GREATER THAN 14WK-TRIPLA	$726.00	$726.00	—	213% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US GREATER THAN 14WK-TWINSA	$726.00	$726.00	—	213% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US GREATER THAN 14WKS-TWINM	$726.00	$726.00	—	213% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US COMP GREATER THAN 14 WKS	$751.00	$751.00	—	224% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US GREATER THAN 14 WKSM	$770.00	$770.00	—	232% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >= 14 WEEKS SINGLE FETUS	$123.00	$123.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB ULTRASOUND	$169.00	$169.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US GREATER THAN 14WK-TRIPLA	$726.00	$726.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US GREATER THAN 14WK TRIPLM	$726.00	$726.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US GREATER THAN 14WKS-TWINM	$726.00	$726.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US GREATER THAN 14WK-TWINSA	$726.00	$726.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US COMP GREATER THAN 14 WKS	$751.00	$751.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US GREATER THAN 14 WKSM	$770.00	$770.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS < 14 WEEKS SINGLE FETUS	$123.00	$123.00	—	41% below	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS LESS THAN 14 WKS-TWINSM	$726.00	$726.00	—	247% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS LESS THAN 14 WKS/TRIPLETM	$726.00	$726.00	—	247% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS LESS THAN 14 WKS/TRIPLETA	$726.00	$726.00	—	247% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS LESS THAN 14 WKS-TWINSA	$726.00	$726.00	—	247% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US LESS THAN 14 WEEKS	$751.00	$751.00	—	259% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US LESS THAN 14 WKSM	$770.00	$770.00	—	269% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS < 14 WEEKS SINGLE FETUS	$123.00	$123.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS LESS THAN 14 WKS/TRIPLETA	$726.00	$726.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS LESS THAN 14 WKS/TRIPLETM	$726.00	$726.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS LESS THAN 14 WKS-TWINSA	$726.00	$726.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS LESS THAN 14 WKS-TWINSM	$726.00	$726.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US LESS THAN 14 WEEKS	$751.00	$751.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US LESS THAN 14 WKSM	$770.00	$770.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS	$123.00	$123.00	—	20% below	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED 1+ FETUS(S)	$330.00	$330.00	—	115% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS	$123.00	$123.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED 1+ FETUS(S)	$330.00	$330.00	—	—	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL - 2 VIEWS RIGHT	$275.00	$275.00	—	107% above	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL - 2 VIEWS	$275.00	$275.00	—	107% above	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS 2 VIEWS XRAY UNILAT	$299.00	$299.00	—	125% above	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL - 2 VIEWS RIGHT	$275.00	$275.00	—	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL - 2 VIEWS	$275.00	$275.00	—	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS 2 VIEWS XRAY UNILAT	$299.00	$299.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB UNILAT;W/PA CHEST RT	$538.00	$538.00	—	286% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB UNILAT;W/PA CHEST LT	$538.00	$538.00	—	286% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB UNILAT;W/PA CHEST LT	$538.00	$538.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB UNILAT;W/PA CHEST RT	$538.00	$538.00	—	—	—
Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREENING YWCA	$73.00	$73.00	—	45% below	—
Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREENING KOMEN	$73.00	$73.00	—	45% below	—
Screening mammogram, both breasts CPT 77067 MAMMOGRAM SCREENING BIL	$489.00	$489.00	—	271% above	—
Screening mammogram, both breasts CPT 77067 3-D MAMMOGRAM SCREENING BIL	$560.00	$560.00	—	325% above	—
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAM SCREENING YWCA	$73.00	$73.00	—	—	—
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAM SCREENING KOMEN	$73.00	$73.00	—	—	—
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAM SCREENING BIL	$489.00	$489.00	—	—	—
Screening mammogram, both breasts inpatient CPT 77067 3-D MAMMOGRAM SCREENING BIL	$560.00	$560.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER XRAY 2+ VIEWS	$299.00	$299.00	—	134% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER,LEFT	$323.00	$323.00	—	153% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER,RIGHT	$323.00	$323.00	—	153% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XRAY SHOULDER 2 VIEW LEFT	$408.00	$408.00	—	220% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XRAY SHOULDER 2 VIEW RIGHT	$408.00	$408.00	—	220% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 LECH SHOULDER,RIGHT	$479.00	$479.00	—	275% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 LECH SHOULDER,LEFT	$479.00	$479.00	—	275% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER XRAY 2+ VIEWS	$299.00	$299.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER,RIGHT	$323.00	$323.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER,LEFT	$323.00	$323.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XRAY SHOULDER 2 VIEW RIGHT	$408.00	$408.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XRAY SHOULDER 2 VIEW LEFT	$408.00	$408.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 LECH SHOULDER,RIGHT	$479.00	$479.00	—	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 LECH SHOULDER,LEFT	$479.00	$479.00	—	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 Sinus Xray 3+ views	$299.00	$299.00	—	94% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES	$387.00	$387.00	—	151% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinus Xray 3+ views	$299.00	$299.00	—	—	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES	$387.00	$387.00	—	—	—
Skull X-ray, fewer than 4 views CPT 70250 BASE OF SKULL	$107.00	$107.00	—	9% below	—
Skull X-ray, fewer than 4 views CPT 70250 AP & LAT SKULL	$285.00	$285.00	—	142% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 BASE OF SKULL	$107.00	$107.00	—	—	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 AP & LAT SKULL	$285.00	$285.00	—	—	—
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$3,722.00	$3,722.00	—	179% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$3,722.00	$3,722.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$566.00	$566.00	—	137% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 LECH MODIFIED BARIUM SWALLOW	$840.00	$840.00	—	252% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$566.00	$566.00	—	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 LECH MODIFIED BARIUM SWALLOW	$840.00	$840.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR XRAY 2 + VIEWS	$299.00	$299.00	—	163% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR,2 VIEWS RIGHT	$313.00	$313.00	—	176% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR,2 VIEWS LEFT	$333.00	$333.00	—	193% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 LECH FEMUR,2 VIEWS RIGHT	$465.00	$465.00	—	309% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 LECH FEMUR,2 VIEWS LEFT	$493.00	$493.00	—	334% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR XRAY 2 + VIEWS	$299.00	$299.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR,2 VIEWS RIGHT	$313.00	$313.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR,2 VIEWS LEFT	$333.00	$333.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 LECH FEMUR,2 VIEWS RIGHT	$465.00	$465.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 LECH FEMUR,2 VIEWS LEFT	$493.00	$493.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,810.00	$1,810.00	—	147% above	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,810.00	$1,810.00	—	—	—
Toe X-ray, 2 or more views CPT 73660 TOE(S) XRAY 2 + VIEWS	$299.00	$299.00	—	178% above	—
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) XRAY 2 + VIEWS	$299.00	$299.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON - OB	$123.00	$123.00	—	37% below	—
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON OB	$623.00	$623.00	—	220% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON - OB	$123.00	$123.00	—	—	—
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON OB	$623.00	$623.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$123.00	$123.00	—	28% below	—
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL OB US	$330.00	$330.00	—	94% above	—
Transvaginal ultrasound during pregnancy CPT 76817 OB US TRANSVAGINAL	$795.00	$795.00	—	367% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$123.00	$123.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL OB US	$330.00	$330.00	—	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB US TRANSVAGINAL	$795.00	$795.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700 US EXAM,ABDOM,COMPLETE	$1,043.00	$1,043.00	—	251% above	—
Ultrasound of the abdomen, complete CPT 76700 LECH US EXAM,ABDOM,COMPLETE	$1,548.00	$1,548.00	—	420% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM,ABDOM,COMPLETE	$1,043.00	$1,043.00	—	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 LECH US EXAM,ABDOM,COMPLETE	$1,548.00	$1,548.00	—	—	—
Ultrasound of the scrotum and testicles CPT 76870 TESTICULAR ULTRASOUND	$672.00	$672.00	—	217% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 TESTICULAR ULTRASOUND	$672.00	$672.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM HEAD & NECK/SOFT TISSU	$662.00	$662.00	—	163% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF THYROID	$702.00	$702.00	—	179% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM HEAD & NECK/SOFT TISSU	$662.00	$662.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF THYROID	$702.00	$702.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GASTROGRAFIN GI	$452.00	$452.00	—	85% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI	$538.00	$538.00	—	120% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W SM BOWEL	$892.00	$892.00	—	265% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI W/SM BOWEL	$1,053.00	$1,053.00	—	331% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GASTROGRAFIN GI	$452.00	$452.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI	$538.00	$538.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W SM BOWEL	$892.00	$892.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI W/SM BOWEL	$1,053.00	$1,053.00	—	—	—
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS XRAY 2 + VIEWS	$299.00	$299.00	—	163% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS,RIGHT	$301.00	$301.00	—	165% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS,MIN 2 VIEWS	$323.00	$323.00	—	184% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 LECH HUMERUS,MIN 2 VIEWS	$479.00	$479.00	—	321% above	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS XRAY 2 + VIEWS	$299.00	$299.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS,RIGHT	$301.00	$301.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS,MIN 2 VIEWS	$323.00	$323.00	—	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 LECH HUMERUS,MIN 2 VIEWS	$479.00	$479.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DPLX LTD	$587.00	$587.00	—	133% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER LTD RIGHT	$258.00	$258.00	—	2% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER LTD UPPER RIGHT	$676.00	$676.00	—	168% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER LTD UPPER LEFT	$676.00	$676.00	—	168% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER LTD LOWER LEFT	$711.00	$711.00	—	182% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS DOPPLER LTD LOWER RIGHT	$711.00	$711.00	—	182% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LECH VENOUS DOPPLER LT UP L	$1,002.00	$1,002.00	—	298% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LECH VENOUS DOPPLER LTD LOW LT	$1,057.00	$1,057.00	—	320% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LECH VENOUS DOPPLER LTD LOW RT	$1,057.00	$1,057.00	—	320% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DPLX LTD	$587.00	$587.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER LTD RIGHT	$258.00	$258.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER LTD UPPER RIGHT	$676.00	$676.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER LTD UPPER LEFT	$676.00	$676.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER LTD LOWER RIGHT	$711.00	$711.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS DOPPLER LTD LOWER LEFT	$711.00	$711.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LECH VENOUS DOPPLER LT UP L	$1,002.00	$1,002.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LECH VENOUS DOPPLER LTD LOW LT	$1,057.00	$1,057.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LECH VENOUS DOPPLER LTD LOW RT	$1,057.00	$1,057.00	—	—	—
Wrist X-ray, 2 views one side CPT 73100 WRIST,LEFT,2 VIEW	$156.00	$156.00	—	48% above	—
Wrist X-ray, 2 views one side CPT 73100 WRIST,RIGHT,2 VIEW	$156.00	$156.00	—	48% above	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST,LEFT,2 VIEW	$156.00	$156.00	—	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST,RIGHT,2 VIEW	$156.00	$156.00	—	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST XRAY 3+ VIEWS	$299.00	$299.00	—	164% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST,RIGHT,MIN 3 VIEW	$284.00	$284.00	—	151% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST,LEFT,MIN 3 VIEW	$284.00	$284.00	—	151% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 LECH WRIST,RIGHT,MIN 3 VIEW	$422.00	$422.00	—	272% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST XRAY 3+ VIEWS	$299.00	$299.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST,RIGHT,MIN 3 VIEW	$284.00	$284.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST,LEFT,MIN 3 VIEW	$284.00	$284.00	—	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 LECH WRIST,RIGHT,MIN 3 VIEW	$422.00	$422.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 PELVIS & UNIL AT HIP 2-3 VIEWS	$268.00	$268.00	—	115% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP,DURING OR PROC-RT	$327.00	$327.00	—	163% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP,DURING OR PROC-LT	$327.00	$327.00	—	163% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP,LEFT (2) VIEW	$352.00	$352.00	—	183% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP,RIGHT,(2) VIEW	$352.00	$352.00	—	183% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 LECH HIP,RIGHT,(2) VIEW	$522.00	$522.00	—	320% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 LECH HIP,LEFT (2) VIEW	$522.00	$522.00	—	320% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 PELVIS & UNIL AT HIP 2-3 VIEWS	$268.00	$268.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP,DURING OR PROC-LT	$327.00	$327.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP,DURING OR PROC-RT	$327.00	$327.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP,LEFT (2) VIEW	$352.00	$352.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP,RIGHT,(2) VIEW	$352.00	$352.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 LECH HIP,RIGHT,(2) VIEW	$522.00	$522.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 LECH HIP,LEFT (2) VIEW	$522.00	$522.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN XRAY 1 VIEW	$100.00	$100.00	—	17% below	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN,CROSS-TAB LAT	$227.00	$227.00	—	88% above	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN,FOR SITZ MARKS	$247.00	$247.00	—	104% above	—
X-ray of the abdomen, 1 view CPT 74018 ABD SGL AP VW	$263.00	$263.00	—	117% above	—
