Fayette Medical Center
Fayette Medical Center in Fayette, AL publishes cash prices for 333 common procedures listed here, from its own machine-readable price file updated Mar 26, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Alabama median for 212 of 331 procedures and above it for 86. By typical cash price it ranks #25 of 53 Alabama hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1653 Temple Avenue, Fayette, AL 35555 Collected Oct 29, 2026 Source price file Check a bill from this hospital (205) 932-5966
Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 010045 · CMS hospital register NPI 1851323836
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Fayette Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Alabama | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT SCAN UPR ABD W/WO Contrast | $1,559.00 | $3,118.00 | $1,559.00–$3,118.00 | 14% above | 50% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABD UPPER W/WO IV CONT ONLY | $1,568.13 | $3,136.25 | $1,568.13–$3,136.25 | 14% above | 50% |
| Abdominal X-ray, 2 views both sides CPT 74019 Abdomen Lat Dec Bilat | $219.25 | $438.50 | $219.25–$438.50 | — | 50% |
| Abdominal X-ray, 2 views CPT 74019 Abdomen Flat Upright | $178.25 | $356.50 | $178.25–$356.50 | 11% below | 50% |
| Abdominal X-ray, 2 views CPT 74019 Abdomen AP/Lat | $193.88 | $387.75 | $94.10–$159.96 | 3% below | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VIEWS RIGHT | $150.75 | $301.50 | $36.18–$301.50 | 28% below | 50% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 VIEWS LEFT | $150.75 | $301.50 | $36.18–$301.50 | 28% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 NIV Ankle/Brachial Index Bilat | $252.88 | $505.75 | $252.88–$505.75 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US RAYNAUD'S EVAL | $252.88 | $505.75 | $252.88–$505.75 | 8% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXTREMITY UPPER LT | $990.00 | $1,980.00 | $237.60–$1,980.00 | 4% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXTREMITY UPPER RT | $990.00 | $1,980.00 | $237.60–$1,980.00 | 4% above | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM-BA SWAL | $265.88 | $531.75 | $157.87–$268.38 | 4% below | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN WHOLE BODY | $1,004.00 | $2,008.00 | $359.81–$611.68 | 9% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Exam RT | $259.38 | $518.75 | $62.25–$518.75 | 1% above | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt | $259.38 | $518.75 | $62.25–$518.75 | 1% above | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Exam Lt Limited | $168.63 | $337.25 | $40.47–$337.25 | 34% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast RT Limited | $168.63 | $337.25 | $40.47–$337.25 | 34% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL | $3,603.50 | $7,207.00 | $3,603.50–$7,207.00 | 42% above | 50% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD | $1,858.50 | $3,717.00 | $157.87–$268.38 | 20% above | 50% |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK | $1,632.25 | $3,264.50 | $157.87–$268.38 | 17% above | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT THORAX FOR PTE | $1,585.50 | $3,171.00 | $1,585.50–$3,171.00 | 16% above | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORAX | $1,585.50 | $3,171.00 | $1,585.50–$3,171.00 | 16% above | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART wo/w CONTRAST | $1,856.00 | $3,712.00 | $314.00–$533.80 | 26% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING | $188.38 | $376.75 | $78.33–$133.15 | at median | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT UPPER ABD/PELVIS NO CONT | $2,148.38 | $4,296.75 | $2,148.38–$4,296.75 | 7% above | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT UP ABD/PEL ORAL CONT ONLY | $2,219.88 | $4,439.75 | $2,219.88–$4,439.75 | 10% above | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT UPPER ABD/PEL W/CONT | $2,468.13 | $4,936.25 | $2,468.13–$4,936.25 | 8% above | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT UP ABD/PEL W/IV CONT ONLY | $2,472.00 | $4,944.00 | $2,472.00–$4,944.00 | 8% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM 3D | $1,510.25 | $3,020.50 | $1,510.25–$3,020.50 | 41% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UP ABD/PEL W/WOIV CONT ONLY | $2,965.75 | $5,931.50 | $2,965.75–$5,931.50 | 15% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UPPER ABD/PEL W/WO CONT | $3,065.38 | $6,130.75 | $3,065.38–$6,130.75 | 19% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $3,451.50 | $6,903.00 | $3,451.50–$6,903.00 | 34% above | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN UPR ABD CON ON | $1,228.25 | $2,456.50 | $157.87–$268.38 | 11% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD UPPER IV CONT ONLY | $1,231.63 | $2,463.25 | $157.87–$268.38 | 10% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT PANCREAS IV CONT ONLY | $1,241.25 | $2,482.50 | $1,241.25–$2,482.50 | 10% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT PANCREAS w/contrast | $1,241.75 | $2,483.50 | $1,241.75–$2,483.50 | 10% below | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT UPPER ABD ORAL ONLY | $1,160.25 | $2,320.50 | $1,160.25–$2,320.50 | 5% above | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN UPPER ABD | $1,184.38 | $2,368.75 | $94.10–$159.96 | 7% above | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES | $974.88 | $1,949.75 | $94.10–$159.96 | 16% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES | $974.88 | $1,949.75 | $94.10–$159.96 | 16% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT LTD ALLERGY | $974.88 | $1,949.75 | $974.88–$1,949.75 | 16% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD | $1,078.75 | $2,157.50 | $94.10–$159.96 | 1% below | 50% |
| CT scan of the head with contrast CPT 70460 CT SCAN HED CON-ONLY | $1,036.63 | $2,073.25 | $1,036.63–$2,073.25 | 9% below | 50% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN HEAD W/WO CONTRAST | $1,273.13 | $2,546.25 | $157.87–$268.38 | 24% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine Mazor | $1,251.75 | $2,503.50 | $1,251.75–$2,503.50 | 1% above | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE | $1,251.75 | $2,503.50 | $1,251.75–$2,503.50 | 1% above | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE | $1,252.38 | $2,504.75 | $1,252.38–$2,504.75 | 4% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine Mazor | $1,252.38 | $2,504.75 | $1,252.38–$2,504.75 | 4% below | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/IV CONT ONLY | $1,224.88 | $2,449.75 | $157.87–$268.38 | 6% below | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS CONT.ONLY | $1,224.88 | $2,449.75 | $157.87–$268.38 | 6% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 U-S CAROTID ARTERIES BILAT | $503.50 | $1,007.00 | $503.50–$1,007.00 | — | 50% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX W/WO CONT DIAG | $1,591.63 | $3,183.25 | $1,591.63–$3,183.25 | at median | 50% |
| Chest X-ray, 2 views both sides CPT 71046 Chest Bilateral Decub | $176.88 | $353.75 | $78.33–$133.15 | — | 50% |
| Chest X-ray, 2 views CPT 71046 AP/Lat Chest | $176.88 | $353.75 | $78.33–$133.15 | 7% below | 50% |
| Chest X-ray, 2 views CPT 71046 Chest 2 Views-PA Lat | $176.88 | $353.75 | $176.88–$353.75 | 7% below | 50% |
| Chest X-ray, 2 views one side CPT 71046 Chest PA Rt Lateral | $176.88 | $353.75 | $78.33–$133.15 | 7% below | 50% |
| Chest X-ray, single view CPT 71045 Chest 1 for NG Tube Placement | $139.50 | $279.00 | $78.33–$133.15 | 2% below | 50% |
| Chest X-ray, single view CPT 71045 Chest Apical Lordotic Only | $139.50 | $279.00 | $78.33–$133.15 | 2% below | 50% |
| Chest X-ray, single view CPT 71045 Chest 1 view | $139.50 | $279.00 | $139.50–$279.00 | 2% below | 50% |
| Chest X-ray, single view one side CPT 71045 Chest Left Lat Dec | $139.50 | $279.00 | $78.33–$133.15 | 2% below | 50% |
| Chest X-ray, single view one side CPT 71045 Chest Right Lat | $139.50 | $279.00 | $139.50–$279.00 | 2% below | 50% |
| Chest X-ray, single view one side CPT 71045 Chest Right Lat Dec | $139.50 | $279.00 | $78.33–$133.15 | 2% below | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT | $129.88 | $259.75 | $31.17–$259.75 | 18% below | 50% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT | $129.88 | $259.75 | $31.17–$259.75 | 18% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL | $397.25 | $794.50 | $397.25–$794.50 | 1% above | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys one side CPT 76770 US RENAL EXAM LT | $397.25 | $794.50 | $95.34–$794.50 | 1% above | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys one side CPT 76770 US RENAL EXAM RT | $397.25 | $794.50 | $95.34–$794.50 | 1% above | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DESITOMETRY | $281.00 | $562.00 | $94.10–$159.96 | at median | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Density Append Skel | $171.25 | $342.50 | $171.25–$342.50 | 78% above | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN THORAX W/O CON DIAG | $1,169.75 | $2,339.50 | $1,169.75–$2,339.50 | at median | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN THORAX W CONT DIAG | $1,299.63 | $2,599.25 | $1,299.63–$2,599.25 | 6% below | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mamm Digital Add'l Bilateral | $153.00 | $306.00 | $153.00–$306.00 | — | 50% |
| Diagnostic mammogram, both breasts CPT 77066 Mamm Diagnostic Digitalw/CAD B | $207.75 | $415.50 | $207.75–$415.50 | 11% below | 50% |
