Community Medical Center
Community Medical Center in Toms River, NJ publishes cash prices for 457 common procedures listed here, from its own machine-readable price file updated Mar 4, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Jersey median for 304 of 451 procedures and above it for 115. By typical cash price it ranks #15 of 55 New Jersey hospitals and #38 of 86 hospitals in the New York, NY area, cheapest first. Select a procedure to compare it with other hospitals nearby.
99 NJ-37, Toms River, NJ 08755 Collected Oct 29, 2026 Source price file Check a bill from this hospital (732) 557-8000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 1 of 5 CCN 310041 · CMS hospital register NPI 1013010917
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Community 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.
State law
This state limits hospital bills for lower-income patients
Why New Jersey prices look low: under state law (P.L.2008, c.60), a hospital may not charge an uninsured New Jersey resident whose family income is below 500% of the federal poverty level more than 115% of what Medicare pays for the same service. If that is you, ask the hospital's billing office to apply this limit; a separate physician fee may still apply. Other states' laws.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Community Medical Center in Toms River, NJ:
- Apr 19, 2021 Warning notice
- Sep 30, 2021 Corrective action plan requested
- Feb 11, 2022 Case closed
- Mar 28, 2025 Met requirements
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New Jersey | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W&W/O Contrast | $775.46 | $3,739.00 | $194.55–$3,420.81 | 12% above | 79% |
| Abdominal X-ray, 2 views CPT 74019 HC Xr Abdomen 2 Views | $108.67 | $524.00 | $32.67–$479.40 | 12% below | 79% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Doppler Arterial Ext Ltd Bil | $186.86 | $901.00 | $111.81–$2,452.00 | 6% above | 79% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Xr Esophagus Sngl Contrast | $226.89 | $1,094.00 | $45.92–$1,000.90 | 8% above | 79% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Bone Wb | $498.58 | $2,404.00 | $123.00–$2,199.41 | 5% below | 79% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC Cta Abd/Pel W/WO Con Postproc | $893.47 | $4,308.00 | $221.00–$3,941.38 | 40% above | 79% |
| CT angiography (CTA) of the head CPT 70496 HC Cta Head W&W/O Contrast | $540.89 | $2,608.00 | $194.55–$2,386.05 | at median | 79% |
| CT angiography (CTA) of the neck CPT 70498 HC Cta Neck W&W/O Contrast | $674.25 | $3,251.00 | $194.55–$2,974.33 | at median | 79% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta Chest W&W/O Contrast | $833.12 | $4,017.00 | $194.55–$3,675.15 | 10% above | 79% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Cta Heart W/Con W/3d Image | $473.90 | $2,285.00 | $221.00–$2,090.54 | 1% below | 79% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast | $630.49 | $3,040.00 | $155.96–$2,781.29 | at median | 79% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd & Pelvis W/ Contrast | $747.67 | $3,605.00 | $221.00–$3,298.21 | at median | 79% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd & Pelv W&W/O Cont 1+Reg | $943.46 | $4,549.00 | $221.00–$4,161.88 | 1% above | 79% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/ Contrast | $620.12 | $2,990.00 | $194.55–$2,735.55 | 9% above | 79% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O Contrast | $415.00 | $2,001.00 | $116.22–$1,830.71 | 7% below | 79% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Max/Facial W/O Contrast | $433.88 | $2,092.00 | $116.22–$1,913.97 | 14% below | 79% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head/Brain W/O Contrast | $432.42 | $2,085.00 | $116.22–$1,907.56 | 4% above | 79% |
| CT scan of the head with contrast CPT 70460 HC CT Head/Brain W/ Contrast | $478.05 | $2,305.00 | $194.55–$2,108.84 | at median | 79% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head/Brain W&W/O Contrast | $608.51 | $2,934.00 | $194.55–$2,684.31 | at median | 79% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-Spine W/O Contrast | $434.08 | $2,093.00 | $116.22–$1,914.88 | 19% below | 79% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT C-Spine W/O Contrast | $458.14 | $2,209.00 | $116.22–$2,021.01 | 17% below | 79% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/ Contrast | $531.56 | $2,563.00 | $194.55–$2,344.88 | 2% above | 79% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Duplex Extracranial Bilat | $385.97 | $1,861.00 | $230.95–$2,452.00 | — | 79% |
| Chest CT scan without and with contrast CPT 71270 HC CT Thorax W&W/O Contrast | $757.42 | $3,652.00 | $194.55–$3,341.21 | 2% below | 79% |
| Chest X-ray, 2 views CPT 71046 HC Xr Chest 2 Views | $105.77 | $510.00 | $30.85–$466.59 | 6% below | 79% |
| Chest X-ray, single view CPT 71045 HC Xr Chest 1 View | $102.45 | $494.00 | $18.99–$451.96 | 2% below | 79% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitioneal Cmpl | $206.15 | $994.00 | $108.24–$909.41 | 1% below | 79% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Xr Bone Density Axial | $180.02 | $868.00 | $76.93–$794.13 | 27% above | 79% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Xr Bone Density Appendicular | $101.00 | $487.00 | $31.85–$445.55 | 3% below | 79% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax W/O Contrast | $455.24 | $2,195.00 | $116.22–$2,008.20 | 15% below | 79% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax W/ Contrast | $618.67 | $2,983.00 | $194.55–$2,729.14 | 1% above | 79% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammo Diagn W/ Cad Bilat | $162.39 | $783.00 | $97.17–$716.36 | — | 79% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Arterial Lwr Ext Bilat | $513.93 | $2,478.00 | $264.17–$2,452.00 | — | 79% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Venous Ext Bilat | $418.53 | $2,018.00 | $250.43–$2,452.00 | — | 79% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2d W/Spec/Color Compl | $776.50 | $3,744.00 | $310.35–$3,425.38 | 6% above | 79% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2d W/Spec/Color W/Contrast | $854.07 | $4,118.00 | $310.35–$3,767.55 | 17% above | 79% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbit/Sel/Fos/Ear W/O Con | $417.49 | $2,013.00 | $116.22–$1,841.69 | at median | 79% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC Xr Facial Bones 3+V | $111.16 | $536.00 | $32.80–$490.38 | 21% below | 79% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM Hepatobil Sys W/Gb if Pres | $568.48 | $2,741.00 | $240.75–$2,507.74 | 11% above | 79% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Study Unattended | $579.26 | $2,793.00 | $170.99–$4,310.00 | 56% above | 79% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Psg 4+ Param 6+ Yrs W/Cpap | $1,849.59 | $8,918.00 | $1,106.72–$8,159.07 | 36% above | 79% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Ltd | $195.37 | $942.00 | $72.16–$861.83 | 19% above | 79% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Low Dose Lung Cancer Screen | $426.62 | $2,057.00 | $116.22–$1,881.94 | 201% above | 79% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head W/O Con | $696.44 | $3,358.00 | $264.17–$3,072.23 | at median | 79% |
| MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen W/O Con | $642.52 | $3,098.00 | $264.17–$2,834.36 | at median | 79% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W&W/O Con | $942.01 | $4,542.00 | $326.00–$4,155.47 | at median | 79% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Con | $680.06 | $3,279.00 | $264.17–$2,999.95 | 2% above | 79% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W&W/O Con | $1,044.88 | $5,038.00 | $326.00–$4,609.26 | 2% above | 79% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI L-Spine W/O Con | $591.91 | $2,854.00 | $264.17–$2,611.12 | at median | 79% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI L-Spine W&W/O Con | $1,007.75 | $4,859.00 | $326.00–$4,445.49 | at median | 79% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI T-Spine W/O Con | $621.37 | $2,996.00 | $264.17–$2,741.04 | at median | 79% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI C-Spine W&W/O Con | $1,018.12 | $4,909.00 | $326.00–$4,491.24 | 2% above | 79% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI C-Spine W/O Con | $571.59 | $2,756.00 | $264.17–$2,521.46 | at median | 79% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W&W/O Con | $1,054.21 | $5,083.00 | $326.00–$4,650.43 | 1% above | 79% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Con | $662.22 | $3,193.00 | $264.17–$2,921.27 | at median | 79% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Xr C-Spine 4 or 5 Views | $172.76 | $833.00 | $42.05–$762.11 | 1% below | 79% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck W/ Contrast | $623.23 | $3,005.00 | $194.55–$2,749.27 | 5% above | 79% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Neck W/O Contrast | $445.70 | $2,149.00 | $116.22–$1,966.12 | 12% below | 79% |
| Neck soft tissue X-ray CPT 70360 HC Xr Neck Soft Tissue | $83.78 | $404.00 | $21.17–$369.61 | 25% below | 79% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM Hrt Muscle Image Spect Mult | $1,017.08 | $4,904.00 | $275.52–$4,486.66 | 34% below | 79% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O Contrast | $418.94 | $2,020.00 | $116.22–$1,848.09 | at median | 79% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvis Ltd Non-OB | $82.54 | $398.00 | $49.39–$364.13 | 38% below | 79% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvis Cmpl Non-OB | $236.02 | $1,138.00 | $108.24–$1,041.15 | at median | 79% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg Abd >14 Wks 1st Gest | $193.08 | $931.00 | $105.94–$851.77 | 2% above | 79% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg Abd < 14 Wks 1st Gest | $154.09 | $743.00 | $90.20–$679.77 | 9% above | 79% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Preg Limited 1 or > Fetuses | $183.34 | $884.00 | $57.40–$808.77 | 1% above | 79% |
| Screening mammogram, both breasts both sides CPT 77067 HC Mammo Screen 2v W/ Cad Bi | $131.49 | $634.00 | $78.67–$580.04 | — | 79% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Xr Sinuses 3+V | $93.74 | $452.00 | $45.10–$413.53 | 17% below | 79% |
| Skull X-ray, fewer than 4 views CPT 70250 HC Xr Skull Ltd <4v | $105.15 | $507.00 | $30.88–$463.85 | 13% below | 79% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Psg 4+ Parameters 6+ Yrs | $1,614.19 | $7,783.00 | $965.87–$7,120.66 | 23% above | 79% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Rest & Stress W/Cont Mont | $788.74 | $3,803.00 | $237.15–$3,479.36 | 12% above | 79% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo Rest&Stress W/Mont&Cntrst | $867.55 | $4,183.00 | $237.15–$3,827.02 | 24% above | 79% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Xr Swallow Cine/Video Cntrst | $216.11 | $1,042.00 | $66.47–$953.32 | 5% below | 79% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT T-Spine W/O Contrast | $416.45 | $2,008.00 | $116.22–$1,837.11 | 14% below | 79% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Non-OB Transvaginal | $221.71 | $1,069.00 | $116.22–$978.02 | at median | 79% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US Pregnancy Transvaginal | $161.97 | $781.00 | $96.92–$714.53 | 14% above | 79% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Cmpl | $226.27 | $1,091.00 | $108.24–$998.15 | 2% above | 79% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum | $188.31 | $908.00 | $84.79–$830.72 | at median | 79% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Soft Tissue Head/Neck | $231.04 | $1,114.00 | $67.14–$1,019.19 | at median | 79% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xr Ugi Sngl Cntrst | $217.35 | $1,048.00 | $78.52–$958.81 | 6% below | 79% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study both sides CPT 93971 HC Duplex Venous Ext Uni/Ltd Bi | $370.00 | $1,784.00 | $116.22–$2,452.00 | — | 79% |
| X-ray of the abdomen, 1 view CPT 74018 HC Xr Abdomen 1 View | $90.42 | $436.00 | $26.76–$398.89 | 19% below | 79% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Xr L-Spine 2-3v | $110.54 | $533.00 | $36.08–$487.64 | 15% below | 79% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Xr L-Spine 4+V | $163.43 | $788.00 | $45.10–$720.94 | 2% above | 79% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Xr T-Spine 2v | $111.16 | $536.00 | $30.59–$490.38 | 17% below | 79% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Xr Nasal Cmpl 3+V | $90.84 | $438.00 | $27.06–$400.72 | 20% below | 79% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Xr C-Spine 2 or 3v | $111.37 | $537.00 | $29.11–$491.30 | 5% below | 79% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xr Pelvis 1-2v | $102.45 | $494.00 | $27.06–$451.96 | 18% below | 79% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Xr Sacrum/Coccyx 2+V | $111.37 | $537.00 | $27.06–$491.30 | 5% below | 79% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New Jersey | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC Assay of Acth - Acth | $42.48 | $286.00 | $18.15–$261.66 | 4% below | 85% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Transferase Alanine Amino (Alt) (Sgpt) - Alt (Sgpt) | $5.83 | $101.00 | $2.49–$92.40 | 4% below | 94% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase Aspartate Amino (Ast) (Sgot) - Ast (Sgot) | $5.70 | $44.00 | $2.43–$40.25 | 4% below | 87% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Hepatitis Panel,Acute | $52.39 | $618.00 | $22.39–$565.40 | 4% below | 92% |
| Albumin blood test CPT 82040 HC Assay of Serum Albumin - Albumin | $5.45 | $60.00 | $2.33–$54.89 | 4% below | 91% |
| Aldosterone blood test CPT 82088 HC Assay of Aldosterone | $44.83 | $294.00 | $19.15–$268.98 | 4% below | 85% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Assay Alkal Phosphatase - Alkaline Phosphatase | $5.70 | $62.00 | $2.43–$56.72 | 4% below | 91% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allg Spec Ige Crude Xtrc Ea | $5.74 | $73.00 | $2.45–$66.78 | 4% below | 92% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein Serum | $18.45 | $218.00 | $7.88–$199.44 | 4% below | 92% |
| Ammonia blood test CPT 82140 HC Assay of Ammonia - Ammonia | $16.03 | $171.00 | $6.85–$156.44 | 4% below | 91% |
| Amylase blood test CPT 82150 HC Assay of Amylase | $7.13 | $116.00 | $3.05–$106.12 | 4% below | 94% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Cirullinated Peptide Antibody - Cyclic Citrul Peptide Antibdy | $14.25 | $148.00 | $6.09–$135.40 | 4% below | 90% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies - Ana (Antinuclear Antibodies) | $13.30 | $175.00 | $5.68–$160.10 | at median | 92% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide | $43.19 | $314.00 | $18.45–$287.27 | 4% below | 86% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Othr Specimn Aerobic | $9.48 | $188.00 | $4.05–$172.00 | 4% below | 95% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel Calcium Total | $9.31 | $164.00 | $3.98–$150.04 | 4% below | 94% |