X-ray of the abdomen, 1 view CPT 74018 LECH ABD SGL AP VW	$389.00	$389.00	—	222% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN XRAY 1 VIEW	$100.00	$100.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN,CROSS-TAB LAT	$227.00	$227.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN,FOR SITZ MARKS	$247.00	$247.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABD SGL AP VW	$263.00	$263.00	—	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 LECH ABD SGL AP VW	$389.00	$389.00	—	—	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS LEFT	$192.00	$192.00	—	82% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS RIGHT	$192.00	$192.00	—	82% above	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS LEFT	$192.00	$192.00	—	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS RIGHT	$192.00	$192.00	—	—	—
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS******	$121.00	$121.00	—	18% above	—
X-ray of the finger(s), 2 or more views CPT 73140 FINDER XRAY 2+ VIEWS	$299.00	$299.00	—	191% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS******	$121.00	$121.00	—	—	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINDER XRAY 2+ VIEWS	$299.00	$299.00	—	—	—
X-ray of the foot, 2 views one side CPT 73620 FOOT,2 VIEWS,RIGHT	$211.00	$211.00	—	99% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT,2 VIEWS,LEFT	$211.00	$211.00	—	99% above	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT,2 VIEWS,LEFT	$211.00	$211.00	—	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT,2 VIEWS,RIGHT	$211.00	$211.00	—	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT XRAY 3 + VIEWS	$299.00	$299.00	—	150% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT,RIGHT	$293.00	$293.00	—	145% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT,LEFT	$293.00	$293.00	—	145% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 LECH FOOT,RIGHT	$435.00	$435.00	—	264% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 LECH FOOT,LEFT	$435.00	$435.00	—	264% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT XRAY 3 + VIEWS	$299.00	$299.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT,LEFT	$293.00	$293.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT,RIGHT	$293.00	$293.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 LECH FOOT,RIGHT	$435.00	$435.00	—	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 LECH FOOT,LEFT	$435.00	$435.00	—	—	—
X-ray of the hand, 3 or more views CPT 73130 HAND XRAY 3+ VIEWS	$299.00	$299.00	—	150% above	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND;MIN 3 VIEWS	$323.00	$323.00	—	170% above	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND; MIN 3 VIEWS	$323.00	$323.00	—	170% above	—
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND XRAY 3+ VIEWS	$299.00	$299.00	—	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND; MIN 3 VIEWS	$323.00	$323.00	—	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND;MIN 3 VIEWS	$323.00	$323.00	—	—	—
X-ray of the knee, 1 or 2 views CPT 73560 KNEE XRAY 1/2 VIEWS	$299.00	$299.00	—	168% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE; AP & LAT LEFT	$313.00	$313.00	—	180% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE; AP & LAT RIGHT	$313.00	$313.00	—	180% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 LECH KNEE; AP & LAT RIGHT	$465.00	$465.00	—	317% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 LECH KNEE; AP & LAT LEFT	$465.00	$465.00	—	317% above	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE XRAY 1/2 VIEWS	$299.00	$299.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE; AP & LAT RIGHT	$313.00	$313.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE; AP & LAT LEFT	$313.00	$313.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LECH KNEE; AP & LAT LEFT	$465.00	$465.00	—	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LECH KNEE; AP & LAT RIGHT	$465.00	$465.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE -2/3 VWS	$372.00	$372.00	—	147% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LECH LS SPINE -2/3 VWS	$551.00	$551.00	—	265% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE -2/3 VWS	$372.00	$372.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LECH LS SPINE -2/3 VWS	$551.00	$551.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110 LS SPINE, MIN 4 VWS	$477.00	$477.00	—	123% above	—
X-ray of the lower back, 4 or more views CPT 72110 LECH LS SPINE, MIN 4 VWS	$708.00	$708.00	—	231% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 LS SPINE, MIN 4 VWS	$477.00	$477.00	—	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 LECH LS SPINE, MIN 4 VWS	$708.00	$708.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE	$363.00	$363.00	—	142% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE	$363.00	$363.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 XRAY EXAM OF NASAL BONES 3+ V	$78.00	$78.00	—	30% below	—
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$312.00	$312.00	—	180% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XRAY EXAM OF NASAL BONES 3+ V	$78.00	$78.00	—	—	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$312.00	$312.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE NO OBL	$431.00	$431.00	—	200% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE NO OBL	$431.00	$431.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS XRAY	$136.00	$136.00	—	4% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS - AP (ONE VIEW)	$304.00	$304.00	—	132% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 LECH PELVIS - AP (ONE VIEW)	$450.00	$450.00	—	244% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS XRAY	$136.00	$136.00	—	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS - AP (ONE VIEW)	$304.00	$304.00	—	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 LECH PELVIS - AP (ONE VIEW)	$450.00	$450.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRO-COCCYGEAL	$352.00	$352.00	—	157% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRO-COCCYGEAL	$352.00	$352.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
ACTH blood test CPT 82024 ACTH	$289.00	$289.00	—	170% above	—
ACTH blood test inpatient CPT 82024 ACTH	$289.00	$289.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$88.00	$88.00	—	355% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$150.00	$150.00	—	675% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT)	$88.00	$88.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$150.00	$150.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$88.00	$88.00	—	358% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST)	$88.00	$88.00	—	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$281.00	$281.00	—	140% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$281.00	$281.00	—	—	—
Albumin blood test CPT 82040 ALBUMIN SERUM	$67.00	$67.00	—	361% above	—
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$67.00	$67.00	—	—	—
Aldosterone blood test CPT 82088 ALDOSTERONE	$276.00	$276.00	—	188% above	—
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$276.00	$276.00	—	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALKA PHOSPHATASE	$77.00	$77.00	—	303% above	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKA PHOSPHATASE	$77.00	$77.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL COMPONENTS	$136.00	$136.00	—	1209% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA-GAL COMPONENTS	$136.00	$136.00	—	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER	$98.00	$98.00	—	87% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP (MATERNAL)	$105.00	$105.00	—	100% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 LECH AFP TUMOR MARKER	$143.00	$143.00	—	173% above	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TUMOR MARKER	$98.00	$98.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP (MATERNAL)	$105.00	$105.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 LECH AFP TUMOR MARKER	$143.00	$143.00	—	—	—
Ammonia blood test CPT 82140 URINE AMMONIUM	$122.00	$122.00	—	147% above	—
Ammonia blood test CPT 82140 AMMONIA	$157.00	$157.00	—	217% above	—
Ammonia blood test CPT 82140 LECH AMMONIA	$234.00	$234.00	—	373% above	—
Ammonia blood test inpatient CPT 82140 URINE AMMONIUM	$122.00	$122.00	—	—	—
Ammonia blood test inpatient CPT 82140 AMMONIA	$157.00	$157.00	—	—	—
Ammonia blood test inpatient CPT 82140 LECH AMMONIA	$234.00	$234.00	—	—	—
Amylase blood test CPT 82150 AMYLASE	$107.00	$107.00	—	380% above	—
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$107.00	$107.00	—	380% above	—
Amylase blood test CPT 82150 URINE AMYLASE	$107.00	$107.00	—	380% above	—
Amylase blood test CPT 82150 LECH AMYLASE	$156.00	$156.00	—	600% above	—
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$107.00	$107.00	—	—	—
Amylase blood test inpatient CPT 82150 URINE AMYLASE	$107.00	$107.00	—	—	—
Amylase blood test inpatient CPT 82150 AMYLASE	$107.00	$107.00	—	—	—
Amylase blood test inpatient CPT 82150 LECH AMYLASE	$156.00	$156.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$125.00	$125.00	—	177% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$125.00	$125.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$165.00	$165.00	—	282% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 LECH ANA	$244.00	$244.00	—	465% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$165.00	$165.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LECH ANA	$244.00	$244.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$188.00	$188.00	—	201% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LECH BRAIN NATRIURETIC PEPTIDE	$278.00	$278.00	—	346% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$188.00	$188.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 LECH BRAIN NATRIURETIC PEPTIDE	$278.00	$278.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 N/P CULTURE	$108.00	$108.00	—	271% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ROUTINE CULTURE	$124.00	$124.00	—	326% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTR SPECIMEN AEROBIC	$124.00	$124.00	—	326% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LECH ROUTINE CULTURE	$183.00	$183.00	—	529% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONELLA CULTURE	$201.00	$201.00	—	591% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 N/P CULTURE	$108.00	$108.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ROUTINE CULTURE	$124.00	$124.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTR SPECIMEN AEROBIC	$124.00	$124.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LECH ROUTINE CULTURE	$183.00	$183.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGIONELLA CULTURE	$201.00	$201.00	—	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$242.00	$242.00	—	627% above	—
Basic metabolic panel (blood test) CPT 80048 LECH BASIC METABOLIC PANEL	$359.00	$359.00	—	978% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$242.00	$242.00	—	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 LECH BASIC METABOLIC PANEL	$359.00	$359.00	—	—	—
Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL	$67.00	$67.00	—	307% above	—
Bilirubin blood test, total CPT 82247 LECH BILIRUBIN, TOTAL	$98.00	$98.00	—	495% above	—
Bilirubin blood test, total CPT 82247 BILLIRUBIN, TOTAL BODY FLUID	$194.00	$194.00	—	1078% above	—
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, TOTAL	$67.00	$67.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 LECH BILIRUBIN, TOTAL	$98.00	$98.00	—	—	—
Bilirubin blood test, total inpatient CPT 82247 BILLIRUBIN, TOTAL BODY FLUID	$194.00	$194.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATH LEVEL 4	$296.00	$296.00	—	262% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATH LEVEL 4	$296.00	$296.00	—	—	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$96.00	$96.00	—	122% above	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE WITH ARD	$153.00	$153.00	—	254% above	—
Blood culture for bacteria CPT 87040 LECH BLOOD CULTURE WITH ARD	$226.00	$226.00	—	423% above	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$96.00	$96.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE WITH ARD	$153.00	$153.00	—	—	—
Blood culture for bacteria inpatient CPT 87040 LECH BLOOD CULTURE WITH ARD	$226.00	$226.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION	$19.00	$19.00	—	130% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$29.00	$29.00	—	251% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$29.00	$29.00	—	251% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION, BLOOD	$34.00	$34.00	—	312% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD COLLECTION FEE	$34.00	$34.00	—	312% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LECH BLOOD COLLECTION FEE	$51.00	$51.00	—	517% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION	$19.00	$19.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$29.00	$29.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$29.00	$29.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD COLLECTION FEE	$34.00	$34.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION, BLOOD	$34.00	$34.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LECH BLOOD COLLECTION FEE	$51.00	$51.00	—	—	—
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE	$14.00	$14.00	—	at median	—
Blood glucose (sugar) test CPT 82947 GLUCOSE	$73.00	$73.00	—	421% above	—
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE	$14.00	$14.00	—	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$73.00	$73.00	—	—	—
Blood lead test CPT 83655 LEAD LEVEL	$122.00	$122.00	—	333% above	—
Blood lead test inpatient CPT 83655 LEAD LEVEL	$122.00	$122.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUALITATIVE	$145.00	$145.00	—	363% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUALITATIVE	$145.00	$145.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC; ABO	$376.00	$376.00	—	723% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LECH BLOOD TYPING SEROLOGIC; A	$518.00	$518.00	—	1033% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LECH BLOOD TYPING SEROLOGI ABO	$518.00	$518.00	—	1033% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC; ABO	$376.00	$376.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LECH BLOOD TYPING SEROLOGIC; A	$518.00	$518.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LECH BLOOD TYPING SEROLOGI ABO	$518.00	$518.00	—	—	—
Blood urea nitrogen (BUN) test CPT 84520 BUN	$72.00	$72.00	—	351% above	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$72.00	$72.00	—	—	—
C-peptide blood test CPT 84681 C-PEPTIDE	$200.00	$200.00	—	261% above	—
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$200.00	$200.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP - SF (PJ)	$105.00	$105.00	—	353% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$113.00	$113.00	—	387% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LECH C-REACTIVE PROTEIN	$166.00	$166.00	—	616% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP - SF (PJ)	$105.00	$105.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$113.00	$113.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LECH C-REACTIVE PROTEIN	$166.00	$166.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE DNA AMPLIFICATION	$181.00	$181.00	—	165% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE DNA AMPLIFICATION	$181.00	$181.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$177.00	$177.00	—	263% above	—
CA 19-9 blood test (tumor marker) CPT 86301 LECH CA 19-9	$262.00	$262.00	—	437% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$177.00	$177.00	—	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 LECH CA 19-9	$262.00	$262.00	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$185.00	$185.00	—	256% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$185.00	$185.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$283.00	$283.00	—	291% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$283.00	$283.00	—	—	—
Calcium blood test, total CPT 82310 CALCIUM (PTH)	$39.00	$39.00	—	107% above	—
Calcium blood test, total CPT 82310 CALCIUM	$66.00	$66.00	—	250% above	—
Calcium blood test, total CPT 82310 LECH CALCIUM	$97.00	$97.00	—	415% above	—
Calcium blood test, total inpatient CPT 82310 CALCIUM (PTH)	$39.00	$39.00	—	—	—
Calcium blood test, total inpatient CPT 82310 CALCIUM	$66.00	$66.00	—	—	—