| Diagnostic mammogram, one breast CPT 77065 Mamm Diag Post Scr Uni | $97.88 | $195.75 | $168.11–$285.79 | 53% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Mamm Digital Add'l Unilat | $97.88 | $195.75 | $168.11–$285.79 | 53% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Mamm Diagnostic Dig/CAD Left | $195.38 | $390.75 | $46.89–$390.75 | 7% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Mamm Diagnostic Dig/CAD Right | $195.38 | $390.75 | $46.89–$390.75 | 7% below | 50% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Bilateral Pseudoaneurysm LE | $277.63 | $555.25 | $214.75–$365.08 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Art Peripheral FL Lower Ext | $277.63 | $555.25 | $277.63–$555.25 | 5% below | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS UE BILAT | $508.63 | $1,017.25 | $508.63–$1,017.25 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS LE BILAT | $508.63 | $1,017.25 | $508.63–$1,017.25 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Mapping Bilat | $508.63 | $1,017.25 | $214.75–$365.08 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEN INSUFFICIENCY BILAT | $508.63 | $1,017.25 | $214.75–$365.08 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO 2D + M-MODE W/DOPPLER | $512.13 | $1,024.25 | $491.80–$836.05 | 51% below | 50% |
| Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS RT | $131.63 | $263.25 | $31.59–$263.25 | 10% below | 50% |
| Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS LEFT | $131.63 | $263.25 | $31.59–$263.25 | 10% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 4 VIEWS RIGHT | $146.25 | $292.50 | $35.10–$292.50 | 10% below | 50% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 4 VIEWS LEFT | $146.25 | $292.50 | $35.10–$292.50 | 10% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS | $1,011.25 | $2,022.50 | $94.10–$159.96 | at median | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAM | $1,011.25 | $2,022.50 | $1,011.25–$2,022.50 | at median | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMPLETE | $211.88 | $423.75 | $211.88–$423.75 | 13% below | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT | $107.38 | $214.75 | $25.77–$214.75 | 33% below | 50% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT | $107.38 | $214.75 | $25.77–$214.75 | 33% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY SCAN | $867.50 | $1,735.00 | $359.81–$611.68 | 11% below | 50% |
| Hand X-ray, 2 views one side CPT 73120 HAND LT 2 VIEWS | $146.75 | $293.50 | $35.22–$293.50 | at median | 50% |
| Hand X-ray, 2 views one side CPT 73120 HAND RT 2 VIEWS | $146.75 | $293.50 | $35.22–$293.50 | at median | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis 1 View Right | $140.50 | $281.00 | $33.72–$281.00 | 4% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis 1 View Left | $140.50 | $281.00 | $33.72–$281.00 | 4% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS RIGHT | $140.50 | $281.00 | $33.72–$281.00 | 4% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS LEFT | $140.50 | $281.00 | $33.72–$281.00 | 4% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS LEFT | $153.50 | $307.00 | $36.84–$307.00 | 13% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS RIGHT | $153.50 | $307.00 | $36.84–$307.00 | 13% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 PATELLA RIGHT | $153.50 | $307.00 | $36.84–$307.00 | 13% below | 50% |
| Knee X-ray, 3 views one side CPT 73562 PATELLA LEFT | $153.50 | $307.00 | $36.84–$307.00 | 13% below | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RT COMPLETE 4/> VIEWS | $231.00 | $462.00 | $55.44–$462.00 | 3% above | 50% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LT COMPLETE 4/> VIEWS | $231.00 | $462.00 | $55.44–$462.00 | 3% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT HIP | $1,047.88 | $2,095.75 | $94.10–$159.96 | 18% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 MAKO CT HIP | $1,047.88 | $2,095.75 | $94.10–$159.96 | 18% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 MAKO CT EXTREMITY LOWER RT | $1,047.88 | $2,095.75 | $251.49–$2,095.75 | 18% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXTREMITY LOWER RT | $1,047.88 | $2,095.75 | $251.49–$2,095.75 | 18% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXTREMITY LOWER LT | $1,047.88 | $2,095.75 | $251.49–$2,095.75 | 18% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 MAKO CT EXTREMITY LOWER LT | $1,047.88 | $2,095.75 | $251.49–$2,095.75 | 18% above | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER EXAM | $138.88 | $277.75 | $138.88–$277.75 | 62% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL ORGAN BX EXAM | $138.88 | $277.75 | $94.10–$159.96 | 62% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US COMMON BILE DUCT | $286.63 | $573.25 | $94.10–$159.96 | 21% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS | $298.50 | $597.00 | $298.50–$597.00 | 18% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER | $308.00 | $616.00 | $308.00–$616.00 | 15% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED | $308.00 | $616.00 | $94.10–$159.96 | 15% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN | $318.75 | $637.50 | $318.75–$637.50 | 12% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US HEPATIC | $328.25 | $656.50 | $94.10–$159.96 | 10% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US RUQ | $371.50 | $743.00 | $371.50–$743.00 | 2% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Limited | $312.00 | $624.00 | $312.00–$624.00 | 56% above | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LD Lung Cancer Screening | $1,170.00 | $2,340.00 | $94.10–$159.96 | 441% above | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA-LEFT | $129.38 | $258.75 | $31.05–$258.75 | 35% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA-RIGHT | $132.13 | $264.25 | $31.71–$264.25 | 33% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WITHOUT CONTRAST | $1,459.63 | $2,919.25 | $1,459.63–$2,919.25 | 8% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV BRAIN | $1,459.63 | $2,919.25 | $1,459.63–$2,919.25 | 8% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR TOE | $1,557.50 | $3,115.00 | $1,557.50–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE LT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP RT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR KNEE RT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE RT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR HIP LT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE LT | $1,557.50 | $3,115.00 | $373.80–$3,115.00 | 5% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE RT CONT WO/W | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR ANKLE LT CONT WO/W | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Knee Right wo/w Contrast | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Knee Left wo/w Contrast | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Hip Right wo/w Contrast | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Hip Left wo/w Contrast | $1,505.13 | $3,010.25 | $361.23–$3,010.25 | 27% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MR UPPER ABDOMEN | $1,127.63 | $2,255.25 | $1,127.63–$2,255.25 | 19% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST | $1,665.38 | $3,330.75 | $1,665.38–$3,330.75 | 20% above | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR Abdomen Upper Wo/W Contrast | $1,730.50 | $3,461.00 | $1,730.50–$3,461.00 | 15% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN | $1,697.38 | $3,394.75 | $1,697.38–$3,394.75 | 1% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN CONTRAST WO/W | $2,315.38 | $4,630.75 | $2,315.38–$4,630.75 | at median | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MR LUMBAR SPINE | $1,516.88 | $3,033.75 | $1,516.88–$3,033.75 | 5% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR LUM SP WWO CONTRAST | $2,397.38 | $4,794.75 | $2,397.38–$4,794.75 | 1% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR DORSAL SPINE | $1,516.38 | $3,032.75 | $1,516.38–$3,032.75 | at median | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL SP CONT WO/W | $2,218.13 | $4,436.25 | $2,218.13–$4,436.25 | at median | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL SPINE | $1,494.00 | $2,988.00 | $1,494.00–$2,988.00 | 8% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MR LUMBAR PLEXUS W/WO | $1,679.88 | $3,359.75 | $314.00–$533.80 | 20% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MR Pelvis Wo/W Contrast | $1,679.88 | $3,359.75 | $1,679.88–$3,359.75 | 20% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MR LUMBAR PLEXUS | $1,370.38 | $2,740.75 | $214.75–$365.08 | 9% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MR Pelvis WO Contrast | $1,370.38 | $2,740.75 | $1,370.38–$2,740.75 | 9% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR FINGER | $1,463.00 | $2,926.00 | $1,463.00–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER LT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW RT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST RT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR SHOULDER RT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR WRIST LT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR ELBOW LT | $1,463.00 | $2,926.00 | $351.12–$2,926.00 | at median | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CER SP COMPLETE | $282.63 | $565.25 | $282.63–$565.25 | at median | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE 4 VIEWS | $282.63 | $565.25 | $282.63–$565.25 | at median | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT NECK CONT | $1,265.25 | $2,530.50 | $157.87–$268.38 | at median | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT NECK | $972.63 | $1,945.25 | $972.63–$1,945.25 | at median | 50% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE | $163.00 | $326.00 | $163.00–$326.00 | at median | 50% |
