SelfPayRates
Hospital Dallas-Fort Worth-Arlington, TX

Childrens Medical Center of Dallas

Listed in its price file as “Childrens Medical Center”.

Childrens Medical Center of Dallas in Dallas, TX publishes cash prices for 388 common procedures listed here, from its own machine-readable price file updated Aug 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Texas median for 358 of 384 procedures and below it for 26. By typical cash price it ranks #228 of 297 Texas hospitals and #61 of 82 hospitals in the Dallas, TX area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1935 Medical District Dr, Dallas, TX 75235 Collected Oct 30, 2026 Source price file Check a bill from this hospital (214) 456-7000

Children's hospital Nonprofit hospital Emergency department CCN 453302 · CMS hospital register NPI 1194743013

Financial assistance

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

Childrens Medical Center of Dallas 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

ProcedureCash priceList priceInsurers payvs TexasOff list
Abdominal CT scan without and with contrast CPT 74170 CT Scan of Abdomen Combo $4,662.75 $6,217.00 $183.81–$6,030.49 62% above 25%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Scan of Abdomen Combo $4,662.75 $6,217.00 $2,300.29–$6,030.49 — 25%
Abdominal X-ray, 2 views CPT 74019 Radiologic Exam Abdomen 2 Views $516.75 $689.00 $38.59–$668.33 37% above 25%
Abdominal X-ray, 2 views inpatient CPT 74019 Radiologic Exam Abdomen 2 Views $516.75 $689.00 $254.93–$668.33 — 25%
Ankle X-ray, complete, 3 or more views CPT 73610 Radex Ankle Complete Minimum 3 Views $552.75 $737.00 $36.75–$714.89 55% above 25%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Radex Ankle Complete Minimum 3 Views $552.75 $737.00 $272.69–$714.89 — 25%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Uxtr C-Matrl $2,081.25 $2,775.00 $109.99–$2,691.75 26% above 25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Uxtr C-Matrl $2,081.25 $2,775.00 $1,026.75–$2,691.75 — 25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic Exam Esophagus Single Contrast Study $987.75 $1,317.00 $102.44–$1,277.49 97% above 25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Radiologic Exam Esophagus Single Contrast Study $987.75 $1,317.00 $487.29–$1,277.49 — 25%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging, Whole Body $2,351.25 $3,135.00 $277.87–$3,040.95 50% above 25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Imaging, Whole Body $2,351.25 $3,135.00 $1,159.95–$3,040.95 — 25%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Uni Real Time With Image Limited $674.25 $899.00 $89.46–$872.03 95% above 25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Uni Real Time With Image Limited $674.25 $899.00 $332.63–$872.03 — 25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd&Plvis Cntrst Mtrl W/WO Cntrst Imges $1,630.50 $2,174.00 $384.74–$2,108.78 60% below 25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd&Plvis Cntrst Mtrl W/WO Cntrst Imges $1,630.50 $2,174.00 $804.38–$2,108.78 — 25%
CT angiography (CTA) of the head CPT 70496 CT Angio,Head Combo,Incl Image Process $3,809.25 $5,079.00 $183.81–$4,926.63 60% above 25%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio,Head Combo,Incl Image Process $3,809.25 $5,079.00 $1,879.23–$4,926.63 — 25%
CT angiography (CTA) of the neck CPT 70498 CT Angio,Neck Combo,Incl Image Process $3,640.50 $4,854.00 $183.81–$4,708.38 53% above 25%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio,Neck Combo,Incl Image Process $3,640.50 $4,854.00 $1,795.98–$4,708.38 — 25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio, Chest, Combo, Incl Image Proc $3,429.75 $4,573.00 $183.81–$4,435.81 33% above 25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio, Chest, Combo, Incl Image Proc $3,429.75 $4,573.00 $1,692.01–$4,435.81 — 25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/3d Image $852.75 $1,137.00 $183.81–$1,225.00 49% below 25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/3d Image $852.75 $1,137.00 $420.69–$1,102.89 — 25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Scan,Abdoment and Pelvis,W/O Contrast $3,532.50 $4,710.00 $197.52–$4,568.70 25% above 25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Scan,Abdoment and Pelvis,W/O Contrast $3,532.50 $4,710.00 $1,742.70–$4,568.70 — 25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Scan,Abdoment and Pelvis,W Contrast $4,318.50 $5,758.00 $312.08–$5,585.26 13% above 25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Scan,Abdoment and Pelvis,W Contrast $4,318.50 $5,758.00 $2,130.46–$5,585.26 — 25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Scan,Abdoment and Pelvis,Combo $4,709.25 $6,279.00 $367.69–$6,090.63 23% above 25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Scan,Abdoment and Pelvis,Combo $4,709.25 $6,279.00 $2,323.23–$6,090.63 — 25%
CT scan of the abdomen with contrast CPT 74160 CT Scan of Abdomen Contrast $3,413.25 $4,551.00 $183.81–$4,414.47 32% above 25%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Scan of Abdomen Contrast $3,413.25 $4,551.00 $1,683.87–$4,414.47 — 25%
CT scan of the abdomen without contrast CPT 74150 CT Scan,Abdomen,W/O Contrast $2,872.50 $3,830.00 $109.99–$3,715.10 42% above 25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Scan,Abdomen,W/O Contrast $2,872.50 $3,830.00 $1,417.10–$3,715.10 — 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxlfcl Area C-Matrl $2,544.75 $3,393.00 $104.75–$3,291.21 54% above 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Scan,Maxillofacial Area,W/O Contrast $2,544.75 $3,393.00 $104.75–$3,291.21 54% above 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Scan,Maxillofacial Area,W/O Contrast $2,544.75 $3,393.00 $1,255.41–$3,291.21 — 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxlfcl Area C-Matrl $2,544.75 $3,393.00 $1,255.41–$3,291.21 — 25%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brn C-Matrl $2,982.75 $3,977.00 $104.75–$3,857.69 78% above 25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brn C-Matrl $2,982.75 $3,977.00 $1,471.49–$3,857.69 — 25%
CT scan of the head with contrast CPT 70460 CT Head/Brn C+ Matrl $3,045.00 $4,060.00 $159.98–$3,938.20 81% above 25%
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brn C+ Matrl $3,045.00 $4,060.00 $1,502.20–$3,938.20 — 25%
CT scan of the head without and with contrast CPT 70470 CT Head/Brn C-/C+ $3,177.75 $4,237.00 $183.81–$4,109.89 56% above 25%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brn C-/C+ $3,177.75 $4,237.00 $1,567.69–$4,109.89 — 25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lmbr Spi C-Matrl $3,165.75 $4,221.00 $109.50–$4,094.37 83% above 25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lmbr Spi C-Matrl $3,165.75 $4,221.00 $1,561.77–$4,094.37 — 25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Scan,Cervical Spine,W/O Contrast $3,483.75 $4,645.00 $109.99–$4,505.65 71% above 25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Scan,Cervical Spine,W/O Contrast $3,483.75 $4,645.00 $1,718.65–$4,505.65 — 25%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis C+ Matrl $3,183.75 $4,245.00 $183.81–$4,117.65 46% above 25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis C+ Matrl $3,183.75 $4,245.00 $1,570.65–$4,117.65 — 25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Scan Extracranial,Bilat $1,401.75 $1,869.00 $225.35–$1,812.93 — 25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Scan Extracranial,Bilat $1,401.75 $1,869.00 $691.53–$1,812.93 — 25%
Chest CT scan without and with contrast CPT 71270 Diagnostic Computed Tomography Thorax C-/C+ $3,429.75 $4,573.00 $183.81–$4,435.81 29% above 25%
Chest CT scan without and with contrast inpatient CPT 71270 Diagnostic Computed Tomography Thorax C-/C+ $3,429.75 $4,573.00 $1,692.01–$4,435.81 — 25%
Chest X-ray, 2 views CPT 71046 Radiologic Exam Chest 2 Views $516.75 $689.00 $33.75–$668.33 33% above 25%
Chest X-ray, 2 views inpatient CPT 71046 Radiologic Exam Chest 2 Views $516.75 $689.00 $254.93–$668.33 — 25%
Chest X-ray, single view CPT 71045 Radiologic Exam Chest Single View $513.75 $685.00 $27.02–$664.45 59% above 25%
Chest X-ray, single view inpatient CPT 71045 Radiologic Exam Chest Single View $513.75 $685.00 $253.45–$664.45 — 25%
Collarbone (clavicle) X-ray, complete CPT 73000 Radex Clavicle Complete $482.25 $643.00 $34.39–$623.71 61% above 25%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Radex Clavicle Complete $482.25 $643.00 $237.91–$623.71 — 25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal R-T W/Image Compl $823.50 $1,098.00 $104.75–$1,065.06 19% above 25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal R-T W/Image Compl $823.50 $1,098.00 $406.26–$1,065.06 — 25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa,Bone Density,Axial Skeleton $690.00 $920.00 $32.46–$892.40 73% above 25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa,Bone Density,Axial Skeleton $690.00 $920.00 $340.40–$892.40 — 25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dexa,Bone Density,Appendiculr Skeltn $577.50 $770.00 $33.33–$746.90 162% above 25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Dexa,Bone Density,Appendiculr Skeltn $577.50 $770.00 $284.90–$746.90 — 25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Diagnostic Computed Tomography Thorax W/O Cntrst $2,274.00 $3,032.00 $109.99–$2,941.04 49% above 25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Diagnostic Computed Tomography Thorax W/O Cntrst $2,274.00 $3,032.00 $1,121.84–$2,941.04 — 25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Diagnostic Computed Tomography Thorax W/Contrast $2,710.50 $3,614.00 $180.33–$3,505.58 35% above 25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Diagnostic Computed Tomography Thorax W/Contrast $2,710.50 $3,614.00 $1,337.18–$3,505.58 — 25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex Lo Extrem Art Bilat $1,337.25 $1,783.00 $283.87–$1,729.51 — 25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Duplex Lo Extrem Art Bilat $1,337.25 $1,783.00 $659.71–$1,729.51 — 25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex Extrem Venous,Bilat $2,176.50 $2,902.00 $221.74–$2,814.94 — 25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex Extrem Venous,Bilat $2,176.50 $2,902.00 $1,073.74–$2,814.94 — 25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W/Doppler, Complete $3,438.00 $4,584.00 $962.64–$4,446.48 74% above 25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte W/Doppler, Complete $3,438.00 $4,584.00 $1,696.08–$4,446.48 — 25%
Elbow X-ray, 2 views CPT 73070 Radex Elbow 2 Views $466.50 $622.00 $29.40–$603.34 48% above 25%
Elbow X-ray, 2 views inpatient CPT 73070 Radex Elbow 2 Views $466.50 $622.00 $230.14–$603.34 — 25%
Elbow X-ray, complete, 3 or more views CPT 73080 Radex Elbow Compl Minimum 3 Views $582.75 $777.00 $34.73–$753.69 52% above 25%
Elbow X-ray, complete, 3 or more views CPT 73080 Radex Elbow Complete Minimum 3 Views $582.75 $777.00 $34.73–$753.69 52% above 25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Radex Elbow Complete Minimum 3 Views $582.75 $777.00 $287.49–$753.69 — 25%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Radex Elbow Compl Minimum 3 Views $582.75 $777.00 $287.49–$753.69 — 25%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella/Post Fossa/Ear C-Matrl $2,976.75 $3,969.00 $109.99–$3,849.93 98% above 25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Sella/Post Fossa/Ear C-Matrl $2,976.75 $3,969.00 $1,468.53–$3,849.93 — 25%
Facial bones X-ray, complete, 3 or more views CPT 70150 Radex Facial Bones Compl Minimum 3 Views $447.75 $597.00 $49.82–$579.09 14% above 25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Radex Facial Bones Compl Minimum 3 Views $447.75 $597.00 $220.89–$579.09 — 25%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Radex Forearm 2 Views $629.25 $839.00 $29.40–$813.83 69% above 25%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Radex Forearm 2 Views $629.25 $839.00 $310.43–$813.83 — 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary Syst Imaging Including Gallbladder $2,917.50 $3,890.00 $305.24–$3,773.30 82% above 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary Syst Imaging Including Gallbladder $2,917.50 $3,890.00 $1,439.30–$3,773.30 — 25%
Hand X-ray, 2 views CPT 73120 Radex Hand 2 Views $312.00 $416.00 $33.33–$403.52 2% below 25%
Hand X-ray, 2 views inpatient CPT 73120 Radex Hand 2 Views $312.00 $416.00 $153.92–$403.52 — 25%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Radex Calcaneus Minimum 2 Views $353.25 $471.00 $30.18–$456.87 23% above 25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Radex Calcaneus Minimum 2 Views $353.25 $471.00 $174.27–$456.87 — 25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd $6,519.00 $8,692.00 $1,825.32–$8,431.24 53% above 25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd $6,519.00 $8,692.00 $3,216.04–$8,431.24 — 25%
