Baylor Scott and White Medical Center Sunnyvale
Listed in its price file as “Texas Regional Medical Center, LLC”.
Baylor Scott and White Medical Center Sunnyvale in Sunnyvale, TX publishes cash prices for 398 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Texas median for 245 of 395 procedures and below it for 150. By typical cash price it ranks #210 of 297 Texas hospitals and #56 of 82 hospitals in the Dallas, TX area, cheapest first. Select a procedure to compare it with other hospitals nearby.
231 S Collins Rd, Sunnyvale, TX 75182 Collected Sep 22, 2026 Source price file Check a bill from this hospital (972) 892-3000
Acute care hospital For-profit hospital Emergency department CMS star rating 2 of 5 CCN 670060 · CMS hospital register NPI 1255579389
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Adrenal Protocol 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | 38% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | 38% below | 40% |
| Abdominal CT scan without and with contrast CPT 74170 BCE CT Abdomen w/o & w/contrast 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | 38% below | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Adrenal Protocol 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 BCE CT Abdomen w/o & w/contrast 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast 74170 | $1,779.00 | $2,965.00 | $167.39–$2,741.26 | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views 74019 | $209.40 | $349.00 | $100.16–$332.84 | 45% below | 40% |
| Abdominal X-ray, 2 views CPT 74019 XR abdomen 2 views 74019 | $209.40 | $349.00 | $100.16–$332.84 | 45% below | 40% |
| Abdominal X-ray, 2 views CPT 74019 BCE Radiologic examination, abdomen; 2 views 74019 | $209.40 | $349.00 | $100.16–$332.84 | 45% below | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 BCE Radiologic examination, abdomen; 2 views 74019 | $209.40 | $349.00 | $100.16–$332.84 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views 74019 | $209.40 | $349.00 | $100.16–$332.84 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR abdomen 2 views 74019 | $209.40 | $349.00 | $100.16–$332.84 | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Bilateral 73610 | $246.60 | $411.00 | $82.79–$380.09 | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 BCE XR Ankle, complete min 3 views 73610 | $246.60 | $411.00 | $82.79–$380.09 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Left 73610 | $246.60 | $411.00 | $82.79–$380.09 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Right 73610 | $246.60 | $411.00 | $82.79–$380.09 | 31% below | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Bilateral 73610 | $246.60 | $411.00 | $82.79–$380.09 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 BCE XR Ankle, complete min 3 views 73610 | $246.60 | $411.00 | $82.79–$380.09 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Right 73610 | $246.60 | $411.00 | $82.79–$380.09 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Left 73610 | $246.60 | $411.00 | $82.79–$380.09 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 BCE US Lmt bl physiologic of U/LE art 93922 | $370.80 | $618.00 | $116.38 | 39% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 BCE US Lmt bl physiologic of U/LE art 93922 | $370.80 | $618.00 | $116.38 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Shoulder w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Forearm w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Elbow w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Hand w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Humerus w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Wrist w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 BCE CT UE; w/o contrast 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Upper Extremity w/+w/o Cont Bl 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/+w/o Cont Lt 73202 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/+w/o Cont Rt 73202 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/ Cont Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/ Cont Right 73201 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | 4% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Elbow w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Shoulder w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Humerus w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Forearm w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Wrist w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Hand w/o Contrast Bilateral 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Upper Extremity w/+w/o Cont Bl 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 BCE CT UE; w/o contrast 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/ Cont Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/ Cont Right 73201 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/+w/o Cont Lt 73202 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/+w/o Cont Rt 73202 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right 73200 | $1,579.80 | $2,633.00 | $100.16–$2,434.35 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Upper GI w/ Gastrografin 74220 | $403.80 | $673.00 | $167.39–$622.35 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus 74220 | $403.80 | $673.00 | $167.39–$622.35 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BCE XR Esophagus 74220 | $403.80 | $673.00 | $167.39–$622.35 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Gastrografin Swallow 74220 | $403.80 | $673.00 | $167.39–$622.35 | 19% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Upper GI w/ Gastrografin 74220 | $403.80 | $673.00 | $167.39–$622.35 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BCE XR Esophagus 74220 | $403.80 | $673.00 | $167.39–$622.35 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Gastrografin Swallow 74220 | $403.80 | $673.00 | $167.39–$622.35 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus 74220 | $403.80 | $673.00 | $167.39–$622.35 | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BCE NM Bone and/or joint imaging; whole body 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | 28% below | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Whole Body Bone Scan 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | 28% below | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 XR Bone and/or Joint Whole Body 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | 28% below | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 XR Bone and/or Joint Whole Body 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | — | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Whole Body Bone Scan 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | — | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BCE NM Bone and/or joint imaging; whole body 78306 | $1,134.00 | $1,890.00 | $375.76–$1,747.25 | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 BCE US Breast, Unilateral; Complete 76641 | $153.00 | $255.00 | $100.16–$235.41 | 65% below | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast, unilateral; complete 76641 | $153.00 | $255.00 | $100.16–$235.41 | 65% below | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast, unilateral; complete 76641 | $153.00 | $255.00 | $100.16–$235.41 | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 BCE US Breast, Unilateral; Complete 76641 | $153.00 | $255.00 | $100.16–$235.41 | — | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast, unilateral; Limited 76642 | $153.00 | $255.00 | $82.79–$235.41 | 56% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 BCE US Breast Unilateral; 76642 | $153.00 | $255.00 | $82.79–$235.41 | 56% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast, unilateral; Limited 76642 | $153.00 | $255.00 | $82.79–$235.41 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 BCE US Breast Unilateral; 76642 | $153.00 | $255.00 | $82.79–$235.41 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 BCE CTA Abdomen and Pelvis w/contrast 74174 | $4,165.20 | $6,942.00 | $350.37–$6,418.28 | 3% above | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen and Pelvis w/ + w/o contrast 74174 | $4,165.20 | $6,942.00 | $350.37–$6,418.28 | 3% above | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen and Pelvis w/ + w/o contrast 74174 | $4,165.20 | $6,942.00 | $350.37–$6,418.28 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 BCE CTA Abdomen and Pelvis w/contrast 74174 | $4,165.20 | $6,942.00 | $350.37–$6,418.28 | — | 40% |