| Neck soft tissue X-ray CPT 70360 CROUP SERIES | $163.00 | $326.00 | $163.00–$326.00 | at median | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC STRESS TEST EXAM | $1,408.00 | $2,816.00 | $1,165.24–$1,980.90 | 33% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL to THIGH EXAM | $3,012.13 | $6,024.25 | $3,012.13–$6,024.25 | 10% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET RESTAGING SKULL/THIGH | $3,012.50 | $6,025.00 | $1,287.01–$2,187.92 | 10% below | 50% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS ORAL ONLY | $1,108.00 | $2,216.00 | $94.10–$159.96 | 3% above | 50% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS NO CONTRAST | $1,108.00 | $2,216.00 | $94.10–$159.96 | 3% above | 50% |
| Pelvic CT scan without contrast CPT 72192 CT SACRUM/COCCYX | $1,108.00 | $2,216.00 | $1,108.00–$2,216.00 | 3% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED | $114.63 | $229.25 | $114.63–$229.25 | 42% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS | $347.88 | $695.75 | $347.88–$695.75 | 21% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG + 14WKS 0 DAYS | $347.88 | $695.75 | $347.88–$695.75 | 9% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND FETAL | $358.00 | $716.00 | $358.00–$716.00 | 6% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG - 14WKS 0 DAYS | $331.00 | $662.00 | $331.00–$662.00 | 9% above | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY F/U | $132.75 | $265.50 | $132.75–$265.50 | 46% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED | $132.75 | $265.50 | $132.75–$265.50 | 46% below | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs RT 2 views | $212.50 | $425.00 | $51.00–$425.00 | 2% above | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs LT 2 views | $212.50 | $425.00 | $51.00–$425.00 | 2% above | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RT 3+ views | $188.88 | $377.75 | $45.33–$377.75 | 18% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LT 3+ views | $188.88 | $377.75 | $45.33–$377.75 | 18% below | 50% |
| Screening mammogram, both breasts CPT 77067 Mamm Screen Digital w/CAD Bil | $180.75 | $361.50 | $180.75–$361.50 | 14% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT - 2 VIEWS | $196.13 | $392.25 | $47.07–$392.25 | 2% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT - 3 VIEWS | $196.13 | $392.25 | $47.07–$392.25 | 2% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT - 3 VIEWS | $196.13 | $392.25 | $47.07–$392.25 | 2% below | 50% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT - 2 VIEWS | $196.13 | $392.25 | $47.07–$392.25 | 2% below | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 PARANASAL SINUSES | $214.13 | $428.25 | $214.13–$428.25 | at median | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL PARTIAL | $182.63 | $365.25 | $182.63–$365.25 | at median | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 AP/LAT SKULL | $182.63 | $365.25 | $94.10–$159.96 | at median | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 FLOURO ESOPHAGRAM VIDEO | $289.50 | $579.00 | $289.50–$579.00 | 18% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Right (3 views) | $157.50 | $315.00 | $37.80–$315.00 | 16% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Left (3 views) | $157.50 | $315.00 | $37.80–$315.00 | 16% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Left (2 views) | $157.50 | $315.00 | $37.80–$315.00 | 16% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Right (2 views) | $157.50 | $315.00 | $37.80–$315.00 | 16% below | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine Mazor | $1,207.88 | $2,415.75 | $94.10–$159.96 | 3% above | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT DORSAL SPINE | $1,207.88 | $2,415.75 | $1,207.88–$2,415.75 | 3% above | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US INTRAVAGINAL ULTRASOUND | $291.75 | $583.50 | $291.75–$583.50 | 14% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG TRANSVAGINAL | $280.38 | $560.75 | $280.38–$560.75 | at median | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US UPPER ABDOMEN | $449.00 | $898.00 | $94.10–$159.96 | 6% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM | $326.50 | $653.00 | $94.10–$159.96 | 11% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid Exam | $302.38 | $604.75 | $302.38–$604.75 | 8% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK/HEAD SOFT TISSUE | $302.38 | $604.75 | $302.38–$604.75 | 8% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $302.38 | $604.75 | $94.10–$159.96 | 8% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI and Ba Sw | $515.88 | $1,031.75 | $515.88–$1,031.75 | 45% above | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI | $515.88 | $1,031.75 | $157.87–$268.38 | 45% above | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT | $127.13 | $254.25 | $30.51–$254.25 | 30% below | 50% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT | $127.13 | $254.25 | $30.51–$254.25 | 30% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VEN INSUFFICIENCY UNI | $306.25 | $612.50 | $306.25–$612.50 | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENOUS LE UNI | $306.25 | $612.50 | $306.25–$612.50 | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENOUS UE UNI | $306.25 | $612.50 | $306.25–$612.50 | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Rt | $306.25 | $612.50 | $73.50–$612.50 | at median | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Lt | $306.25 | $612.50 | $73.50–$612.50 | at median | 50% |
| Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS RIGHT | $127.13 | $254.25 | $30.51–$254.25 | 2% below | 50% |
| Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS LEFT | $127.13 | $254.25 | $30.51–$254.25 | 2% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS RIGHT | $135.50 | $271.00 | $32.52–$271.00 | 33% below | 50% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS LEFT | $135.50 | $271.00 | $32.52–$271.00 | 33% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Left (2 views) | $179.88 | $359.75 | $43.17–$359.75 | 1% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Right (2 views) | $179.88 | $359.75 | $43.17–$359.75 | 1% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Pediatric Hips unilat 2-3 view | $179.88 | $359.75 | $78.33–$133.15 | 1% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Unilat Left 2-3 views | $179.88 | $359.75 | $43.17–$359.75 | 1% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Unilat Right 2-3 views | $179.88 | $359.75 | $43.17–$359.75 | 1% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 KUB | $145.00 | $290.00 | $78.33–$133.15 | at median | 50% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen 1 view | $167.50 | $335.00 | $78.33–$133.15 | 16% above | 50% |
| X-ray of the abdomen, 1 view one side CPT 74018 Abdomen Lat Dec Lt | $219.25 | $438.50 | $219.25–$438.50 | 51% above | 50% |
| X-ray of the abdomen, 1 view one side CPT 74018 Abdomen Lat Dec Rt | $219.25 | $438.50 | $78.33–$133.15 | 51% above | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS LEFT | $138.38 | $276.75 | $33.21–$276.75 | at median | 50% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS RIGHT | $138.38 | $276.75 | $33.21–$276.75 | at median | 50% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 1 View Left | $137.25 | $274.50 | $32.94–$274.50 | 2% above | 50% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS RIGHT | $137.25 | $274.50 | $32.94–$274.50 | 2% above | 50% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS LEFT | $137.25 | $274.50 | $32.94–$274.50 | 2% above | 50% |
| X-ray of the foot, 2 views one side CPT 73620 Foot 1 View Right | $137.25 | $274.50 | $32.94–$274.50 | 2% above | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS LEFT | $147.88 | $295.75 | $35.49–$295.75 | 18% below | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 4 VIEWS RIGHT | $147.88 | $295.75 | $35.49–$295.75 | 18% below | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS RIGHT | $147.88 | $295.75 | $35.49–$295.75 | 18% below | 50% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 4 VIEWS LEFT | $147.88 | $295.75 | $35.49–$295.75 | 18% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT | $154.50 | $309.00 | $37.08–$309.00 | 23% below | 50% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT | $154.50 | $309.00 | $37.08–$309.00 | 23% below | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS RIGHT | $153.50 | $307.00 | $36.84–$307.00 | 5% above | 50% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS LEFT | $153.50 | $307.00 | $36.84–$307.00 | 5% above | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE PARTIAL | $176.00 | $352.00 | $176.00–$352.00 | 13% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBO SAC SPINE OBLQ | $176.00 | $352.00 | $176.00–$352.00 | 13% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SP ROUTINE | $176.00 | $352.00 | $176.00–$352.00 | 13% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 LS SP BENDING | $245.00 | $490.00 | $245.00–$490.00 | 15% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 LS SP with Obliques 4+ views | $245.00 | $490.00 | $94.10–$159.96 | 15% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE 4 VIEWS | $245.00 | $490.00 | $245.00–$490.00 | 15% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 DORSAL SP | $188.38 | $376.75 | $188.38–$376.75 | 4% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 DORSAL SP PARTIAL | $188.38 | $376.75 | $94.10–$159.96 | 4% below | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES | $140.00 | $280.00 | $140.00–$280.00 | 20% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cer.Sp Flex Ext Only 2or3 vw | $199.88 | $399.75 | $78.33–$133.15 | at median | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cer Sp partial 2or3view | $199.88 | $399.75 | $199.88–$399.75 | at median | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS | $151.75 | $303.50 | $94.10–$159.96 | 7% below | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 2 AP LAT | $151.75 | $303.50 | $94.10–$159.96 | 7% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM | $154.50 | $309.00 | $78.33–$133.15 | 24% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX | $154.50 | $309.00 | $154.50–$309.00 | 24% below | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Alabama | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH FASTING | $133.88 | $267.75 | $133.88–$267.75 | at median | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $18.13 | $36.25 | $5.30–$9.01 | 34% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 KIDNEY STONE FORMER PRFL PT 19 | $10.25 | $20.50 | $10.25–$20.50 | 70% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $18.13 | $36.25 | $5.18–$8.81 | 47% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST BODY FLUID | $53.50 | $107.00 | $5.18–$8.81 | 57% above | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $221.50 | $443.00 | $47.63–$80.97 | at median | 50% |