Knee X-ray, 3 views CPT 73562 Radex Knee 3 Views $568.50 $758.00 $43.16–$735.26 51% above 25%
Knee X-ray, 3 views inpatient CPT 73562 Radex Knee 3 Views $568.50 $758.00 $280.46–$735.26 — 25%
Knee X-ray, complete, 4 or more views CPT 73564 Radex Knee Complete 4/More Views $659.25 $879.00 $49.82–$852.63 55% above 25%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Radex Knee Complete 4/More Views $659.25 $879.00 $325.23–$852.63 — 25%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Lxtr C-Matrl $3,311.25 $4,415.00 $109.99–$4,282.55 96% above 25%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lxtr C-Matrl $3,311.25 $4,415.00 $1,633.55–$4,282.55 — 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Retroperitoneal R-T W/Image Compl $924.75 $1,233.00 $87.21–$1,196.01 53% above 25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Retroperitoneal R-T W/Image Compl $924.75 $1,233.00 $456.21–$1,196.01 — 25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Lmtd Jt/Fcl Eval Nonvasc Xtr Strux R-T W/Img $580.50 $774.00 $31.87–$750.78 43% above 25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Lmtd Jt/Fcl Eval Nonvasc Xtr Strux R-T W/Img $580.50 $774.00 $286.38–$750.78 — 25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Radex Tibfib 2 Views $513.75 $685.00 $31.74–$664.45 49% above 25%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Radex Tibia Fibula 2 Views $513.75 $685.00 $31.74–$664.45 49% above 25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Radex Tibia Fibula 2 Views $513.75 $685.00 $253.45–$664.45 — 25%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Radex Tibfib 2 Views $513.75 $685.00 $253.45–$664.45 — 25%
MR angiography (MRA) of the head without contrast CPT 70544 MR Angio, Head $2,641.50 $3,522.00 $233.31–$3,416.34 46% above 25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR Angio, Head $2,641.50 $3,522.00 $1,303.14–$3,416.34 — 25%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Extrem Jt, W/O Contrast $3,825.00 $5,100.00 $219.28–$4,947.00 74% above 25%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lower Extrem Jt, W/O Contrast $3,825.00 $5,100.00 $1,887.00–$4,947.00 — 25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI, Joint of Leg. Combo $4,432.50 $5,910.00 $384.74–$5,732.70 47% above 25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI, Joint of Leg. Combo $4,432.50 $5,910.00 $2,186.70–$5,732.70 — 25%
MRI of the abdomen without contrast CPT 74181 MRI, Abdomen (MRI) $2,748.75 $3,665.00 $211.90–$3,555.05 25% above 25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI, Abdomen (MRI) $2,748.75 $3,665.00 $1,356.05–$3,555.05 — 25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI, Abdomen, Combo $4,288.50 $5,718.00 $365.93–$5,546.46 40% above 25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI, Abdomen, Combo $4,288.50 $5,718.00 $2,115.66–$5,546.46 — 25%
MRI of the brain, no contrast dye CPT 70551 MRI Brain $3,054.75 $4,073.00 $202.15–$3,950.81 61% above 25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain $3,054.75 $4,073.00 $1,507.01–$3,950.81 — 25%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Combo $4,288.50 $5,718.00 $328.11–$5,546.46 52% above 25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Combo $4,288.50 $5,718.00 $2,115.66–$5,546.46 — 25%
MRI of the lower back, no contrast dye CPT 72148 MRI, Lumbar Spine $3,015.00 $4,020.00 $197.14–$3,899.40 38% above 25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI, Lumbar Spine $3,015.00 $4,020.00 $1,487.40–$3,899.40 — 25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI, Lumbar Spine Combo $4,485.75 $5,981.00 $345.59–$5,801.57 40% above 25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI, Lumbar Spine Combo $4,485.75 $5,981.00 $2,212.97–$5,801.57 — 25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI, Dorsal Spine $3,433.50 $4,578.00 $205.95–$4,440.66 69% above 25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI, Dorsal Spine $3,433.50 $4,578.00 $1,693.86–$4,440.66 — 25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI, Cerv Spine Combo $5,104.50 $6,806.00 $346.28–$6,601.82 56% above 25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI, Cerv Spine Combo $5,104.50 $6,806.00 $2,518.22–$6,601.82 — 25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI, Cerv Spine $3,384.00 $4,512.00 $206.30–$4,376.64 49% above 25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI, Cerv Spine $3,384.00 $4,512.00 $1,669.44–$4,376.64 — 25%
MRI of the pelvis without and with contrast CPT 72197 MRI, Pelvis, Combo $3,847.50 $5,130.00 $364.52–$4,976.10 21% above 25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI, Pelvis, Combo $3,847.50 $5,130.00 $1,898.10–$4,976.10 — 25%
MRI of the pelvis, no contrast dye CPT 72195 MRI, Pelvis, W/O Contrast $2,641.50 $3,522.00 $245.14–$3,416.34 12% above 25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI, Pelvis, W/O Contrast $2,641.50 $3,522.00 $1,303.14–$3,416.34 — 25%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI, Joint Upper Extrem $3,525.00 $4,700.00 $219.62–$4,559.00 97% above 25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI, Joint Upper Extrem $3,525.00 $4,700.00 $1,739.00–$4,559.00 — 25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Radex Spine Cervical 4 or 5 Views $597.00 $796.00 $56.49–$772.12 9% above 25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Radex Spine Cervical 4 or 5 Views $597.00 $796.00 $294.52–$772.12 — 25%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tiss Nck C+ Matrl $2,531.25 $3,375.00 $183.81–$3,273.75 28% above 25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tiss Nck C+ Matrl $2,531.25 $3,375.00 $1,248.75–$3,273.75 — 25%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tiss Nck C-Matrl $2,454.00 $3,272.00 $109.99–$3,173.84 59% above 25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tiss Nck C-Matrl $2,454.00 $3,272.00 $1,210.64–$3,173.84 — 25%
Neck soft tissue X-ray CPT 70360 Radex Neck Soft Tissue $289.50 $386.00 $32.98–$374.42 22% above 25%
Neck soft tissue X-ray inpatient CPT 70360 Radex Neck Soft Tissue $289.50 $386.00 $142.82–$374.42 — 25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial Spect Multiple Studies $3,616.50 $4,822.00 $443.46–$4,677.34 13% below 25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial Spect Multiple Studies $3,616.50 $4,822.00 $1,784.14–$4,677.34 — 25%
OCT scan of the retina (optical coherence tomography) CPT 92134 Computerized Ophthalmic Imaging Retina $148.50 $198.00 $41.58–$192.06 11% below 25%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Computerized Ophthalmic Imaging Retina $148.50 $198.00 $73.26–$192.06 — 25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Imaging CT Attenuation Skull Base Mid-Thigh $6,230.25 $8,307.00 $1,531.52–$8,057.79 45% above 25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet Imaging CT Attenuation Skull Base Mid-Thigh $6,230.25 $8,307.00 $3,073.59–$8,057.79 — 25%
Pelvic CT scan without contrast CPT 72192 CT Pelvis C-Matrl $2,805.75 $3,741.00 $109.99–$3,628.77 73% above 25%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis C-Matrl $2,805.75 $3,741.00 $1,384.17–$3,628.77 — 25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pel Nonob B-Scan&/R-T Img Lmtd/F-Up+C97 $395.25 $527.00 $53.33–$550.00 18% below 25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pel Nonob B-Scan&/R-T Img Lmtd/F-Up+C97 $395.25 $527.00 $194.99–$511.19 — 25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Nonob Real-Time Img Complete $1,092.75 $1,457.00 $96.28–$1,413.29 44% above 25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Nonob Real-Time Img Complete $1,092.75 $1,457.00 $539.09–$1,413.29 — 25%
Rib X-ray, one side, 2 views one side CPT 71100 Radex Ribs Unilateral 2 Views $508.50 $678.00 $38.59–$657.66 71% above 25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Radex Ribs Unilateral 2 Views $508.50 $678.00 $250.86–$657.66 — 25%
Shoulder X-ray, complete, 2 or more views CPT 73030 Radex Shoulder Complete Minimum 2 Views $466.50 $622.00 $36.84–$603.34 43% above 25%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Radex Shoulder Complete Minimum 2 Views $466.50 $622.00 $230.14–$603.34 — 25%
Sinus X-ray, complete, 3 or more views CPT 70220 Radex Sinuses Paransl Complete Minimum 3 Views $713.25 $951.00 $39.65–$922.47 73% above 25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Radex Sinuses Paransl Complete Minimum 3 Views $713.25 $951.00 $351.87–$922.47 — 25%
Skull X-ray, fewer than 4 views CPT 70250 Radex Skull < 4 Views $375.75 $501.00 $37.89–$485.97 18% above 25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Radex Skull < 4 Views $375.75 $501.00 $185.37–$485.97 — 25%
Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $5,308.50 $7,078.00 $1,486.38–$6,865.66 28% above 25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd $5,308.50 $7,078.00 $2,618.86–$6,865.66 — 25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic Exam Swallow Function Contrast Study $888.00 $1,184.00 $131.21–$1,148.48 48% above 25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Radiologic Exam Swallow Function Contrast Study $888.00 $1,184.00 $438.08–$1,148.48 — 25%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Radiologic Examination Femur Minimum 2 Views $447.75 $597.00 $37.54–$579.09 37% above 25%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Radiologic Examination Femur Minimum 2 Views $447.75 $597.00 $220.89–$579.09 — 25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thrc Spi C-Matrl $3,174.75 $4,233.00 $109.99–$4,106.01 68% above 25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Thrc Spi C-Matrl $3,174.75 $4,233.00 $1,566.21–$4,106.01 — 25%
Toe X-ray, 2 or more views CPT 73660 Radex Toe(S) Minimum 2 Views $365.25 $487.00 $30.87–$472.39 34% above 25%
Toe X-ray, 2 or more views inpatient CPT 73660 Radex Toe(S) Minimum 2 Views $365.25 $487.00 $180.19–$472.39 — 25%
Transvaginal pelvic ultrasound CPT 76830 US Trvg $474.75 $633.00 $109.99–$614.01 22% below 25%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Trvg $474.75 $633.00 $234.21–$614.01 — 25%
Ultrasound of the abdomen, complete CPT 76700 US Abdominal R-T W/Image Documentation $1,284.75 $1,713.00 $109.99–$1,661.61 64% above 25%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal R-T W/Image Documentation $1,284.75 $1,713.00 $633.81–$1,661.61 — 25%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum&Cnts $1,021.50 $1,362.00 $105.25–$1,321.14 67% above 25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum&Cnts $1,021.50 $1,362.00 $503.94–$1,321.14 — 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tiss Head&Nck R-T Img $872.25 $1,163.00 $104.75–$1,128.11 38% above 25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tiss Head&Nck R-T Img $872.25 $1,163.00 $430.31–$1,128.11 — 25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic Exam Upr GI Trc Single Contrast Study $1,403.25 $1,871.00 $129.11–$1,814.87 94% above 25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Radiologic Exam Upr GI Trc Single Contrast Study $1,403.25 $1,871.00 $692.27–$1,814.87 — 25%
Upper arm X-ray (humerus), 2 views CPT 73060 Radex Humerus Minimum 2 Views $399.75 $533.00 $33.68–$517.01 14% above 25%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Radex Humerus Minimum 2 Views $399.75 $533.00 $197.21–$517.01 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplex Extrem Venous,Uni or Ltd $787.50 $1,050.00 $127.61–$1,018.50 at median 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Duplex Extrem Venous,Uni or Ltd $787.50 $1,050.00 $388.50–$1,018.50 — 25%
Wrist X-ray, 2 views CPT 73100 Radex Wrist 2 Views $460.50 $614.00 $35.79–$595.58 55% above 25%
Wrist X-ray, 2 views inpatient CPT 73100 Radex Wrist 2 Views $460.50 $614.00 $227.18–$595.58 — 25%
Wrist X-ray, complete, 3 or more views CPT 73110 Radex Wrist Complete Minimum 3 Views $515.25 $687.00 $41.44–$666.39 39% above 25%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Radex Wrist Complete Minimum 3 Views $515.25 $687.00 $254.19–$666.39 — 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views $405.75 $541.00 $50.17–$524.77 10% above 25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views $405.75 $541.00 $200.17–$524.77 — 25%
X-ray of the abdomen, 1 view CPT 74018 Radiologic Exam Abdomen 1 View $495.00 $660.00 $30.40–$640.20 46% above 25%
X-ray of the abdomen, 1 view inpatient CPT 74018 Radiologic Exam Abdomen 1 View $495.00 $660.00 $244.20–$640.20 — 25%
X-ray of the ankle, 2 views CPT 73600 Radex Ankle 2 Views $399.75 $533.00 $34.03–$517.01 34% above 25%
X-ray of the ankle, 2 views inpatient CPT 73600 Radex Ankle 2 Views $399.75 $533.00 $197.21–$517.01 — 25%
X-ray of the finger(s), 2 or more views CPT 73140 Radex Finger(S) Minimum 2 Views $413.25 $551.00 $40.35–$534.47 71% above 25%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Radex Finger(S) Minimum 2 Views $413.25 $551.00 $203.87–$534.47 — 25%