Calcium blood test, total inpatient CPT 82310 LECH CALCIUM	$97.00	$97.00	—	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 C E A	$156.00	$156.00	—	165% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 LECH C E A	$230.00	$230.00	—	290% above	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 C E A	$156.00	$156.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 LECH C E A	$230.00	$230.00	—	—	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS Ab IgG	$43.00	$43.00	—	15% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLAZOSTER ANTIBODY, QUAL	$107.00	$107.00	—	185% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER ANTIBODY	$140.00	$140.00	—	273% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG	$181.00	$181.00	—	382% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$181.00	$181.00	—	382% above	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER VIRUS Ab IgG	$43.00	$43.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLAZOSTER ANTIBODY, QUAL	$107.00	$107.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY	$140.00	$140.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG	$181.00	$181.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$181.00	$181.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE	$136.00	$136.00	—	132% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS CONJ SWA	$153.00	$153.00	—	161% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE	$136.00	$136.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS CONJ SWA	$153.00	$153.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$210.00	$210.00	—	327% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LECH LIPID PANEL	$312.00	$312.00	—	535% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$210.00	$210.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LECH LIPID PANEL	$312.00	$312.00	—	—	—
Complete blood count (CBC) with differential CPT 85025 CBC W/ AUTO DIFF	$193.00	$193.00	—	624% above	—
Complete blood count (CBC) with differential CPT 85025 LECH CBC W/ AUTO DIFF	$284.00	$284.00	—	965% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ AUTO DIFF	$193.00	$193.00	—	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 LECH CBC W/ AUTO DIFF	$284.00	$284.00	—	—	—
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF	$117.00	$117.00	—	320% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF	$117.00	$117.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$257.00	$257.00	—	246% above	—
Comprehensive metabolic panel (blood test) CPT 80053 LECH COMP METABOLIC PANEL	$381.00	$381.00	—	413% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$257.00	$257.00	—	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 LECH COMP METABOLIC PANEL	$381.00	$381.00	—	—	—
Cortisol blood test, total CPT 82533 CORTISOL	$129.00	$129.00	—	237% above	—
Cortisol blood test, total CPT 82533 CORTISOL, SALIVARY MIDNIGHT	$680.00	$680.00	—	1676% above	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$129.00	$129.00	—	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SALIVARY MIDNIGHT	$680.00	$680.00	—	—	—
Creatinine blood test CPT 82565 CREATININE;BLD	$75.00	$75.00	—	329% above	—
Creatinine blood test inpatient CPT 82565 CREATININE;BLD	$75.00	$75.00	—	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 TORCH ANTIBODY IgG	$51.00	$51.00	—	38% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ABS, IGG	$122.00	$122.00	—	230% above	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 TORCH ANTIBODY IgG	$51.00	$51.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ABS, IGG	$122.00	$122.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE-SU	$191.00	$191.00	—	232% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE-SU	$191.00	$191.00	—	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN	$38.00	$38.00	—	33% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCP SCREEN	$41.00	$41.00	—	43% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCR ONE/MULT CLASS	$67.00	$67.00	—	134% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 CLIN DRUG SCR, URINE	$148.00	$148.00	—	417% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN (SERUM)	$244.00	$244.00	—	753% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN GASTRIC	$559.00	$559.00	—	1855% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN MULITIPLE CLASS	$607.00	$607.00	—	2022% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE CHEM ANA	$640.00	$640.00	—	2138% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 LECH DRUG SCREEN MULITIPLE CLA	$900.00	$900.00	—	3047% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN	$38.00	$38.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCP SCREEN	$41.00	$41.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCR ONE/MULT CLASS	$67.00	$67.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CLIN DRUG SCR, URINE	$148.00	$148.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN (SERUM)	$244.00	$244.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN GASTRIC	$559.00	$559.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN MULITIPLE CLASS	$607.00	$607.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE CHEM ANA	$640.00	$640.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LECH DRUG SCREEN MULITIPLE CLA	$900.00	$900.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$167.00	$167.00	—	351% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$167.00	$167.00	—	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB TO VIR CAPS AG IG	$145.00	$145.00	—	184% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB TO VIR. CAPS. AG, I	$145.00	$145.00	—	184% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB TO VIR CAPS AG IG	$145.00	$145.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB TO VIR. CAPS. AG, I	$145.00	$145.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$156.00	$156.00	—	177% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$156.00	$156.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$630.00	$630.00	—	533% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$630.00	$630.00	—	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$115.00	$115.00	—	150% above	—
Ferritin blood test (iron stores) CPT 82728 LECH FERRITIN	$170.00	$170.00	—	269% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$115.00	$115.00	—	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 LECH FERRITIN	$170.00	$170.00	—	—	—
Fibrinogen blood test CPT 85384 FIBRINOGEN LEV	$168.00	$168.00	—	456% above	—
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN LEV	$168.00	$168.00	—	—	—
Folate (folic acid) blood test CPT 82746 FOLATE LEVEL	$147.00	$147.00	—	273% above	—
Folate (folic acid) blood test CPT 82746 LECH FOLATE LEVEL	$217.00	$217.00	—	450% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE LEVEL	$147.00	$147.00	—	—	—
Folate (folic acid) blood test inpatient CPT 82746 LECH FOLATE LEVEL	$217.00	$217.00	—	—	—
Free T3 thyroid hormone test CPT 84481 T3 FREE	$304.00	$304.00	—	609% above	—
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$304.00	$304.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$139.00	$139.00	—	299% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 LECH T4 FREE	$204.00	$204.00	—	486% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$139.00	$139.00	—	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LECH T4 FREE	$204.00	$204.00	—	—	—
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$183.00	$183.00	—	199% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$183.00	$183.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$71.00	$71.00	—	186% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 LECH GAMMA GT	$104.00	$104.00	—	319% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$150.00	$150.00	—	504% above	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT	$71.00	$71.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 LECH GAMMA GT	$104.00	$104.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$150.00	$150.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST POST	$12.00	$12.00	—	26% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 HR POST-PRANDIAL GLUCO	$72.00	$72.00	—	344% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 HR DMS	$92.00	$92.00	—	468% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST POST	$12.00	$12.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 2 HR POST-PRANDIAL GLUCO	$72.00	$72.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1 HR DMS	$92.00	$92.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$68.00	$68.00	—	52% above	—
Glucose tolerance test, 3 samples CPT 82951 4 HR GTT (3 SPEC.)	$108.00	$108.00	—	142% above	—
Glucose tolerance test, 3 samples CPT 82951 5 HR GTT (3 SPEC.)	$140.00	$140.00	—	213% above	—
Glucose tolerance test, 3 samples CPT 82951 3 HR GTT	$140.00	$140.00	—	213% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$68.00	$68.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 4 HR GTT (3 SPEC.)	$108.00	$108.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 5 HR GTT (3 SPEC.)	$140.00	$140.00	—	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 3 HR GTT	$140.00	$140.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA AMPLIFICATION	$64.00	$64.00	—	9% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA AMPLIFICATION	$136.00	$136.00	—	132% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA AMPLIFICATION	$64.00	$64.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA AMPLIFICATION	$136.00	$136.00	—	—	—
H. pylori antibody blood test CPT 86677 H. pylori ANTIBODY,IgM	$64.00	$64.00	—	40% above	—
H. pylori antibody blood test CPT 86677 H. pylori ANTIBODY,IgA	$83.00	$83.00	—	82% above	—
H. pylori antibody blood test CPT 86677 H. pylori ANTIBODY, IgG	$96.00	$96.00	—	111% above	—
H. pylori antibody blood test CPT 86677 ANTI-PYLORI	$156.00	$156.00	—	242% above	—
H. pylori antibody blood test inpatient CPT 86677 H. pylori ANTIBODY,IgM	$64.00	$64.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 H. pylori ANTIBODY,IgA	$83.00	$83.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 H. pylori ANTIBODY, IgG	$96.00	$96.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 ANTI-PYLORI	$156.00	$156.00	—	—	—
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN	$265.00	$265.00	—	330% above	—
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN	$265.00	$265.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT. BY PCR	$496.00	$496.00	—	188% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT. BY PCR	$496.00	$496.00	—	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1,2	$43.00	$43.00	—	45% above	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 ABS	$177.00	$177.00	—	498% above	—
HIV-1 and HIV-2 antibody test CPT 86703 LECH HIV-1/HIV-2 ABS	$262.00	$262.00	—	785% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1,2	$43.00	$43.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 ABS	$177.00	$177.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 LECH HIV-1/HIV-2 ABS	$262.00	$262.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN w/RFX	$432.00	$432.00	—	798% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN w/RFX	$432.00	$432.00	—	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$136.00	$136.00	—	157% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$136.00	$136.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN;GLYCATED	$23.00	$23.00	—	30% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$31.00	$31.00	—	5% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LC	$33.00	$33.00	—	1% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$145.00	$145.00	—	342% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LECH GLYCOSYLATED HEMOGLOBIN T	$214.00	$214.00	—	552% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN;GLYCATED	$23.00	$23.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$31.00	$31.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C LC	$33.00	$33.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$145.00	$145.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LECH GLYCOSYLATED HEMOGLOBIN T	$214.00	$214.00	—	—	—
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$66.00	$66.00	—	534% above	—
Hemoglobin blood test CPT 85018 LECH HEMOGLOBIN	$97.00	$97.00	—	832% above	—
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$66.00	$66.00	—	—	—
Hemoglobin blood test inpatient CPT 85018 LECH HEMOGLOBIN	$97.00	$97.00	—	—	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB, IGG/IGM	$135.00	$135.00	—	368% above	—
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB, IGG/IGM	$135.00	$135.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTI CFS	$104.00	$104.00	—	263% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURF. AB.	$135.00	$135.00	—	371% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTI CFS	$104.00	$104.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURF. AB.	$135.00	$135.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP. B SURF. ANTIGEN	$102.00	$102.00	—	178% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 LECH HEP. B SURF. ANTIGEN	$152.00	$152.00	—	314% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP. B SURF. ANTIGEN	$102.00	$102.00	—	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LECH HEP. B SURF. ANTIGEN	$152.00	$152.00	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C	$140.00	$140.00	—	201% above	—
Hepatitis C antibody blood test (screening) CPT 86803 LECH HEPATITIS C	$206.00	$206.00	—	343% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C	$140.00	$140.00	—	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 LECH HEPATITIS C	$206.00	$206.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA, QUANT.	$500.00	$500.00	—	326% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA, QUANT.	$500.00	$500.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695 TORCH ANTIBODY IgG	$67.00	$67.00	—	156% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 GLYCOPROTEIN G-S Ab	$86.00	$86.00	—	229% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE I, IGM	$107.00	$107.00	—	309% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 TORCH ANTIBODY IgG	$67.00	$67.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 GLYCOPROTEIN G-S Ab	$86.00	$86.00	—	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE I, IGM	$107.00	$107.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696 TORCH ANTIBODY IgG	$51.00	$51.00	—	15% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 GLYCOPROTEIN G-S Ab	$113.00	$113.00	—	155% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE II, IGM	$113.00	$113.00	—	155% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE II AB, IGG	$113.00	$113.00	—	155% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH ANTIBODY IgG	$51.00	$51.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE II AB, IGG	$113.00	$113.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 GLYCOPROTEIN G-S Ab	$113.00	$113.00	—	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE II, IGM	$113.00	$113.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP,HS W/CARDIAC RISK	$113.00	$113.00	—	161% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP,HS W/CARDIAC RISK	$113.00	$113.00	—	—	—
Homocysteine blood test CPT 83090 HOMOCYSTINE	$98.00	$98.00	—	72% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$98.00	$98.00	—	—	—
Insulin blood test CPT 83525 INSULIN #2	$51.00	$51.00	—	54% above	—
Insulin blood test CPT 83525 INSULIN #1	$51.00	$51.00	—	54% above	—
Insulin blood test CPT 83525 INSULIN #3	$51.00	$51.00	—	54% above	—
Insulin blood test CPT 83525 INSULIN	$122.00	$122.00	—	270% above	—
Insulin blood test inpatient CPT 83525 INSULIN #2	$51.00	$51.00	—	—	—
Insulin blood test inpatient CPT 83525 INSULIN #1	$51.00	$51.00	—	—	—
Insulin blood test inpatient CPT 83525 INSULIN #3	$51.00	$51.00	—	—	—
Insulin blood test inpatient CPT 83525 INSULIN	$122.00	$122.00	—	—	—
Iron blood test (serum iron) CPT 83540 URINE IRON	$92.00	$92.00	—	326% above	—
Iron blood test (serum iron) CPT 83540 IRON-SERUM	$92.00	$92.00	—	326% above	—
Iron blood test (serum iron) CPT 83540 LECH IRON-SERUM	$134.00	$134.00	—	520% above	—
Iron blood test (serum iron) inpatient CPT 83540 URINE IRON	$92.00	$92.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON-SERUM	$92.00	$92.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 LECH IRON-SERUM	$134.00	$134.00	—	—	—