| Albumin blood test CPT 82040 MS PROFILE PART 1 | $19.75 | $39.50 | $4.95–$8.42 | 24% below | 50% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $35.63 | $71.25 | $4.95–$8.42 | 37% above | 50% |
| Aldosterone blood test CPT 82088 ALDOSTERONE (BLOOD) | $135.00 | $270.00 | $40.75–$69.28 | 4% above | 50% |
| Aldosterone blood test CPT 82088 ALDOSTERONE 24HR URINE | $140.50 | $281.00 | $140.50–$281.00 | 8% above | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $18.13 | $36.25 | $5.18–$8.81 | 30% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MUSSEL | $9.13 | $18.25 | $9.13–$18.25 | 40% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN-23 IgE EACH | $14.13 | $28.25 | $5.22–$8.87 | 7% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE QUANT | $14.13 | $28.25 | $14.13–$28.25 | 7% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IgE CAT HAIR/DANDER | $14.13 | $28.25 | $5.22–$8.87 | 7% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IgE DOG HAIR/DANDER | $14.13 | $28.25 | $5.22–$8.87 | 7% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IgE LATEX | $14.13 | $28.25 | $5.22–$8.87 | 7% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL ALLERGEN | $39.38 | $78.75 | $5.22–$8.87 | 159% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT COMPONENT PANEL | $87.75 | $175.50 | $87.75–$175.50 | 477% above | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW COMPONENT PANEL | $87.75 | $175.50 | $87.75–$175.50 | 477% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TETRA PART 1 | $39.38 | $78.75 | $16.77–$28.51 | 46% below | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP EXTRA PART 1 | $48.38 | $96.75 | $48.38–$96.75 | 34% below | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL | $86.63 | $173.25 | $16.77–$28.51 | 18% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN | $220.38 | $440.75 | $220.38–$440.75 | 201% above | 50% |
| Ammonia blood test CPT 82140 KID STONE URINE PROF PART 15 | $17.00 | $34.00 | $14.57–$24.77 | 77% below | 50% |
| Ammonia blood test CPT 82140 AMMONIA | $55.13 | $110.25 | $55.13–$110.25 | 27% below | 50% |
| Amylase blood test CPT 82150 AMYLASE (BODY FLUID) RedPath | $15.25 | $30.50 | $15.25–$30.50 | 65% below | 50% |
| Amylase blood test CPT 82150 AMYLASE ISOENZYMES | $29.88 | $59.75 | $29.88–$59.75 | 32% below | 50% |
| Amylase blood test CPT 82150 AMYLASE | $52.88 | $105.75 | $6.48–$11.02 | 20% above | 50% |
| Amylase blood test CPT 82150 AMYLASE-URINE | $90.50 | $181.00 | $90.50–$181.00 | 106% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IgG/IgA ANTIBODIES | $26.50 | $53.00 | $12.95–$22.02 | 49% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN IFA | $36.13 | $72.25 | $36.13–$72.25 | 15% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN DIRECT | $54.63 | $109.25 | $12.09–$20.55 | 28% above | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies (RDL) | $83.25 | $166.50 | $83.25–$166.50 | 95% above | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE | $49.63 | $99.25 | $39.26–$66.74 | 52% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE BACTERIAL | $90.00 | $180.00 | $90.00–$180.00 | 72% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE B PERTUSSIS | $131.63 | $263.25 | $131.63–$263.25 | 151% above | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONAIRES CULTURE | $165.25 | $330.50 | $8.62–$14.65 | 216% above | 50% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL Ca TOTAL | $105.13 | $210.25 | $8.46–$14.38 | 76% above | 50% |
| Bilirubin blood test, total CPT 82247 KIDNEY STONE FORMER PRFL PT 17 | $10.25 | $20.50 | $10.25–$20.50 | 58% below | 50% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN-TOTAL | $16.38 | $32.75 | $16.38–$32.75 | 33% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE SMALL (LEVEL IV) | $170.63 | $341.25 | $170.63–$341.25 | 2% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK | $174.88 | $349.75 | $174.88–$349.75 | 4% above | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CORE BIOPSY | $174.88 | $349.75 | $174.88–$349.75 | 4% above | 50% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $71.50 | $143.00 | $10.32–$17.54 | 13% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $7.50 | $15.00 | $7.50–$15.00 | 4% above | 50% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD 2-HOUR PC | $16.38 | $32.75 | $16.38–$32.75 | 37% below | 50% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING | $25.38 | $50.75 | $25.38–$50.75 | 3% below | 50% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD | $30.38 | $60.75 | $3.93–$6.68 | 16% above | 50% |
| Blood glucose (sugar) test CPT 82947 ISTAT-GLU | $64.25 | $128.50 | $64.25–$128.50 | 146% above | 50% |
| Blood lead test CPT 83655 ComAP Lead | $18.38 | $36.75 | $12.11–$20.59 | 55% below | 50% |
| Blood lead test CPT 83655 HEAVY METALS 24HR URINE PART B | $32.13 | $64.25 | $32.13–$64.25 | 22% below | 50% |
| Blood lead test CPT 83655 HEAVY METALS BLOOD PART B | $34.38 | $68.75 | $34.38–$68.75 | 17% below | 50% |
| Blood lead test CPT 83655 LEAD RANDOM URINE | $39.38 | $78.75 | $12.11–$20.59 | 4% below | 50% |
| Blood lead test CPT 83655 LEAD/ZPP PART A | $40.63 | $81.25 | $12.11–$20.59 | 1% below | 50% |
| Blood lead test CPT 83655 LEAD 24 HOUR URINE | $41.13 | $82.25 | $12.11–$20.59 | at median | 50% |
| Blood lead test CPT 83655 LEAD BLOOD (ADULT) | $45.13 | $90.25 | $45.13–$90.25 | 9% above | 50% |
| Blood lead test CPT 83655 LEAD BLOOD (PEDIATRIC) | $45.13 | $90.25 | $45.13–$90.25 | 9% above | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE | $63.63 | $127.25 | $63.63–$127.25 | 35% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE POST-TRANSFUSION | $79.50 | $159.00 | $119.75–$203.57 | 22% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $79.50 | $159.00 | $119.75–$203.57 | 22% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 REF LAB FEE ABO | $79.50 | $159.00 | $119.75–$203.57 | 22% above | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE PRE-TRANSFUSION | $79.50 | $159.00 | $119.75–$203.57 | 22% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $17.50 | $35.00 | $17.50–$35.00 | 38% below | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 ISTAT-BUN | $24.88 | $49.75 | $24.88–$49.75 | 11% below | 50% |
| C-peptide blood test CPT 84681 C-PEPTIDE | $94.00 | $188.00 | $94.00–$188.00 | 27% above | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $43.38 | $86.75 | $43.38–$86.75 | 1% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF MOLECULAR | $83.75 | $167.50 | $37.27–$63.36 | 15% below | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA19-9 SERUM | $69.75 | $139.50 | $20.81–$35.38 | 32% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA125 | $69.75 | $139.50 | $69.75–$139.50 | 19% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 covid-19 amp prb | $73.25 | $146.50 | $51.31–$87.23 | 25% above | 50% |
| Calcium blood test, total CPT 82310 CALCIUM | $23.75 | $47.50 | $5.16–$8.77 | 13% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA (BODY FLUID) RedPath | $54.13 | $108.25 | $54.13–$108.25 | 31% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA (CARCINOEMBRYONIC ANTIGEN) | $64.25 | $128.50 | $64.25–$128.50 | 19% below | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGG AB | $59.63 | $119.25 | $59.63–$119.25 | at median | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGM AB | $72.00 | $144.00 | $72.00–$144.00 | 21% above | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS NAA | $28.13 | $56.25 | $35.09–$59.65 | 57% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NAA URINE | $58.00 | $116.00 | $35.09–$59.65 | 11% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 NuSwab Chlamydia | $82.25 | $164.50 | $35.09–$59.65 | 27% above | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 EXEC PROF LIPID | $11.38 | $22.75 | $13.39–$22.76 | 78% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE FASTING | $50.13 | $100.25 | $50.13–$100.25 | 4% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 EXEC PROF CBC | $11.38 | $22.75 | $7.77–$13.21 | 69% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTOMATED DIFF | $56.25 | $112.50 | $56.25–$112.50 | 53% above | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF | $42.25 | $84.50 | $6.47–$11.00 | 25% above | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 EXEC PROF CMP | $15.25 | $30.50 | $10.56–$17.95 | 80% below | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $94.50 | $189.00 | $94.50–$189.00 | 24% above | 50% |