| Bilirubin blood test, total CPT 82247 HC Bilirubin Total | $5.52 | $58.00 | $2.36–$53.06 | 4% below | 90% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Level IV Surg Pathology Gross&Microscopic Exam | $88.97 | $429.00 | $23.57–$392.49 | 9% below | 79% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Prostate Biopsy Any Method | $88.97 | $429.00 | $23.57–$392.49 | 9% below | 79% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture | $9.71 | $52.00 | $1.65–$47.57 | at median | 81% |
| Blood glucose (sugar) test CPT 82947 HC Assay Quantitative,Blood Glucose | $4.32 | $46.00 | $1.85–$42.08 | 4% below | 91% |
| Blood lead test CPT 83655 HC Assay of Lead | $13.32 | $263.00 | $5.69–$240.61 | 4% below | 95% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Chorionic Gonadotropin, Qual - Hcg Qualitative | $8.27 | $99.00 | $3.53–$90.57 | 4% below | 92% |
| Blood urea nitrogen (BUN) test CPT 84520 HC Assay Urea Nitrogen | $4.35 | $43.00 | $1.86–$39.34 | 4% below | 90% |
| C-peptide blood test CPT 84681 HC Assay of C-Peptide - C-Peptide | $22.89 | $218.00 | $9.78–$199.44 | 4% below | 90% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein - C-Reactive Protein | $5.70 | $83.00 | $2.43–$75.93 | 4% below | 93% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Amplified Probe | $41.00 | $269.00 | $17.52–$246.10 | 4% below | 85% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9 | $22.89 | $214.00 | $9.78–$195.78 | 4% below | 89% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay, Tumor Antigen, Ca 125 - Ca 125 | $22.89 | $183.00 | $9.78–$167.42 | 4% below | 87% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid Rucdr Saliva Testing | $56.44 | $129.00 | $17.51–$209.62 | at median | 56% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid 19 Lab Test Non-Cdc | $56.44 | $129.00 | $17.51–$209.62 | at median | 56% |
| Calcium blood test, total CPT 82310 HC Assay of Calcium, Total - Calcium | $5.68 | $58.00 | $2.43–$53.06 | 4% below | 90% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen) | $20.86 | $269.00 | $8.91–$246.10 | 4% below | 92% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella-Zoster Antibody | $14.17 | $177.00 | $6.05–$161.93 | 4% below | 92% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr | $38.60 | $253.00 | $16.49–$231.46 | 4% below | 85% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $14.73 | $247.00 | $6.29–$225.98 | 4% below | 94% |
| Complete blood count (CBC) with differential CPT 85025 HC Complete Cbc & Auto Diff Wbc - Additional Charge | $8.55 | $146.00 | $3.65–$133.57 | 4% below | 94% |
| Complete blood count (CBC), no differential CPT 85027 HC Complete Cbc Automated | $7.12 | $102.00 | $3.04–$93.31 | 4% below | 93% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Metabolic Panel,Comprehensive | $11.62 | $328.00 | $4.96–$300.08 | 4% below | 96% |
| Cortisol blood test, total CPT 82533 HC Total Cortisol | $17.93 | $183.00 | $7.66–$167.42 | 4% below | 90% |
| Creatine kinase (CK) blood test, total CPT 82550 HC Assay of CK (Cpk) - CK | $7.16 | $69.00 | $3.06–$63.12 | 4% below | 90% |
| Creatinine blood test CPT 82565 HC Assay of Creatinine | $5.63 | $53.00 | $2.41–$48.48 | 4% below | 89% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Antibody - Cmv Igg | $15.83 | $122.00 | $6.76–$111.61 | at median | 87% |
| D-dimer blood test (blood clot marker) CPT 85379 HC Fibrin Degradproducts,D-Dimer, Quant - D-Dimer,Quantitative | $11.20 | $94.00 | $4.78–$86.00 | 4% below | 88% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dehydroepiandrosterone-Sulfate - Dhea-Sulfate | $24.45 | $161.00 | $10.45–$147.29 | 2% below | 85% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test Prsmv Chem Analyzr | $68.35 | $324.00 | $29.21–$296.42 | 4% below | 79% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel | $7.71 | $133.00 | $3.29–$121.68 | 4% below | 94% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Vca | $19.95 | $142.00 | $8.53–$129.91 | 4% below | 86% |
| Estradiol blood test CPT 82670 HC Assay of Estradiol - Estradiol | $30.73 | $272.00 | $13.13–$248.85 | 4% below | 89% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Gonadotropin (Fsh) - Fsh | $20.44 | $307.00 | $8.73–$280.87 | 4% below | 93% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin | $21.59 | $230.00 | $9.23–$210.42 | 4% below | 91% |
| Ferritin blood test (iron stores) CPT 82728 HC Assay of Ferritin - Ferritin | $14.99 | $170.00 | $6.41–$155.53 | 4% below | 91% |
| Fibrinogen blood test CPT 85384 HC Fibrinogen, Activity - Fibrinogen,Quantitative | $10.69 | $92.00 | $4.57–$84.17 | 4% below | 88% |
| Folate (folic acid) blood test CPT 82746 HC Blood Folic Acid Serum - Folate | $16.17 | $184.00 | $6.91–$168.34 | 4% below | 91% |
| Free T3 thyroid hormone test CPT 84481 HC Triiodothyronine Free Assay (Ft-3) - T3 Free | $18.63 | $190.00 | $7.96–$173.83 | 4% below | 90% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Assay of Free Thyroxine - T4 Free | $9.92 | $154.00 | $4.24–$140.89 | 4% below | 94% |
| Free testosterone test CPT 84402 HC Assay of Testosterone - Testosterone Free | $28.02 | $317.00 | $11.97–$290.02 | at median | 91% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Assay of Ggt - Gamma Gt | $7.92 | $119.00 | $3.29–$108.87 | 4% below | 93% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel | $129.21 | $623.00 | $19.11–$569.98 | 48% below | 79% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Post Glucose Dose | $5.23 | $61.00 | $2.23–$55.80 | 4% below | 91% |
| Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance Test (Gtt) - Gtt 2 Hour | $14.16 | $130.00 | $6.05–$118.93 | 4% below | 89% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.Gonorrhoeae, Dna, Amp Prob - Gc Dna Pcr | $38.60 | $253.00 | $16.49–$231.46 | 4% below | 85% |
| H. pylori antibody blood test CPT 86677 HC Helicobacter Pylori | $18.54 | $122.00 | $7.92–$111.61 | 4% below | 85% |
| H. pylori stool antigen test CPT 87338 HC Iaad Ia Hpylori Stool - H Pylori Antigen Stool | $15.82 | $128.00 | $6.76–$117.10 | at median | 88% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv-1 Quant&Revrse Trnscrpj - Hiv 1 Rna Quant by Pcr | $93.61 | $749.00 | $40.00–$685.26 | 4% below | 88% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv 1 Pcr Quant | $93.61 | $749.00 | $40.00–$685.26 | 4% below | 88% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 and 2 Screen | $15.08 | $126.00 | $6.44–$115.27 | 4% below | 88% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv 1 Antigens With Hiv 1 & Hiv 2 Antibodies by Immunoassay | $26.49 | $174.00 | $11.32–$159.19 | 4% below | 85% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp | $38.60 | $253.00 | $16.49–$231.46 | at median | 85% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycosylated Hemoglobin Test - Hemoglobin A1c | $10.68 | $115.00 | $4.56–$105.21 | 4% below | 91% |
| Hemoglobin blood test CPT 85018 HC Hemoglobin | $2.61 | $47.00 | $1.11–$43.00 | 36% below | 94% |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total | $13.26 | $152.00 | $5.66–$139.06 | at median | 91% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hep B Surface Antibody | $11.81 | $155.00 | $5.05–$141.80 | 4% below | 92% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Iaad Ia Hepatitis B Surface Antigen - Hepatitis B Surface Antigen | $11.36 | $123.00 | $4.86–$112.53 | 4% below | 91% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Ab Test - Hepatitis C Antibody | $15.70 | $219.00 | $6.71–$200.36 | 4% below | 93% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription | $47.12 | $484.00 | $20.13–$442.81 | 4% below | 90% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex Test Type 1 | $14.51 | $96.00 | $6.20–$87.83 | 4% below | 85% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex Type 2 Test | $21.29 | $140.00 | $9.09–$128.08 | 4% below | 85% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein,High Sensitivity - High Sensitivity Crp | $14.25 | $120.00 | $6.09–$109.78 | 4% below | 88% |