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACI	$109.00	$109.00	—	239% above	—
Iron-binding capacity (TIBC) test CPT 83550 LECH TOTAL IRON BINDING CAPACI	$161.00	$161.00	—	400% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACI	$109.00	$109.00	—	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 LECH TOTAL IRON BINDING CAPACI	$161.00	$161.00	—	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$174.00	$174.00	—	219% above	—
Kidney function blood test panel CPT 80069 LECH RENAL FUNCTION PANEL	$256.00	$256.00	—	369% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$174.00	$174.00	—	—	—
Kidney function blood test panel inpatient CPT 80069 LECH RENAL FUNCTION PANEL	$256.00	$256.00	—	—	—
LH (luteinizing hormone) test CPT 83002 LH	$163.00	$163.00	—	202% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LH	$163.00	$163.00	—	—	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$120.00	$120.00	—	329% above	—
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$120.00	$120.00	—	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, TOTAL	$93.00	$93.00	—	347% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE - SF (NSA)	$105.00	$105.00	—	404% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LECH LDH, TOTAL	$136.00	$136.00	—	553% above	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH, TOTAL	$93.00	$93.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE - SF (NSA)	$105.00	$105.00	—	—	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LECH LDH, TOTAL	$136.00	$136.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$134.00	$134.00	—	435% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LECH LIPASE	$197.00	$197.00	—	686% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$134.00	$134.00	—	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LECH LIPASE	$197.00	$197.00	—	—	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$153.00	$153.00	—	199% above	—
Liver function blood test panel CPT 80076 LECH HEPATIC FUNCTION PANEL	$226.00	$226.00	—	342% above	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$153.00	$153.00	—	—	—
Liver function blood test panel inpatient CPT 80076 LECH HEPATIC FUNCTION PANEL	$226.00	$226.00	—	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE SCREEN	$213.00	$213.00	—	321% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SCREEN	$213.00	$213.00	—	—	—
Magnesium blood test CPT 83735 URINE MAGNESIUM	$67.00	$67.00	—	203% above	—
Magnesium blood test CPT 83735 MAGNESIUM	$88.00	$88.00	—	298% above	—
Magnesium blood test CPT 83735 LECH MAGNESIUM	$129.00	$129.00	—	484% above	—
Magnesium blood test CPT 83735 MAGNESIUM, RBC	$325.00	$325.00	—	1371% above	—
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM	$67.00	$67.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$88.00	$88.00	—	—	—
Magnesium blood test inpatient CPT 83735 LECH MAGNESIUM	$129.00	$129.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC	$325.00	$325.00	—	—	—
Measles (rubeola) antibody test CPT 86765 MUMPS, IgG	$141.00	$141.00	—	356% above	—
Measles (rubeola) antibody test CPT 86765 MUMPS, IgM	$164.00	$164.00	—	431% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB, IGG	$182.00	$182.00	—	489% above	—
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA), IgG	$182.00	$182.00	—	489% above	—
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA), IgM	$182.00	$182.00	—	489% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB, IGM	$182.00	$182.00	—	489% above	—
Measles (rubeola) antibody test inpatient CPT 86765 MUMPS, IgG	$141.00	$141.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MUMPS, IgM	$164.00	$164.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB, IGG	$182.00	$182.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB, IGM	$182.00	$182.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA), IgM	$182.00	$182.00	—	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA), IgG	$182.00	$182.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 QUAL HETEROPHILE AB	$13.00	$13.00	—	44% below	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST	$175.00	$175.00	—	659% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 QUAL HETEROPHILE AB	$13.00	$13.00	—	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST	$175.00	$175.00	—	—	—
Mumps immunity blood test CPT 86735 MUMPS AB, IGM	$115.00	$115.00	—	279% above	—
Mumps immunity blood test CPT 86735 MUMPS AB (IGG)	$115.00	$115.00	—	279% above	—
Mumps immunity blood test inpatient CPT 86735 MUMPS AB (IGG)	$115.00	$115.00	—	—	—
Mumps immunity blood test inpatient CPT 86735 MUMPS AB, IGM	$115.00	$115.00	—	—	—
Obstetric blood test panel CPT 80055 OB PANEL	$245.00	$245.00	—	203% above	—
Obstetric blood test panel inpatient CPT 80055 OB PANEL	$245.00	$245.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$146.00	$146.00	—	200% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$146.00	$146.00	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$202.00	$202.00	—	354% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN	$202.00	$202.00	—	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$115.00	$115.00	—	166% above	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$115.00	$115.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CP CERV/VAG (PAP -THIN PREP)	$88.00	$88.00	—	204% above	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$277.00	$277.00	—	857% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CP CERV/VAG (PAP -THIN PREP)	$88.00	$88.00	—	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$277.00	$277.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$349.00	$349.00	—	282% above	—
Parathyroid hormone (PTH) blood test CPT 83970 LECH PARATHYROID HORMONE	$516.00	$516.00	—	465% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$349.00	$349.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LECH PARATHYROID HORMONE	$516.00	$516.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$100.00	$100.00	—	382% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 LECH PTT	$147.00	$147.00	—	608% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$100.00	$100.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LECH PTT	$147.00	$147.00	—	—	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS	$67.00	$67.00	—	310% above	—
Phosphorus (phosphate) blood test CPT 84100 LECH PHOSPHOROUS	$98.00	$98.00	—	499% above	—
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS	$67.00	$67.00	—	—	—
Phosphorus (phosphate) blood test inpatient CPT 84100 LECH PHOSPHOROUS	$98.00	$98.00	—	—	—
Potassium blood test CPT 84132 POTASSIUM	$67.00	$67.00	—	296% above	—
Potassium blood test inpatient CPT 84132 POTASSIUM	$67.00	$67.00	—	—	—
Progesterone blood test CPT 84144 PROGESTERONE	$146.00	$146.00	—	163% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$146.00	$146.00	—	—	—
Prolactin blood test CPT 84146 PROLACTIN ASSAY	$202.00	$202.00	—	212% above	—
Prolactin blood test inpatient CPT 84146 PROLACTIN ASSAY	$202.00	$202.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME - D	$89.00	$89.00	—	515% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$89.00	$89.00	—	515% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 LECH PROTIME	$130.00	$130.00	—	799% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$89.00	$89.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME - D	$89.00	$89.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LECH PROTIME	$130.00	$130.00	—	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST DIRECT OBS	$51.00	$51.00	—	121% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$51.00	$51.00	—	121% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST DIRECT OBS	$51.00	$51.00	—	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$51.00	$51.00	—	—	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO	$38.00	$38.00	—	68% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLU TESTING	$42.00	$42.00	—	86% above	—
Rapid flu test (influenza antigen) CPT 87804 iaadiadoo influenza	$55.00	$55.00	—	144% above	—
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay	$57.00	$57.00	—	153% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLU VIRUS A AG	$95.00	$95.00	—	321% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA IA W DO	$38.00	$38.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLU TESTING	$42.00	$42.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 iaadiadoo influenza	$55.00	$55.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Assay	$57.00	$57.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLU VIRUS A AG	$95.00	$95.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$38.00	$38.00	—	55% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A	$42.00	$42.00	—	71% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 QUICK STREP SCREEN	$89.00	$89.00	—	263% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$38.00	$38.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A	$42.00	$42.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 QUICK STREP SCREEN	$89.00	$89.00	—	—	—
Renin blood test CPT 84244 RENIN	$156.00	$156.00	—	160% above	—
Renin blood test inpatient CPT 84244 RENIN	$156.00	$156.00	—	—	—
Rh blood typing CPT 86901 RH CHARGE ONLY (LBC)	$103.00	$103.00	—	386% above	—
Rh blood typing CPT 86901 RH FACTOR	$119.00	$119.00	—	461% above	—
Rh blood typing CPT 86901 LECH RH FACTOR	$152.00	$152.00	—	617% above	—
Rh blood typing CPT 86901 LECH RH CHARGE ONLY (LBC)	$153.00	$153.00	—	621% above	—
Rh blood typing inpatient CPT 86901 RH CHARGE ONLY (LBC)	$103.00	$103.00	—	—	—
Rh blood typing inpatient CPT 86901 RH FACTOR	$119.00	$119.00	—	—	—
Rh blood typing inpatient CPT 86901 LECH RH FACTOR	$152.00	$152.00	—	—	—
Rh blood typing inpatient CPT 86901 LECH RH CHARGE ONLY (LBC)	$153.00	$153.00	—	—	—
Rheumatoid factor (RF) test CPT 86431 RA TEST	$111.00	$111.00	—	379% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RA TEST	$111.00	$111.00	—	—	—
Rubella antibody test (immunity check) CPT 86762 TORCH ANTIBODY IgG	$51.00	$51.00	—	53% above	—
Rubella antibody test (immunity check) CPT 86762 TORCH ANTIBODY IgM	$51.00	$51.00	—	53% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN	$87.00	$87.00	—	160% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$161.00	$161.00	—	381% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB, IGM	$161.00	$161.00	—	381% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH ANTIBODY IgG	$51.00	$51.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH ANTIBODY IgM	$51.00	$51.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN	$87.00	$87.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$161.00	$161.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB, IGM	$161.00	$161.00	—	—	—
Sodium blood test CPT 84295 SODIUM	$67.00	$67.00	—	293% above	—
Sodium blood test inpatient CPT 84295 SODIUM	$67.00	$67.00	—	—	—
Stool ova and parasites exam CPT 87177 OCP (STOOL)	$81.00	$81.00	—	168% above	—
Stool ova and parasites exam CPT 87177 LECH OCP (STOOL)	$120.00	$120.00	—	297% above	—
Stool ova and parasites exam inpatient CPT 87177 OCP (STOOL)	$81.00	$81.00	—	—	—
Stool ova and parasites exam inpatient CPT 87177 LECH OCP (STOOL)	$120.00	$120.00	—	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$27.00	$27.00	—	100% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD, FECAL, SCREENING	$51.00	$51.00	—	277% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$27.00	$27.00	—	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD, FECAL, SCREENING	$51.00	$51.00	—	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 FLUORESCENT TREPONEMAL Ab, CSF	$71.00	$71.00	—	165% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM IgG ELISA	$153.00	$153.00	—	471% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$165.00	$165.00	—	516% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum IgG	$165.00	$165.00	—	516% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 LECH TREPONEMA PALLIDUM	$244.00	$244.00	—	810% above	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FLUORESCENT TREPONEMAL Ab, CSF	$71.00	$71.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM IgG ELISA	$153.00	$153.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum IgG	$165.00	$165.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$165.00	$165.00	—	—	—
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 LECH TREPONEMA PALLIDUM	$244.00	$244.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, QUALITATIVE TEST, SERUM	$20.00	$20.00	—	55% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL OR RPR	$115.00	$115.00	—	793% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, QUALITATIVE TEST, SERUM	$20.00	$20.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL OR RPR	$115.00	$115.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD IN TUBE	$658.00	$658.00	—	458% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 LECH QUANTIFERON TB GOLD IN TU	$976.00	$976.00	—	727% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD IN TUBE	$658.00	$658.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 LECH QUANTIFERON TB GOLD IN TU	$976.00	$976.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE	$249.00	$249.00	—	318% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE	$249.00	$249.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$171.00	$171.00	—	356% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$171.00	$171.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (THYR STIM HORM)	$139.00	$139.00	—	245% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 LECH TSH (THYR STIM HORM)	$204.00	$204.00	—	406% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (THYR STIM HORM)	$139.00	$139.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LECH TSH (THYR STIM HORM)	$204.00	$204.00	—	—	—
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$128.00	$128.00	—	232% above	—
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$128.00	$128.00	—	—	—
Total cholesterol blood test CPT 82465 CHOLESTEROL	$67.00	$67.00	—	347% above	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$67.00	$67.00	—	—	—
Total thyroxine (T4) blood test CPT 84436 TOTAL THYROXINE (T4)	$86.00	$86.00	—	268% above	—
Total thyroxine (T4) blood test CPT 84436 LECH TOTAL THYROXINE (T4)	$126.00	$126.00	—	439% above	—
Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL THYROXINE (T4)	$86.00	$86.00	—	—	—
Total thyroxine (T4) blood test inpatient CPT 84436 LECH TOTAL THYROXINE (T4)	$126.00	$126.00	—	—	—
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3; TOTAL	$145.00	$145.00	—	227% above	—
Total triiodothyronine (T3) blood test CPT 84480 LECH TRIIODOTHYRONINE T3; TOTA	$214.00	$214.00	—	382% above	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3; TOTAL	$145.00	$145.00	—	—	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 LECH TRIIODOTHYRONINE T3; TOTA	$214.00	$214.00	—	—	—
Transferrin blood test CPT 84466 TRANSFERRIN	$101.00	$101.00	—	152% above	—
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$101.00	$101.00	—	—	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$155.00	$155.00	—	197% above	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$155.00	$155.00	—	—	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$101.00	$101.00	—	323% above	—
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$101.00	$101.00	—	—	—
Troponin test, quantitative CPT 84484 TROPONIN	$159.00	$159.00	—	318% above	—
Troponin test, quantitative CPT 84484 LECH TROPONIN	$235.00	$235.00	—	517% above	—
Troponin test, quantitative inpatient CPT 84484 TROPONIN	$159.00	$159.00	—	—	—
Troponin test, quantitative inpatient CPT 84484 LECH TROPONIN	$235.00	$235.00	—	—	—
Uric acid blood test CPT 84550 URIC ACID	$74.00	$74.00	—	345% above	—
Uric acid blood test CPT 84550 LECH URIC ACID	$109.00	$109.00	—	555% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$74.00	$74.00	—	—	—
Uric acid blood test inpatient CPT 84550 LECH URIC ACID	$109.00	$109.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001 U/A AUTO W/SCOPE	$12.00	$12.00	—	49% below	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS DIPSTICK W/MICRO	$75.00	$75.00	—	217% above	—