| Cortisol blood test, total CPT 82533 CAH-6 PROF - PART B | $42.25 | $84.50 | $42.25–$84.50 | 36% below | 50% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL-BLOOD | $53.50 | $107.00 | $16.30–$27.71 | 19% below | 50% |
| Cortisol blood test, total CPT 82533 CORTISOL SALIVARY | $103.50 | $207.00 | $16.30–$27.71 | 57% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CK ISOENZYMES PART II | $20.38 | $40.75 | $20.38–$40.75 | 37% below | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 CK | $32.63 | $65.25 | $6.51–$11.07 | at median | 50% |
| Creatinine blood test CPT 82565 FENA PART C | $18.13 | $36.25 | $18.13–$36.25 | 37% below | 50% |
| Creatinine blood test CPT 82565 CREATININE | $20.88 | $41.75 | $5.12–$8.70 | 28% below | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV-IGG ANTIBODIES | $32.13 | $64.25 | $14.39–$24.46 | 53% below | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG Avidity | $337.13 | $674.25 | $337.13–$674.25 | 397% above | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE | $85.00 | $170.00 | $22.23–$37.79 | 3% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DOT DRUG SCREEN - OCC HLTH | $35.63 | $71.25 | $62.14–$105.64 | 56% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN (COC) | $35.63 | $71.25 | $35.63–$71.25 | 56% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NONDOT DRUG SCREEN - OCC HLTH | $35.63 | $71.25 | $35.63–$71.25 | 56% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DCH 8-CLASS DRUG SCREEN | $36.63 | $73.25 | $62.14–$105.64 | 54% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DCH DRUG SCREEN-MERCEDES | $37.13 | $74.25 | $62.14–$105.64 | 54% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DCH 5-CLASS DRUG SCREEN | $37.13 | $74.25 | $62.14–$105.64 | 54% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DOT/NONDOT DRUG SCREEN - ED | $39.38 | $78.75 | $39.38–$78.75 | 51% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 LYSERGIC ACID DIETHYLAMIDE-URN | $45.63 | $91.25 | $62.14–$105.64 | 43% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 7-Aminoflunitrazepam Confirm | $88.25 | $176.50 | $88.25–$176.50 | 10% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Flunitrazepam Confirmation | $88.25 | $176.50 | $88.25–$176.50 | 10% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 VOLATILE BLOOD | $92.75 | $185.50 | $62.14–$105.64 | 15% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Srn Per Drug Class | $139.50 | $279.00 | $62.14–$105.64 | 74% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN CLIN URINE INST | $220.38 | $440.75 | $62.14–$105.64 | 174% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN MECONIUM INST | $220.38 | $440.75 | $220.38–$440.75 | 174% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 10 WB | $241.75 | $483.50 | $62.14–$105.64 | 201% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Flunitrazepam Screen | $310.25 | $620.50 | $310.25–$620.50 | 286% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 GABAPENTIN | $397.88 | $795.75 | $62.14–$105.64 | 395% above | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Sedative Hypnotic Panel Urine | $884.88 | $1,769.75 | $884.88–$1,769.75 | 1002% above | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES | $32.63 | $65.25 | $7.01–$11.92 | 34% below | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR AB PROFILE PT III | $27.63 | $55.25 | $27.63–$55.25 | 46% below | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgG | $60.75 | $121.50 | $18.14–$30.84 | 18% above | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgM ANTIBODY | $60.75 | $121.50 | $18.14–$30.84 | 18% above | 50% |
| Estradiol blood test CPT 82670 ESTRADIOL | $100.13 | $200.25 | $100.13–$200.25 | at median | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH (BLOOD) | $86.63 | $173.25 | $18.58–$31.59 | at median | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECES | $191.13 | $382.25 | $191.13–$382.25 | 2% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $41.13 | $82.25 | $13.63–$23.17 | 27% below | 50% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN LEVEL | $21.88 | $43.75 | $21.88–$43.75 | 53% below | 50% |
| Fibrinogen blood test CPT 85384 Fibrinogen Activity | $27.13 | $54.25 | $9.72–$16.52 | 41% below | 50% |
| Folate (folic acid) blood test CPT 82746 FOLATE LEVEL | $46.75 | $93.50 | $14.70–$24.99 | 24% below | 50% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $61.38 | $122.75 | $16.94–$28.80 | 11% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $43.88 | $87.75 | $43.88–$87.75 | 28% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE BY EQUILIBRIUM DIALYSI | $83.25 | $166.50 | $9.02–$15.33 | 37% above | 50% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $113.13 | $226.25 | $113.13–$226.25 | 52% above | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $32.63 | $65.25 | $7.20–$12.24 | 1% below | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST DOSE- ADDITIONAL | $15.88 | $31.75 | $15.88–$31.75 | 61% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL.6 HR 3 SPECIMENS | $42.25 | $84.50 | $12.87–$21.88 | 31% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL. 3 HR 3 SPECIMENS | $42.25 | $84.50 | $42.25–$84.50 | 31% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL. 4 HR 3 SPECIMENS | $42.25 | $84.50 | $42.25–$84.50 | 31% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL.5 HR 3 SPECIMENS | $42.25 | $84.50 | $12.87–$21.88 | 31% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NAA | $28.13 | $56.25 | $28.13–$56.25 | 60% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA NAA URINE | $58.00 | $116.00 | $35.09–$59.65 | 17% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Nuswab GC | $82.25 | $164.50 | $82.25–$164.50 | 18% above | 50% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori IGM AB | $36.63 | $73.25 | $16.85–$28.65 | 9% below | 50% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGA AB | $36.63 | $73.25 | $16.85–$28.65 | 9% below | 50% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGG AB | $89.50 | $179.00 | $16.85–$28.65 | 122% above | 50% |
| H. pylori antibody blood test CPT 86677 HELICO PYLORI AB SCREEN | $91.13 | $182.25 | $16.85–$28.65 | 126% above | 50% |
| H. pylori stool antigen test CPT 87338 HELICO PYLORI STOOL ANTIGEN | $114.13 | $228.25 | $14.38–$24.45 | 66% above | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA BY PCR | $196.13 | $392.25 | $196.13–$392.25 | 15% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV (VIRAL LOAD) QUANTITATIVE | $259.63 | $519.25 | $259.63–$519.25 | 12% above | 50% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 ANTIBODIES | $84.38 | $168.75 | $84.38–$168.75 | 183% above | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIGEN/ANTIBODY ASSAY | $84.38 | $168.75 | $84.38–$168.75 | 39% above | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES | $126.50 | $253.00 | $126.50–$253.00 | 155% above | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN TOTAL | $27.63 | $55.25 | $9.71–$16.51 | 8% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C (GLYCO HGB) | $38.88 | $77.75 | $38.88–$77.75 | 30% above | 50% |
| Hemoglobin blood test CPT 85018 G6PD HEMOGLOBIN | $5.75 | $11.50 | $5.75–$11.50 | 67% below | 50% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $19.75 | $39.50 | $19.75–$39.50 | 13% above | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB (HBcAB) | $77.75 | $155.50 | $77.75–$155.50 | 30% above | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB (HBsAB) | $118.63 | $237.25 | $10.74–$18.26 | 128% above | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG (HBsAG) | $74.25 | $148.50 | $10.33–$17.56 | 99% above | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $110.88 | $221.75 | $110.88–$221.75 | 54% above | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS RNA QUANT | $112.38 | $224.75 | $112.38–$224.75 | 42% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRUS RNA DIAGNOSIS | $307.50 | $615.00 | $42.84–$72.83 | 58% above | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANT ULTRA-SENS | $363.13 | $726.25 | $363.13–$726.25 | 87% above | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE-I IgG ANTIBODY | $25.38 | $50.75 | $25.38–$50.75 | 57% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE II IgG ANTIBODIES | $25.38 | $50.75 | $25.38–$50.75 | 60% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE II Ab SUPPLEMENTAL | $128.25 | $256.50 | $128.25–$256.50 | 104% above | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 High Sens C Reactive Protein | $31.13 | $62.25 | $12.95–$22.02 | 42% below | 50% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE SERUM | $147.25 | $294.50 | $17.92–$30.46 | 14% above | 50% |
| Insulin blood test CPT 83525 INSULIN | $80.00 | $160.00 | $11.43–$19.43 | 15% above | 50% |
| Iron blood test (serum iron) CPT 83540 IRON-SERUM | $27.13 | $54.25 | $27.13–$54.25 | 5% below | 50% |
| Iron blood test (serum iron) CPT 83540 IRON 24 HOUR URINE | $86.00 | $172.00 | $6.47–$11.00 | 202% above | 50% |
| Iron blood test (serum iron) CPT 83540 IRON QUANT-TISSUE | $149.00 | $298.00 | $149.00–$298.00 | 424% above | 50% |
| Kidney function blood test panel CPT 80069 KIDNEY STONE FORMER PRFL PT 1 | $15.25 | $30.50 | $15.25–$30.50 | 80% below | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $219.75 | $439.50 | $8.68–$14.76 | 187% above | 50% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH) | $125.38 | $250.75 | $18.52–$31.48 | 34% above | 50% |