| Homocysteine blood test CPT 83090 HC Assay of Homocystine | $19.71 | $227.00 | $8.42–$207.68 | 4% below | 91% |
| Insulin blood test CPT 83525 HC Assay of Insulin,Total - Insulin, Total | $12.57 | $83.00 | $5.37–$75.93 | 4% below | 85% |
| Iron blood test (serum iron) CPT 83540 HC Assay of Iron | $7.12 | $90.00 | $3.04–$82.34 | 4% below | 92% |
| Iron-binding capacity (TIBC) test CPT 83550 HC Iron Bind Capacity | $9.61 | $100.00 | $4.11–$91.49 | 4% below | 90% |
| LH (luteinizing hormone) test CPT 83002 HC Gonadotropin (Lh) - Luteinizing Hormone | $20.37 | $296.00 | $8.70–$270.81 | at median | 93% |
| Lactate (lactic acid) blood test CPT 83605 HC Assay of Lactic Acid | $12.73 | $337.00 | $5.44–$308.32 | 4% below | 96% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase Ldh | $6.64 | $95.00 | $2.84–$86.91 | 4% below | 93% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Assay of Lipase | $7.58 | $95.00 | $3.24–$86.91 | 4% below | 92% |
| Lyme disease antibody test CPT 86618 HC Lyme Disease Antibody | $18.73 | $162.00 | $8.00–$148.21 | 4% below | 88% |
| Magnesium blood test CPT 83735 HC Assay of Magnesium | $7.37 | $104.00 | $3.15–$95.14 | 4% below | 93% |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola Antibody | $14.17 | $156.00 | $6.05–$142.72 | 4% below | 91% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Heterophile Antibodies,Screen - Mononucleosis Screen | $5.70 | $104.00 | $2.43–$95.14 | 51% below | 95% |
| Mumps immunity blood test CPT 86735 HC Mumps Antibody | $14.36 | $144.00 | $6.13–$131.74 | 4% below | 90% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $52.59 | $344.00 | $22.47–$314.72 | at median | 85% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa Free | $20.23 | $197.00 | $8.64–$180.23 | 4% below | 90% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Assay of Prostate Specific Antigen Total | $20.23 | $319.00 | $8.64–$291.85 | 4% below | 94% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC Cytopath C/V Auto Fluid Redo - Lab Cytopat,Cer/Vag,Thin Layer,Inter | $29.27 | $305.00 | $12.51–$279.04 | at median | 90% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer | $22.29 | $186.00 | $9.52–$170.17 | 4% below | 88% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Assay of Parathormone | $45.41 | $410.00 | $19.40–$375.10 | 4% below | 89% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Aptt | $6.61 | $123.00 | $2.82–$112.53 | 4% below | 95% |
| Phosphorus (phosphate) blood test CPT 84100 HC Assay of Inorganic Phosphorus | $5.21 | $90.00 | $2.23–$82.34 | 4% below | 94% |
| Potassium blood test CPT 84132 HC Assay of Serum Potassium - Potassium | $5.24 | $60.00 | $2.24–$54.89 | 4% below | 91% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Fetal Chrmoml Aneuploidy | $834.96 | $3,908.00 | $356.75–$3,575.42 | at median | 79% |
| Progesterone blood test CPT 84144 HC Assay of Progesterone - Progesterone | $22.95 | $239.00 | $9.80–$218.66 | 4% below | 90% |
| Prolactin blood test CPT 84146 HC Assay of Prolactin - Prolactin | $21.32 | $283.00 | $9.11–$258.91 | 4% below | 92% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $4.72 | $93.00 | $2.02–$85.08 | 4% below | 95% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $13.86 | — | $9.81–$50.75 | 4% below | — |
| Rapid flu test (influenza antigen) CPT 87804 HC Detect Agent,Immun,Dir Obs,Influenza | $18.21 | $120.00 | $7.78–$109.78 | at median | 85% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Assay W/Optic | $18.18 | $110.00 | $7.77–$100.63 | at median | 83% |
| Renin blood test CPT 84244 HC Assay of Renin | $24.19 | $159.00 | $10.34–$145.46 | 2% below | 85% |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quantitative | $6.24 | $104.00 | $2.66–$95.14 | 4% below | 94% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella Antibody | $15.83 | $119.00 | $6.76–$108.87 | 4% below | 87% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC Semen Analysis,Volume, Count, Motility, Diff - Semen Analysis | $13.54 | $197.00 | $5.79–$180.23 | at median | 93% |
| Sodium blood test CPT 84295 HC Assay of Serum Sodium - Sodium | $5.29 | $49.00 | $2.26–$44.83 | at median | 89% |
| Stool ova and parasites exam CPT 87177 HC Ova and Parasites Smears - Ova and Parasite Examination | $9.79 | $80.00 | $4.18–$73.19 | 4% below | 88% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Occult Bld | $4.82 | $68.00 | $1.97–$62.21 | 4% below | 93% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood Feces | $17.51 | $106.00 | $7.48–$96.97 | 4% below | 83% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Antibody Treponema Pallidum | $14.56 | $96.00 | $6.22–$87.83 | 4% below | 85% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual | $4.70 | $78.00 | $2.01–$71.36 | 4% below | 94% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Test, Cell Mediated Antigen Response,Gamma Interfron - TB Test | $68.18 | $446.00 | $29.13–$408.04 | at median | 85% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Assay of Total Testosterone - Testosterone | $28.39 | $296.00 | $12.13–$270.81 | 4% below | 90% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody Each | $16.01 | $130.00 | $6.84–$118.93 | at median | 88% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $18.48 | $275.00 | $7.90–$251.59 | 4% below | 93% |
| Total IgE blood test CPT 82785 HC Assay of Gammaglobulin Ige | $18.11 | $142.00 | $7.74–$129.91 | 4% below | 87% |
| Total cholesterol blood test CPT 82465 HC Assay, Bld/Serum Cholesterol | $4.79 | $62.00 | $2.04–$56.72 | 4% below | 92% |
| Total thyroxine (T4) blood test CPT 84436 HC Assay of Total Thyroxine - T4 (Thyroid Hormone) | $7.56 | $114.00 | $3.23–$104.29 | 4% below | 93% |
| Total triiodothyronine (T3) blood test CPT 84480 HC Assay Triiodothyronine (T3) | $15.60 | $184.00 | $6.66–$168.34 | 4% below | 92% |
| Transferrin blood test CPT 84466 HC Assay of Transferrin - Transferrin | $14.04 | $129.00 | $6.00–$118.02 | 4% below | 89% |
| Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amp | $38.60 | $253.00 | $16.49–$231.46 | 4% below | 85% |
| Triglycerides blood test CPT 84478 HC Assay of Triglycerides | $6.31 | $60.00 | $2.70–$54.89 | 4% below | 89% |
| Troponin test, quantitative CPT 84484 HC Assay of Troponin Quantitative | $13.72 | $130.00 | $5.86–$118.93 | 4% below | 89% |
| Uric acid blood test CPT 84550 HC Assay of Uric Acid, Blood - Uric Acid | $4.97 | $102.00 | $2.12–$93.31 | 4% below | 95% |
| Urinalysis with microscope exam, manual CPT 81000 HC Urinalysis Nonauto W/Micro | $4.42 | $84.00 | $1.89–$76.85 | at median | 95% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Auto W/O Scope | $2.48 | $77.00 | $1.06–$70.44 | 51% below | 97% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Nonauto W/O Scope | $3.83 | $43.00 | $1.64–$39.34 | at median | 91% |
| Urine culture for bacteria, with colony count CPT 87086 HC Culture Urine | $8.88 | $130.00 | $3.79–$118.93 | 4% below | 93% |