| CT angiography (CTA) of the head CPT 70496 CTA Head Stroke Protocol W/ Contrast | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | 17% below | 40% |
| CT angiography (CTA) of the head CPT 70496 CTA Head w/ + w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | 17% below | 40% |
| CT angiography (CTA) of the head CPT 70496 BCE CTA Head w/ + w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | 17% below | 40% |
| CT angiography (CTA) of the head CPT 70496 BCE STROKE CTA Head w & w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | 17% below | 40% |
| CT angiography (CTA) of the head CPT 70496 CTA Head w/ Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | 17% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 BCE STROKE CTA Head w & w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 BCE CTA Head w/ + w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Head w/ Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Head w/ + w/o Contrast 70496 | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Head Stroke Protocol W/ Contrast | $1,976.40 | $3,294.00 | $167.39–$3,045.61 | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 CTA Neck w/ Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | 17% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 BCE STROKE CTA Neck w & w/o Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | 17% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 CTA Neck Stroke Protocol W/ Contrast | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | 17% below | 40% |
| CT angiography (CTA) of the neck CPT 70498 CTA Neck w/ + w/o Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | 17% below | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck w/ + w/o Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck w/ Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck Stroke Protocol W/ Contrast | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | — | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 BCE STROKE CTA Neck w & w/o Contrast 70498 | $1,977.60 | $3,296.00 | $167.39–$3,046.87 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | 34% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE Protocol 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | 34% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 BCE CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | 34% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest w/ Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | 34% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE Protocol 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest w/ Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 BCE CTA Chest w/ + w/o Contrast 71275 | $1,713.60 | $2,856.00 | $167.39–$2,640.71 | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 BCE CT Heart w/o Contrast 75571 | $82.80 | $138.00 | $60.29–$127.47 | 56% below | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart w/o Contrast 75571 | $82.80 | $138.00 | $60.29–$127.47 | 56% below | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 BCE CT Heart w/o Contrast 75571 | $82.80 | $138.00 | $60.29–$127.47 | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart w/o Contrast 75571 | $82.80 | $138.00 | $60.29–$127.47 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd and Pelvis w/o Contrast 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | 4% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd/Pelvis w/ Oral Contrast Only74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | 4% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Renal Stone Protocol 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | 4% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 BCE CT Abd & Pelvis, w/o contrast 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | 4% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Renal Stone Protocol 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd/Pelvis w/ Oral Contrast Only74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd and Pelvis w/o Contrast 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 BCE CT Abd & Pelvis, w/o contrast 74176 | $2,735.40 | $4,559.00 | $223.25–$4,215.75 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | 11% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 BCE CT Abd & Pelvis, w/contrast 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | 11% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | 11% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 BCE CT Abd & Pelvis, w/contrast 74177 | $3,394.20 | $5,657.00 | $350.37–$5,229.50 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd and Pelvis w/ + w/o Con 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 BCE CT Abd & Pelvis, w & w/o contrast 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Four Phase Liver Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Pancreatic Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Renal Mass Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd and Pelvis w/ + w/o Con 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Renal Mass Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Pancreatic Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Four Phase Liver Protocol 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 BCE CT Abd & Pelvis, w & w/o contrast 74178 | $3,568.20 | $5,947.00 | $350.37–$5,497.94 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $167.39–$2,693.40 | 33% below | 40% |
| CT scan of the abdomen with contrast CPT 74160 BCE CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $167.39–$2,693.40 | 33% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $167.39–$2,693.40 | — | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 BCE CT Abdomen w/ Contrast 74160 | $1,747.80 | $2,913.00 | $167.39–$2,693.40 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | 31% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 BCE CT Abdomen, w/o contrast 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | 31% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/ Oral Contrast Only 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | 31% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/ Oral Contrast Only 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | — | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 BCE CT Abdomen, w/o contrast 74150 | $1,385.40 | $2,309.00 | $100.16–$2,134.86 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 BCE CT Maxillofacial area w/o contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | 32% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | 32% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | 32% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | 32% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 BCE CT Maxillofacial area w/o contrast 70486 | $1,130.40 | $1,884.00 | $100.16–$1,742.08 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 BCE STROKE CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | 20% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Protocol W/O Contrast | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | 20% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | 20% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 BCE CT, Head or brain; w/o contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | 20% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Protocol W/O Contrast | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 BCE STROKE CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 BCE CT, Head or brain; w/o contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast 70450 | $1,330.80 | $2,218.00 | $100.16–$2,050.77 | — | 40% |