| Lactate (lactic acid) blood test CPT 83605 ISTAT - LACTATE | $58.50 | $117.00 | $58.50–$117.00 | at median | 50% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $63.00 | $126.00 | $63.00–$126.00 | 8% above | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 KIDNEY STONE FORMER PRFL PT 18 | $11.38 | $22.75 | $11.38–$22.75 | 55% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH ISOENZYMES PT A | $17.50 | $35.00 | $17.50–$35.00 | 30% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH - SERUM | $29.88 | $59.75 | $6.04–$10.27 | 19% above | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH CSF/BODY FLUID | $40.63 | $81.25 | $40.63–$81.25 | 62% above | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $49.63 | $99.25 | $6.89–$11.71 | at median | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $102.88 | $205.75 | $102.88–$205.75 | 29% above | 50% |
| Lyme disease antibody test CPT 86618 LYME IgM REFLEX | $22.63 | $45.25 | $17.03–$28.95 | 69% below | 50% |
| Lyme disease antibody test CPT 86618 LYME IgG REFLEX | $22.63 | $45.25 | $17.03–$28.95 | 69% below | 50% |
| Lyme disease antibody test CPT 86618 LYME TOTAL ANTIBODY EIA | $22.63 | $45.25 | $17.03–$28.95 | 69% below | 50% |
| Lyme disease antibody test CPT 86618 LYME IGM ANTIBODIES | $73.75 | $147.50 | $73.75–$147.50 | at median | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $82.75 | $165.50 | $82.75–$165.50 | 13% above | 50% |
| Lyme disease antibody test CPT 86618 Lyme Disease Serology | $220.38 | $440.75 | $220.38–$440.75 | 200% above | 50% |
| Magnesium blood test CPT 83735 EXEC PROF MG | $5.00 | $10.00 | $6.70–$11.39 | 78% below | 50% |
| Magnesium blood test CPT 83735 KIDNEY STONE FORMER PRFL PT 7 | $12.50 | $25.00 | $12.50–$25.00 | 44% below | 50% |
| Magnesium blood test CPT 83735 KID STONE URINE PROF PART 9 | $17.00 | $34.00 | $6.70–$11.39 | 24% below | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM | $40.13 | $80.25 | $40.13–$80.25 | 78% above | 50% |
| Magnesium blood test CPT 83735 MAGNESIUM-24 HR URINE | $79.25 | $158.50 | $6.70–$11.39 | 252% above | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODIES IgG | $57.38 | $114.75 | $57.38–$114.75 | 30% above | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY IgM | $62.00 | $124.00 | $12.88–$21.90 | 41% above | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $38.38 | $76.75 | $38.38–$76.75 | 21% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS AB IgM | $43.88 | $87.75 | $13.05–$22.19 | at median | 50% |
| Mumps immunity blood test CPT 86735 MUMPS AB IgG | $45.13 | $90.25 | $13.05–$22.19 | 3% above | 50% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $501.25 | $1,002.50 | $501.25–$1,002.50 | 170% above | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $65.25 | $130.50 | $65.25–$130.50 | 5% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC | $80.00 | $160.00 | $18.39–$31.26 | 2% below | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THIN-LAYER DIAG | $69.75 | $139.50 | $20.26–$34.44 | 70% above | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 KIDNEY STONE FORMER PRFL PT 10 | $58.00 | $116.00 | $41.28–$70.18 | 57% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH HORMONE INTACT | $71.00 | $142.00 | $71.00–$142.00 | 48% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH CAP/CIP TOTAL | $116.88 | $233.75 | $41.28–$70.18 | 14% below | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH CAP | $116.88 | $233.75 | $41.28–$70.18 | 14% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $42.25 | $84.50 | $42.25–$84.50 | at median | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG DRVVT | $83.75 | $167.50 | $83.75–$167.50 | 98% above | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $112.38 | $224.75 | $6.01–$10.22 | 166% above | 50% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $36.13 | $72.25 | $4.74–$8.06 | 48% above | 50% |
| Potassium blood test CPT 84132 POTASSIUM (K) | $31.13 | $62.25 | $4.76–$8.09 | 13% above | 50% |
| Potassium blood test CPT 84132 ISTAT-K | $63.00 | $126.00 | $63.00–$126.00 | 129% above | 50% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHROMOSOMAL ANEUPLOIDY | $894.63 | $1,789.25 | $759.05–$1,290.39 | 11% below | 50% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MaterniT21 | $1,121.50 | $2,243.00 | $759.05–$1,290.39 | 12% above | 50% |
| Progesterone blood test CPT 84144 CAH-6 PROF - PART G | $55.13 | $110.25 | $55.13–$110.25 | 44% below | 50% |
| Progesterone blood test CPT 84144 PROGESTERONE | $81.50 | $163.00 | $20.86–$35.46 | 17% below | 50% |
| Prolactin blood test CPT 84146 PROLACTIN | $126.50 | $253.00 | $126.50–$253.00 | 22% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN.TIME (PT) | $24.25 | $48.50 | $24.25–$48.50 | 2% above | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $38.38 | $76.75 | $4.29–$7.29 | 61% above | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ANTIGEN | $52.38 | $104.75 | $16.55–$28.14 | 78% above | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A ANTIGEN | $52.38 | $104.75 | $16.55–$28.14 | 78% above | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 GROUP A STREP TEST | $37.88 | $75.75 | $16.53–$28.10 | 12% below | 50% |
| Renin blood test CPT 84244 RENIN ACTIVITY | $125.88 | $251.75 | $125.88–$251.75 | 42% above | 50% |
| Rh blood typing CPT 86901 RH TYPE POST-TRANSFUSION | $23.13 | $46.25 | $33.62–$57.15 | 7% below | 50% |
| Rh blood typing CPT 86901 RH TYPE PRE-TRANSFUSION | $23.13 | $46.25 | $33.62–$57.15 | 7% below | 50% |
| Rh blood typing CPT 86901 REF LAB FEE RH | $37.88 | $75.75 | $33.62–$57.15 | 53% above | 50% |
| Rh blood typing CPT 86901 RH TYPE | $37.88 | $75.75 | $33.62–$57.15 | 53% above | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACT QUANT | $47.38 | $94.75 | $47.38–$94.75 | 5% above | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (RF) | $79.25 | $158.50 | $79.25–$158.50 | 76% above | 50% |
| Rheumatoid factor (RF) test CPT 86431 GAD AUTOANTIBODY | $93.38 | $186.75 | $5.67–$9.64 | 108% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IgG | $24.88 | $49.75 | $14.39–$24.46 | 35% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY TOTAL | $77.00 | $154.00 | $77.00–$154.00 | 103% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES IgM | $92.25 | $184.50 | $92.25–$184.50 | 143% above | 50% |
| Sodium blood test CPT 84295 FENA PART A | $16.38 | $32.75 | $16.38–$32.75 | 31% below | 50% |
| Sodium blood test CPT 84295 SODIUM (NA) | $29.38 | $58.75 | $4.81–$8.18 | 24% above | 50% |
| Sodium blood test CPT 84295 ISTAT-NA | $64.25 | $128.50 | $64.25–$128.50 | 172% above | 50% |
| Stool ova and parasites exam CPT 87177 O P - FECES | $70.25 | $140.50 | $70.25–$140.50 | 55% above | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMAL ABS TPPA | $11.38 | $22.75 | $13.24–$22.51 | 70% below | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS SCRN - TREPONEMA AB | $59.13 | $118.25 | $59.13–$118.25 | 56% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $45.63 | $91.25 | $45.63–$91.25 | 76% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS SCREEN - RPR | $46.13 | $92.25 | $46.13–$92.25 | 77% above | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Gold (No Incubate) | $68.00 | $136.00 | $61.98–$105.37 | 41% below | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD | $153.50 | $307.00 | $153.50–$307.00 | 34% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $60.75 | $121.50 | $60.75–$121.50 | 14% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH-6 PROF - PART H | $68.13 | $136.25 | $68.13–$136.25 | 4% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH7-TESTOSTERONE | $72.00 | $144.00 | $72.00–$144.00 | 1% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $110.25 | $220.50 | $110.25–$220.50 | 55% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-MICROSOMAL ABS | $50.63 | $101.25 | $50.63–$101.25 | 15% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID ANTIBODIES PART II | $74.25 | $148.50 | $74.25–$148.50 | 69% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab (RDL) | $83.25 | $166.50 | $14.55–$24.74 | 89% above | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVR/KIDNY MICROSOMAL ABS | $95.13 | $190.25 | $14.55–$24.74 | 116% above | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH(THYROID STIMULATING HORMON | $55.13 | $110.25 | $55.13–$110.25 | 2% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH HIGH SENSITIVITY | $63.63 | $127.25 | $63.63–$127.25 | 14% above | 50% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE | $50.63 | $101.25 | $16.46–$27.98 | 2% above | 50% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $80.50 | $161.00 | $4.35–$7.40 | 162% above | 50% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) | $9.75 | $19.50 | $9.75–$19.50 | 80% below | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL | $60.75 | $121.50 | $60.75–$121.50 | 27% above | 50% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $55.13 | $110.25 | $55.13–$110.25 | at median | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS NAA | $28.13 | $56.25 | $28.13–$56.25 | 60% below | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS NAA URINE | $58.00 | $116.00 | $35.09–$59.65 | 17% below | 50% |
| Trichomonas test (NAAT) CPT 87661 Nuswab Trichomonas | $82.25 | $164.50 | $82.25–$164.50 | 18% above | 50% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $43.38 | $86.75 | $43.38–$86.75 | 38% above | 50% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $60.75 | $121.50 | $60.75–$121.50 | 13% below | 50% |
| Uric acid blood test CPT 84550 EXEC PROF URIC ACID | $5.00 | $10.00 | $4.52–$7.68 | 83% below | 50% |