X-ray of the foot, 2 views CPT 73620 Radex Foot 2 Views $351.00 $468.00 $30.18–$453.96 5% above 25%
X-ray of the foot, 2 views inpatient CPT 73620 Radex Foot 2 Views $351.00 $468.00 $173.16–$453.96 — 25%
X-ray of the foot, complete, 3 or more views CPT 73630 Radex Foot Complete Minimum 3 Views $418.50 $558.00 $34.41–$541.26 13% above 25%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Radex Foot Complete Minimum 3 Views $418.50 $558.00 $206.46–$541.26 — 25%
X-ray of the hand, 3 or more views CPT 73130 Radex Hand Minimum 3 Views $504.75 $673.00 $37.43–$652.81 32% above 25%
X-ray of the hand, 3 or more views inpatient CPT 73130 Radex Hand Minimum 3 Views $504.75 $673.00 $249.01–$652.81 — 25%
X-ray of the knee, 1 or 2 views CPT 73560 Radex Knee 1/2 Views $536.25 $715.00 $36.13–$693.55 82% above 25%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Radex Knee 1/2 Views $536.25 $715.00 $264.55–$693.55 — 25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radex Spine Lumbosac 2/3 Views $550.50 $734.00 $42.11–$711.98 24% above 25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Radex Spine Lumbosac 2/3 Views $550.50 $734.00 $271.58–$711.98 — 25%
X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosac Minimum 4 Views $699.00 $932.00 $54.74–$904.04 24% above 25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosac Minimum 4 Views $699.00 $932.00 $344.84–$904.04 — 25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radex Spine Thoracic 2 Views $486.00 $648.00 $34.73–$628.56 21% above 25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Radex Spine Thoracic 2 Views $486.00 $648.00 $239.76–$628.56 — 25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radex Spine Cervical 2 or 3 Views $531.00 $708.00 $41.75–$686.76 46% above 25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Radex Spine Cervical 2 or 3 Views $531.00 $708.00 $261.96–$686.76 — 25%
X-ray of the pelvis, 1 or 2 views CPT 72170 Radex Pelvis 1/2 Views $389.25 $519.00 $29.46–$503.43 24% above 25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Radex Pelvis 1/2 Views $389.25 $519.00 $192.03–$503.43 — 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radex Sacrum&Coccyx Minimum 2 Views $492.75 $657.00 $34.39–$637.29 60% above 25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Radex Sacrum&Coccyx Minimum 2 Views $492.75 $657.00 $243.09–$637.29 — 25%

Lab tests

ProcedureCash priceList priceInsurers payvs TexasOff list
ACTH blood test CPT 82024 Adrenocorticotropic Horm $375.75 $501.00 $40.55–$485.97 76% above 25%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Horm $375.75 $501.00 $185.37–$485.97 — 25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase Alanine Amino $130.50 $174.00 $5.57–$168.78 155% above 25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Transferase Alanine Amino $130.50 $174.00 $64.38–$168.78 — 25%
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase Aspartate Amino $82.50 $110.00 $5.44–$106.70 60% above 25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase Aspartate Amino $82.50 $110.00 $40.70–$106.70 — 25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel,Acute $261.75 $349.00 $50.01–$338.53 32% below 25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel,Acute $261.75 $349.00 $129.13–$338.53 — 25%
Albumin blood test CPT 82040 Assay Serum Albumin $111.00 $148.00 $5.20–$143.56 198% above 25%
Albumin blood test CPT 82040 Albumin Serum $126.75 $169.00 $5.20–$163.93 241% above 25%
Albumin blood test inpatient CPT 82040 Assay Serum Albumin $111.00 $148.00 $54.76–$143.56 — 25%
Albumin blood test inpatient CPT 82040 Albumin Serum $126.75 $169.00 $62.53–$163.93 — 25%
Aldosterone blood test CPT 82088 Aldosterone $221.25 $295.00 $42.79–$286.15 69% above 25%
Aldosterone blood test inpatient CPT 82088 Aldosterone $221.25 $295.00 $109.15–$286.15 — 25%
Alkaline phosphatase (ALP) blood test CPT 84075 Phosphatase Alkaline $80.25 $107.00 $5.44–$103.79 65% above 25%
Alkaline phosphatase (ALP) blood test CPT 84075 Assay Alkal Phosphatase $175.50 $234.00 $5.44–$226.98 260% above 25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Phosphatase Alkaline $80.25 $107.00 $39.59–$103.79 — 25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Assay Alkal Phosphatase $175.50 $234.00 $86.58–$226.98 — 25%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige Crude Allergen Extract Each $36.00 $48.00 $5.48–$46.56 50% above 25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Spec Ige Crude Allergen Extract Each $36.00 $48.00 $17.76–$46.56 — 25%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein Serum $257.25 $343.00 $17.61–$332.71 116% above 25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-Fetoprotein Serum $257.25 $343.00 $126.91–$332.71 — 25%
Ammonia blood test CPT 82140 Ammonia $186.75 $249.00 $15.30–$241.53 31% above 25%
Ammonia blood test inpatient CPT 82140 Ammonia $186.75 $249.00 $92.13–$241.53 — 25%
Amylase blood test CPT 82150 Assay of Amylase $93.00 $124.00 $6.80–$120.28 22% above 25%
Amylase blood test CPT 82150 Amylase $213.75 $285.00 $6.80–$276.45 181% above 25%
Amylase blood test inpatient CPT 82150 Assay of Amylase $93.00 $124.00 $45.88–$120.28 — 25%
Amylase blood test inpatient CPT 82150 Amylase $213.75 $285.00 $105.45–$276.45 — 25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Cirullinated Peptide Antibody $138.75 $185.00 $13.60–$179.45 162% above 25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Cirullinated Peptide Antibody $138.75 $185.00 $68.45–$179.45 — 25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies $226.50 $302.00 $12.69–$292.94 194% above 25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies $226.50 $302.00 $111.74–$292.94 — 25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide $392.25 $523.00 $41.22–$507.31 151% above 25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic Peptide $392.25 $523.00 $193.51–$507.31 — 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Spec, Bacteria, Not Urine,Stool,Blood $468.00 $624.00 $7.24–$605.28 599% above 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Bact Xcpt Urine Bld/Stl Aerc Isol $771.00 $1,028.00 $7.24–$997.16 1051% above 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Spec, Bacteria, Not Urine,Stool,Blood $468.00 $624.00 $230.88–$605.28 — 25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Bact Xcpt Urine Bld/Stl Aerc Isol $771.00 $1,028.00 $380.36–$997.16 — 25%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel Calcium Total $270.75 $361.00 $7.11–$350.17 29% above 25%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel Calcium Total $270.75 $361.00 $133.57–$350.17 — 25%
Bilirubin blood test, total CPT 82247 Bilirubin Total $129.00 $172.00 $5.27–$166.84 126% above 25%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total $129.00 $172.00 $63.64–$166.84 — 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Lev IV Gm4 $585.00 $780.00 $163.80–$756.60 97% above 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lvl IV-Surg Path Gross&Mcrscp Xm $585.00 $780.00 $163.80–$756.60 97% above 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology Lev IV Gm4 $585.00 $780.00 $288.60–$756.60 — 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lvl IV-Surg Path Gross&Mcrscp Xm $585.00 $780.00 $288.60–$756.60 — 25%
Blood culture for bacteria CPT 87040 Blood Culture for Bacteria $449.25 $599.00 $8.67–$581.03 120% above 25%
Blood culture for bacteria inpatient CPT 87040 Blood Culture for Bacteria $449.25 $599.00 $221.63–$581.03 — 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Blood, Venipuncture $24.00 $32.00 $6.72–$31.04 33% above 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Venous Blood, Venipuncture $24.00 $32.00 $11.84–$31.04 — 25%
Blood glucose (sugar) test CPT 82947 Assay Quantitative, Glucose $71.25 $95.00 $4.13–$92.15 71% above 25%
Blood glucose (sugar) test CPT 82947 POC Assay Quantitative, Glucose $100.50 $134.00 $4.13–$129.98 141% above 25%
Blood glucose (sugar) test inpatient CPT 82947 Assay Quantitative, Glucose $71.25 $95.00 $35.15–$92.15 — 25%
Blood glucose (sugar) test inpatient CPT 82947 POC Assay Quantitative, Glucose $100.50 $134.00 $49.58–$129.98 — 25%
Blood lead test CPT 83655 LEAD $113.25 $151.00 $12.72–$146.47 143% above 25%
Blood lead test CPT 83655 Lead Level $131.25 $175.00 $12.72–$169.75 182% above 25%
Blood lead test CPT 83655 Assay for Lead $131.25 $175.00 $12.72–$169.75 182% above 25%
Blood lead test inpatient CPT 83655 LEAD $113.25 $151.00 $55.87–$146.47 — 25%
Blood lead test inpatient CPT 83655 Assay for Lead $131.25 $175.00 $64.75–$169.75 — 25%
Blood lead test inpatient CPT 83655 Lead Level $131.25 $175.00 $64.75–$169.75 — 25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 POC Chorionic Gonadotropin Assay $283.50 $378.00 $6.32–$366.66 107% above 25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 POC Chorionic Gonadotropin Assay $283.50 $378.00 $139.86–$366.66 — 25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing Serologic Abo $159.75 $213.00 $3.14–$206.61 81% above 25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing Serologic Abo $159.75 $213.00 $78.81–$206.61 — 25%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen $128.25 $171.00 $4.15–$165.87 136% above 25%
Blood urea nitrogen (BUN) test CPT 84520 POC Urea N Quan $128.25 $171.00 $4.15–$165.87 136% above 25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen $128.25 $171.00 $63.27–$165.87 — 25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 POC Urea N Quan $128.25 $171.00 $63.27–$165.87 — 25%
C-peptide blood test CPT 84681 Assay C-Peptide $223.50 $298.00 $21.85–$289.06 207% above 25%
C-peptide blood test inpatient CPT 84681 Assay C-Peptide $223.50 $298.00 $110.26–$289.06 — 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein $105.00 $140.00 $5.44–$135.80 106% above 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein $105.00 $140.00 $51.80–$135.80 — 25%
C. difficile toxin gene test (stool PCR) CPT 87493 Cytomed, Dna, Amp Probe $407.25 $543.00 $39.13–$526.71 132% above 25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Cytomed, Dna, Amp Probe $407.25 $543.00 $200.91–$526.71 — 25%
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay Tumor Antigen Quan Ca 19-9 $211.50 $282.00 $21.85–$273.54 59% above 25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay Tumor Antigen Quan Ca 19-9 $211.50 $282.00 $104.34–$273.54 — 25%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay, Tumor Antigen, Ca 125 $219.00 $292.00 $21.85–$283.24 44% above 25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immunoassay, Tumor Antigen, Ca 125 $219.00 $292.00 $108.04–$283.24 — 25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious Agent Detection by Nuc Acid Sars-Cov-2 Covid-19 Amp Prb Tq $205.50 $274.00 $53.88–$265.78 131% above 25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious Agent Detection by Na Sars-Cov-2 Covid-19 Amp Prb Tq $205.50 $274.00 $53.88–$265.78 131% above 25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Infectious Agent Detection by Na Sars-Cov-2 Covid-19 Amp Prb Tq $205.50 $274.00 $101.38–$265.78 — 25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Infectious Agent Detection by Nuc Acid Sars-Cov-2 Covid-19 Amp Prb Tq $205.50 $274.00 $101.38–$265.78 — 25%
Calcium blood test, total CPT 82310 Calcium Total $126.75 $169.00 $5.42–$163.93 117% above 25%
Calcium blood test, total inpatient CPT 82310 Calcium Total $126.75 $169.00 $62.53–$163.93 — 25%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen $255.00 $340.00 $19.91–$329.80 91% above 25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen $255.00 $340.00 $125.80–$329.80 — 25%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster $171.00 $228.00 $13.52–$221.16 173% above 25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster $171.00 $228.00 $84.36–$221.16 — 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious Agent Detection by Nucleic Acid Chlamydia Trachomatis Amp Prb $261.75 $349.00 $36.84–$338.53 111% above 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Infectious Agent Detection by Nucleic Acid Chlamydia Trachomatis Amp Prb $261.75 $349.00 $129.13–$338.53 — 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 POC Lipid Panel $326.25 $435.00 $14.06–$421.95 120% above 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $326.25 $435.00 $14.06–$421.95 120% above 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $326.25 $435.00 $160.95–$421.95 — 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 POC Lipid Panel $326.25 $435.00 $160.95–$421.95 — 25%
Complete blood count (CBC) with differential CPT 85025 Bld# Compl Auto Hhrwp&Auto Diffial $184.50 $246.00 $6.53–$238.62 102% above 25%
Complete blood count (CBC) with differential inpatient CPT 85025 Bld# Compl Auto Hhrwp&Auto Diffial $184.50 $246.00 $91.02–$238.62 — 25%