| CT scan of the head with contrast CPT 70460 BCE CT head or brain w/contrast 70460 | $1,466.40 | $2,444.00 | $167.39–$2,260.01 | 13% below | 40% |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast 70460 | $1,466.40 | $2,444.00 | $167.39–$2,260.01 | 13% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 BCE CT head or brain w/contrast 70460 | $1,466.40 | $2,444.00 | $167.39–$2,260.01 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast 70460 | $1,466.40 | $2,444.00 | $167.39–$2,260.01 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 BCE CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $167.39–$2,744.14 | 13% below | 40% |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $167.39–$2,744.14 | 13% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 BCE CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $167.39–$2,744.14 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast 70470 | $1,780.80 | $2,968.00 | $167.39–$2,744.14 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast 72131 | $1,524.60 | $2,541.00 | $100.16–$2,349.44 | 12% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 BCE CT Lumbar Spine w/o contrast 72131 | $1,524.60 | $2,541.00 | $100.16–$2,349.44 | 12% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast 72131 | $1,524.60 | $2,541.00 | $100.16–$2,349.44 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 BCE CT Lumbar Spine w/o contrast 72131 | $1,524.60 | $2,541.00 | $100.16–$2,349.44 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 BCE CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $100.16–$2,093.03 | 33% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $100.16–$2,093.03 | 33% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 BCE CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $100.16–$2,093.03 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast 72125 | $1,358.40 | $2,264.00 | $100.16–$2,093.03 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast 72193 | $1,646.40 | $2,744.00 | $167.39–$2,536.11 | 24% below | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 BCE CT Pelvis s/contrast 72193 | $1,646.40 | $2,744.00 | $167.39–$2,536.11 | 24% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast 72193 | $1,646.40 | $2,744.00 | $167.39–$2,536.11 | — | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 BCE CT Pelvis s/contrast 72193 | $1,646.40 | $2,744.00 | $167.39–$2,536.11 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex scan of extracranial arteries, complete bil 93880 | $793.80 | $1,323.00 | $223.25 | 26% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 BCE US Duplex Carotid 93880 | $825.60 | $1,376.00 | $223.25 | 23% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Duplex Carotid 93880 | $825.60 | $1,376.00 | $223.25 | 23% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex scan of extracranial arteries, complete bil 93880 | $793.80 | $1,323.00 | $223.25 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 BCE US Duplex Carotid 93880 | $825.60 | $1,376.00 | $223.25 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Duplex Carotid 93880 | $825.60 | $1,376.00 | $223.25 | — | 40% |
| Chest CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast 71270 | $1,939.80 | $3,233.00 | $167.39–$2,989.75 | 27% below | 40% |
| Chest CT scan without and with contrast CPT 71270 BCE CT Thorax w/ + w/o Contrast 71270 | $1,939.80 | $3,233.00 | $167.39–$2,989.75 | 27% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 BCE CT Thorax w/ + w/o Contrast 71270 | $1,939.80 | $3,233.00 | $167.39–$2,989.75 | — | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast 71270 | $1,939.80 | $3,233.00 | $167.39–$2,989.75 | — | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 View (Frontal & Lat) 71046 | $171.00 | $285.00 | $82.79–$271.62 | 56% below | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views 71046 | $171.00 | $285.00 | $82.79–$271.62 | 56% below | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $171.00 | $285.00 | $82.79–$271.62 | 56% below | 40% |
| Chest X-ray, 2 views CPT 71046 BCE Radiologic examination, chest; 2 views 71046 | $171.00 | $285.00 | $82.79–$271.62 | 56% below | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views 71046 | $171.00 | $285.00 | $82.79–$271.62 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $171.00 | $285.00 | $82.79–$271.62 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 BCE Radiologic examination, chest; 2 views 71046 | $171.00 | $285.00 | $82.79–$271.62 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 View (Frontal & Lat) 71046 | $171.00 | $285.00 | $82.79–$271.62 | — | 40% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal 71045 | $127.20 | $212.00 | $82.79–$202.30 | 61% below | 40% |
| Chest X-ray, single view CPT 71045 BCE Radiologic examination, chest; single view 71045 | $127.20 | $212.00 | $82.79–$202.30 | 61% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal 71045 | $127.20 | $212.00 | $82.79–$202.30 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 BCE Radiologic examination, chest; single view 71045 | $127.20 | $212.00 | $82.79–$202.30 | — | 40% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR Clavicle Bilateral 73000 | $196.20 | $327.00 | $82.79–$302.24 | — | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 BCE XR Clavicle 73000 | $196.20 | $327.00 | $82.79–$302.24 | 35% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right 73000 | $196.20 | $327.00 | $82.79–$302.24 | 35% below | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left 73000 | $196.20 | $327.00 | $82.79–$302.24 | 35% below | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR Clavicle Bilateral 73000 | $196.20 | $327.00 | $82.79–$302.24 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 BCE XR Clavicle 73000 | $196.20 | $327.00 | $82.79–$302.24 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left 73000 | $196.20 | $327.00 | $82.79–$302.24 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right 73000 | $196.20 | $327.00 | $82.79–$302.24 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 BCE US retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76770 | $421.20 | $702.00 | $100.16–$648.96 | 39% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete 76770 | $421.20 | $702.00 | $100.16–$648.96 | 39% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Aorta Renal 76770 | $421.20 | $702.00 | $100.16–$648.96 | 39% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 BCE US retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76770 | $421.20 | $702.00 | $100.16–$648.96 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Aorta Renal 76770 | $421.20 | $702.00 | $100.16–$648.96 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete 76770 | $421.20 | $702.00 | $100.16–$648.96 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD DXA Study 1/more Axial Skeleton 77080 | $332.40 | $554.00 | $100.16–$512.37 | 17% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BCE BD DXA Study 1 or more sites 77080 | $332.40 | $554.00 | $100.16–$512.37 | 17% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD DXA Study 1/more Axial Skeleton 77080 | $332.40 | $554.00 | $100.16–$512.37 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BCE BD DXA Study 1 or more sites 77080 | $332.40 | $554.00 | $100.16–$512.37 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $223.25–$613.60 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 BCE US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $223.25–$613.60 | 42% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 BCE US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $223.25–$613.60 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w/ Detail 76811 | $398.40 | $664.00 | $223.25–$613.60 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | 6% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 BCE CT Thorax, w/o contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | 6% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | 6% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | 6% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 BCE CT Thorax, w/o contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution 71250 | $1,437.00 | $2,395.00 | $100.16–$2,214.01 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast 71260 | $1,713.60 | $2,856.00 | $167.39–$2,640.68 | 14% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 BCE CT Thorax w/contrast 71260 | $1,713.60 | $2,856.00 | $167.39–$2,640.68 | 14% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 BCE CT Thorax w/contrast 71260 | $1,713.60 | $2,856.00 | $167.39–$2,640.68 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast 71260 | $1,713.60 | $2,856.00 | $167.39–$2,640.68 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Dx Mammo Incl Cad Bilateral 77066 | $150.00 | $250.00 | $112.43–$237.70 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 BCE MA Dx Mammo Incl Cad Bilateral 77066 | $150.00 | $250.00 | $112.43–$237.70 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Dx Mammo Incl Cad Bilateral 77066 | $150.00 | $250.00 | $112.43–$237.70 | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BCE MA Dx Mammo Incl Cad Bilateral 77066 | $150.00 | $250.00 | $112.43–$237.70 | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Dx Mammo+Cad Unilat Lt 77065 | $121.80 | $203.00 | $91.46–$193.36 | 55% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Dx Mammo+Cad Unilat Rt 77065 | $121.80 | $203.00 | $91.46–$193.36 | 55% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 BCE MA Dx Mammo+Cad Unilat 77065 | $121.80 | $203.00 | $91.46–$193.36 | 55% below | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Dx Mammo+Cad Unilat Lt 77065 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 BCE MA Dx Mammo+Cad Unilat 77065 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Dx Mammo+Cad Unilat Rt 77065 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 BCE US DUPLEX SCAN, ARTERIAL, LOWER EXTREMITY, BILATERAL 93925 | $1,123.80 | $1,873.00 | $223.25 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Duplex Arterial LE Bl 93925 | $1,123.80 | $1,873.00 | $223.25 | 20% below | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 BCE US DUPLEX SCAN, ARTERIAL, LOWER EXTREMITY, BILATERAL 93925 | $1,123.80 | $1,873.00 | $223.25 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Duplex Arterial LE Bl 93925 | $1,123.80 | $1,873.00 | $223.25 | — | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 BCE US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $223.25 | 49% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Doppler Extremity Bl 93970 | $825.60 | $1,376.00 | $223.25 | 47% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 BCE BCE US Venous Doppler Extremity Bl 93970 | $825.60 | $1,376.00 | $223.25 | 47% below | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BCE US Venous Doppler Extremity Bl 93970 | $793.80 | $1,323.00 | $223.25 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Doppler Extremity Bl 93970 | $825.60 | $1,376.00 | $223.25 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BCE BCE US Venous Doppler Extremity Bl 93970 | $825.60 | $1,376.00 | $223.25 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 BCE US Echocardiography w/Color Flow 93306 | $1,845.60 | $3,076.00 | $502.61 | 7% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echocardiogram w/ Color flow 93306 | $1,845.60 | $3,076.00 | $502.61 | 7% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo Complete w/ Contrast if nec 93306 | $1,845.60 | $3,076.00 | $502.61 | 7% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo Complete W/ Bubble Study 93306 | $1,845.60 | $3,076.00 | $502.61 | 7% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo Complete Dop & Color Flow 93306 | $1,845.60 | $3,076.00 | $502.61 | 7% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo Complete Dop & Color Flow 93306 | $1,845.60 | $3,076.00 | $502.61 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 BCE US Echocardiography w/Color Flow 93306 | $1,845.60 | $3,076.00 | $502.61 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo Complete w/ Contrast if nec 93306 | $1,845.60 | $3,076.00 | $502.61 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echocardiogram w/ Color flow 93306 | $1,845.60 | $3,076.00 | $502.61 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo Complete W/ Bubble Study 93306 | $1,845.60 | $3,076.00 | $502.61 | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 Views Bilateral 73070 | $254.40 | $424.00 | $82.79–$392.42 | — | 40% |
| Elbow X-ray, 2 views CPT 73070 BCE XR Elbow 2 Views 73070 | $254.40 | $424.00 | $82.79–$392.42 | 19% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right 73070 | $254.40 | $424.00 | $82.79–$392.42 | 19% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left 73070 | $254.40 | $424.00 | $82.79–$392.42 | 19% below | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 Views Bilateral 73070 | $254.40 | $424.00 | $82.79–$392.42 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 BCE XR Elbow 2 Views 73070 | $254.40 | $424.00 | $82.79–$392.42 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right 73070 | $254.40 | $424.00 | $82.79–$392.42 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left 73070 | $254.40 | $424.00 | $82.79–$392.42 | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete Bilateral 73080 | $271.20 | $452.00 | $82.79–$418.11 | — | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 BCE XR Elbow Complete, min 3 views 73080 | $271.20 | $452.00 | $82.79–$418.11 | 29% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Left 73080 | $271.20 | $452.00 | $82.79–$418.11 | 29% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Right 73080 | $271.20 | $452.00 | $82.79–$418.11 | 29% below | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete Bilateral 73080 | $271.20 | $452.00 | $82.79–$418.11 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 BCE XR Elbow Complete, min 3 views 73080 | $271.20 | $452.00 | $82.79–$418.11 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Left 73080 | $271.20 | $452.00 | $82.79–$418.11 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Right 73080 | $271.20 | $452.00 | $82.79–$418.11 | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella Ear w/o Contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | 4% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Mid Inner Ear w/o Contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | 4% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 BCE CT orbit, sella, or posterior fossa or outer, middle, or inner ear; w/o contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | 4% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Temporal Bones (IAC's) 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | 4% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Mid Inner Ear w/o Contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Temporal Bones (IAC's) 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 BCE CT orbit, sella, or posterior fossa or outer, middle, or inner ear; w/o contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Sella Ear w/o Contrast 70480 | $1,435.80 | $2,393.00 | $100.16–$2,212.37 | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views 70150 | $220.80 | $368.00 | $100.16–$340.50 | 44% below | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 BCE XR facial bones; complete, minimum of 3 views 70150 | $220.80 | $368.00 | $100.16–$340.50 | 44% below | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 BCE XR facial bones; complete, minimum of 3 views 70150 | $220.80 | $368.00 | $100.16–$340.50 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Minimum 3 Views 70150 | $220.80 | $368.00 | $100.16–$340.50 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 Views Bilateral 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR 1 View Forearm 73090 | $264.60 | $441.00 | $82.79–$407.52 | 29% below | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 BCE XR Forearm, 2 views 73090 | $264.60 | $441.00 | $82.79–$407.52 | 29% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right 73090 | $264.60 | $441.00 | $82.79–$407.52 | 29% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left 73090 | $264.60 | $441.00 | $82.79–$407.52 | 29% below | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 Views Bilateral 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR 1 View Forearm 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 BCE XR Forearm, 2 views 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left 73090 | $264.60 | $441.00 | $82.79–$407.52 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging 78226 | $1,174.80 | $1,958.00 | $375.76–$1,810.56 | 27% below | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 BCE NM Hepatobiliary Imaging 78226 | $1,174.80 | $1,958.00 | $375.76–$1,810.56 | 27% below | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 BCE NM Hepatobiliary Imaging 78226 | $1,174.80 | $1,958.00 | $375.76–$1,810.56 | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging 78226 | $1,174.80 | $1,958.00 | $375.76–$1,810.56 | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 Views Bilateral 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 XR Hand 1 View Bilateral 73120-52 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views CPT 73120 BCE XR Hand 2 Views 73120 | $277.80 | $463.00 | $100.16–$427.42 | 13% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left 73120 | $277.80 | $463.00 | $100.16–$427.42 | 13% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right 73120 | $277.80 | $463.00 | $100.16–$427.42 | 13% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand Left 2 views 73120 | $277.80 | $463.00 | $100.16–$427.42 | 13% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand Right 2 views 73120 | $277.80 | $463.00 | $100.16–$427.42 | 13% below | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 2 Views Bilateral 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 1 View Bilateral 73120-52 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 BCE XR Hand 2 Views 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand Left 2 views 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand Right 2 views 73120 | $277.80 | $463.00 | $100.16–$427.42 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneous Bilateral 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR Calcaneus Minimum 2 Views 73650 | $100.80 | $168.00 | $73.48–$155.34 | 65% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 BCE XR Calcaneus, min 2 views 73650 | $100.80 | $168.00 | $73.48–$155.34 | 65% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Right 73650 | $100.80 | $168.00 | $73.48–$155.34 | 65% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Left 73650 | $100.80 | $168.00 | $73.48–$155.34 | 65% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneous Bilateral 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 BCE XR Calcaneus, min 2 views 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR Calcaneus Minimum 2 Views 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Right 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Left 73650 | $100.80 | $168.00 | $73.48–$155.34 | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral 73562 | $265.80 | $443.00 | $82.79–$409.60 | — | 40% |
| Knee X-ray, 3 views CPT 73562 BCE XR Knee 3 Views 73562 | $265.80 | $443.00 | $82.79–$409.60 | 29% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right 73562 | $265.80 | $443.00 | $82.79–$409.60 | 29% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left 73562 | $265.80 | $443.00 | $82.79–$409.60 | 29% below | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral 73562 | $265.80 | $443.00 | $82.79–$409.60 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 BCE XR Knee 3 Views 73562 | $265.80 | $443.00 | $82.79–$409.60 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right 73562 | $265.80 | $443.00 | $82.79–$409.60 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left 73562 | $265.80 | $443.00 | $82.79–$409.60 | — | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR Knee Comp 4/more Views Bl 73564 | $311.40 | $519.00 | $100.16–$480.13 | 27% below | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 BCE XR Knee, complete, 4 or more views 73564 | $311.40 | $519.00 | $100.16–$480.13 | 27% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4/more Views Rt 73564 | $311.40 | $519.00 | $100.16–$480.13 | 27% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4/more Views Left 73564 | $311.40 | $519.00 | $100.16–$480.13 | 27% below | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 BCE XR Knee, complete, 4 or more views 73564 | $311.40 | $519.00 | $100.16–$480.13 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR Knee Comp 4/more Views Bl 73564 | $311.40 | $519.00 | $100.16–$480.13 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4/more Views Rt 73564 | $311.40 | $519.00 | $100.16–$480.13 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4/more Views Left 73564 | $311.40 | $519.00 | $100.16–$480.13 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Ankle w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Foot w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Hip w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Femur w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Knee w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 BCE CT LE w/o contrast 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Tibia/Fibula w/o Contrast Bl 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | 11% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Femur w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Ankle w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Foot w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Hip w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Knee w/o Contrast Bilateral 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Tibia/Fibula w/o Contrast Bl 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 BCE CT LE w/o contrast 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Right 73700 | $1,496.40 | $2,494.00 | $100.16–$2,305.67 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 BCE US Abdominal, limited 76705 | $445.80 | $743.00 | $100.16–$686.50 | 26% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited 76705 | $445.80 | $743.00 | $100.16–$686.50 | 26% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Back 76705 | $445.80 | $743.00 | $100.16–$686.50 | 26% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Lower Quadrant 76705 | $445.80 | $743.00 | $100.16–$686.50 | 26% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant 76705 | $445.80 | $743.00 | $100.16–$686.50 | 26% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited 76705 | $445.80 | $743.00 | $100.16–$686.50 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 BCE US Abdominal, limited 76705 | $445.80 | $743.00 | $100.16–$686.50 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Back 76705 | $445.80 | $743.00 | $100.16–$686.50 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Lower Quadrant 76705 | $445.80 | $743.00 | $100.16–$686.50 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant 76705 | $445.80 | $743.00 | $100.16–$686.50 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Extremity, Nonvascular, Limited, Bilateral | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LE Nonvascular Limited Bl 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 BCE US Extremity, non-vascular; limited 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US UE Nonvascular Limited Bl 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US UE Nonvascular Limited Right 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LE Nonvascular Limited Rt 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US LE Nonvascular Limited Left 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US