Urinalysis with microscope exam, automated CPT 81001 LECH URINALYSIS DIPSTICK W/MIC	$112.00	$112.00	—	373% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 U/A AUTO W/SCOPE	$12.00	$12.00	—	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS DIPSTICK W/MICRO	$75.00	$75.00	—	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 LECH URINALYSIS DIPSTICK W/MIC	$112.00	$112.00	—	—	—
Urinalysis with microscope exam, manual CPT 81000 U/A NON AUTO W/SCOPE	$12.00	$12.00	—	63% above	—
Urinalysis with microscope exam, manual inpatient CPT 81000 U/A NON AUTO W/SCOPE	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003 URINE VOLUME	$8.00	$8.00	—	8% below	—
Urinalysis without microscope exam, automated CPT 81003 URINE DIP STICK W/O	$9.00	$9.00	—	4% above	—
Urinalysis without microscope exam, automated CPT 81003 UA	$11.00	$11.00	—	27% above	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto	$12.00	$12.00	—	38% above	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO	$16.00	$16.00	—	84% above	—
Urinalysis without microscope exam, automated CPT 81003 DEXTROSTIX	$28.00	$28.00	—	223% above	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK	$37.00	$37.00	—	326% above	—
Urinalysis without microscope exam, automated CPT 81003 LECH URINALYSIS DIPSTICK	$54.00	$54.00	—	522% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE VOLUME	$8.00	$8.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIP STICK W/O	$9.00	$9.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 UA	$11.00	$11.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto	$12.00	$12.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO	$16.00	$16.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 DEXTROSTIX	$28.00	$28.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK	$37.00	$37.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 LECH URINALYSIS DIPSTICK	$54.00	$54.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK	$10.00	$10.00	—	45% above	—
Urinalysis without microscope exam, manual CPT 81002 U/A NON AUTO W/O SCOPE	$12.00	$12.00	—	74% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK	$10.00	$10.00	—	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 U/A NON AUTO W/O SCOPE	$12.00	$12.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086 ORGANISM CC, URINE	$44.00	$44.00	—	20% above	—
Urine culture for bacteria, with colony count CPT 87086 LECH ORGANISM CC, URINE	$63.00	$63.00	—	71% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 ORGANISM CC, URINE	$44.00	$44.00	—	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 LECH ORGANISM CC, URINE	$63.00	$63.00	—	—	—
Urine microalbumin (albumin) test CPT 82043 ALBUMIN, TIMED URINE	$27.00	$27.00	—	38% above	—
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN, URINE	$86.00	$86.00	—	341% above	—
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN, TIMED URINE	$27.00	$27.00	—	—	—
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN, URINE	$86.00	$86.00	—	—	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$12.00	$12.00	—	40% below	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY	$24.00	$24.00	—	20% above	—
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$28.00	$28.00	—	40% above	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY, URINE	$68.00	$68.00	—	240% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$12.00	$12.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY	$24.00	$24.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$28.00	$28.00	—	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY, URINE	$68.00	$68.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12	$159.00	$159.00	—	299% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 LECH VITAMIN B 12	$235.00	$235.00	—	490% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12	$159.00	$159.00	—	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 LECH VITAMIN B 12	$235.00	$235.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D, 25 HYDROXY	$295.00	$295.00	—	283% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VIT. D-	$352.00	$352.00	—	357% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LECH CALCIFEDIOL (25-OH VIT. D	$521.00	$521.00	—	577% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D, 25 HYDROXY	$295.00	$295.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VIT. D-	$352.00	$352.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LECH CALCIFEDIOL (25-OH VIT. D	$521.00	$521.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 LECH DIHYDROXYVITAMIN D 1,25	$143.00	$143.00	—	40% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1,25	$378.00	$378.00	—	270% above	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 LECH DIHYDROXYVITAMIN D 1,25	$143.00	$143.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1,25	$378.00	$378.00	—	—	—
Zinc blood test CPT 84630 ZINC	$109.00	$109.00	—	224% above	—
Zinc blood test inpatient CPT 84630 ZINC	$109.00	$109.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG (AFP)	$121.00	$121.00	—	138% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, QUANTITATIVE	$214.00	$214.00	—	321% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG (AFP)	$121.00	$121.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, QUANTITATIVE	$214.00	$214.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSL/SINS NDSC SURG MAX SINS	$17,153.00	$17,153.00	—	545% above	—
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NSL/SINS NDSC SURG MAX SINS	$17,153.00	$17,153.00	—	—	—
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$771.00	$771.00	—	380% above	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$771.00	$771.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS	$608.00	$608.00	—	233% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DIST FIB FX W/O MAN	$628.00	$628.00	—	244% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLTX DSTL FIBULAR FX LAT MALLS	$608.00	$608.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DIST FIB FX W/O MAN	$628.00	$628.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX W/O M	$190.00	$190.00	—	2% below	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX; WO MANIP	$608.00	$608.00	—	212% above	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX W/O M	$190.00	$190.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX; WO MANIP	$608.00	$608.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION, ELECTIVE	$1,614.00	$1,614.00	—	177% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION, ELECTIVE	$1,614.00	$1,614.00	—	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$1,997.00	$1,997.00	—	297% above	—
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$1,997.00	$1,997.00	—	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$5,624.00	$5,624.00	—	374% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$5,624.00	$5,624.00	—	—	—
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE <=28 DAYS	$1,695.00	$1,695.00	—	88% above	—
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE <=28 DAYS	$1,695.00	$1,695.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL S	$608.00	$608.00	—	145% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL TX DIS RAD FX ETC W/O	$628.00	$628.00	—	153% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL S	$608.00	$608.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CL TX DIS RAD FX ETC W/O	$628.00	$628.00	—	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$888.00	$888.00	—	246% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$888.00	$888.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,644.00	$1,644.00	—	159% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,695.00	$1,695.00	—	167% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,644.00	$1,644.00	—	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,695.00	$1,695.00	—	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTR BENIGN SKIN LESION	$311.00	$311.00	—	220% above	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTR BENIGN SKIN LESION	$311.00	$311.00	—	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GEN ANESTHESIA	$3,986.00	$3,986.00	—	170% above	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GEN ANESTHESIA	$3,986.00	$3,986.00	—	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 TYMPANOSTOMY LOCAL; UNILATERAL	$1,334.00	$1,334.00	—	167% above	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 TYMPANOSTOMY LOCAL; UNILATERAL	$1,334.00	$1,334.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX; UNI	$162.00	$162.00	—	131% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNIL	$166.00	$166.00	—	137% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX; UNI	$162.00	$162.00	—	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNIL	$166.00	$166.00	—	—	—
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN	$90.00	$90.00	—	46% above	—
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UN	$165.00	$165.00	—	168% above	—
Earwax removal with instruments, one ear CPT 69210 HBO - REMOVE IMPACTED EAR WAX	$174.00	$174.00	—	182% above	—
Earwax removal with instruments, one ear one side CPT 69210 REM IMPACT CERUMEN INST UNILAT	$162.00	$162.00	—	163% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN	$90.00	$90.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UN	$165.00	$165.00	—	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 HBO - REMOVE IMPACTED EAR WAX	$174.00	$174.00	—	—	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 REM IMPACT CERUMEN INST UNILAT	$162.00	$162.00	—	—	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$536.00	$536.00	—	244% above	—
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$536.00	$536.00	—	—	—
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT	$17,153.00	$17,153.00	—	124% above	—
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT	$17,153.00	$17,153.00	—	—	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NSL/SINS NDSC W/TOT ETHMDCT	$9,125.00	$9,125.00	—	177% above	—
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NSL/SINS NDSC W/TOT ETHMDCT	$9,125.00	$9,125.00	—	—	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL ENDO W MA; W REM TISS MS	$17,153.00	$17,153.00	—	154% above	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL ENDO W MA; W REM TISS MS	$17,153.00	$17,153.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$2,127.00	$2,127.00	—	185% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$2,127.00	$2,127.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$2,866.00	$2,866.00	—	322% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$2,866.00	$2,866.00	—	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRA DEV	$139.00	$139.00	—	15% below	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRA DEV	$139.00	$139.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS-SIMP/SING	$505.00	$505.00	—	150% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC; SMPL OR SGL	$530.00	$530.00	—	163% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$531.00	$531.00	—	163% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC; SMPL OR SGL WCC	$630.00	$630.00	—	212% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS-SIMP/SING	$505.00	$505.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC; SMPL OR SGL	$530.00	$530.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS	$531.00	$531.00	—	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC; SMPL OR SGL WCC	$630.00	$630.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SGL TENDON SHTH OR LIGAMEN	$591.00	$591.00	—	172% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH, ETC	$591.00	$591.00	—	172% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SGL TENDON SHTH OR LIGAME	$771.00	$771.00	—	254% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 inj tendon sheath	$819.00	$819.00	—	276% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SGL TENDON SHTH OR LIGAMEN	$591.00	$591.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH, ETC	$591.00	$591.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SGL TENDON SHTH OR LIGAME	$771.00	$771.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 inj tendon sheath	$819.00	$819.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROC/ASP/INJ MAJOR JOINT	$710.00	$710.00	—	175% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JOINT/BURSA W	$771.00	$771.00	—	198% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 inj/aspirate major joint	$819.00	$819.00	—	217% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MJR JNT/BURSA W/OUS	$912.00	$912.00	—	253% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JT/BURSA W/O U	$915.00	$915.00	—	254% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Inj/Drain-Jt/shldr/knee/hip LT	$771.00	$771.00	—	198% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 DRAIN/MJR JT/BURSA W/O US RT M	$771.00	$771.00	—	198% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 DRAIN/MJR JNT/BURSA W/O US RT	$771.00	$771.00	—	198% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROC/ASP/INJ MAJOR JOINT	$710.00	$710.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JOINT/BURSA W	$771.00	$771.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 inj/aspirate major joint	$819.00	$819.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MJR JNT/BURSA W/OUS	$912.00	$912.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JT/BURSA W/O U	$915.00	$915.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 DRAIN/MJR JT/BURSA W/O US RT M	$771.00	$771.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Inj/Drain-Jt/shldr/knee/hip LT	$771.00	$771.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 DRAIN/MJR JNT/BURSA W/O US RT	$771.00	$771.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMP DEV	$355.00	$355.00	—	310% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMP DEV	$355.00	$355.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCE/ASP/INJ INTERMED	$723.00	$723.00	—	191% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTER JOINT/BURSA W/	$771.00	$771.00	—	210% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTE JNT/BURSA W/OUS	$912.00	$912.00	—	267% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/IN INTER JOINT/BURSA W/O	$915.00	$915.00	—	268% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCE/ASP/INJ INTERMED	$723.00	$723.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTER JOINT/BURSA W/	$771.00	$771.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTE JNT/BURSA W/OUS	$912.00	$912.00	—	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/IN INTER JOINT/BURSA W/O	$915.00	$915.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHOCEN/ASP/INJ SM JOINT	$491.00	$491.00	—	90% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JT/BURSA W/O US	$491.00	$491.00	—	90% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SM JOINT/BURSA W/OUS	$491.00	$491.00	—	90% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ SMALL JOINT/BURSA W/	$912.00	$912.00	—	253% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHOCEN/ASP/INJ SM JOINT	$491.00	$491.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SM JOINT/BURSA W/OUS	$491.00	$491.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SM JT/BURSA W/O US	$491.00	$491.00	—	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ SMALL JOINT/BURSA W/	$912.00	$912.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CL WND 2.5CM< SC,AX,TRK	$739.00	$739.00	—	129% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.	$1,020.00	$1,020.00	—	216% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 CL WND 2.5CM< SC,AX,TRK	$739.00	$739.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.	$1,020.00	$1,020.00	—	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,211.00	$2,211.00	—	212% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,211.00	$2,211.00	—	—	—
Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL STEROID INJECTION	$1,545.00	$1,545.00	—	295% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE L/S (CD)	$2,211.00	$2,211.00	—	465% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL STEROID INJECTION	$1,545.00	$1,545.00	—	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT SPINE L/S (CD)	$2,211.00	$2,211.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL L/S	$2,866.00	$2,866.00	—	435% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL L/S	$2,866.00	$2,866.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 < CM	$1,270.00	$1,270.00	—	237% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,835.00	$1,835.00	—	386% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5CM/<	$2,174.00	$2,174.00	—	476% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 < CM	$1,270.00	$1,270.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,835.00	$1,835.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5CM/<	$2,174.00	$2,174.00	—	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BLES,F/E,N,L,MM; 0.5CM/<	$1,270.00	$1,270.00	—	235% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BLES,F/E,N,L,MM; 0.5CM/<	$1,270.00	$1,270.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE, ONE	$318.00	$318.00	—	124% above	—
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$531.00	$531.00	—	275% above	—
Nail removal (partial or complete), one nail CPT 11730 SPL AVULSE NP; SGL - WCC	$628.00	$628.00	—	343% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE, ONE	$318.00	$318.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$531.00	$531.00	—	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 SPL AVULSE NP; SGL - WCC	$628.00	$628.00	—	—	—
Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTH; GREATER OCCIPITAL	$590.00	$590.00	—	128% above	—
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$945.00	$945.00	—	266% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTH; GREATER OCCIPITAL	$590.00	$590.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$945.00	$945.00	—	—	—
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,990.00	$1,990.00	—	273% above	—
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,990.00	$1,990.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$1,020.00	$1,020.00	—	155% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED - WCC	$1,209.00	$1,209.00	—	202% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC OF NAIL, PERMANENT	$1,309.00	$1,309.00	—	227% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$1,020.00	$1,020.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED - WCC	$1,209.00	$1,209.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC OF NAIL, PERMANENT	$1,309.00	$1,309.00	—	—	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$6,110.00	$6,110.00	—	502% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$6,110.00	$6,110.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 INC & REM FB, SUBQ TISS. SIMP	$990.00	$990.00	—	292% above	—
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body	$1,076.00	$1,076.00	—	326% above	—
Removal of a foreign object under the skin, simple CPT 10120 I&R FOREIGN BDY SUB TISS SMPL	$1,209.00	$1,209.00	—	378% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REM FB, SUBQ TISS. SIMP	$990.00	$990.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body	$1,076.00	$1,076.00	—	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FOREIGN BDY SUB TISS SMPL	$1,209.00	$1,209.00	—	—	—
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT	$14,905.00	$14,905.00	—	169% above	—
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT	$14,905.00	$14,905.00	—	—	—
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESEC	$7,751.00	$7,751.00	—	35% above	—
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESEC	$7,751.00	$7,751.00	—	—	—
Short arm cast (elbow to hand) CPT 29075 APPLI CAST; ELBOW TO FINGER	$439.00	$439.00	—	152% above	—
Short arm cast (elbow to hand) CPT 29075 Application Cast Elbow Finger	$712.00	$712.00	—	308% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLI CAST; ELBOW TO FINGER	$439.00	$439.00	—	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 Application Cast Elbow Finger	$712.00	$712.00	—	—	—
Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT	$293.00	$293.00	—	139% above	—
Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint F	$333.00	$333.00	—	172% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHORT ARM SPLINT	$293.00	$293.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm Splint F	$333.00	$333.00	—	—	—
Short leg cast (below the knee) CPT 29405 APP SHORT LEG CAST	$560.00	$560.00	—	168% above	—
Short leg cast (below the knee) CPT 29405 Application Short Leg Cast Bel	$712.00	$712.00	—	240% above	—
Short leg cast (below the knee) CPT 29405 APP SHORT LEG CAST WCC	$844.00	$844.00	—	303% above	—
Short leg cast (below the knee) inpatient CPT 29405 APP SHORT LEG CAST	$560.00	$560.00	—	—	—
Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast Bel	$712.00	$712.00	—	—	—
Short leg cast (below the knee) inpatient CPT 29405 APP SHORT LEG CAST WCC	$844.00	$844.00	—	—	—
Short leg splint (calf to foot) CPT 29515 APPLI SHORT LEG SPLINT	$364.00	$364.00	—	138% above	—
Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint C	$418.00	$418.00	—	173% above	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLI SHORT LEG SPLINT	$364.00	$364.00	—	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Splint C	$418.00	$418.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 S REP S/N/A/G/TR/E; 2.5CM/<	$350.00	$350.00	—	79% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$530.00	$530.00	—	171% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 S REP S/N/A/G/TR/E; 2.5CM/<	$350.00	$350.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$530.00	$530.00	—	—	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$1,020.00	$1,020.00	—	280% above	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LES	$1,209.00	$1,209.00	—	350% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$1,020.00	$1,020.00	—	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LES	$1,209.00	$1,209.00	—	—	—
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS, UP TO 15	$131.00	$131.00	—	1% below	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15	$565.00	$565.00	—	329% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS, UP TO 15	$131.00	$131.00	—	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <W/15	$565.00	$565.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT, LUMBAR, DX	$178.00	$178.00	—	59% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT. LUMBAR, DX	$1,846.00	$1,846.00	—	327% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT LUMBAR DX	$1,980.00	$1,980.00	—	358% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT, LUMBAR, DX	$178.00	$178.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT. LUMBAR, DX	$1,846.00	$1,846.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT LUMBAR DX	$1,980.00	$1,980.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP REP WND 2.6-7.5CM,SC	$516.00	$516.00	—	175% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$702.00	$702.00	—	274% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMP REP WND 2.6-7.5CM,SC	$516.00	$516.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$702.00	$702.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM; 2.5CM/<	$200.00	$200.00	—	9% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP WND 2.5CM<, FACE,EAR E	$516.00	$516.00	—	181% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM; 2.5 CM/<	$630.00	$630.00	—	243% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SREP F/E/N/L/MM; 2.5CM/<	$200.00	$200.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REP WND 2.5CM<, FACE,EAR E	$516.00	$516.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SREP F/E/N/L/MM; 2.5 CM/<	$630.00	$630.00	—	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BS SKIN SINGLE LES	$744.00	$744.00	—	335% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BS SKIN SINGLE LES	$744.00	$744.00	—	—	—
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/IMAGING	$1,614.00	$1,614.00	—	151% above	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMG	$1,769.00	$1,769.00	—	175% above	—
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,803.00	$1,803.00	—	180% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/IMAGING	$1,614.00	$1,614.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMG	$1,769.00	$1,769.00	—	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,803.00	$1,803.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ,SING/MULT TRIG PTS 1or2 MU	$408.00	$408.00	—	178% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$771.00	$771.00	—	426% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT Â½ MUSCL	$938.00	$938.00	—	540% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ,SING/MULT TRIG PTS 1or2 MU	$408.00	$408.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$771.00	$771.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT Â½ MUSCL	$938.00	$938.00	—	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 U/S VACUUM ASSISTED BIOPSY	$4,133.00	$4,133.00	—	339% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 U/S VACUUM ASSISTED BIOPSY	$4,133.00	$4,133.00	—	—	—
Wart removal, up to 14 warts CPT 17110 DEST FL WARTS ETC, 1-14	$311.00	$311.00	—	130% above	—
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$695.00	$695.00	—	414% above	—
Wart removal, up to 14 warts inpatient CPT 17110 DEST FL WARTS ETC, 1-14	$311.00	$311.00	—	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14	$695.00	$695.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,020.00	$1,020.00	—	160% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN, SUB Q TISSUE	$1,092.00	$1,092.00	—	179% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< WCC	$1,334.00	$1,334.00	—	240% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,020.00	$1,020.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN, SUB Q TISSUE	$1,092.00	$1,092.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/< WCC	$1,334.00	$1,334.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$1,242.00	$1,242.00	—	161% above	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/COMPONE	$1,275.00	$1,275.00	—	168% above	—
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE	$1,297.00	$1,297.00	—	173% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$1,242.00	$1,242.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/COMPONE	$1,275.00	$1,275.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION SERVICE	$1,297.00	$1,297.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 LECH INITIAL NEBULIZER TX DAY	$389.00	$389.00	—	370% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 LECH INITIAL INC EXERCISE P D	$389.00	$389.00	—	370% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TREATMENT INITIAL	$596.00	$596.00	—	620% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INITIAL INC EXERCISE PER DAY	$606.00	$606.00	—	632% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INITIAL NEBULIZER TX PER DAY	$606.00	$606.00	—	632% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 LECH AIRWAY INHALATION TREATME	$705.00	$705.00	—	752% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 LECH INITIAL INC EXERCISE P D	$389.00	$389.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 LECH INITIAL NEBULIZER TX DAY	$389.00	$389.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB TREATMENT INITIAL	$596.00	$596.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INITIAL NEBULIZER TX PER DAY	$606.00	$606.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INITIAL INC EXERCISE PER DAY	$606.00	$606.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 LECH AIRWAY INHALATION TREATME	$705.00	$705.00	—	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY BY INFUSION	$741.00	$741.00	—	160% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$964.00	$964.00	—	238% above	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1HR	$999.00	$999.00	—	250% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY BY INFUSION	$741.00	$741.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$964.00	$964.00	—	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1HR	$999.00	$999.00	—	—	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Compre Audiometry Threshold Ev	$413.00	$413.00	—	306% above	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Compre Audiometry Threshold Ev	$413.00	$413.00	—	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, 1ST HOUR	$2,434.00	$2,434.00	—	196% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, 1ST HOUR	$2,434.00	$2,434.00	—	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$823.00	$823.00	—	168% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 LECH EEG	$1,222.00	$1,222.00	—	298% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$823.00	$823.00	—	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 LECH EEG	$1,222.00	$1,222.00	—	—	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 LEAD EKG GLOBAL	$41.00	$41.00	—	at median	—
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 12 LEAD EKG GLOBAL	$41.00	$41.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ****ELECTROCARDIOGRAM (ECG)	$43.00	$43.00	—	43% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG - TRACING ONLY	$75.00	$75.00	—	1% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG TRACE	$77.00	$77.00	—	1% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$189.00	$189.00	—	149% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 LECH EKG	$273.00	$273.00	—	259% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ****ELECTROCARDIOGRAM (ECG)	$43.00	$43.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG - TRACING ONLY	$75.00	$75.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG TRACE	$77.00	$77.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$189.00	$189.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 LECH EKG	$273.00	$273.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER NURSING FEE LEVEL 1	$223.00	$223.00	—	80% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TRIAGE FEE	$271.00	$271.00	—	119% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER NURSING FEE LEVEL 1	$223.00	$223.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER TRIAGE FEE	$271.00	$271.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER NURSING FEE LEVEL 2	$449.00	$449.00	—	172% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER NURSING FEE LEVEL 2	$449.00	$449.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER NURSING FEE LEVEL 3	$783.00	$783.00	—	197% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER NURSING FEE LEVEL 3	$783.00	$783.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER NURSING FEE LEVEL 4	$1,213.00	$1,213.00	—	190% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER NURSING FEE LEVEL 4	$1,213.00	$1,213.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER NURSING FEE LEVEL 5	$1,514.00	$1,514.00	—	188% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER NURSING FEE LEVEL 5	$1,514.00	$1,514.00	—	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS ANALYSIS	$880.00	$880.00	—	160% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$959.00	$959.00	—	183% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS ANALYSIS	$880.00	$880.00	—	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST	$959.00	$959.00	—	—	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$403.00	$403.00	—	257% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PT	$403.00	$403.00	—	257% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY PER HOUR	$572.00	$572.00	—	406% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50 MIN	$403.00	$403.00	—	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PT	$403.00	$403.00	—	—	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY PER HOUR	$572.00	$572.00	—	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCH THERAPY	$380.00	$380.00	—	196% above	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PT	$403.00	$403.00	—	214% above	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$403.00	$403.00	—	214% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCH THERAPY	$380.00	$380.00	—	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PT	$403.00	$403.00	—	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PT 50 MIN	$403.00	$403.00	—	—	—
Group psychotherapy session CPT 90853 GROUP THERAPY PER HOUR	$180.00	$180.00	—	87% above	—