Complete blood count (CBC), no differential CPT 85027 Complete Cbc Automated $294.75 $393.00 $5.43–$381.21 215% above 25%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Cbc Automated $294.75 $393.00 $145.41–$381.21 — 25%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel $442.50 $590.00 $8.87–$572.30 76% above 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel $442.50 $590.00 $218.30–$572.30 — 25%
Cortisol blood test, total CPT 82533 Cortisol Total $211.50 $282.00 $17.12–$273.54 153% above 25%
Cortisol blood test, total CPT 82533 Total Cortisol $221.25 $295.00 $17.12–$286.15 165% above 25%
Cortisol blood test, total inpatient CPT 82533 Cortisol Total $211.50 $282.00 $104.34–$273.54 — 25%
Cortisol blood test, total inpatient CPT 82533 Total Cortisol $221.25 $295.00 $109.15–$286.15 — 25%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total $295.50 $394.00 $6.84–$382.18 362% above 25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase Total $295.50 $394.00 $145.78–$382.18 — 25%
Creatinine blood test CPT 82565 POC Creatinine Bld $129.00 $172.00 $5.38–$166.84 141% above 25%
Creatinine blood test CPT 82565 Creatinine, Serum $129.00 $172.00 $5.38–$166.84 141% above 25%
Creatinine blood test inpatient CPT 82565 Creatinine, Serum $129.00 $172.00 $63.64–$166.84 — 25%
Creatinine blood test inpatient CPT 82565 POC Creatinine Bld $129.00 $172.00 $63.64–$166.84 — 25%
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv Antibody $155.25 $207.00 $15.11–$200.79 107% above 25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cmv Antibody $155.25 $207.00 $76.59–$200.79 — 25%
D-dimer blood test (blood clot marker) CPT 85379 Fibrin Degradation,Quant $213.75 $285.00 $10.69–$276.45 26% above 25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin Degradation,Quant $213.75 $285.00 $105.45–$276.45 — 25%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-Sulfate $265.50 $354.00 $23.34–$343.38 76% above 25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone-Sulfate $265.50 $354.00 $130.98–$343.38 — 25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Tst Prsmv Instrmnt Chem Analyzers PR Date $235.50 $314.00 $65.25–$304.58 279% above 25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Tst Prsmv Instrmnt Chem Analyzers PR Date $235.50 $314.00 $116.18–$304.58 — 25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel $333.00 $444.00 $7.36–$430.68 109% above 25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel $333.00 $444.00 $164.28–$430.68 — 25%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein-Barr Antibody,V Capsid $155.25 $207.00 $19.05–$200.79 79% above 25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein-Barr Antibody,V Capsid $155.25 $207.00 $76.59–$200.79 — 25%
Estradiol blood test CPT 82670 Assay of Total Estradiol $211.50 $282.00 $29.34–$273.54 71% above 25%
Estradiol blood test inpatient CPT 82670 Assay of Total Estradiol $211.50 $282.00 $104.34–$273.54 — 25%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin (Fsh) $198.75 $265.00 $19.51–$257.05 27% above 25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin (Fsh) $198.75 $265.00 $98.05–$257.05 — 25%
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for Calprotectin Fecal $900.00 $1,200.00 $20.61–$1,164.00 321% above 25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for Calprotectin Fecal $900.00 $1,200.00 $444.00–$1,164.00 — 25%
Ferritin blood test (iron stores) CPT 82728 Ferritin $149.25 $199.00 $14.31–$193.03 79% above 25%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $149.25 $199.00 $73.63–$193.03 — 25%
Fibrinogen blood test CPT 85384 Fibrinogen, Activity $197.25 $263.00 $10.21–$255.11 128% above 25%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen, Activity $197.25 $263.00 $97.31–$255.11 — 25%
Folate (folic acid) blood test CPT 82746 Folic Acid Serum $106.50 $142.00 $15.44–$137.74 33% above 25%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid Serum $106.50 $142.00 $52.54–$137.74 — 25%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3 Fr $65.25 $87.00 $17.79–$84.39 53% below 25%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine T3 Fr $65.25 $87.00 $32.19–$84.39 — 25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free $198.00 $264.00 $7.58–$256.08 164% above 25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Fr $198.00 $264.00 $7.58–$256.08 164% above 25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Fr $198.00 $264.00 $97.68–$256.08 — 25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free $198.00 $264.00 $97.68–$256.08 — 25%
Free testosterone test CPT 84402 Testosterone Free $219.00 $292.00 $26.74–$283.24 107% above 25%
Free testosterone test inpatient CPT 84402 Testosterone Free $219.00 $292.00 $108.04–$283.24 — 25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltrase Gamma $162.75 $217.00 $7.56–$210.49 177% above 25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Glutamyltrase Gamma $162.75 $217.00 $80.29–$210.49 — 25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel $713.25 $951.00 $199.71–$922.47 60% above 25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel $713.25 $951.00 $351.87–$922.47 — 25%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test (Gtt) $160.50 $214.00 $13.51–$207.58 6% above 25%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test (Gtt) $160.50 $214.00 $79.18–$207.58 — 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious Agent Detection by Nucleic Acid Neisseria Gonorrhoeae Amp Prb $261.75 $349.00 $36.84–$338.53 101% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Infectious Agent Detection by Nucleic Acid Neisseria Gonorrhoeae Amp Prb $261.75 $349.00 $129.13–$338.53 — 25%
H. pylori stool antigen test CPT 87338 Infectious Agent Antigen Detection by Ia Hpylori Stool $396.75 $529.00 $15.10–$513.13 361% above 25%
H. pylori stool antigen test inpatient CPT 87338 Infectious Agent Antigen Detection by Ia Hpylori Stool $396.75 $529.00 $195.73–$513.13 — 25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious Agent Detection by Nucleic Acid Hiv-1 Quant & Reverse Transcription $433.50 $578.00 $89.36–$560.66 43% above 25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Infectious Agent Detection by Nucleic Acid Hiv-1 Quant & Reverse Transcription $433.50 $578.00 $213.86–$560.66 — 25%
HIV-1 and HIV-2 antibody test CPT 86703 Antibody Hiv-1&Hiv-2 Single Result $171.00 $228.00 $14.40–$221.16 111% above 25%
HIV-1 and HIV-2 antibody test CPT 86703 POC Antibody Hiv-1&Hiv-2 Single Result $267.00 $356.00 $14.40–$345.32 229% above 25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Antibody Hiv-1&Hiv-2 Single Result $171.00 $228.00 $84.36–$221.16 — 25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 POC Antibody Hiv-1&Hiv-2 Single Result $267.00 $356.00 $131.72–$345.32 — 25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv Screen $241.50 $322.00 $25.28–$312.34 78% above 25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv Screen $241.50 $322.00 $119.14–$312.34 — 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 POC Glycated Hemoglobin Test $191.25 $255.00 $8.16–$247.35 126% above 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycated Hemoglobin Test $191.25 $255.00 $8.16–$247.35 126% above 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycated Hemoglobin Test $191.25 $255.00 $94.35–$247.35 — 25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 POC Glycated Hemoglobin Test $191.25 $255.00 $94.35–$247.35 — 25%
Hemoglobin blood test CPT 85018 POC Bld# Hgb $68.25 $91.00 $2.49–$88.27 57% above 25%
Hemoglobin blood test CPT 85018 Bld# Hgb $68.25 $91.00 $2.49–$88.27 57% above 25%
Hemoglobin blood test inpatient CPT 85018 POC Bld# Hgb $68.25 $91.00 $33.67–$88.27 — 25%
Hemoglobin blood test inpatient CPT 85018 Bld# Hgb $68.25 $91.00 $33.67–$88.27 — 25%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab Test, Total $131.25 $175.00 $12.65–$169.75 80% above 25%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab Test, Total $131.25 $175.00 $64.75–$169.75 — 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody $151.50 $202.00 $11.28–$195.94 137% above 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody $151.50 $202.00 $74.74–$195.94 — 25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious Agent Antigen Detection by Ia Hepatitis B Surface Antigen $192.00 $256.00 $10.85–$248.32 174% above 25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Infectious Agent Antigen Detection by Ia Hepatitis B Surface Antigen $192.00 $256.00 $94.72–$248.32 — 25%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C $167.25 $223.00 $14.98–$216.31 94% above 25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C $167.25 $223.00 $82.51–$216.31 — 25%
Hepatitis C viral load (HCV RNA) test CPT 87522 Infectious Agent Detection by Nucleic Acid Hepatitis C Quant & Reverse Transcription $547.50 $730.00 $44.98–$708.10 128% above 25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Infectious Agent Detection by Nucleic Acid Hepatitis C Quant & Reverse Transcription $547.50 $730.00 $270.10–$708.10 — 25%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Test $106.50 $142.00 $13.85–$137.74 48% above 25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Test $106.50 $142.00 $52.54–$137.74 — 25%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Test, Type 2 $88.50 $118.00 $20.32–$114.46 7% above 25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Test, Type 2 $88.50 $118.00 $43.66–$114.46 — 25%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Hi Sensitivity $126.75 $169.00 $13.60–$163.93 61% above 25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Hi Sensitivity $126.75 $169.00 $62.53–$163.93 — 25%
Homocysteine blood test CPT 83090 Assay Homocystine $245.25 $327.00 $18.82–$317.19 64% above 25%
Homocysteine blood test inpatient CPT 83090 Assay Homocystine $245.25 $327.00 $120.99–$317.19 — 25%
Insulin blood test CPT 83525 Assay of Insulin,Total $44.25 $59.00 $12.00–$57.23 36% below 25%
Insulin blood test CPT 83525 Insulin Total $132.75 $177.00 $12.00–$171.69 93% above 25%
Insulin blood test inpatient CPT 83525 Assay of Insulin,Total $44.25 $59.00 $21.83–$57.23 — 25%
Insulin blood test inpatient CPT 83525 Insulin Total $132.75 $177.00 $65.49–$171.69 — 25%
Iron blood test (serum iron) CPT 83540 IRON $164.25 $219.00 $6.79–$212.43 132% above 25%
Iron blood test (serum iron) CPT 83540 Assay Iron $164.25 $219.00 $6.79–$212.43 132% above 25%
Iron blood test (serum iron) inpatient CPT 83540 IRON $164.25 $219.00 $81.03–$212.43 — 25%
Iron blood test (serum iron) inpatient CPT 83540 Assay Iron $164.25 $219.00 $81.03–$212.43 — 25%
Iron-binding capacity (TIBC) test CPT 83550 Iron Bndng Cap $159.00 $212.00 $9.18–$205.64 77% above 25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Bndng Cap $159.00 $212.00 $78.44–$205.64 — 25%
Kidney function blood test panel CPT 80069 Renal Function Panel $367.50 $490.00 $9.11–$475.30 107% above 25%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $367.50 $490.00 $181.30–$475.30 — 25%
LH (luteinizing hormone) test CPT 83002 Gonadotropin (Lh) $192.00 $256.00 $19.45–$248.32 36% above 25%
LH (luteinizing hormone) test inpatient CPT 83002 Gonadotropin (Lh) $192.00 $256.00 $94.72–$248.32 — 25%
Lactate (lactic acid) blood test CPT 83605 POC Lactate $195.00 $260.00 $12.15–$252.20 104% above 25%
Lactate (lactic acid) blood test CPT 83605 Lactate $195.00 $260.00 $12.15–$252.20 104% above 25%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate $195.00 $260.00 $96.20–$252.20 — 25%
Lactate (lactic acid) blood test inpatient CPT 83605 POC Lactate $195.00 $260.00 $96.20–$252.20 — 25%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase $175.50 $234.00 $6.34–$226.98 294% above 25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase $175.50 $234.00 $86.58–$226.98 — 25%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $183.75 $245.00 $7.23–$237.65 175% above 25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase $183.75 $245.00 $90.65–$237.65 — 25%
Liver function blood test panel CPT 80076 Hepatic Function Panel $244.50 $326.00 $8.58–$316.22 26% above 25%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $244.50 $326.00 $120.62–$316.22 — 25%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody $155.25 $207.00 $17.88–$200.79 88% above 25%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody $155.25 $207.00 $76.59–$200.79 — 25%
Magnesium blood test CPT 83735 Magnesium $169.50 $226.00 $5.63–$219.22 285% above 25%
Magnesium blood test inpatient CPT 83735 Magnesium $169.50 $226.00 $83.62–$219.22 — 25%
Measles (rubeola) antibody test CPT 86765 Rubeola $46.50 $62.00 $13.52–$60.14 52% above 25%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola $46.50 $62.00 $22.94–$60.14 — 25%
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Antibodies,Screen $177.00 $236.00 $5.44–$228.92 108% above 25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile Antibodies,Screen $177.00 $236.00 $87.32–$228.92 — 25%
Mumps immunity blood test CPT 86735 Mumps $54.00 $72.00 $13.70–$69.84 10% below 25%