| Urine microalbumin (albumin) test CPT 82043 HC Urine Albumin Quantitative | $6.36 | $84.00 | $2.72–$76.85 | 4% below | 92% |
| Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test - Pregnancy Urine | $9.47 | $90.00 | $4.05–$82.34 | 4% below | 89% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B-12 - Vitamin B12 | $16.59 | $148.00 | $7.09–$135.40 | 4% below | 89% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D 25 Hydroxy | $32.56 | $281.00 | $13.91–$257.08 | 4% below | 88% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vit D 1 25 Dihydroxy Includes Fractions if Performed | $42.35 | $277.00 | $18.10–$253.42 | 4% below | 85% |
| Zinc blood test CPT 84630 HC Assay of Zinc | $12.53 | $83.00 | $5.35–$75.93 | 4% below | 85% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Chorionic Gonadotropin Quant | $16.56 | $131.00 | $7.07–$119.85 | 4% below | 87% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New Jersey | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $3,786.00 | — | $130.90–$7,053.14 | 13% below | — |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT NTRBDY CERVICAL | $3,786.00 | — | $1,266.53–$27,983.16 | 73% below | — |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY | $3,786.00 | — | $535.64–$4,174.00 | 29% below | — |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY | $3,786.00 | — | $433.48–$13,570.41 | 45% below | — |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY | $3,786.00 | — | $744.50–$15,536.41 | 52% below | — |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR | $3,786.00 | — | $756.50–$15,536.41 | 52% below | — |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 NSL/SINS NDSC SURG MAX SINS | $3,786.00 | — | $1,548.85–$15,055.21 | 38% below | — |
| Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE | $3,786.00 | — | $104.58–$4,174.00 | 102% above | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC | $3,786.00 | — | $1,770.73–$5,009.00 | 27% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $3,786.00 | — | $223.14–$4,174.00 | 194% above | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $3,786.00 | — | $68.85–$4,174.00 | 955% above | — |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 COR HLX VLGS DSTL MTAR OSTEO | $3,786.00 | — | $524.31–$7,056.48 | 18% below | — |
| Bunion correction with removal of part of the big toe joint CPT 28292 COR HLX VLGS RSC PRX PHLX BS | $3,786.00 | — | $438.57–$7,056.48 | 18% below | — |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HC Lt Hrt Art/Ventricle Angio | $4,540.81 | $21,894.00 | $2,717.04–$21,771.00 | 9% above | 79% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Electv External | $900.32 | $4,341.00 | $538.71–$3,971.58 | 8% above | 79% |
| Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY | $3,786.00 | — | $296.33–$5,009.00 | 45% above | — |
| Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP | $3,786.00 | — | $872.10–$7,514.00 | 24% above | — |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $3,786.00 | — | $42.84–$4,174.00 | 203% above | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY | $3,786.00 | — | $1,016.60–$4,174.00 | 29% below | — |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER | $3,786.00 | — | $164.90–$5,009.00 | at median | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $3,786.00 | — | $102.00–$4,455.17 | 13% below | — |
| Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE | $3,786.00 | — | $119.00–$5,009.00 | 16% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $3,786.00 | — | $205.29–$4,174.00 | 93% above | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $3,786.00 | — | $323.82–$5,009.00 | 53% above | — |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL | $3,786.00 | — | $460.70–$5,009.00 | 83% above | — |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $3,786.00 | — | $340.34–$5,009.00 | 138% above | — |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $3,786.00 | — | $282.37–$5,009.00 | 211% above | — |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP | $3,786.00 | — | $142.80–$6,914.93 | 11% below | — |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $3,786.00 | — | $146.63–$5,009.00 | 627% above | — |
| Complex cataract surgery with lens implant CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP | $3,786.00 | — | $1,139.00–$7,514.00 | 10% above | — |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT | $3,786.00 | — | $198.90–$7,500.93 | 18% below | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY | $3,786.00 | — | $76.50–$4,174.00 | 359% above | — |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE | $3,786.00 | — | $167.93–$6,914.93 | 11% below | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $3,786.00 | — | $380.03–$3,266.00 | 793% above | — |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING | $3,786.00 | — | $127.14–$5,845.00 | 13% below | — |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 CREATE EARDRUM OPENING | $3,786.00 | — | $95.20–$5,845.00 | 3% below | — |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $3,786.00 | — | $12.33–$4,174.00 | 918% above | — |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $3,786.00 | — | $49.03–$4,174.00 | 1253% above | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $3,786.00 | — | $105.38–$4,174.00 | 1310% above | — |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/TOT ETHMDCT | $3,786.00 | — | $340.00–$15,055.21 | 40% below | — |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL | $3,786.00 | — | $722.50–$15,055.21 | 40% below | — |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS | $3,786.00 | — | $160.82–$8,018.49 | 34% below | — |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $3,786.00 | — | $193.80–$15,055.21 | 42% below | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Inj Epidural Subarac C/T W/Img | $3,786.00 | $5,153.00 | $184.39–$4,714.47 | 300% above | 27% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $3,786.00 | — | $1,324.47–$3,301.00 | 300% above | — |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 INJECTION EYE DRUG | $3,786.00 | — | $136.00–$4,174.00 | 67% above | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $3,786.00 | — | $1,702.72–$3,301.00 | 33% above | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Anes/Ster Lumb/Sacr Sgl | $3,786.00 | $2,299.00 | $172.06–$4,174.00 | 33% above | -65% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC | $3,786.00 | — | $416.26–$13,570.41 | 44% below | — |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC | $3,786.00 | — | $559.20–$13,570.41 | 45% below | — |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC | $3,786.00 | — | $248.85–$7,675.11 | 18% below | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY | $3,786.00 | — | $80.75–$4,174.00 | 211% above | — |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $3,786.00 | — | $495.28–$12,688.76 | 41% below | — |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH | $3,786.00 | — | $533.00–$12,688.76 | 41% below | — |
| Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER | $3,786.00 | — | $593.54–$6,680.00 | 29% below | — |
| Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE | $3,786.00 | — | $3,102.00–$6,205.45 | 9% below | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S) | $3,786.00 | — | $70.62–$4,174.00 | 50% above | — |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP | $3,786.00 | — | $315.11–$5,964.23 | 4% above | — |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 TOTAL HIP ARTHROPLASTY | $3,786.00 | — | $7,245.00–$26,240.00 | 35% below | — |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY | $3,786.00 | — | $620.84–$9,184.00 | 22% below | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Cath/Intro Saline/Contrast Sis | $3,786.00 | $836.00 | $88.79–$4,174.00 | 715% above | -353% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $3,786.00 | — | $2,445.00–$3,266.00 | 715% above | — |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION | $3,786.00 | — | $612.00–$10,735.95 | 31% below | — |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $3,786.00 | — | $208.32–$6,914.93 | 5% below | — |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $3,786.00 | — | $4,174.00 | 38% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $3,786.00 | — | $380.03–$3,266.00 | 1000% above | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR | $3,786.00 | — | $344.32–$7,675.11 | 20% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Single Tendon/Ligament | $3,786.00 | $903.00 | $54.25–$4,174.00 | 342% above | -319% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $3,786.00 | — | $564.57–$3,266.00 | 342% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthro Asp/Inj Jt Major W/O US | $3,786.00 | $1,519.00 | $66.61–$4,174.00 | 255% above | -149% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $3,786.00 | — | $564.57–$3,266.00 | 255% above | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $3,786.00 | — | $140.87–$4,174.00 | 2101% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthro Asp/Inj Jt Inter W/O US | $3,786.00 | $1,048.00 | $43.32–$4,174.00 | 342% above | -261% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $3,786.00 | — | $564.57–$3,266.00 | 342% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $3,786.00 | — | $564.57–$3,266.00 | 420% above | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthro Asp/Inj Jt Small W/O US | $3,786.00 | $950.00 | $51.12–$4,174.00 | 420% above | -299% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY | $3,786.00 | — | $490.31–$7,056.48 | 13% below | — |
| Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY | $3,786.00 | — | $482.80–$7,056.48 | 13% below | — |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY | $3,786.00 | — | $489.12–$7,056.48 | 15% below | — |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY | $3,786.00 | — | $428.40–$7,056.48 | 12% below | — |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 LAP GASTRIC BYPASS/ROUX-EN-Y | $3,786.00 | — | $1,429.50–$4,174.00 | 26% below | — |
| Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 LAP PLACE GASTR ADJ DEVICE | $3,786.00 | — | $11,378.21–$26,240.00 | 67% below | — |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $3,786.00 | — | $387.11–$12,688.76 | 41% below | — |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY | $3,786.00 | — | $742.80–$22,642.64 | 67% below | — |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS | $3,786.00 | — | $8,349.00–$22,642.64 | 67% below | — |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS | $3,786.00 | — | $8,349.00–$22,642.64 | 67% below | — |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT | $3,786.00 | — | $309.40–$12,688.76 | 40% below | — |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR | $3,786.00 | — | $373.44–$12,688.76 | 40% below | — |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 LAP RMVL GASTR ADJ ALL PARTS | $3,786.00 | — | $4,157.89–$26,240.00 | 18% below | — |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA | $3,786.00 | — | $486.81–$12,688.76 | 40% below | — |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY | $3,786.00 | — | $13,375.00–$26,240.00 | 22% below | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 AFTER CATARACT LASER SURGERY | $3,786.00 | — | $256.70–$5,009.00 | 433% above | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $3,786.00 | — | $764.12–$3,266.00 | 163% above | — |
| Left heart catheterization, diagnostic one side CPT 93452 HC Left Heart Cath W/Ventrclgrph | $2,926.82 | $14,112.00 | $1,751.29–$21,771.00 | 18% below | 79% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $3,786.00 | — | $1,324.47–$3,301.00 | 58% above | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Inj Epidural Subarac L/S W/Img | $3,786.00 | $4,047.00 | $180.99–$4,174.00 | 58% above | 6% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $3,786.00 | — | $136.94–$4,174.00 | 91% above | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Epidural Lumb/Sacrl Sgl | $3,786.00 | $3,935.00 | $237.85–$4,174.00 | 26% above | 4% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1 | $3,786.00 | — | $1,702.72–$3,301.00 | 26% above | — |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $3,786.00 | — | $1,018.30–$15,536.41 | 32% below | — |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRD CMBN 1NTRSPC LUMBAR | $3,786.00 | — | $1,346.71–$39,995.26 | 81% below | — |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRD PST TQ 1NTRSPC LUM | $3,786.00 | — | $1,217.20–$39,995.26 | 81% below | — |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETEC & FORAMOT LUMBAR | $3,786.00 | — | $1,130.50–$15,536.41 | 52% below | — |
| Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRD PST TQ 1NTRSPC LUMBAR | $3,786.00 | — | $1,096.50–$39,995.26 | 81% below | — |
| Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY | $3,786.00 | — | $4,184.94–$8,328.03 | 26% below | — |
| Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE | $3,786.00 | — | $6,680.00–$14,183.07 | 48% below | — |
| Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE | $3,786.00 | — | $249.90–$7,514.00 | 6% below | — |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS 1 STAGE H/N/HF/G | $3,786.00 | — | $668.98–$5,009.00 | 126% above | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $3,786.00 | — | $1,345.65–$3,301.00 | 190% above | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $3,786.00 | — | $1,345.65–$3,301.00 | 301% above | — |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $3,786.00 | — | $380.03–$3,266.00 | 1137% above | — |
| Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV | $3,786.00 | — | $81.75–$4,174.00 | 181% above | — |
| Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 GASTRIC BYPASS FOR OBESITY | $3,786.00 | — | $1,032.61–$4,174.00 | 26% below | — |
| Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT | $3,786.00 | — | $3,266.00–$20,015.36 | 67% below | — |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/ Imaging | $3,786.00 | $2,650.00 | $223.53–$5,009.00 | 212% above | -43% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $3,786.00 | — | $1,793.12–$4,523.00 | 212% above | — |
| Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT | $3,786.00 | — | $7,245.00–$27,983.16 | 40% below | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $3,786.00 | — | $764.12–$3,266.00 | 561% above | — |
| Prostate biopsy CPT 55700 HC Bx Prostate Needle/Punch | $3,786.00 | $6,593.00 | $71.40–$6,031.93 | 39% above | 43% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE | $3,786.00 | — | $2,677.00–$4,523.00 | 39% above | — |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD | $3,786.00 | — | $1,148.06–$22,642.64 | 67% below | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT | $3,786.00 | — | $431.31–$4,246.94 | 1% below | — |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $3,786.00 | — | $3,102.00–$7,323.65 | 26% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $3,786.00 | — | $764.12–$3,266.00 | 595% above | — |