Group psychotherapy session CPT 90853 RECREATIONAL THERAPY GROUP	$180.00	$180.00	—	87% above	—
Group psychotherapy session CPT 90853 GROUP THERAPY NOT MULTI-FAMILY	$219.00	$219.00	—	128% above	—
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY	$257.00	$257.00	—	167% above	—
Group psychotherapy session inpatient CPT 90853 RECREATIONAL THERAPY GROUP	$180.00	$180.00	—	—	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY PER HOUR	$180.00	$180.00	—	—	—
Group psychotherapy session inpatient CPT 90853 GROUP THERAPY NOT MULTI-FAMILY	$219.00	$219.00	—	—	—
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY	$257.00	$257.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$642.00	$642.00	—	350% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION, INIT	$644.00	$644.00	—	351% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$642.00	$642.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION, INIT	$644.00	$644.00	—	—	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF, INIT	$644.00	$644.00	—	240% above	—
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$723.00	$723.00	—	282% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF, INIT	$644.00	$644.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$723.00	$723.00	—	—	—
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH CT	$234.00	$234.00	—	140% above	—
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$604.00	$604.00	—	519% above	—
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IA	$723.00	$723.00	—	641% above	—
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH CT	$234.00	$234.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$604.00	$604.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IA	$723.00	$723.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION, SQ/IM	$73.00	$73.00	—	38% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic Prophylactic/Dx In	$184.00	$184.00	—	247% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 DX INJECT IM	$196.00	$196.00	—	270% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ/IM	$201.00	$201.00	—	280% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 therapeutic prophylactic dx in	$205.00	$205.00	—	287% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$223.00	$223.00	—	321% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION, SQ/IM	$73.00	$73.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic Prophylactic/Dx In	$184.00	$184.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 DX INJECT IM	$196.00	$196.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SQ/IM	$201.00	$201.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 therapeutic prophylactic dx in	$205.00	$205.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$223.00	$223.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 OT ASSESSMENT	$182.00	$182.00	—	67% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHOSOCIAL ASSESSMENT	$204.00	$204.00	—	87% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$403.00	$403.00	—	270% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 AT ASSESSMENT	$403.00	$403.00	—	270% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 NURSING ASSESSMENT	$403.00	$403.00	—	270% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 OT ASSESSMENT	$182.00	$182.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHOSOCIAL ASSESSMENT	$204.00	$204.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 NURSING ASSESSMENT	$403.00	$403.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 AT ASSESSMENT	$403.00	$403.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$403.00	$403.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112 LECH PT NEUROMUSC RE ED EA 15	$149.00	$149.00	—	285% above	—
Neuromuscular re-education, 15 minutes CPT 97112 LECH OT NEUROMUSC RE ED EA 15	$153.00	$153.00	—	295% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 LECH PT NEUROMUSC RE ED EA 15	$149.00	$149.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 LECH OT NEUROMUSC RE ED EA 15	$153.00	$153.00	—	—	—
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW LEVEL 3	$123.00	$123.00	—	68% above	—
New patient office visit, about 30 minutes CPT 99203 Office Outpatient New 30 Minut	$303.00	$303.00	—	315% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$333.00	$333.00	—	356% above	—
New patient office visit, about 30 minutes CPT 99203 level 3 new patient office vis	$355.00	$355.00	—	386% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT/NEW/LVL 3	$391.00	$391.00	—	435% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT - LEVEL 3 WCC	$501.00	$501.00	—	586% above	—
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3	$553.00	$553.00	—	657% above	—
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30-44MIN	$579.00	$579.00	—	693% above	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT NEW LEVEL 3	$123.00	$123.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 Office Outpatient New 30 Minut	$303.00	$303.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30-44 MIN	$333.00	$333.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 level 3 new patient office vis	$355.00	$355.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT/NEW/LVL 3	$391.00	$391.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT - LEVEL 3 WCC	$501.00	$501.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3	$553.00	$553.00	—	—	—
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30-44MIN	$579.00	$579.00	—	—	—
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT NEW LEVEL 4	$195.00	$195.00	—	114% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT/NEW/LVL 4	$426.00	$426.00	—	367% above	—
New patient office visit, about 45 minutes CPT 99204 Office Outpatient New 45 Minut	$437.00	$437.00	—	379% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$475.00	$475.00	—	421% above	—
New patient office visit, about 45 minutes CPT 99204 level 4 new patient office vis	$536.00	$536.00	—	488% above	—
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT - LEVEL 4 WCC	$662.00	$662.00	—	626% above	—
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4	$804.00	$804.00	—	781% above	—
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-49MIN	$842.00	$842.00	—	823% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT NEW LEVEL 4	$195.00	$195.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT/NEW/LVL 4	$426.00	$426.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 Office Outpatient New 45 Minut	$437.00	$437.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$475.00	$475.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 level 4 new patient office vis	$536.00	$536.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT - LEVEL 4 WCC	$662.00	$662.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4	$804.00	$804.00	—	—	—
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45-49MIN	$842.00	$842.00	—	—	—
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT NEW LEVEL 5	$239.00	$239.00	—	120% above	—
New patient office visit, about 60 minutes CPT 99205 Office Outpatient New 60 Minut	$437.00	$437.00	—	303% above	—
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT/NEW/LVL 5	$461.00	$461.00	—	325% above	—
New patient office visit, about 60 minutes CPT 99205 level 5 new patient office vis	$700.00	$700.00	—	545% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5	$804.00	$804.00	—	641% above	—
New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$842.00	$842.00	—	676% above	—
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT - LEVEL 5 WCC	$907.00	$907.00	—	736% above	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT NEW LEVEL 5	$239.00	$239.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 Office Outpatient New 60 Minut	$437.00	$437.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT/NEW/LVL 5	$461.00	$461.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 level 5 new patient office vis	$700.00	$700.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5	$804.00	$804.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60-74 MIN	$842.00	$842.00	—	—	—
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT - LEVEL 5 WCC	$907.00	$907.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP NEW LOW 10-29 MIN	$90.00	$90.00	—	51% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Level 2 new patient office vis	$230.00	$230.00	—	287% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Outpatient New 20 Minut	$261.00	$261.00	—	339% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Outpatient New 10 Minut	$261.00	$261.00	—	339% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT/NEW/LVL 2	$288.00	$288.00	—	384% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT - LEVEL 1 WCC	$294.00	$294.00	—	394% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT - LEVEL 2 WCC	$433.00	$433.00	—	628% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2	$481.00	$481.00	—	709% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15-29MIN	$502.00	$502.00	—	744% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP NEW LOW 10-29 MIN	$90.00	$90.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Level 2 new patient office vis	$230.00	$230.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Outpatient New 10 Minut	$261.00	$261.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Outpatient New 20 Minut	$261.00	$261.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT/NEW/LVL 2	$288.00	$288.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT - LEVEL 1 WCC	$294.00	$294.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT - LEVEL 2 WCC	$433.00	$433.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2	$481.00	$481.00	—	—	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15-29MIN	$502.00	$502.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165 LECH OT EVAL LOW COMPLEX 30 MI	$221.00	$221.00	—	94% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 LECH OT EVAL LOW COMPLEX 30 MI	$221.00	$221.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 LECH PT EVAL HIGH COMPLEX 45 M	$284.00	$284.00	—	123% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 LECH PT EVAL HIGH COMPLEX 45 M	$284.00	$284.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 LECH PT EVAL LOW COMPLEX 20 MI	$30.00	$30.00	—	72% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 LECH PT EVAL LOW COMPLEX 20 MI	$30.00	$30.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 LECH PT EVAL MOD COMPLEX 30 MI	$252.00	$252.00	—	108% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 LECH PT EVAL MOD COMPLEX 30 MI	$252.00	$252.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LECH PT MANUAL THERAPY EA 15 M	$131.00	$131.00	—	239% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LECH OT MANUAL THERAPY EA 15 M	$131.00	$131.00	—	239% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LECH OT MANUAL THERAPY EA 15 M	$131.00	$131.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LECH PT MANUAL THERAPY EA 15 M	$131.00	$131.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 MEDICAID PT 1 MOD	$37.00	$37.00	—	2% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 MEDICAID PT 2 OR > MOD	$75.00	$75.00	—	98% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 MEDICAID PT W/PROCEDURE 30MIN	$83.00	$83.00	—	119% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 MEDICAID PT W/PROCEDURE 45MIN	$124.00	$124.00	—	227% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LECH PT THERAPEUTIC EXER EA 15	$158.00	$158.00	—	316% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LECH OT THERAPEUTIC EXER EA 15	$158.00	$158.00	—	316% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 MEDICAID PT W/PROCEDURE 60MIN	$165.00	$165.00	—	335% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 MEDICAID PT 1 MOD	$37.00	$37.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 MEDICAID PT 2 OR > MOD	$75.00	$75.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 MEDICAID PT W/PROCEDURE 30MIN	$83.00	$83.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 MEDICAID PT W/PROCEDURE 45MIN	$124.00	$124.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LECH PT THERAPEUTIC EXER EA 15	$158.00	$158.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LECH OT THERAPEUTIC EXER EA 15	$158.00	$158.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 MEDICAID PT W/PROCEDURE 60MIN	$165.00	$165.00	—	—	—
Preventive checkup, new patient aged 18–39 CPT 99385 Initial Preventive Medicine Ne	$344.00	$344.00	—	130% above	—
Preventive checkup, new patient aged 18–39 CPT 99385 Int Preventive Med New Pat 18-	$361.00	$361.00	—	141% above	—
Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39	$361.00	$361.00	—	141% above	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial Preventive Medicine Ne	$344.00	$344.00	—	—	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV VISIT NEW AGE 18-39	$361.00	$361.00	—	—	—
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Int Preventive Med New Pat 18-	$361.00	$361.00	—	—	—
Preventive checkup, new patient aged 40–64 CPT 99386 Initial Preventive Medicine Ne	$375.00	$375.00	—	168% above	—
Preventive checkup, new patient aged 40–64 CPT 99386 Int Preventive Med New Pat 40-	$394.00	$394.00	—	181% above	—
Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64	$394.00	$394.00	—	181% above	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial Preventive Medicine Ne	$375.00	$375.00	—	—	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV VISIT NEW AGE 40-64	$394.00	$394.00	—	—	—
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Int Preventive Med New Pat 40-	$394.00	$394.00	—	—	—
Preventive checkup, new patient aged 65 or older CPT 99387 Initial Preventive Medicine Ne	$313.00	$313.00	—	129% above	—
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$328.00	$328.00	—	140% above	—
Preventive checkup, new patient aged 65 or older CPT 99387 PREV VISIT NEW AGE 65 +	$333.00	$333.00	—	143% above	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Initial Preventive Medicine Ne	$313.00	$313.00	—	—	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INIT PM E/M NEW PAT 65+ YRS	$328.00	$328.00	—	—	—
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREV VISIT NEW AGE 65 +	$333.00	$333.00	—	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 Periodic Preventive Med Est Pa	$344.00	$344.00	—	245% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$361.00	$361.00	—	262% above	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST 18-39	$367.00	$367.00	—	268% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Periodic Preventive Med Est Pa	$344.00	$344.00	—	—	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV VISIT EST AGE 18-39	$361.00	$361.00	—	—	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV VISIT EST 18-39	$367.00	$367.00	—	—	—
Preventive checkup, returning patient aged 40–64 CPT 99396 Periodic Preventive Med Est Pa	$375.00	$375.00	—	217% above	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64	$394.00	$394.00	—	233% above	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Periodic Preventive Med Est Pa	$375.00	$375.00	—	—	—
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV VISIT EST AGE 40-64	$394.00	$394.00	—	—	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV VISIT EST AGE 65 +	$156.00	$156.00	—	28% above	—
Preventive checkup, returning patient aged 65 or older CPT 99397 Periodic Preventive Med Est Pa	$251.00	$251.00	—	106% above	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR	$273.00	$273.00	—	124% above	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV VISIT EST AGE 65 +	$156.00	$156.00	—	—	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Periodic Preventive Med Est Pa	$251.00	$251.00	—	—	—
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PER PM REEVAL EST PAT 65+ YR	$273.00	$273.00	—	—	—
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$403.00	$403.00	—	243% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W/MED SRVCS	$403.00	$403.00	—	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60MIN	$403.00	$403.00	—	326% above	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$481.00	$481.00	—	408% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60MIN	$403.00	$403.00	—	—	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYTX CRISIS INITIAL 60 MIN	$481.00	$481.00	—	—	—