Mumps immunity blood test inpatient CPT 86735 Mumps $54.00 $72.00 $26.64–$69.84 — 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen,Total $235.50 $314.00 $19.31–$304.58 175% above 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen,Total $235.50 $314.00 $116.18–$304.58 — 25%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytpathology C/V Auto Thin Lyr Prepj Scr Mnl Rescr Phys $231.75 $309.00 $27.94–$299.73 215% above 25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytpathology C/V Auto Thin Lyr Prepj Scr Mnl Rescr Phys $231.75 $309.00 $114.33–$299.73 — 25%
Parathyroid hormone (PTH) blood test CPT 83970 Assay of Parathormone $444.00 $592.00 $43.34–$574.24 116% above 25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Assay of Parathormone $444.00 $592.00 $219.04–$574.24 — 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Tm Prtl Plsm/Whl Bld $193.50 $258.00 $6.31–$250.26 287% above 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Tm Prtl Plsm/Whl Bld $193.50 $258.00 $95.46–$250.26 — 25%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Inorganic $136.50 $182.00 $4.98–$176.54 119% above 25%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Inorganic $136.50 $182.00 $67.34–$176.54 — 25%
Potassium blood test CPT 84132 POC Assay Serum Potassium $129.75 $173.00 $5.00–$167.81 117% above 25%
Potassium blood test CPT 84132 Potassium Serum $129.75 $173.00 $5.00–$167.81 117% above 25%
Potassium blood test inpatient CPT 84132 Potassium Serum $129.75 $173.00 $64.01–$167.81 — 25%
Potassium blood test inpatient CPT 84132 POC Assay Serum Potassium $129.75 $173.00 $64.01–$167.81 — 25%
Progesterone blood test CPT 84144 Assay Progesterone $225.00 $300.00 $21.90–$291.00 119% above 25%
Progesterone blood test inpatient CPT 84144 Assay Progesterone $225.00 $300.00 $111.00–$291.00 — 25%
Prolactin blood test CPT 84146 Prolactin $207.00 $276.00 $20.35–$267.72 88% above 25%
Prolactin blood test inpatient CPT 84146 Prolactin $207.00 $276.00 $102.12–$267.72 — 25%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time $174.00 $232.00 $4.50–$225.04 278% above 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time $174.00 $232.00 $85.84–$225.04 — 25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 POC Drug Test Prsmv Read Direct Optical Obs PR Date $64.50 $86.00 $13.23–$83.42 39% below 25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 POC Drug Test Prsmv Read Direct Optical Obs PR Date $64.50 $86.00 $31.82–$83.42 — 25%
Rapid flu test (influenza antigen) CPT 87804 Infectious Agent Antigen Detection by Ia W/Direct Optical Influenza $144.75 $193.00 $13.90–$187.21 55% above 25%
Rapid flu test (influenza antigen) inpatient CPT 87804 Infectious Agent Antigen Detection by Ia W/Direct Optical Influenza $144.75 $193.00 $71.41–$187.21 — 25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious Agent Antigen Detection by Ia W/Direct Optical Streptococcus Group A $197.25 $263.00 $13.89–$255.11 100% above 25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Infectious Agent Antigen Detection by Ia W/Direct Optical Streptococcus Group A $197.25 $263.00 $97.31–$255.11 — 25%
Renin blood test CPT 84244 Assay of Renin $204.75 $273.00 $23.09–$264.81 100% above 25%
Renin blood test inpatient CPT 84244 Assay of Renin $204.75 $273.00 $101.01–$264.81 — 25%
Rh blood typing CPT 86901 Blood Typing Serologic Rh (D) $132.00 $176.00 $3.14–$170.72 106% above 25%
Rh blood typing inpatient CPT 86901 Blood Typing Serologic Rh (D) $132.00 $176.00 $65.12–$170.72 — 25%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantatative $151.50 $202.00 $5.95–$195.94 232% above 25%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantatative $151.50 $202.00 $74.74–$195.94 — 25%
Rubella antibody test (immunity check) CPT 86762 Rubella $55.50 $74.00 $15.11–$71.78 21% above 25%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella $55.50 $74.00 $27.38–$71.78 — 25%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate RBC Auto $90.00 $120.00 $2.84–$116.40 47% above 25%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate RBC Auto $90.00 $120.00 $44.40–$116.40 — 25%
Sodium blood test CPT 84295 POC Assay Sodium Serum $94.50 $126.00 $5.05–$122.22 52% above 25%
Sodium blood test CPT 84295 Assay Sodium Serum $126.75 $169.00 $5.05–$163.93 104% above 25%
Sodium blood test inpatient CPT 84295 POC Assay Sodium Serum $94.50 $126.00 $46.62–$122.22 — 25%
Sodium blood test inpatient CPT 84295 Assay Sodium Serum $126.75 $169.00 $62.53–$163.93 — 25%
Stool ova and parasites exam CPT 87177 Ova&Parasites Dir Smrs Concentration&ID $237.00 $316.00 $9.35–$306.52 246% above 25%
Stool ova and parasites exam inpatient CPT 87177 Ova&Parasites Dir Smrs Concentration&ID $237.00 $316.00 $116.92–$306.52 — 25%
Syphilis antibody test (Treponema pallidum) CPT 86780 Antibody Treponema Pallidum $257.25 $343.00 $13.90–$332.71 482% above 25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Antibody Treponema Pallidum $257.25 $343.00 $126.91–$332.71 — 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test Qualitative $142.50 $190.00 $4.48–$184.30 248% above 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test Qualitative $142.50 $190.00 $70.30–$184.30 — 25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test, Cell Mediated Antigen Response,Gamma Interfron $193.50 $258.00 $61.92–$250.26 2% below 25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test, Cell Mediated Antigen Response,Gamma Interfron $193.50 $258.00 $95.46–$250.26 — 25%
Testosterone blood test, total (not free testosterone) CPT 84403 Tstosterone Total $261.75 $349.00 $27.10–$338.53 164% above 25%
Testosterone blood test, total (not free testosterone) CPT 84403 Tstosterone Tot $540.00 $720.00 $27.10–$698.40 444% above 25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Tstosterone Total $261.75 $349.00 $129.13–$338.53 — 25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Tstosterone Tot $540.00 $720.00 $266.40–$698.40 — 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibodies Ea $94.50 $126.00 $15.28–$122.22 13% above 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibodies Ea $94.50 $126.00 $46.62–$122.22 — 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyr Stimulating Horm $220.50 $294.00 $14.11–$285.18 100% above 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyr Stimulating Horm $220.50 $294.00 $108.78–$285.18 — 25%
Total IgE blood test CPT 82785 Assay, Gammaglobulin Ige $177.00 $236.00 $17.28–$228.92 117% above 25%
Total IgE blood test inpatient CPT 82785 Assay, Gammaglobulin Ige $177.00 $236.00 $87.32–$228.92 — 25%
Total cholesterol blood test CPT 82465 Cholesterol Serum/Whl Bld Tot $51.00 $68.00 $4.57–$65.96 9% below 25%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Serum/Whl Bld Tot $51.00 $68.00 $25.16–$65.96 — 25%
Total thyroxine (T4) blood test CPT 84436 Thyroxine Total $138.75 $185.00 $7.21–$179.45 73% above 25%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine Total $138.75 $185.00 $68.45–$179.45 — 25%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyro9 T3 Total $174.00 $232.00 $14.89–$225.04 39% above 25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyro9 T3 Total $174.00 $232.00 $85.84–$225.04 — 25%
Transferrin blood test CPT 84466 Transferrin $155.25 $207.00 $13.40–$200.79 30% above 25%
Transferrin blood test inpatient CPT 84466 Transferrin $155.25 $207.00 $76.59–$200.79 — 25%
Trichomonas test (NAAT) CPT 87661 Detection Test by Nucleic Acid for Trichomonas Vaginalis Amplif $110.25 $147.00 $35.28–$142.59 26% above 25%
Trichomonas test (NAAT) inpatient CPT 87661 Detection Test by Nucleic Acid for Trichomonas Vaginalis Amplif $110.25 $147.00 $54.39–$142.59 — 25%
Triglycerides blood test CPT 84478 Triglycerides $84.00 $112.00 $6.03–$108.64 22% above 25%
Triglycerides blood test inpatient CPT 84478 Triglycerides $84.00 $112.00 $41.44–$108.64 — 25%
Troponin test, quantitative CPT 84484 Troponin Quan $265.50 $354.00 $13.09–$343.38 133% above 25%
Troponin test, quantitative inpatient CPT 84484 Troponin Quan $265.50 $354.00 $130.98–$343.38 — 25%
Uric acid blood test CPT 84550 Uric Acid Bld $146.25 $195.00 $4.75–$189.15 87% above 25%
Uric acid blood test inpatient CPT 84550 Uric Acid Bld $146.25 $195.00 $72.15–$189.15 — 25%
Urinalysis with microscope exam, automated CPT 81001 Urnls Dip Stick/Tablet Rgnt Auto Mic $151.50 $202.00 $2.66–$195.94 62% above 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urnls Dip Stick/Tablet Rgnt Auto Mic $151.50 $202.00 $74.74–$195.94 — 25%
Urinalysis without microscope exam, automated CPT 81003 POC Urnls Dip Stick/Tablet Rgnt Auto W/O Mic $75.00 $100.00 $1.89–$97.00 55% above 25%
Urinalysis without microscope exam, automated CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Mic $100.50 $134.00 $1.89–$129.98 107% above 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC Urnls Dip Stick/Tablet Rgnt Auto W/O Mic $75.00 $100.00 $37.00–$97.00 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urnls Dip Stick/Tablet Rgnt Auto W/O Mic $100.50 $134.00 $49.58–$129.98 — 25%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture, Colony Count $315.75 $421.00 $6.78–$408.37 144% above 25%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Colony Count $315.75 $421.00 $155.77–$408.37 — 25%
Urine microalbumin (albumin) test CPT 82043 Urine Albumin Quantitative $100.50 $134.00 $6.07–$129.98 97% above 25%
Urine microalbumin (albumin) test CPT 82043 POC Urine Albumin Quantitative $119.25 $159.00 $6.07–$154.23 134% above 25%
Urine microalbumin (albumin) test inpatient CPT 82043 Urine Albumin Quantitative $100.50 $134.00 $49.58–$129.98 — 25%
Urine microalbumin (albumin) test inpatient CPT 82043 POC Urine Albumin Quantitative $119.25 $159.00 $58.83–$154.23 — 25%
Urine pregnancy test, read by color change CPT 81025 Qualitative, Urine $183.75 $245.00 $9.04–$237.65 127% above 25%
Urine pregnancy test, read by color change inpatient CPT 81025 Qualitative, Urine $183.75 $245.00 $90.65–$237.65 — 25%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin $106.50 $142.00 $15.83–$137.74 17% above 25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Cyanocobalamin $106.50 $142.00 $52.54–$137.74 — 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Assay of Vit D,Calcifediol $320.25 $427.00 $24.86–$414.19 168% above 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Assay of Vit D,Calcifediol $320.25 $427.00 $157.99–$414.19 — 25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Assay, Dihydroxyvitamin D $162.75 $217.00 $40.43–$210.49 6% above 25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Assay, Dihydroxyvitamin D $162.75 $217.00 $80.29–$210.49 — 25%
Zinc blood test CPT 84630 ZINC $122.25 $163.00 $11.96–$158.11 79% above 25%
Zinc blood test inpatient CPT 84630 ZINC $122.25 $163.00 $60.31–$158.11 — 25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic Gonadotropin Test $281.25 $375.00 $15.80–$363.75 150% above 25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chorionic Gonadotropin Test $281.25 $375.00 $138.75–$363.75 — 25%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs TexasOff list
Botox injections for chronic migraine CPT 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine $804.00 $1,072.00 $62.21–$1,039.84 44% above 25%
Botox injections for chronic migraine inpatient CPT 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine $804.00 $1,072.00 $396.64–$1,039.84 — 25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed Rx Dist Fibula Fx $693.75 $925.00 $102.38–$897.25 49% above 25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed Rx Dist Fibula Fx $693.75 $925.00 $342.25–$897.25 — 25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Rx Metatarsal Fx $635.25 $847.00 $102.38–$821.59 127% above 25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Rx Metatarsal Fx $635.25 $847.00 $313.39–$821.59 — 25%
Cardiac catheterization with coronary angiogram CPT 93458 Cath Plmt L Hrt & Arts W/Njx & Angio Img S&I $27,694.50 $36,926.00 $7,754.46–$35,818.22 164% above 25%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Cath Plmt L Hrt & Arts W/Njx & Angio Img S&I $27,694.50 $36,926.00 $13,662.62–$35,818.22 — 25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective Arrhythmia External $2,277.75 $3,037.00 $637.77–$2,945.89 71% above 25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Elective Arrhythmia External $2,277.75 $3,037.00 $1,123.69–$2,945.89 — 25%
Catheter ablation for atrial fibrillation CPT 93656 Compre Ep Eval Abltj Atr Fib $77,276.25 $103,035.00 $21,637.35–$99,943.95 155% above 25%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Compre Ep Eval Abltj Atr Fib $77,276.25 $103,035.00 $38,122.95–$99,943.95 — 25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision,Clamp,Newborn $2,567.25 $3,423.00 $685.44–$3,320.31 109% above 25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision,Clamp,Newborn $2,567.25 $3,423.00 $1,266.51–$3,320.31 — 25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Rx Dist Rad/Ulna Fx $679.50 $906.00 $102.38–$878.82 50% above 25%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed Rx Dist Rad/Ulna Fx $679.50 $906.00 $335.22–$878.82 — 25%