| Uric acid blood test CPT 84550 KIDNEY STONE FORMER PRFL PT 20 | $10.25 | $20.50 | $10.25–$20.50 | 66% below | 50% |
| Uric acid blood test CPT 84550 URIC ACID | $36.63 | $73.25 | $36.63–$73.25 | 23% above | 50% |
| Urinalysis with microscope exam, automated CPT 81001 EXEC PROF UA | $5.00 | $10.00 | $3.17–$5.39 | 84% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MIC | $52.38 | $104.75 | $52.38–$104.75 | 69% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 KIDNEY STONE FORMER PRFL PT 6 | $5.75 | $11.50 | $2.25–$3.83 | 74% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 KID STONE URINE PROF PART 14 | $17.00 | $34.00 | $2.25–$3.83 | 22% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 ALBUMIN URINE QUAL | $23.75 | $47.50 | $23.75–$47.50 | 8% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS w/o MIC | $27.63 | $55.25 | $27.63–$55.25 | 26% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINE GLUCOSE ACETONE | $33.38 | $66.75 | $2.25–$3.83 | 52% above | 50% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY-URINE | $41.63 | $83.25 | $2.25–$3.83 | 90% above | 50% |
| Urinalysis without microscope exam, manual CPT 81002 BILE | $15.88 | $31.75 | $15.88–$31.75 | 35% above | 50% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE COL CT | $79.25 | $158.50 | $8.07–$13.72 | 49% above | 50% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN | $23.75 | $47.50 | $5.78–$9.83 | 42% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST(URINE) | $36.63 | $73.25 | $36.63–$73.25 | 4% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $44.50 | $89.00 | $44.50–$89.00 | 16% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $58.50 | $117.00 | $29.60–$50.32 | 38% below | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 KIDNEY STONE FORMER PRFL PT 16 | $54.63 | $109.25 | $54.63–$109.25 | 59% below | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DIHYDROXY | $109.13 | $218.25 | $109.13–$218.25 | 19% below | 50% |
| Zinc blood test CPT 84630 ZINC RANDOM URINE | $26.50 | $53.00 | $26.50–$53.00 | 43% below | 50% |
| Zinc blood test CPT 84630 ZINC | $46.13 | $92.25 | $46.13–$92.25 | at median | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP TETRA PART 3 | $33.38 | $66.75 | $15.05–$25.59 | 42% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP EXTRA PART 2 | $48.38 | $96.75 | $15.05–$25.59 | 15% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE | $83.75 | $167.50 | $15.05–$25.59 | 47% above | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA SUB UNIT | $133.88 | $267.75 | $133.88–$267.75 | 134% above | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Alabama | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Core Biopsy Lt Stereo | $1,447.88 | $2,895.75 | $900.00–$1,948.00 | 33% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 Breast Core Biopsy Rt Stereo | $1,447.88 | $2,895.75 | $347.49–$2,895.75 | 33% below | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CL TX DSTL FIB FX WO MANIP LT | $241.13 | $482.25 | $57.87–$482.25 | 11% below | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 CL TX DSTL FIB FX WO MANIP RT | $241.13 | $482.25 | $57.87–$482.25 | 11% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION 92960 | $483.25 | $966.50 | $594.88–$2,250.00 | 38% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $483.25 | $966.50 | $483.25–$966.50 | 38% below | 50% |
| Catheter ablation for atrial fibrillation CPT 93656 CMP EVAL ABL AFIB PULMVEIN ISO | $14,157.38 | $28,314.75 | $3,850.00–$39,992.75 | 44% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIUS/ULNA FX 25600 | $274.13 | $548.25 | $222.01–$377.42 | at median | 50% |
| Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL | $11,853.50 | $23,707.00 | $10,390.24–$17,663.42 | 1% below | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $710.75 | $1,421.50 | $710.75–$1,421.50 | 56% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED EARWAX 69209LT | $64.75 | $129.50 | $15.54–$129.50 | 35% below | 50% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED EARWAX 69209RT | $64.75 | $129.50 | $15.54–$129.50 | 35% below | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX 69210 | $64.75 | $129.50 | $64.75–$129.50 | 34% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACTED EARWAX 69210RT | $64.75 | $129.50 | $15.54–$129.50 | 34% below | 50% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACTED EARWAX 69210LT | $64.75 | $129.50 | $15.54–$129.50 | 34% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUMBAR FACET 1 | $876.50 | $1,753.00 | $796.06–$1,704.00 | 18% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJECTION | $876.50 | $1,753.00 | $796.06–$1,704.00 | 18% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUM. FACET #1 | $876.50 | $1,753.00 | $796.06–$1,704.00 | 18% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HSG INJECTION | $46.38 | $92.75 | $11.13–$92.75 | 78% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS 10060 | $251.25 | $502.50 | $251.25–$502.50 | 10% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE SKIN SUBCU | $251.25 | $502.50 | $122.00–$2,795.00 | 10% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJ JT | $282.63 | $565.25 | $276.27–$2,795.00 | 27% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ. JNT/BURSA 20610 | $282.63 | $565.25 | $276.27–$469.66 | 27% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Inj Major Jt LT | $282.63 | $565.25 | $1,500.00–$2,795.00 | 27% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROGRAM HIP INJ RT | $282.63 | $565.25 | $1,500.00–$2,795.00 | 27% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ. JNT/BURSA 20605 | $217.00 | $434.00 | $276.27–$469.66 | 35% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROSENTESIS INTERM JT | $304.63 | $609.25 | $276.27–$2,795.00 | 9% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROSENTESIS SM JT | $304.63 | $609.25 | $276.27–$2,795.00 | 21% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE WOUND 12031 | $276.88 | $553.75 | $365.88–$622.00 | 28% below | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NM Cisternogram inj w/imaging | $1,134.88 | $2,269.75 | $635.32–$1,704.00 | 16% below | 50% |
| 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/< | $607.50 | $1,215.00 | $607.50–$1,215.00 | 31% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE 11730 | $150.13 | $300.25 | $150.13–$300.25 | 33% below | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAG 49083 | $904.63 | $1,809.25 | $816.32–$1,387.75 | at median | 50% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS ASPIRATION | $904.63 | $1,809.25 | $816.32–$1,704.00 | at median | 50% |
| Paracentesis with imaging guidance CPT 49083 ANGIO US PARACENTESIS | $904.63 | $1,809.25 | $816.32–$1,704.00 | at median | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED 11750 | $345.63 | $691.25 | $345.63–$691.25 | 38% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY 10120 | $291.13 | $582.25 | $291.13–$582.25 | 44% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 Apply short arm splint | $104.13 | $208.25 | $119.75–$203.57 | 40% below | 50% |
| Short leg splint (calf to foot) CPT 29515 Apply short leg splint | $104.13 | $208.25 | $104.13–$208.25 | 38% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFIC WOUND/S 12001 | $168.63 | $337.25 | $168.63–$337.25 | 24% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS<15 LESIONS 11200 | $126.50 | $253.00 | $126.50–$253.00 | 57% below | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGN 62270 | $674.88 | $1,349.75 | $674.88–$1,349.75 | at median | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFIC WOUND 12002 | $195.38 | $390.75 | $195.38–$390.75 | 15% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP SUPERFIC WOUND 12011 | $220.63 | $441.25 | $220.63–$441.25 | 1% below | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,236.00 | $2,472.00 | $1,236.00–$2,472.00 | 17% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING | $1,236.00 | $2,472.00 | $564.60–$1,704.00 | 17% above | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1/2 MUSC 20552 | $191.13 | $382.25 | $191.13–$382.25 | 40% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Rt | $1,447.88 | $2,895.75 | $900.00–$1,948.00 | 40% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Vacuum Assist Bx Lt | $1,447.88 | $2,895.75 | $900.00–$1,948.00 | 40% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Lt | $1,447.88 | $2,895.75 | $900.00–$1,948.00 | 40% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Vacuum Assist Bx Rt | $1,447.88 | $2,895.75 | $900.00–$1,948.00 | 40% below | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UGI BALLOON DIL ESOPH <30 MM | $2,167.25 | $4,334.50 | $1,727.10–$2,936.06 | 18% below | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UGI W BX. SGL/MULTIPLE 43239 | $664.63 | $1,329.25 | $664.63–$1,329.25 | 66% below | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $679.38 | $1,358.75 | $816.32–$1,387.75 | 62% below | 50% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $477.63 | $955.25 | $180.58–$306.98 | 39% above | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid Subq Tissue 20 SQ CM/< | $604.00 | $1,208.00 | $365.88–$2,795.00 | 5% above | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SKIN/TISSUE 20SQ CM< 11042 | $604.00 | $1,208.00 | $604.00–$1,208.00 | 5% above | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Alabama | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT ADMINISTRATION | $309.00 | $618.00 | $309.00–$618.00 | 21% below | 50% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $309.00 | $618.00 | $309.00–$618.00 | 21% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 POSITIVE