UE Nonvascular Limited Left 76882 | $278.40 | $464.00 | $100.16 | 31% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Extremity, Nonvascular, Limited, Bilateral | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LE Nonvascular Limited Bl 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 BCE US Extremity, non-vascular; limited 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US UE Nonvascular Limited Bl 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US LE Nonvascular Limited Left 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US UE Nonvascular Limited Right 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US LE Nonvascular Limited Rt 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US UE Nonvascular Limited Left 76882 | $278.40 | $464.00 | $100.16 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening 71271 | $128.40 | $214.00 | $96.58–$204.19 | 47% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 BCE CT Low Dose Lung Screening 71271 | $128.40 | $214.00 | $96.58–$204.19 | 47% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening 71271 | $128.40 | $214.00 | $96.58–$204.19 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 BCE CT Low Dose Lung Screening 71271 | $128.40 | $214.00 | $96.58–$204.19 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia/Fibula 2 Views Bilateral 73590 | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia/Fibula Bilateral | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 BCE XR Tibia/Fibula 2 Views 73590 | $255.00 | $425.00 | $82.79–$393.22 | 26% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Left 73590 | $255.00 | $425.00 | $82.79–$393.22 | 26% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $255.00 | $425.00 | $82.79–$393.22 | 26% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $255.00 | $425.00 | $82.79–$393.22 | 26% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula 2 Views Right 73590 | $255.00 | $425.00 | $82.79–$393.22 | 26% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia/Fibula Bilateral | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia/Fibula 2 Views Bilateral 73590 | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 BCE XR Tibia/Fibula 2 Views 73590 | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Right 73590 | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula 2 Views Left 73590 | $255.00 | $425.00 | $82.79–$393.22 | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | 30% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 BCE MRA/MRV Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | 30% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | 30% below | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 BCE MRA/MRV Head w/o Contrast 70544 | $1,272.60 | $2,121.00 | $223.25–$1,960.54 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 BCE MRI w/o contrast lower extremity 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Signature Knee w/o contrast L 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Signature Knee w/o contrast R 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | 7% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip w/o Contrast Bilateral 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Signature Knee w/o contrast L 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 BCE MRI w/o contrast lower extremity 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Signature Knee w/o contrast R 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left 73721 | $2,043.00 | $3,405.00 | $223.25–$3,148.31 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Ankle w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Knee w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 BCE MRI any joint of lower extremity w/ + w/o Contrast 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Hip w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | 37% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 BCE MRI any joint of lower extremity w/ + w/o Contrast 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Knee w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Hip w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Ankle w/ + w/o Contrast Bl 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right 73723 | $1,904.40 | $3,174.00 | $350.37–$2,934.18 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast 74181 | $1,737.60 | $2,896.00 | $223.25–$2,677.68 | 21% below | 40% |
| MRI of the abdomen without contrast CPT 74181 BCE MRI, abdomen; without contrast material(s) 74181 | $1,737.60 | $2,896.00 | $223.25–$2,677.68 | 21% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast 74181 | $1,737.60 | $2,896.00 | $223.25–$2,677.68 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 BCE MRI, abdomen; without contrast material(s) 74181 | $1,737.60 | $2,896.00 | $223.25–$2,677.68 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast 74183 | $2,400.00 | $4,000.00 | $350.37–$3,697.79 | 22% below | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 BCE MRI, abdomen; w/o contrast & w/contrast 74183 | $2,400.00 | $4,000.00 | $350.37–$3,697.79 | 22% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast 74183 | $2,400.00 | $4,000.00 | $350.37–$3,697.79 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 BCE MRI, abdomen; w/o contrast & w/contrast 74183 | $2,400.00 | $4,000.00 | $350.37–$3,697.79 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | 4% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI Pituitary 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | 4% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 BCE MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | 4% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | 4% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 BCE MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary 70551 | $1,816.80 | $3,028.00 | $223.25–$2,800.01 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 BCE MRI Brain, w/o & w/contrast 70553 | $2,571.00 | $4,285.00 | $350.37–$3,961.18 | 9% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast 70553 | $2,571.00 | $4,285.00 | $350.37–$3,961.18 | 9% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BCE MRI Brain, w/o & w/contrast 70553 | $2,571.00 | $4,285.00 | $350.37–$3,961.18 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast 70553 | $2,571.00 | $4,285.00 | $350.37–$3,961.18 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 BCE MRI Spine Lumbar w/o contrast 72148 | $1,788.00 | $2,980.00 | $223.25–$2,754.77 | 18% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast 72148 | $1,788.00 | $2,980.00 | $223.25–$2,754.77 | 18% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast 72148 | $1,788.00 | $2,980.00 | $223.25–$2,754.77 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 BCE MRI Spine Lumbar w/o contrast 72148 | $1,788.00 | $2,980.00 | $223.25–$2,754.77 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast 72158 | $2,608.80 | $4,348.00 | $350.37–$4,020.58 | 18% below | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 BCE MRI Spine Lumbar w/ & w/o contrast 72158 | $2,608.80 | $4,348.00 | $350.37–$4,020.58 | 18% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 BCE MRI Spine Lumbar w/ & w/o contrast 72158 | $2,608.80 | $4,348.00 | $350.37–$4,020.58 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast 72158 | $2,608.80 | $4,348.00 | $350.37–$4,020.58 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $223.25–$2,559.05 | 18% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 BCE MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $223.25–$2,559.05 | 18% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $223.25–$2,559.05 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 BCE MRI Spine Thoracic w/o Contrast 72146 | $1,660.20 | $2,767.00 | $223.25–$2,559.05 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Cont 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 BCE MRI Spinal canal w/o & w/contrast, cervical 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast one side CPT 72156 MRI Brachial Plexus w/+w/o Left 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast one side CPT 72156 MRI Brachial Plexus w/+w/o Right 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | 22% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Cont 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 BCE MRI Spinal canal w/o & w/contrast, cervical 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient one side CPT 72156 MRI Brachial Plexus w/+w/o Left 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient one side CPT 72156 MRI Brachial Plexus w/+w/o Right 72156 | $2,533.80 | $4,223.00 | $350.37–$3,905.13 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 BCE MRI Spine Cervical 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | 18% below | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | 18% below | 40% |