Psychotherapy session, 30 minutes CPT 90832 IND PSYCHOTHERAPY 20-30 MIN.	$369.00	$369.00	—	329% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MIN	$403.00	$403.00	—	369% above	—
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES	$406.00	$406.00	—	372% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 IND PSYCHOTHERAPY 20-30 MIN.	$369.00	$369.00	—	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MIN	$403.00	$403.00	—	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MINUTES	$406.00	$406.00	—	—	—
Psychotherapy session, 45 minutes CPT 90834 IND PSYCHOTHERAPY 45-50 MIN.	$380.00	$380.00	—	249% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MIN	$403.00	$403.00	—	270% above	—
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL PSYCHOTHERAPY 45-50	$403.00	$403.00	—	270% above	—
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES	$481.00	$481.00	—	341% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 IND PSYCHOTHERAPY 45-50 MIN.	$380.00	$380.00	—	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MIN	$403.00	$403.00	—	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL PSYCHOTHERAPY 45-50	$403.00	$403.00	—	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MINUTES	$481.00	$481.00	—	—	—
Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY 75-80	$403.00	$403.00	—	270% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MIN	$403.00	$403.00	—	270% above	—
Psychotherapy session, 60 minutes CPT 90837 PSYTX W PT 60 MINUTES	$481.00	$481.00	—	341% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY 75-80	$403.00	$403.00	—	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX W PT 60 MIN	$403.00	$403.00	—	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX W PT 60 MINUTES	$481.00	$481.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 CHNG SMOKING 3-10 MIN	$84.00	$84.00	—	349% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CHNG SMOKING 3-10 MIN	$84.00	$84.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST. PATIENT LEVEL 5	$125.00	$125.00	—	75% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT EST LEVEL 5	$167.00	$167.00	—	133% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Outpatient Visit 40 Min	$437.00	$437.00	—	511% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT/EST/LVL 5	$461.00	$461.00	—	544% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office visit, est level 5	$481.00	$481.00	—	572% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB OUTPATIENT VISIT EST LEV 5	$525.00	$525.00	—	634% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PATIENT - LEVEL 5 WCC	$662.00	$662.00	—	825% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED LEVEL 5	$804.00	$804.00	—	1024% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40-54 MIN	$842.00	$842.00	—	1077% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST. PATIENT LEVEL 5	$125.00	$125.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT EST LEVEL 5	$167.00	$167.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Outpatient Visit 40 Min	$437.00	$437.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT/EST/LVL 5	$461.00	$461.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office visit, est level 5	$481.00	$481.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB OUTPATIENT VISIT EST LEV 5	$525.00	$525.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PATIENT - LEVEL 5 WCC	$662.00	$662.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED LEVEL 5	$804.00	$804.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40-54 MIN	$842.00	$842.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST. PATIENT LEVEL 3	$78.00	$78.00	—	37% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT EST LEVEL 3	$84.00	$84.00	—	48% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office visit, est level 3	$263.00	$263.00	—	363% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Outpatient Visit 15 Min	$303.00	$303.00	—	434% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB OUTPATIENT VISIT EST LEV 3	$375.00	$375.00	—	561% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT/EST/LVL 3	$391.00	$391.00	—	589% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PATIENT - LEVEL 3 WCC	$433.00	$433.00	—	663% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED LEVEL3	$553.00	$553.00	—	874% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$579.00	$579.00	—	920% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST. PATIENT LEVEL 3	$78.00	$78.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT EST LEVEL 3	$84.00	$84.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office visit, est level 3	$263.00	$263.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Outpatient Visit 15 Min	$303.00	$303.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB OUTPATIENT VISIT EST LEV 3	$375.00	$375.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT/EST/LVL 3	$391.00	$391.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PATIENT - LEVEL 3 WCC	$433.00	$433.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED LEVEL3	$553.00	$553.00	—	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$579.00	$579.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST. PATIENT LEVEL 4	$103.00	$103.00	—	56% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Consultation New/Estab	$105.00	$105.00	—	59% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT EST LEVEL 4	$123.00	$123.00	—	86% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office visit, est level 4	$372.00	$372.00	—	464% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$394.00	$394.00	—	497% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT/EST/LVL 4	$426.00	$426.00	—	545% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Outpatient Visit 25 Min	$437.00	$437.00	—	562% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB OUTPATIENT VISIT EST LEV 4	$450.00	$450.00	—	582% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PATIENT - LEVEL 4 WCC	$501.00	$501.00	—	659% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED LEVEL4	$804.00	$804.00	—	1118% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$842.00	$842.00	—	1176% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST. PATIENT LEVEL 4	$103.00	$103.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Consultation New/Estab	$105.00	$105.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT EST LEVEL 4	$123.00	$123.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office visit, est level 4	$372.00	$372.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN	$394.00	$394.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT/EST/LVL 4	$426.00	$426.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Outpatient Visit 25 Min	$437.00	$437.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB OUTPATIENT VISIT EST LEV 4	$450.00	$450.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PATIENT - LEVEL 4 WCC	$501.00	$501.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED LEVEL4	$804.00	$804.00	—	—	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30-39 MIN	$842.00	$842.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST LEVEL 2	$56.00	$56.00	—	8% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST. PATIENT LEVEL 2	$67.00	$67.00	—	29% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office visit, est level 2	$159.00	$159.00	—	206% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Outpatient Visit 10 Min	$261.00	$261.00	—	402% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB OUTPATIENT VIST EST LEV 2	$300.00	$300.00	—	477% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PATIENT - LEVEL 2 WCC	$322.00	$322.00	—	520% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB OUTPATIENT VISIT EST LEV 2	$345.00	$345.00	—	564% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT/EST/LVL 2	$355.00	$355.00	—	583% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED LEVEL2	$481.00	$481.00	—	826% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10-19MIN	$502.00	$502.00	—	866% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10-19 MIN	$511.00	$511.00	—	884% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT EST LEVEL 2	$56.00	$56.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST. PATIENT LEVEL 2	$67.00	$67.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office visit, est level 2	$159.00	$159.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Outpatient Visit 10 Min	$261.00	$261.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB OUTPATIENT VIST EST LEV 2	$300.00	$300.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PATIENT - LEVEL 2 WCC	$322.00	$322.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB OUTPATIENT VISIT EST LEV 2	$345.00	$345.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT/EST/LVL 2	$355.00	$355.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED LEVEL2	$481.00	$481.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10-19MIN	$502.00	$502.00	—	—	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10-19 MIN	$511.00	$511.00	—	—	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consultation New/Estab	$261.00	$261.00	—	75% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consult New/Est 45 min	$355.00	$355.00	—	138% above	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consultation New/Estab	$261.00	$261.00	—	—	—
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consult New/Est 45 min	$355.00	$355.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consultation New/Estab	$365.00	$365.00	—	140% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consult MDM 40 Min	$536.00	$536.00	—	253% above	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consultation New/Estab	$365.00	$365.00	—	—	—
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consult MDM 40 Min	$536.00	$536.00	—	—	—
Speech and language evaluation CPT 92523 LECH ST EVAL SPEECH SOUND LANG	$368.00	$368.00	—	98% above	—
Speech and language evaluation inpatient CPT 92523 LECH ST EVAL SPEECH SOUND LANG	$368.00	$368.00	—	—	—
Speech therapy session, individual CPT 92507 SPEECH THERAPY MD	$91.00	$91.00	—	10% above	—
Speech therapy session, individual CPT 92507 LECH ST SPEECH HEARING THRPY B	$226.00	$226.00	—	172% above	—
Speech therapy session, individual CPT 92507 LECH ST SPEECH HEARING THRPY E	$226.00	$226.00	—	172% above	—
Speech therapy session, individual CPT 92507 LECH ST SPEECH HEARING THRPY I	$226.00	$226.00	—	172% above	—
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY MD	$91.00	$91.00	—	—	—
Speech therapy session, individual inpatient CPT 92507 LECH ST SPEECH HEARING THRPY I	$226.00	$226.00	—	—	—
Speech therapy session, individual inpatient CPT 92507 LECH ST SPEECH HEARING THRPY E	$226.00	$226.00	—	—	—
Speech therapy session, individual inpatient CPT 92507 LECH ST SPEECH HEARING THRPY B	$226.00	$226.00	—	—	—
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION	$441.00	$441.00	—	249% above	—
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION	$441.00	$441.00	—	—	—
Spirometry before and after a bronchodilator CPT 94060 PFT (PRE & POST)	$827.00	$827.00	—	301% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT (PRE & POST)	$827.00	$827.00	—	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 MCD OT 30 MINUTES	$71.00	$71.00	—	80% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 MCD OT 45 MINUTES	$106.00	$106.00	—	169% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 LECH PT THERAP DYNAMIC EA 15 M	$126.00	$126.00	—	220% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 LECH OT THERAP DYNAMIC EA 15 M	$126.00	$126.00	—	220% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 MCD OT 60 MINUTES	$141.00	$141.00	—	258% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 MCD OT 30 MINUTES	$71.00	$71.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 MCD OT 45 MINUTES	$106.00	$106.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 LECH PT THERAP DYNAMIC EA 15 M	$126.00	$126.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 LECH OT THERAP DYNAMIC EA 15 M	$126.00	$126.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 MCD OT 60 MINUTES	$141.00	$141.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$354.00	$354.00	—	253% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$413.00	$413.00	—	312% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$354.00	$354.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$413.00	$413.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL DTAP VACCINE	$289.00	$289.00	—	716% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL DTAP VACCINE	$289.00	$289.00	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B PF PED/ADOL.	$60.00	$60.00	—	54% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC PREFILLED SYR	$88.00	$88.00	—	126% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B PF PED/ADOL.	$60.00	$60.00	—	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC PREFILLED SYR	$88.00	$88.00	—	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 vaccine preserv free	$230.00	$230.00	—	258% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 vaccine preserv free	$230.00	$230.00	—	—	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 SYRINGE	$79.00	$79.00	—	62% below	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 SYRINGE	$79.00	$79.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL P-SAC VAC	$36.00	$36.00	—	73% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23	$75.00	$75.00	—	44% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL P-SAC VAC	$36.00	$36.00	—	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23	$75.00	$75.00	—	—	—
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE	$565.00	$565.00	—	19% below	—
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE	$565.00	$565.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD 7 YEARS OR OLDER	$34.00	$34.00	—	24% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS TOXOID INJ	$89.00	$89.00	—	100% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPH TOX(AGE 7&UP)	$289.00	$289.00	—	549% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD 7 YEARS OR OLDER	$34.00	$34.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS TOXOID INJ	$89.00	$89.00	—	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPH TOX(AGE 7&UP)	$289.00	$289.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS >IM	$46.00	$46.00	—	28% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH PERTUSS(ACELL) TET VAC/PF	$185.00	$185.00	—	189% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS >IM	$46.00	$46.00	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH PERTUSS(ACELL) TET VAC/PF	$185.00	$185.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF TDAP (OP) VACCINE	$130.00	$130.00	—	225% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN	$201.00	$201.00	—	402% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM; 1 VACCINE	$201.00	$201.00	—	402% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM: 1 VACCINE	$204.00	$204.00	—	410% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 im adm prq id subq/ 1 vaccine	$205.00	$205.00	—	412% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$223.00	$223.00	—	458% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF TDAP (OP) VACCINE	$130.00	$130.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM; 1 VACCINE	$201.00	$201.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN	$201.00	$201.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM: 1 VACCINE	$204.00	$204.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 im adm prq id subq/ 1 vaccine	$205.00	$205.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$223.00	$223.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM; ED ADDTL VAC	$74.00	$74.00	—	177% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM; ED ADDTL VAC	$74.00	$74.00	—	—	—

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://mrfs.hyvehealthcare.com/NatchitochesRegionalMedical/203171304_llc-i%2C-llc_standardcharges.json