| Removal of a foreign object under the skin, simple CPT 10120 HC Incision/Rem FB Subq Smp | $3,786.00 | $1,074.00 | $133.28–$4,174.00 | 595% above | -253% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID | $3,786.00 | — | $540.36–$12,688.76 | 41% below | — |
| Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM | $3,786.00 | — | $366.89–$7,053.14 | 13% below | — |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $3,786.00 | — | $636.74–$12,165.00 | 14% below | — |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $3,786.00 | — | $83.45–$4,174.00 | 331% above | — |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $3,786.00 | — | $49.30–$4,174.00 | 393% above | — |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $3,786.00 | — | $507.94–$3,266.00 | 479% above | — |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $3,786.00 | — | $301.79–$3,266.00 | 497% above | — |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC | $3,786.00 | — | $486.22–$7,514.00 | 18% below | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION | $3,786.00 | — | $509.51–$5,845.00 | 35% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $3,786.00 | — | $380.03–$3,266.00 | 801% above | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $3,786.00 | — | $764.12–$3,266.00 | 602% above | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/< | $3,786.00 | — | $182.68–$4,174.00 | 278% above | — |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $3,786.00 | — | $50.49–$4,174.00 | 679% above | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $3,786.00 | — | $1,324.47–$3,301.00 | 301% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $3,786.00 | — | $380.03–$3,266.00 | 628% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $3,786.00 | — | $64.26–$4,174.00 | 284% above | — |
| TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP) | $3,786.00 | — | $5,555.79–$11,056.02 | 33% below | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $3,786.00 | — | $380.03–$3,266.00 | 595% above | — |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $3,786.00 | — | $476.78–$4,174.00 | 112% above | — |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS | $3,786.00 | — | $230.44–$7,514.00 | 9% below | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS | $3,786.00 | — | $201.45–$12,865.57 | 42% below | — |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS | $3,786.00 | — | $189.62–$7,053.14 | 13% below | — |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS | $3,786.00 | — | $188.02–$12,865.57 | 42% below | — |
| Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY | $3,786.00 | — | $7,245.00–$27,983.16 | 40% below | — |
| Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY | $3,786.00 | — | $7,245.00–$27,983.16 | 40% below | — |
| Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT | $3,786.00 | — | $7,245.00–$39,995.26 | 40% below | — |
| Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID | $3,786.00 | — | $709.67–$12,688.76 | 41% below | — |
| Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH | $3,786.00 | — | $339.41–$5,009.00 | 77% above | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj Trigger Pt 1-2 Muscle(S) | $3,786.00 | $1,293.00 | $51.22–$4,174.00 | 853% above | -193% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $3,786.00 | — | $564.57–$3,266.00 | 853% above | — |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY | $3,786.00 | — | $5,845.00–$12,688.76 | 41% below | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG | $3,786.00 | — | $1,770.73–$5,009.00 | 27% above | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM | $3,786.00 | — | $224.40–$5,009.00 | 50% above | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $3,786.00 | — | $340.95–$5,009.00 | 173% above | — |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ | $3,786.00 | — | $238.00–$5,009.00 | 49% above | — |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE | $3,786.00 | — | $256.70–$5,009.00 | 50% above | — |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $3,786.00 | — | $238.00–$5,009.00 | 121% above | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $3,786.00 | — | $256.70–$4,174.00 | 76% above | — |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD W/TRANSMURAL DRAIN CYST | $3,786.00 | — | $357.00–$12,946.36 | 43% below | — |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $3,786.00 | — | $428.40–$11,056.02 | 32% below | — |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY | $3,786.00 | — | $303.37–$11,056.02 | 38% below | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY | $3,786.00 | — | $4,174.00 | 28% below | — |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OBSTETRICAL CARE | $3,786.00 | — | $867.00–$4,174.00 | 29% below | — |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) | $3,786.00 | — | $2,238.78–$5,009.00 | 28% below | — |
| Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN | $3,786.00 | — | $3,266.00–$12,887.00 | 22% below | — |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $3,786.00 | — | $61.20–$4,174.00 | 1308% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $3,786.00 | — | $764.12–$3,582.00 | 602% above | — |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL | $3,786.00 | — | $7,514.00–$15,536.41 | 38% below | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New Jersey | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $3,786.00 | — | $22.92 | 355% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment | $132.94 | $641.00 | $62.90–$586.45 | 41% below | 79% |
| Chemotherapy IV infusion, first hour CPT 96413 HC IV Inf Chemo 1st Hr Initial | $483.65 | $2,332.00 | $125.39–$2,133.54 | 9% above | 79% |
| Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 30-74 Min | $1,154.38 | $5,566.00 | $690.74–$5,080.08 | 6% above | 79% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake/Drowsy | $233.94 | $1,128.00 | $139.98–$1,460.00 | 32% below | 79% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Electrocardiogram, Tracing | $74.45 | $359.00 | $44.55–$334.00 | at median | 79% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level 1 | $218.18 | $1,052.00 | $96.23–$2,675.00 | at median | 79% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level 2 | $295.95 | $1,427.00 | $143.00–$2,675.00 | at median | 79% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level 3 | $468.93 | $2,261.00 | $280.59–$2,675.00 | 27% above | 79% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level 4 | $642.73 | $3,099.00 | $384.58–$2,828.45 | 17% above | 79% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level 5 | $903.64 | $4,357.00 | $540.70–$3,976.63 | 14% above | 79% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Stress Test Tracing Only | $418.53 | $2,018.00 | $250.43–$1,846.26 | 6% above | 79% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Inf Hydration 1st Hr | $196.20 | $946.00 | $119.57–$865.49 | 21% below | 79% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Inf Nonchemo 1st Hr | $234.98 | $1,133.00 | $63.34–$1,036.58 | 11% below | 79% |
| IV push of a medicine, first drug CPT 96374 HC IV Push Nonchemo Initial Drug | $116.55 | $562.00 | $25.30–$514.17 | 50% below | 79% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Im/Sq Injection Nonchemo | $68.02 | $328.00 | $7.97–$300.08 | 19% below | 79% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psychiatric Diagnostic Evaluation 30 Min | $177.94 | $858.00 | $108.45–$784.98 | 6% below | 79% |
| New patient office visit, about 30 minutes CPT 99203 HC E&M Visit New Level 3 | $119.87 | $578.00 | $64.24–$528.81 | 23% above | 79% |