| MRI of the neck (cervical spine), no contrast dye one side CPT 72141 MRI Brachial Plexus wo/Contrast Lt 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | 18% below | 40% |
| MRI of the neck (cervical spine), no contrast dye one side CPT 72141 MRI Brachial Plexus wo/Contrast Rt 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | 18% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 BCE MRI Spine Cervical 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient one side CPT 72141 MRI Brachial Plexus wo/Contrast Lt 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient one side CPT 72141 MRI Brachial Plexus wo/Contrast Rt 72141 | $1,849.80 | $3,083.00 | $223.25–$2,850.45 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 BCE MRI Pelvis w/o Contrast + w Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | 35% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | 35% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum/Coccyx w + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | 35% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 BCE MRI Pelvis w/o Contrast + w Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Sacrum/Coccyx w + w/o Contrast 72197 | $2,047.80 | $3,413.00 | $350.37–$3,155.95 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum/Coccyx w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | 36% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 BCE MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | 36% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | 36% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum/Coccyx w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 BCE MRI Pelvis w/o Contrast 72195 | $1,518.00 | $2,530.00 | $223.25–$2,339.82 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 BCE MRI UE Joint 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Shoulder w/o Contrast Bl 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | 11% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow w/o Contrast Bilateral 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 BCE MRI UE Joint 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Shoulder w/o Contrast Bl 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right 73221 | $1,985.40 | $3,309.00 | $223.25–$3,059.38 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 Views 72050 | $342.00 | $570.00 | $100.16–$526.98 | 37% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 BCE XR Spine, cervical 4 or 5 views 72050 | $342.00 | $570.00 | $100.16–$526.98 | 37% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 Views 72050 | $342.00 | $570.00 | $100.16–$526.98 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 BCE XR Spine, cervical 4 or 5 views 72050 | $342.00 | $570.00 | $100.16–$526.98 | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Parotid w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | 25% below | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 BCE CT Soft Tissue Neck w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | 25% below | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | 25% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 BCE CT Soft Tissue Neck w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | — | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Parotid w/ Contrast 70491 | $1,484.40 | $2,474.00 | $167.39–$2,287.88 | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 BCE CT Soft tissue neck, w/o contrast 70490 | $1,257.00 | $2,095.00 | $100.16–$1,936.72 | 18% below | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast 70490 | $1,257.00 | $2,095.00 | $100.16–$1,936.72 | 18% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck w/o Contrast 70490 | $1,257.00 | $2,095.00 | $100.16–$1,936.72 | — | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 BCE CT Soft tissue neck, w/o contrast 70490 | $1,257.00 | $2,095.00 | $100.16–$1,936.72 | — | 40% |
| Neck soft tissue X-ray CPT 70360 BCE XR Neck Soft Tissue 70360 | $130.80 | $218.00 | $82.79–$202.14 | 45% below | 40% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue 70360 | $130.80 | $218.00 | $82.79–$202.14 | 45% below | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 BCE XR Neck Soft Tissue 70360 | $130.80 | $218.00 | $82.79–$202.14 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue 70360 | $130.80 | $218.00 | $82.79–$202.14 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perf Mult Studies Rest/S 78452 | $2,514.00 | $4,190.00 | $1,293.68–$3,873.60 | 39% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 BCE NM Myocardial Perf Mult Studies Rest/S 78452 | $2,514.00 | $4,190.00 | $1,293.68–$3,873.60 | 39% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perf Mult Studies Rest/S 78452 | $2,514.00 | $4,190.00 | $1,293.68–$3,873.60 | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 BCE NM Myocardial Perf Mult Studies Rest/S 78452 | $2,514.00 | $4,190.00 | $1,293.68–$3,873.60 | — | 40% |
| Pelvic CT scan without contrast CPT 72192 BCE CT Pelvis w/o Contrast 72192 | $1,350.60 | $2,251.00 | $100.16–$2,080.91 | 17% below | 40% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast 72192 | $1,350.60 | $2,251.00 | $100.16–$2,080.91 | 17% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast 72192 | $1,350.60 | $2,251.00 | $100.16–$2,080.91 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 BCE CT Pelvis w/o Contrast 72192 | $1,350.60 | $2,251.00 | $100.16–$2,080.91 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $100.16–$636.69 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 BCE US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $100.16–$636.69 | 15% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 BCE US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $100.16–$636.69 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non-OB Limited 76857 | $412.80 | $688.00 | $100.16–$636.69 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 BCE US Pelvic (non-ob) Complete 76856 | $487.24 | $812.06 | $100.16–$812.06 | 36% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete 76856 | $527.40 | $879.00 | $100.16–$812.06 | 31% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 BCE US Pelvic (non-ob) Complete 76856 | $487.24 | $812.06 | $100.16–$812.06 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete 76856 | $527.40 | $879.00 | $100.16–$812.06 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 BCE US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $100.16–$445.78 | 52% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $100.16–$445.78 | 52% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $100.16–$445.78 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 BCE US Pregnancy After 1st Trimester 76805 | $289.80 | $483.00 | $100.16–$445.78 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 BCE US Pregnancy 1st trimester trasnabdominal 76801 | $364.80 | $608.00 | $100.16–$562.84 | 38% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester 76801 | $364.80 | $608.00 | $100.16–$562.84 | 38% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 BCE US Pregnancy 1st trimester trasnabdominal 76801 | $364.80 | $608.00 | $100.16–$562.84 