Colonoscopy with endoscopic ultrasound CPT 45391 Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux $2,502.75 $3,337.00 $515.11–$3,236.89 136% above 25%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux $2,502.75 $3,337.00 $1,234.69–$3,236.89 — 25%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $3,720.00 $4,960.00 $515.11–$4,811.20 184% above 25%
Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq $3,720.00 $4,960.00 $1,835.20–$4,811.20 — 25%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple $4,345.50 $5,794.00 $515.11–$5,620.18 205% above 25%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy Single/Multiple $4,345.50 $5,794.00 $2,143.78–$5,620.18 — 25%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $2,677.50 $3,570.00 $394.20–$3,462.90 74% above 25%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd $2,677.50 $3,570.00 $1,320.90–$3,462.90 — 25%
Coronary stent placement, one artery CPT 92928 Prq Trluml Coronary Stent W/Angio One Art/Brnch $17,949.00 $23,932.00 $5,025.72–$23,214.04 53% above 25%
Coronary stent placement, one artery inpatient CPT 92928 Prq Trluml Coronary Stent W/Angio One Art/Brnch $17,949.00 $23,932.00 $8,854.84–$23,214.04 — 25%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Incision of Eardrum With Insertion of Eardrum Tube Under Local or Topical Anesthesia $1,734.00 $2,312.00 $123.54–$3,015.00 102% above 25%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Incision of Eardrum With Insertion of Eardrum Tube Under Local or Topical Anesthesia $1,734.00 $2,312.00 $855.44–$2,242.64 — 25%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat $197.25 $263.00 $55.23–$255.11 77% above 25%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat $197.25 $263.00 $97.31–$255.11 — 25%
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat $192.00 $256.00 $53.76–$248.32 55% above 25%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat $192.00 $256.00 $94.72–$248.32 — 25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn $3,317.25 $4,423.00 $276.00–$4,290.31 131% above 25%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn $3,317.25 $4,423.00 $1,636.51–$4,290.31 — 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flexible Dx W/Collection Specimen Brushing/Washing if Pfrmd $2,412.00 $3,216.00 $152.77–$3,119.52 179% above 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy Flexible Dx W/Collection Specimen Brushing/Washing if Pfrmd $2,412.00 $3,216.00 $1,189.92–$3,119.52 — 25%
IUD insertion (the device itself billed separately) CPT 58300 Insert Intrauterine Device $341.25 $455.00 $95.55–$441.35 10% below 25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insert Intrauterine Device $341.25 $455.00 $168.35–$441.35 — 25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Abscess Smpl/1 $730.50 $974.00 $68.31–$944.78 63% above 25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc Smpl/1 $730.50 $974.00 $68.31–$944.78 63% above 25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Abscess Smpl/1 $730.50 $974.00 $360.38–$944.78 — 25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc Smpl/1 $730.50 $974.00 $360.38–$944.78 — 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US $848.25 $1,131.00 $29.36–$1,097.07 43% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US $848.25 $1,131.00 $418.47–$1,097.07 — 25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Drug Delivery Implant $344.25 $459.00 $48.70–$445.23 43% above 25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion Drug Delivery Implant $344.25 $459.00 $169.83–$445.23 — 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US $750.75 $1,001.00 $24.72–$970.97 28% above 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US $750.75 $1,001.00 $370.37–$970.97 — 25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US $747.00 $996.00 $23.84–$966.12 76% above 25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US $747.00 $996.00 $368.52–$966.12 — 25%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Post-Cataract Laser Surgery $1,749.00 $2,332.00 $218.75–$2,262.04 32% above 25%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Post-Cataract Laser Surgery $1,749.00 $2,332.00 $862.84–$2,262.04 — 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate Scalp/Axillae/Trunk/Extremities $957.75 $1,277.00 $171.70–$1,238.69 80% above 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Intermediate Scalp/Axillae/Trunk/Extremities $957.75 $1,277.00 $472.49–$1,238.69 — 25%
Left heart catheterization, diagnostic CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $24,074.25 $32,099.00 $6,740.79–$31,136.03 158% above 25%
Left heart catheterization, diagnostic inpatient CPT 93452 L Hrt Cath W/Njx L Ventriculography Img S&I $24,074.25 $32,099.00 $11,876.63–$31,136.03 — 25%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $2,481.00 $3,308.00 $276.00–$3,208.76 48% above 25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn $2,481.00 $3,308.00 $1,223.96–$3,208.76 — 25%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $1,292.25 $1,723.00 $276.00–$1,671.31 5% above 25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn $1,292.25 $1,723.00 $637.51–$1,671.31 — 25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $3,030.75 $4,041.00 $357.81–$3,919.77 106% above 25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level $3,030.75 $4,041.00 $1,495.17–$3,919.77 — 25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision, Benign Lesion, Trunk/Arms/Legs $879.00 $1,172.00 $81.68–$1,136.84 9% above 25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision, Benign Lesion, Trunk/Arms/Legs $879.00 $1,172.00 $433.64–$1,136.84 — 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excision, Benign Lesion, Face/Head $903.00 $1,204.00 $90.70–$1,167.88 2% above 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excision, Benign Lesion, Face/Head $903.00 $1,204.00 $445.48–$1,167.88 — 25%
Nail removal (partial or complete), one nail CPT 11730 Removal of Nail Plate $777.00 $1,036.00 $217.56–$1,004.92 175% above 25%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal of Nail Plate $777.00 $1,036.00 $383.32–$1,004.92 — 25%
Occipital nerve block (injection for headaches) CPT 64405 Injection Aa&/Strd Greater Occipital Nerve $1,217.25 $1,623.00 $31.69–$1,574.31 185% above 25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection Aa&/Strd Greater Occipital Nerve $1,217.25 $1,623.00 $600.51–$1,574.31 — 25%
Pacemaker implant (dual chamber) CPT 33208 Ins New/Rplcmt M Pm W/Transv Eltrd Atrial&Vent $13,669.50 $18,226.00 $436.48–$17,679.22 28% below 25%
Pacemaker implant (dual chamber) inpatient CPT 33208 Ins New/Rplcmt M Pm W/Transv Eltrd Atrial&Vent $13,669.50 $18,226.00 $6,743.62–$17,679.22 — 25%
Paracentesis with imaging guidance CPT 49083 Abdom Paracentesis Dx/Ther W Imaging Guidance $1,328.25 $1,771.00 $371.91–$1,717.87 9% below 25%
Paracentesis with imaging guidance inpatient CPT 49083 Abdom Paracentesis Dx/Ther W Imaging Guidance $1,328.25 $1,771.00 $655.27–$1,717.87 — 25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of Nail Bed $932.25 $1,243.00 $101.65–$1,205.71 83% above 25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal of Nail Bed $932.25 $1,243.00 $459.91–$1,205.71 — 25%
Removal of a foreign object under the skin, simple CPT 10120 Inc&Rmvl FB Subq Tiss Smpl $1,046.25 $1,395.00 $90.70–$1,353.15 97% above 25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc&Rmvl FB Subq Tiss Smpl $1,046.25 $1,395.00 $516.15–$1,353.15 — 25%
Short arm cast (elbow to hand) CPT 29075 Apply Forearm Cast $495.00 $660.00 $54.16–$640.20 77% above 25%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Forearm Cast $495.00 $660.00 $244.20–$640.20 — 25%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint,Static $363.75 $485.00 $101.85–$470.45 61% above 25%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint,Static $363.75 $485.00 $179.45–$470.45 — 25%
Short leg cast (below the knee) CPT 29405 Apply Short Leg Cast $490.50 $654.00 $46.84–$634.38 45% above 25%
Short leg cast (below the knee) inpatient CPT 29405 Apply Short Leg Cast $490.50 $654.00 $241.98–$634.38 — 25%
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint $299.25 $399.00 $36.05–$387.03 10% above 25%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint $299.25 $399.00 $147.63–$387.03 — 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Lac Repair, Simple 2.5cm or Less $540.75 $721.00 $151.41–$699.37 49% above 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Lac Repair, Simple 2.5cm or Less $540.75 $721.00 $266.77–$699.37 — 25%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion $445.50 $594.00 $83.43–$576.18 1% above 25%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Single Lesion $445.50 $594.00 $219.78–$576.18 — 25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Diagnostic Lumbar Spinal Puncture $795.75 $1,061.00 $222.81–$1,029.17 24% below 25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Diagnostic Lumbar Spinal Puncture $795.75 $1,061.00 $392.57–$1,029.17 — 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Lac Repair 2.6cm-7.5cm $557.25 $743.00 $156.03–$720.71 22% above 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Lac Repair 2.6cm-7.5cm $557.25 $743.00 $274.91–$720.71 — 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Rpr Superficial Wnds Face/Ear(S)/Eyelid(S)/Nose/Lips/Mucous Membrn 2.5cm/< $557.25 $743.00 $156.03–$720.71 43% above 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Rpr Superficial Wnds Face/Ear(S)/Eyelid(S)/Nose/Lips/Mucous Membrn 2.5cm/< $557.25 $743.00 $274.91–$720.71 — 25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion $445.50 $594.00 $124.74–$576.18 24% above 25%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential Biopsy Skin Single Lesion $445.50 $594.00 $219.78–$576.18 — 25%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Needle/Cath Pleura W/Imaging $1,803.75 $2,405.00 $234.94–$2,332.85 28% above 25%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Needle/Cath Pleura W/Imaging $1,803.75 $2,405.00 $889.85–$2,332.85 — 25%
Trigger point injections, 1 or 2 muscles CPT 20552 Njx 1/Mlt Trigger Point 1/2 Musc $308.25 $411.00 $24.42–$398.67 30% below 25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Njx 1/Mlt Trigger Point 1/2 Musc $308.25 $411.00 $152.07–$398.67 — 25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast W Device 1st Lesion Ultrasound Guide $4,083.75 $5,445.00 $510.77–$5,281.65 48% above 25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast W Device 1st Lesion Ultrasound Guide $4,083.75 $5,445.00 $2,014.65–$5,281.65 — 25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus $3,074.25 $4,099.00 $677.96–$3,976.03 109% above 25%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Egd Balloon Dilation Esophagus $3,074.25 $4,099.00 $1,516.63–$3,976.03 — 25%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple $3,574.50 $4,766.00 $401.94–$6,850.00 202% above 25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Transoral Biopsy Single/Multiple $3,574.50 $4,766.00 $1,763.42–$4,623.02 — 25%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection $3,074.25 $4,099.00 $401.94–$3,976.03 320% above 25%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Esophagogastroduodenoscopy Submucosal Injection $3,074.25 $4,099.00 $1,516.63–$3,976.03 — 25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech $2,674.50 $3,566.00 $677.96–$3,459.02 135% above 25%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech $2,674.50 $3,566.00 $1,319.42–$3,459.02 — 25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus $3,395.25 $4,527.00 $401.94–$4,391.19 364% above 25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus $3,395.25 $4,527.00 $1,674.99–$4,391.19 — 25%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $3,474.00 $4,632.00 $401.94–$4,493.04 139% above 25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic $3,474.00 $4,632.00 $1,713.84–$4,493.04 — 25%
Vein ablation, radiofrequency, first vein CPT 36475 Endoven Abltj Incmptnt Vein Xtr Rf 1st Vein $9,321.75 $12,429.00 $1,174.13–$12,056.13 124% above 25%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endoven Abltj Incmptnt Vein Xtr Rf 1st Vein $9,321.75 $12,429.00 $4,598.73–$12,056.13 — 25%
Wart removal, up to 14 warts CPT 17110 Destruc Flat Warts, Up to 14 Lesions $445.50 $594.00 $124.74–$576.18 123% above 25%