| New patient office visit, about 45 minutes CPT 99204 HC E&M Visit New Level 4 | $144.55 | $697.00 | $86.49–$637.68 | 2% below | 79% |
| New patient office visit, about 60 minutes CPT 99205 HC E&M Visit New Level 5 | $167.78 | $809.00 | $100.39–$740.15 | 2% below | 79% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC E&M Visit New Level 2 | $81.09 | $391.00 | $42.02–$357.72 | 7% above | 79% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC E&M Visit New Level 1 | $81.09 | $391.00 | $42.02–$357.72 | 7% above | 79% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Nutrition Therapy Ind Eval Ea 15 Min | $43.34 | $209.00 | $25.93–$232.00 | 6% above | 79% |
| Psychiatric evaluation with medical services CPT 90792 HC Psychiatric Diagnostic Eval W/Medical Services 30 Min | $200.14 | $965.00 | $121.97–$882.87 | 6% above | 79% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smok Cess Coun Inter 3-10 Min | $19.70 | $95.00 | $8.12–$86.91 | 40% below | 79% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC E&M Visit Est Level 5 | $137.92 | $665.00 | $82.52–$608.40 | 2% below | 79% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC E&M Visit Est Level 3 | $106.39 | $513.00 | $63.66–$469.34 | at median | 79% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC E&M Visit Est Level 4 | $116.97 | $564.00 | $69.99–$516.00 | at median | 79% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC E&M Visit Est Level 2 | $96.44 | $465.00 | $49.06–$425.42 | at median | 79% |
| Spirometry (breathing test) CPT 94010 HC Spirometry W/Graphic Record | $168.82 | $814.00 | $101.01–$744.72 | 9% below | 79% |
| Spirometry before and after a bronchodilator CPT 94060 HC Spirometry W/Bronchodilators | $298.86 | $1,441.00 | $178.82–$1,318.37 | 13% below | 79% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy Therapeutic | $144.14 | $695.00 | $1.93–$4,174.00 | 10% below | 79% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New Jersey | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC Moderna Spikevax 50mcg/0.5ml | $59.78 | $288.25 | $36.43–$263.71 | 11% below | 79% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC Sarscov2 Vacc 30mcg/0.3ml Tris-Sucr Im | $66.88 | $322.50 | $40.76–$295.05 | 12% below | 79% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC Varicella Virus Vaccine Live Sq | $70.19 | $338.47 | $42.78–$309.66 | 52% below | 79% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 HC Dtap-Ipv Vaccine 4-6 Yrs Im | $21.51 | $103.72 | $13.11–$160.20 | 76% below | 79% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 HC Dtap Vaccine < 7 Yrs Im | $19.90 | $95.98 | $12.13–$87.81 | 54% below | 79% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HC Dtap-Hep B-Ipv Vaccine Im | $30.41 | $146.63 | $18.53–$134.15 | 62% below | 79% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 HC Dtap-Hib-Ipv Im | $33.20 | $160.10 | $20.23–$146.47 | 65% below | 79% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 HC Dtap-Ipv-Hib-Hepb Vaccine Im | $65.43 | $315.50 | $39.87–$392.90 | 30% below | 79% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 HC Influenza Vac Triv Pf Im 0.5ml | $26.70 | $128.75 | $16.27–$117.79 | 57% below | 79% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC Influenza Vacc Splt Pf 0.5ml | $7.41 | $35.75 | $4.51–$32.70 | 82% below | 79% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC Hpv Vaccine 9-Valent 2/3 Dose Im | $112.51 | $542.50 | $68.57–$496.33 | 53% below | 79% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC Hepatitis a&B Adult Vacc Im | $47.17 | $227.45 | $28.74–$208.09 | 50% below | 79% |
| Hepatitis A vaccine, adult dose CPT 90632 HC Hepatitis a Vacc Adult 1440u | $31.05 | $149.74 | $18.92–$136.99 | 67% below | 79% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HC Hepatitis a Vacc Peds 720u | $13.02 | $62.79 | $7.93–$57.44 | 64% below | 79% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC Hep B Vacc 20 Mcg/1 Ml Im | $20.69 | $99.80 | $12.61–$91.30 | 73% below | 79% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HC Hep B Vacc 10 Mcg/0.5 Ml Im | $7.61 | $36.74 | $4.64–$36.92 | 75% below | 79% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HC Hib Prp-Omp Vacc 3 Dose Im | $12.58 | $60.70 | $7.67–$55.53 | 73% below | 79% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HC Haemophilus B Prp-T Vacc Im | $5.25 | $25.35 | $3.20–$23.19 | 52% below | 79% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC Influenza Hd Pf Iiv Antigen | $34.28 | $165.33 | $20.89–$151.26 | 70% below | 79% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 HC Japanese Encephalitis Virus Vacc Im | $122.54 | $590.88 | $74.68–$540.59 | 11% below | 79% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HC Measles/Mumps/Rubella Vacc | $19.01 | $91.69 | $11.58–$117.78 | 71% below | 79% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 HC Measl/Mumps/Rub/Varic Vacc | $129.63 | $625.03 | $79.00–$571.83 | 9% below | 79% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 HC Meningoc a/C/Y/W-Menquadfi | $55.87 | $269.40 | $34.05–$246.47 | 35% below | 79% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC Mening Rec Sero B 2 Dose Im | $76.28 | $367.82 | $46.49–$336.51 | 62% below | 79% |
| Mpox and smallpox vaccine (Jynneos), 2-dose schedule CPT 90611 HC Smallpox Monkeypox Vacc 0.5ml | $135.41 | $652.93 | $0.01–$597.36 | 5% below | 79% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC Pneumococcal Vacc 13 Val Im | $98.60 | $475.41 | $60.09–$434.95 | 60% below | 79% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 HC Pneumococcal Vacc 15 Val Im | $104.89 | $505.75 | $63.92–$462.71 | 47% below | 79% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HC Pneumococcal Vacc 20 Val Im | $112.16 | $540.83 | $68.36–$494.80 | 43% below | 79% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC Pneumococcal Ppsv23 >2yr Sq | $51.92 | $250.34 | $31.64–$229.03 | 71% below | 79% |
| Polio vaccine, inactivated (IPV) CPT 90713 HC Poliovirus Vacc Inactivated Sq/Im | $11.80 | $56.91 | $7.19–$56.21 | 86% below | 79% |
| Rabies vaccine, one dose CPT 90675 HC Rabies Vaccine 2.5u/Ml Im | $164.86 | $794.89 | $100.47–$727.24 | 55% below | 79% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC Rotavirus Vac Live Att Oral | $48.66 | $234.65 | $29.65–$214.68 | 40% below | 79% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 HC Rotavirus Vaccine 2ml Sus | $44.02 | $212.26 | $26.82–$194.19 | 13% below | 79% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC Varicella Zoster Rec Adj Im | $34.87 | $168.13 | $21.25–$242.22 | 48% below | 79% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC Diphth/Tetanus Pf >7 Yr Im | $15.67 | $75.59 | $9.55–$69.15 | 64% below | 79% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC Diphth/Tet/Acell Pert >7 Yr Im | $17.58 | $84.79 | $10.71–$77.57 | 69% below | 79% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 HC Typhoid Vaccine Inact | $46.80 | $225.69 | $28.52–$206.48 | 51% below | 79% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 HC Typhoid Vaccine Live Oral Cap | $8.18 | $39.48 | $4.99–$130.56 | 73% below | 79% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immune Admin Vaccine-Init | $38.36 | $185.00 | $22.95–$169.25 | 47% below | 79% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immune Adm Vaccine Ea Add | $20.32 | $98.00 | $12.16–$89.66 | 42% below | 79% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://mrfs.hyvehealthcare.com/RWJBarnabasHealth/223452306_community-medical-center_standardcharges.json