AIRWAY PRESSURE TX | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN 1ST DAILY | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN SUBSEQUENT | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN WITH BAN SUBSEQUENT | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI/DPI TREATMENT 1ST DAILY | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT 1ST DAILY | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT SUBSEQUENT | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TREATMENT SUBSEQUENT | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN TREATMENT INITIAL | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TREATMENT INITIAL | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL-O2/AIR DAILY | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL-O2/AIR DAY 1 | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN TREATMENT SUBSEQUENT | $138.88 | $277.75 | $197.09–$335.05 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INDUCED SPUTUM COLLECT | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTRAPULMONARY PERCUSS SUBSEQ | $138.88 | $277.75 | $138.88–$277.75 | 11% above | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION 1ST HOUR | $310.25 | $620.50 | $310.25–$620.50 | 31% below | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION FIRST HOUR | $310.25 | $620.50 | $297.29–$505.39 | 31% below | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehens Audio Thres SpRec | $121.38 | $242.75 | $115.81–$196.88 | 24% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE > 30 MIN | $1,067.50 | $2,135.00 | $743.46–$1,575.00 | 3% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG REGULAR TRACING ONLY | $80.75 | $161.50 | $80.75–$161.50 | 27% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $160.75 | $321.50 | $160.75–$321.50 | 46% above | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL I - may not req phy/qhp | $112.38 | $224.75 | $75.89–$140.00 | 21% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL II | $168.63 | $337.25 | $138.20–$275.00 | 33% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL III | $281.00 | $562.00 | $245.69–$650.00 | 20% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL IV | $449.50 | $899.00 | $375.55–$950.00 | 21% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL V | $674.25 | $1,348.50 | $536.00–$1,575.00 | 17% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 GRADED EXERCISE TEST/STRESS | $504.63 | $1,009.25 | $504.63–$1,009.25 | 17% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST/TRACING EXT PHAR | $504.63 | $1,009.25 | $194.34–$330.38 | 17% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 GRADED EXERCISE TEST | $504.63 | $1,009.25 | $504.63–$1,009.25 | 17% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION UP TO 1 HOUR | $232.50 | $465.00 | $191.44–$325.45 | 1% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION FIRST HOUR | $232.50 | $465.00 | $232.50–$465.00 | 1% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION 1st HOUR | $232.50 | $465.00 | $191.44–$325.45 | 20% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion 1st hr 16-60 mins | $232.50 | $465.00 | $232.50–$465.00 | 20% below | 50% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion 1st hr 16-60 mins | $232.50 | $465.00 | $191.44–$325.45 | 20% below | 50% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH1st | $172.25 | $344.50 | $172.25–$344.50 | 20% above | 50% |
| IV push of a medicine, first drug CPT 96374 INJECTION IV/PUSH 1st DRUG | $172.25 | $344.50 | $191.44–$325.45 | 20% above | 50% |
| IV push of a medicine, first drug CPT 96374 INJECTION-INTRAVENOUS | $172.25 | $344.50 | $172.25–$344.50 | 20% above | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection | $42.00 | $84.00 | $64.80–$110.17 | 36% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ. SUBCU/INTRAMUSCULAR | $47.38 | $94.75 | $64.80–$110.17 | 28% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ/IM | $47.38 | $94.75 | $47.38–$94.75 | 28% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ANTIBIOTIC INJECTION | $47.38 | $94.75 | $64.80–$110.17 | 28% below | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 RHOGAM IM INJ ADMINISTRATION | $47.38 | $94.75 | $47.38–$94.75 | 28% below | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL VISIT 30 MIN | $84.38 | $168.75 | $84.38–$168.75 | 63% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL VISIT 45 MIN | $126.50 | $253.00 | $35.63–$60.57 | 144% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL VISIT 60 MIN | $168.63 | $337.25 | $35.63–$60.57 | 226% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL VISIT 75 MIN | $210.75 | $421.50 | $35.63–$60.57 | 307% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL VISIT 90 MIN | $252.88 | $505.75 | $35.63–$60.57 | 388% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation 3-10 min | $28.13 | $56.25 | $33.72–$57.33 | 22% below | 50% |
| Spirometry (breathing test) CPT 94010 PFT LAB SPIROMETRY | $165.88 | $331.75 | $165.88–$331.75 | 4% below | 50% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $165.88 | $331.75 | $165.88–$331.75 | 4% below | 50% |
| Spirometry (breathing test) CPT 94010 BEDSIDE FV LOOP | $165.88 | $331.75 | $194.34–$330.38 | 4% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY BEFORE AFTER TEST | $244.50 | $489.00 | $244.50–$489.00 | 22% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 PFT LAB SPIROMETRY PRE/POST | $244.50 | $489.00 | $335.86–$570.96 | 22% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 BEDSIDE FV LOOP PRE/POST | $244.50 | $489.00 | $335.86–$570.96 | 22% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $79.50 | $159.00 | $119.75–$203.57 | 28% below | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Alabama | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VAC24-25(12+)30mcg/0.3ml | $376.07 | $752.13 | $90.26–$752.13 | 55% below | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VAC24-25(12+)30mcg/0.3ml | $376.07 | $752.13 | $90.26–$752.13 | — | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE INJ | $526.27 | $1,052.54 | $126.30–$1,052.54 | 7% above | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX 0.5ML INJ | $75.19 | $150.37 | $18.04–$150.37 | 32% below | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vacc TS 25-26(6m-64y)0.5ml | $55.36 | $110.72 | $13.29–$110.72 | 3% above | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A-B vaccine (per1) | $360.06 | $720.12 | $86.41–$720.12 | at median | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hep B vacc adult 3 dose IM | $196.60 | $393.20 | $47.18–$393.20 | 31% above | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Heplisav-B vac 20mcg/0.5ml (1) | $428.32 | $856.63 | $102.80–$856.63 | 3% below | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Heplisav-B vac 20mcg/0.5ml (1) | $428.32 | $856.63 | $102.80–$856.63 | — | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepb vacc ped/adol 3 dose IM | $78.38 | $156.75 | $18.81–$156.75 | 4% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B 5MCG INJ | $78.43 | $156.86 | $18.82–$156.86 | 4% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HiB TITER PF INJ | $36.19 | $72.38 | $8.69–$72.38 | 9% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vacc HD TS 25-26(65+)0.5ml | $235.07 | $470.14 | $56.42–$470.14 | 82% above | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAP ENCEPH 6 MCG/0.5 ML SYR | $811.47 | $1,622.94 | $194.75–$1,622.94 | at median | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAP ENCEPH 6 MCG/0.5 ML SYR | $811.47 | $1,622.94 | $194.75–$1,622.94 | — | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE INJ | $263.29 | $526.57 | $63.19–$526.57 | 65% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC ACYW-135 0.5ML INJ | $456.50 | $913.00 | $109.56–$913.00 | 35% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VAC ACYW-135 0.5ML INJ | $456.50 | $913.00 | $109.56–$913.00 | — | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menningococcal B Vac 0.5 ml vl | $650.05 | $1,300.09 | $156.01–$1,300.09 | 3% below | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menningococcal B Vac 0.5 ml vl | $650.05 | $1,300.09 | $156.01–$1,300.09 | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20-Val Vac 0.5ml | $776.77 | $1,553.53 | $186.42–$1,553.53 | 5% below | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal 20-Val Vac 0.5ml | $776.77 | $1,553.53 | $186.42–$1,553.53 | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSACCHARIDE | $321.97 | $643.94 | $77.27–$643.94 | 67% above | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VAC INJ | $1,294.18 | $2,588.36 | $310.60–$2,588.36 | 857% above | 50% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VAC INJ | $1,294.18 | $2,588.36 | $310.60–$2,588.36 | — | 50% |
| Rabies vaccine, one dose CPT 90675 Rabies vaccine IM | $1,290.33 | $2,580.66 | $1,290.33–$2,580.66 | 92% above | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies vaccine IM | $1,290.33 | $2,580.66 | $1,290.33–$2,580.66 | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIP/TET TOX PF >=7 IM inj | $122.13 | $244.26 | $29.31–$244.26 | 119% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap vaccine 7 yrs/> im | $132.64 | $265.27 | $31.83–$265.27 | at median | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 MENING VACCINE ADMINISTRATION | $42.00 | $84.00 | $64.80–$110.17 | 30% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE | $47.38 | $94.75 | $47.38–$94.75 | 21% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM; EA ADDTL VAC | $33.88 | $67.75 | $8.13–$67.75 | 32% below | 50% |
Source file: https://dch.pt.panaceainc.com/MRFDownload/dch/fayette