Wart removal, up to 14 warts inpatient CPT 17110 Destruc Flat Warts, Up to 14 Lesions $445.50 $594.00 $219.78–$576.18 — 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm $1,292.25 $1,723.00 $107.46–$1,671.31 28% above 25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm $1,292.25 $1,723.00 $637.51–$1,671.31 — 25%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs TexasOff list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Bld/Bld Components $1,470.00 $1,960.00 $34.74–$6,200.00 92% above 25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Bld/Bld Components $1,470.00 $1,960.00 $725.20–$1,901.20 — 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpressurized Inhalation Treatment $192.00 $256.00 $53.76–$248.32 6% below 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressurized/Nonpressurized Inhalation Treatment $192.00 $256.00 $94.72–$248.32 — 25%
Chemotherapy IV infusion, first hour CPT 96413 Chemother, IV Infusion, 1 Hr $742.50 $990.00 $207.90–$960.30 37% above 25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemother, IV Infusion, 1 Hr $742.50 $990.00 $366.30–$960.30 — 25%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Hearing Test $508.50 $678.00 $142.38–$657.66 70% above 25%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Comprehensive Hearing Test $508.50 $678.00 $250.86–$657.66 — 25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg,W/Awake & Drowsy Record $1,315.50 $1,754.00 $368.34–$1,701.38 43% above 25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg,W/Awake & Drowsy Record $1,315.50 $1,754.00 $648.98–$1,701.38 — 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, Tracing $413.25 $551.00 $115.71–$534.47 52% above 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram, Tracing $413.25 $551.00 $203.87–$534.47 — 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Service Level I $323.25 $431.00 $90.51–$418.07 38% above 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Service Level I $323.25 $431.00 $159.47–$418.07 — 25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Service Level II $683.25 $911.00 $191.31–$883.67 58% above 25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Service Level II $683.25 $911.00 $337.07–$883.67 — 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Service Level III $1,226.25 $1,635.00 $343.35–$1,585.95 59% above 25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Service Level III $1,226.25 $1,635.00 $604.95–$1,585.95 — 25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Service Level IV $1,963.50 $2,618.00 $549.78–$2,539.46 52% above 25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Service Level IV $1,963.50 $2,618.00 $968.66–$2,539.46 — 25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Service Level V $2,931.00 $3,908.00 $820.68–$3,790.76 65% above 25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Service Level V $2,931.00 $3,908.00 $1,445.96–$3,790.76 — 25%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Tst,Tracing Only $1,317.75 $1,757.00 $368.97–$1,704.29 5% above 25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Tst,Tracing Only $1,317.75 $1,757.00 $650.09–$1,704.29 — 25%
Family therapy with the patient, 50 minutes CPT 90847 Family Psychotherapy W/Patient Esent 50 Mins $620.25 $827.00 $173.67–$802.19 120% above 25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psychotherapy W/Patient Esent 50 Mins $620.25 $827.00 $305.99–$802.19 — 25%
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Patient Esent 50 Mins $585.75 $781.00 $164.01–$757.57 127% above 25%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Patient Esent 50 Mins $585.75 $781.00 $288.97–$757.57 — 25%
Group psychotherapy session CPT 90853 Group Psychotherapy $324.75 $433.00 $90.93–$420.01 100% above 25%
Group psychotherapy session inpatient CPT 90853 Group Psychotherapy $324.75 $433.00 $160.21–$420.01 — 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV Infusion, Init $389.25 $519.00 $108.99–$503.43 10% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV Infusion, Init $389.25 $519.00 $192.03–$503.43 — 25%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag IV Inf, Init $576.00 $768.00 $161.28–$744.96 28% above 25%
IV infusion of a medicine, first hour CPT 96365 Med Admin-IV-1st Hr $576.00 $768.00 $161.28–$744.96 28% above 25%
IV infusion of a medicine, first hour inpatient CPT 96365 Med Admin-IV-1st Hr $576.00 $768.00 $284.16–$744.96 — 25%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag IV Inf, Init $576.00 $768.00 $284.16–$744.96 — 25%
IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj, IV Push $285.00 $380.00 $79.80–$368.60 24% above 25%
IV push of a medicine, first drug CPT 96374 Med IV Push - 1st Drug $285.00 $380.00 $79.80–$368.60 24% above 25%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj, IV Push $285.00 $380.00 $140.60–$368.60 — 25%
IV push of a medicine, first drug inpatient CPT 96374 Med IV Push - 1st Drug $285.00 $380.00 $140.60–$368.60 — 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj, Sc/Im $167.25 $223.00 $46.83–$216.31 14% above 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Subq/Intramuscular $167.25 $223.00 $46.83–$216.31 14% above 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection,Subq/Intramuscular $167.25 $223.00 $82.51–$216.31 — 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj, Sc/Im $167.25 $223.00 $82.51–$216.31 — 25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation $469.50 $626.00 $131.46–$607.22 22% above 25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diagnostic Evaluation $469.50 $626.00 $231.62–$607.22 — 25%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Motor &/Sens 7-8 Nrv Cndj Econf Eltrode Limb $225.00 $300.00 $63.00–$291.00 69% below 25%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Motor &/Sens 7-8 Nrv Cndj Econf Eltrode Limb $225.00 $300.00 $111.00–$291.00 — 25%
Neuromuscular re-education, 15 minutes CPT 97112 Ther Px 1+ Areas Ea 15 Min Neuromusc Reeducaj $155.25 $207.00 $43.47–$200.79 38% above 25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Ther Px 1+ Areas Ea 15 Min Neuromusc Reeducaj $155.25 $207.00 $76.59–$200.79 — 25%
New patient office visit, about 30 minutes CPT 99203 Office/Outpatient New Low Mdm 30-44 Minutes $536.25 $715.00 $150.15–$693.55 137% above 25%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient New Low Mdm 30-44 Minutes $536.25 $715.00 $264.55–$693.55 — 25%
New patient office visit, about 45 minutes CPT 99204 Office/Outpatient New Moderate Mdm 45-59 Minutes $687.00 $916.00 $192.36–$888.52 135% above 25%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient New Moderate Mdm 45-59 Minutes $687.00 $916.00 $338.92–$888.52 — 25%
New patient office visit, about 60 minutes CPT 99205 Office/Outpatient New High Mdm 60-74 Minutes $849.75 $1,133.00 $237.93–$1,099.01 191% above 25%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient New High Mdm 60-74 Minutes $849.75 $1,133.00 $419.21–$1,099.01 — 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/Outpatient New Sf Mdm 15-29 Minutes $347.25 $463.00 $97.23–$449.11 133% above 25%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/Outpatient New Sf Mdm 15-29 Minutes $347.25 $463.00 $171.31–$449.11 — 25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Nutrition Therapy, 1st Assessment, Each 15 Min $75.00 $100.00 $21.00–$97.00 49% above 25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Nutrition Therapy, 1st Assessment, Each 15 Min $75.00 $100.00 $37.00–$97.00 — 25%
Occupational therapy evaluation, low complexity CPT 97165 Occupational Therapy Eval Low Complex 30 Mins $445.50 $594.00 $124.74–$576.18 83% above 25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Occupational Therapy Eval Low Complex 30 Mins $445.50 $594.00 $219.78–$576.18 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 15 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 30 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 45 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 60 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 75 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 120 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 105 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation High Complex 90 Mins $366.75 $489.00 $102.69–$474.33 27% above 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 15 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 105 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 90 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 75 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 60 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 45 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 30 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy Evaluation High Complex 120 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 15 Mins $353.25 $471.00 $98.91–$456.87 75% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 90 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 120 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 75 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 60 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 45 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 30 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Low Complex 105 Mins $366.75 $489.00 $102.69–$474.33 82% above 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 15 Mins $353.25 $471.00 $174.27–$456.87 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 60 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 45 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 30 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 75 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 105 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 90 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Evaluation Low Complex 120 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 90 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 105 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 120 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 75 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 60 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 45 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 30 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Mod Complex 15 Mins $366.75 $489.00 $102.69–$474.33 51% above 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 30 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 120 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 105 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 90 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 75 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 60 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 45 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Evaluation Mod Complex 15 Mins $366.75 $489.00 $180.93–$474.33 — 25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Mnl Ther Tqs 1+ Regions Ea 15 Min $152.25 $203.00 $42.63–$196.91 38% above 25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Mnl Ther Tqs 1+ Regions Ea 15 Min $152.25 $203.00 $75.11–$196.91 — 25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther Px 1+ Areas Ea 15 Min Ther Xerss $168.00 $224.00 $47.04–$217.28 50% above 25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther Px 1+ Areas Ea 15 Min Ther Xerss $168.00 $224.00 $82.88–$217.28 — 25%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psychological Tst Eval Svc Phys/Qhp First Hour $633.75 $845.00 $177.45–$819.65 107% above 25%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psychological Tst Eval Svc Phys/Qhp First Hour $633.75 $845.00 $312.65–$819.65 — 25%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis Initial 60 Minutes $343.50 $458.00 $96.18–$444.26 5% above 25%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis Initial 60 Minutes $343.50 $458.00 $169.46–$444.26 — 25%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/Patient 30 Minutes $353.25 $471.00 $98.91–$456.87 87% above 25%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/Patient 30 Minutes $353.25 $471.00 $174.27–$456.87 — 25%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/Patient 45 Minutes $551.25 $735.00 $154.35–$712.95 101% above 25%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/Patient 45 Minutes $551.25 $735.00 $271.95–$712.95 — 25%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/Patient 60 Minutes $690.00 $920.00 $193.20–$892.40 151% above 25%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/Patient 60 Minutes $690.00 $920.00 $340.40–$892.40 — 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpatient Established High Mdm 40-54 Min $651.00 $868.00 $182.28–$841.96 129% above 25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/Outpatient Established High Mdm 40-54 Min $651.00 $868.00 $321.16–$841.96 — 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpatient Established Low Mdm 20-29 Min $231.75 $309.00 $64.89–$299.73 32% above 25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office/Outpatient Established Low Mdm 20-29 Min $231.75 $309.00 $114.33–$299.73 — 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpatient Established Mod Mdm 30-39 Min $353.25 $471.00 $98.91–$456.87 83% above 25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office/Outpatient Established Mod Mdm 30-39 Min $353.25 $471.00 $174.27–$456.87 — 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpatient Established Sf Mdm 10-19 Min $231.75 $309.00 $64.89–$299.73 84% above 25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/Outpatient Established Sf Mdm 10-19 Min $231.75 $309.00 $114.33–$299.73 — 25%
Speech and language evaluation CPT 92523 Eval Speech Sound Oduct Language Comehension $593.25 $791.00 $166.11–$767.27 56% above 25%
Speech and language evaluation inpatient CPT 92523 Eval Speech Sound Oduct Language Comehension $593.25 $791.00 $292.67–$767.27 — 25%
Speech therapy session, individual CPT 92507 Tx Sp Lang Comunicaj Pcx Disorder Indiv $366.75 $489.00 $102.69–$474.33 69% above 25%
Speech therapy session, individual inpatient CPT 92507 Tx Sp Lang Comunicaj Pcx Disorder Indiv $366.75 $489.00 $180.93–$474.33 — 25%
Spirometry (breathing test) CPT 94010 Spirometry W/Vc Expiratory Flo +-Mxml Vol Vntj $444.00 $592.00 $124.32–$574.24 24% above 25%
Spirometry (breathing test) inpatient CPT 94010 Spirometry W/Vc Expiratory Flo +-Mxml Vol Vntj $444.00 $592.00 $219.04–$574.24 — 25%
Spirometry before and after a bronchodilator CPT 94060 Eval of Bronchospasm $741.00 $988.00 $207.48–$958.36 25% above 25%
Spirometry before and after a bronchodilator inpatient CPT 94060 Eval of Bronchospasm $741.00 $988.00 $365.56–$958.36 — 25%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeut Actvity Direct Pt Contact Each 15 Min $158.25 $211.00 $44.31–$204.67 41% above 25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeut Actvity Direct Pt Contact Each 15 Min $158.25 $211.00 $78.07–$204.67 — 25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Ther Spx $241.50 $322.00 $67.62–$312.34 8% above 25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Ther Spx $241.50 $322.00 $119.14–$312.34 — 25%
Visual field test, extended both sides CPT 92083 Vis Fld Xm Uni/Bi I&R Extnd Xm $360.75 $481.00 $101.01–$466.57 — 25%
Visual field test, extended inpatient both sides CPT 92083 Vis Fld Xm Uni/Bi I&R Extnd Xm $360.75 $481.00 $177.97–$466.57 — 25%

Vaccines

ProcedureCash priceList priceInsurers payvs TexasOff list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID vac 25-26(12up)(Mod)(PF) 50 mcg/0.5 mL Syrg 0.5 mL Syringe $638.10 $850.80 $178.67–$825.28 420% above 25%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID vac 25-26(12up)(Mod)(PF) 50 mcg/0.5 mL Syrg 0.5 mL Syringe $638.10 $850.80 $314.80–$825.28 — 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID vac 25-26(12up)(Pfi)(PF) 30 mcg/0.3 mL Syrg 0.3 mL Syringe $764.30 $1,019.06 $214.00–$988.49 358% above 25%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID vac 25-26(12up)(Pfi)(PF) 30 mcg/0.3 mL Syrg 0.3 mL Syringe $764.30 $1,019.06 $377.05–$988.49 — 25%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (varicella) Susr 1 Each Vial $1,465.47 $1,953.96 $410.33–$1,895.34 196% above 25%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (varicella) Susr 1 Each Vial $1,465.47 $1,953.96 $722.97–$1,895.34 — 25%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX (DTaP-IPV) Syrg 0.5 mL Syringe $570.84 $761.12 $159.84–$738.29 691% above 25%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX (DTaP-IPV) Syrg 0.5 mL Syringe $570.84 $761.12 $281.61–$738.29 — 25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX (DTaP) Syrg 0.5 mL Syringe $271.08 $361.44 $75.90–$350.60 200% above 25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL (DTaP) Susp 0.5 mL Vial $278.49 $371.31 $77.98–$360.17 209% above 25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX (DTaP) Syrg 0.5 mL Syringe $271.08 $361.44 $133.73–$350.60 — 25%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL (DTaP) Susp 0.5 mL Vial $278.49 $371.31 $137.38–$360.17 — 25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX (DTaP-Hep B-IPV) Syrg 0.5 mL Syringe $831.15 $1,108.20 $232.72–$1,074.95 331% above 25%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX (DTaP-Hep B-IPV) Syrg 0.5 mL Syringe $831.15 $1,108.20 $410.03–$1,074.95 — 25%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL (DTaP-IPV-Hib) Kit 1 Each KIT $793.09 $1,057.45 $222.06–$1,025.73 183% above 25%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL (DTaP-IPV-Hib) Kit 1 Each KIT $793.09 $1,057.45 $391.26–$1,025.73 — 25%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS (DTaP-Hep B-IPV-Hib) Syrg 0.5 mL Syringe $1,249.97 $1,666.62 $349.99–$1,616.62 451% above 25%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS (DTaP-Hep B-IPV-Hib) Syrg 0.5 mL Syringe $1,249.97 $1,666.62 $616.65–$1,616.62 — 25%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 flu vaccine EGG FREE 2025-2026 (9 yrs +) Syrg 0.5 mL Syringe $56.25 $75.00 $15.75–$72.75 84% below 25%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 flu vaccine EGG FREE 2025-2026 (9 yrs +) Syrg 0.5 mL Syringe $56.25 $75.00 $27.75–$72.75 — 25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 flu vaccine 2025-2026 (6 months +) Syrg 0.5 mL Syringe $26.24 $34.98 $7.35–$33.93 30% below 25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 flu vaccine 2025-2026 (6 months +) Syrg 0.5 mL Syringe $26.24 $34.98 $12.94–$33.93 — 25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (hpv) Syrg 0.5 mL Syringe $2,501.01 $3,334.67 $700.28–$3,234.63 357% above 25%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (hpv) Syrg 0.5 mL Syringe $2,501.01 $3,334.67 $1,233.83–$3,234.63 — 25%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (hep A & B) 720 ELISA unit- 20 mcg/mL Syrg 1 mL Syringe $1,077.88 $1,437.17 $301.81–$1,394.05 68% above 25%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (hep A & B) 720 ELISA unit- 20 mcg/mL Syrg 1 mL Syringe $1,077.88 $1,437.17 $531.75–$1,394.05 — 25%
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (hep A) 1,440 ELISA unit/mL Syrg 1 mL Syringe $690.21 $920.27 $193.26–$892.66 271% above 25%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (hep A) 1,440 ELISA unit/mL Syrg 1 mL Syringe $690.21 $920.27 $340.50–$892.66 — 25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX (hep A) 720 ELISA unit/0.5 mL Syrg 0.5 mL Syringe $369.52 $492.69 $103.46–$477.91 294% above 25%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX (hep A) 720 ELISA unit/0.5 mL Syrg 0.5 mL Syringe $369.52 $492.69 $182.30–$477.91 — 25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (hep B) 20 mcg/mL Syrg 1 mL Syringe $678.54 $904.71 $189.99–$877.57 303% above 25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (hep B) 20 mcg/mL Syrg 1 mL Syringe $678.54 $904.71 $334.74–$877.57 — 25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B (hep B) 10 mcg/0.5 mL Syrg 0.5 mL Syringe $279.27 $372.35 $78.19–$361.18 231% above 25%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B (hep B) 10 mcg/0.5 mL Syrg 0.5 mL Syringe $279.27 $372.35 $137.77–$361.18 — 25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB (haemophilus B) Solr 1 Each Vial $135.55 $180.73 $37.95–$175.31 188% above 25%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB (haemophilus B) Solr 1 Each Vial $135.55 $180.73 $66.87–$175.31 — 25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (measles-mumps-rubella) Solr 1 Each Vial $742.55 $990.06 $207.91–$960.36 214% above 25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (measles-mumps-rubella) Solr 1 Each Vial $742.55 $990.06 $366.32–$960.36 — 25%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PROQUAD (measles-mumps-rubella-varicella) Susr 1 Each Vial $2,182.19 $2,909.58 $611.01–$2,822.29 791% above 25%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PROQUAD (measles-mumps-rubella-varicella) Susr 1 Each Vial $2,182.19 $2,909.58 $1,076.54–$2,822.29 — 25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO (meningococcal A,C,Y,W-135) Kit 1 Each KIT $1,349.00 $1,798.66 $377.72–$1,744.70 280% above 25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO (meningococcal A,C,Y,W-135) Kit 1 Each KIT $1,349.00 $1,798.66 $665.50–$1,744.70 — 25%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI (MENINGOCOCCAL A,C,Y,W-135) Soln 0.5 mL Vial $1,352.02 $1,802.69 $378.56–$1,748.61 104% above 25%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI (MENINGOCOCCAL A,C,Y,W-135) Soln 0.5 mL Vial $1,352.02 $1,802.69 $667.00–$1,748.61 — 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO (meningococcal B) Syrg 0.5 mL Syringe $1,912.98 $2,550.64 $535.63–$2,474.12 216% above 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO (meningococcal B) Syrg 0.5 mL Syringe $1,912.98 $2,550.64 $943.74–$2,474.12 — 25%
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA (meningococcal B) Syrg 0.5 mL Syringe $1,720.96 $2,294.61 $481.87–$2,225.77 129% above 25%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA (meningococcal B) Syrg 0.5 mL Syringe $1,720.96 $2,294.61 $849.01–$2,225.77 — 25%
Nasal spray flu vaccine, live (FluMist) CPT 90660 flu vaccine (2025-2026) NASAL (2-49yrs) Nssy 1 Each Syringe $42.09 $56.11 $11.78–$54.43 136% above 25%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 flu vaccine (2025-2026) NASAL (2-49yrs) Nssy 1 Each Syringe $42.09 $56.11 $20.76–$54.43 — 25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 (pneumococcal) Syrg 0.5 mL Syringe $1,724.90 $2,299.86 $482.97–$2,230.86 254% above 25%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 (pneumococcal) Syrg 0.5 mL Syringe $1,724.90 $2,299.86 $850.95–$2,230.86 — 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (pneumococcal) Syrg 0.5 mL Syringe $2,410.81 $3,214.41 $675.03–$3,117.98 328% above 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (pneumococcal) Syrg 0.5 mL Syringe $2,410.81 $3,214.41 $1,189.33–$3,117.98 — 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 (pneumococcal) Soln 1 Each Vial $776.15 $1,034.86 $217.32–$1,003.81 207% above 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 (pneumococcal) Syrg 0.5 mL Syringe $903.88 $1,205.17 $253.09–$1,169.01 257% above 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 (pneumococcal) Soln 1 Each Vial $776.15 $1,034.86 $382.90–$1,003.81 — 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 (pneumococcal) Syrg 0.5 mL Syringe $903.88 $1,205.17 $445.91–$1,169.01 — 25%
Polio vaccine, inactivated (IPV) CPT 90713 IPOL (poliovirus) Susp 5 mL Vial $436.37 $581.82 $122.18–$564.37 31% above 25%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPOL (poliovirus) Susp 5 mL Vial $436.37 $581.82 $215.27–$564.37 — 25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab-alip (BEYFORTUS) 100 mg/mL Syrg 1 mL Syringe $3,623.03 $4,830.70 $1,014.45–$4,685.78 270% above 25%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab-alip (BEYFORTUS) 100 mg/mL Syrg 1 mL Syringe $3,623.03 $4,830.70 $1,787.36–$4,685.78 — 25%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip (BEYFORTUS) 50 mg/0.5 mL Syrg 0.5 mL Syringe $3,623.03 $4,830.70 $1,014.45–$4,685.78 270% above 25%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip (BEYFORTUS) 50 mg/0.5 mL Syrg 0.5 mL Syringe $3,623.03 $4,830.70 $1,787.36–$4,685.78 — 25%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine, PCEC 2.5 unit Susr 1 Each KIT $2,651.18 $3,534.90 $742.33–$3,428.85 158% above 25%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, PCEC 2.5 unit Susr 1 Each KIT $2,651.18 $3,534.90 $1,307.91–$3,428.85 — 25%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTATEQ (rotavirus) Soln 2 mL Tube $471.90 $629.19 $132.13–$610.31 359% above 25%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTATEQ (rotavirus) Soln 2 mL Tube $471.90 $629.19 $232.80–$610.31 — 25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (Td) Syrg 0.5 mL Syringe $412.87 $550.49 $115.60–$533.98 277% above 25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (Td) Syrg 0.5 mL Syringe $412.87 $550.49 $203.68–$533.98 — 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX (Tdap) Syrg 0.5 mL Syringe $443.73 $591.64 $124.24–$573.89 240% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (Tdap) Syrg 0.5 mL Syringe $452.05 $602.73 $126.57–$584.65 246% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX (Tdap) Syrg 0.5 mL Syringe $443.73 $591.64 $218.91–$573.89 — 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (Tdap) Syrg 0.5 mL Syringe $452.05 $602.73 $223.01–$584.65 — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Administration, First Shot $10.32 $13.75 $2.89–$13.34 86% below 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Administration, First Shot $10.32 $13.75 $5.09–$13.34 — 25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Administration, Each Additional Shot $10.32 $13.75 $2.89–$13.34 78% below 25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Administration, Each Additional Shot $10.32 $13.75 $5.09–$13.34 — 25%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://assets.childrens.com/asset/e4699fb1-3c03-422e-b1ee-c8ed4ee1422d/DALLAS-Price-Transparency-CSV-Cost-Estimates.csv