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester 76801 | $364.80 | $608.00 | $100.16–$562.84 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited 76815 | $125.40 | $209.00 | $91.29–$193.00 | 73% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 BCE US Pregnancy Limited 76815 | $125.40 | $209.00 | $91.29–$193.00 | 73% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 BCE US Pregnancy Limited 76815 | $125.40 | $209.00 | $91.29–$193.00 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited 76815 | $125.40 | $209.00 | $91.29–$193.00 | — | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs Unilateral 2 View Right 71100 | $229.20 | $382.00 | $82.79–$353.14 | 23% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 BCE XR Ribs, unilateral; 2 views 71100 | $229.20 | $382.00 | $82.79–$353.14 | 23% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs Unilateral 2 View Left 71100 | $229.20 | $382.00 | $82.79–$353.14 | 23% below | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs Unilateral 2 View Right 71100 | $229.20 | $382.00 | $82.79–$353.14 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 BCE XR Ribs, unilateral; 2 views 71100 | $229.20 | $382.00 | $82.79–$353.14 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs Unilateral 2 View Left 71100 | $229.20 | $382.00 | $82.79–$353.14 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Unilat incl PA Chest Lt 71101 | $352.80 | $588.00 | $100.16–$542.80 | 11% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs Unilat incl PA Chest Rt 71101 | $352.80 | $588.00 | $100.16–$542.80 | 11% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 BCE XR Ribs, unilateral, min 3 views 71101 | $352.80 | $588.00 | $100.16–$542.80 | 11% below | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Unilat incl PA Chest Rt 71101 | $352.80 | $588.00 | $100.16–$542.80 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs Unilat incl PA Chest Lt 71101 | $352.80 | $588.00 | $100.16–$542.80 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 BCE XR Ribs, unilateral, min 3 views 71101 | $352.80 | $588.00 | $100.16–$542.80 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 BCE MA Scrn Mammo+Cad Bilat 77067 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MA Scrn Mammo+Cad Bilat 77067 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MA Scrn Mammo+Cad Bilat 77067 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 BCE MA Scrn Mammo+Cad Bilat 77067 | $121.80 | $203.00 | $91.46–$193.36 | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete Bilateral 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 BCE XR Shoulder Complete 73030 | $255.00 | $425.00 | $82.79–$393.72 | 22% below | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR Shoulder Comp Min 2 View BL 73030 | $255.00 | $425.00 | $82.79–$393.72 | 22% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 View Right 73030 | $255.00 | $425.00 | $82.79–$393.72 | 22% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Comp Min 2 View Left 73030 | $255.00 | $425.00 | $82.79–$393.72 | 22% below | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete Bilateral 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR Shoulder Comp Min 2 View BL 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 BCE XR Shoulder Complete 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Comp Min 2 View Right 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Comp Min 2 View Left 73030 | $255.00 | $425.00 | $82.79–$393.72 | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 BCE XR Sinus Paranasal Comp Min 3 V 70220 | $246.00 | $410.00 | $82.79–$379.19 | 40% below | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinus Paranasal Comp Min 3 V 70220 | $246.00 | $410.00 | $82.79–$379.19 | 40% below | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinus Paranasal Comp Min 3 V 70220 | $246.00 | $410.00 | $82.79–$379.19 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 BCE XR Sinus Paranasal Comp Min 3 V 70220 | $246.00 | $410.00 | $82.79–$379.19 | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 BCE XR Skull Less Than 4 Views 70250 | $207.00 | $345.00 | $100.16–$319.18 | 35% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 Views 70250 | $207.00 | $345.00 | $100.16–$319.18 | 35% below | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 Views 70250 | $207.00 | $345.00 | $100.16–$319.18 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 BCE XR Skull Less Than 4 Views 70250 | $207.00 | $345.00 | $100.16–$319.18 | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US Echo Stress w/ complete contEKG 93351 | $1,974.00 | $3,290.00 | $502.61 | 26% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TRANSTHORACIC ECHO COMPLETE 93351 CL | $1,974.00 | $3,290.00 | $502.61 | 26% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US Echo Stress w/ Complete ContEKG 93351 | $1,974.00 | $3,290.00 | $502.61 | 26% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US Echo Stress w/ complete contEKG 93351 | $1,974.00 | $3,290.00 | $502.61 | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TRANSTHORACIC ECHO COMPLETE 93351 CL | $1,974.00 | $3,290.00 | $502.61 | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US Echo Stress w/ Complete ContEKG 93351 | $1,974.00 | $3,290.00 | $502.61 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BCE Swallowing function, w/cineradiography74230 | $440.40 | $734.00 | $167.39–$678.88 | 27% below | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video 74230 | $440.40 | $734.00 | $167.39–$678.88 | 27% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Video 74230 | $440.40 | $734.00 | $167.39–$678.88 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BCE Swallowing function, w/cineradiography74230 | $440.40 | $734.00 | $167.39–$678.88 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur Min 2v Bilateral 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur Complete Bilateral 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 BCE XR Femur, minimum 2 Views 73552 | $194.40 | $324.00 | $82.79–$308.70 | 40% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Min 2v Right 73552 | $194.40 | $324.00 | $82.79–$308.70 | 40% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Min 2v Left 73552 | $194.40 | $324.00 | $82.79–$308.70 | 40% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Complete Right 73552 | $194.40 | $324.00 | $82.79–$308.70 | 40% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Complete Left 73552 | $194.40 | $324.00 | $82.79–$308.70 | 40% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur Min 2v Bilateral 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur Complete Bilateral 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 BCE XR Femur, minimum 2 Views 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Complete Right 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Complete Left 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Min 2v Right 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Min 2v Left 73552 | $194.40 | $324.00 | $82.79–$308.70 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast 72128 | $1,574.40 | $2,624.00 | $100.16–$2,425.51 | 17% below | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 BCE CT Spine Thoracic w/o contrast 72128 | $1,574.40 | $2,624.00 | $100.16–$2,425.51 | 17% below | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 BCE CT Spine Thoracic w/o contrast 72128 | $1,574.40 | $2,624.00 | $100.16–$2,425.51 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast 72128 | $1,574.40 | $2,624.00 | $100.16–$2,425.51 | — | 40% |
| Toe X-ray, 2 or more views CPT 73660 BCE XRToes, min 2 views 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | 41% below | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 BCE XRToes, min 2 views 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Right 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Left 73660 | $159.60 | $266.00 | $82.79–$246.16 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 BCE US Transvaginal 76830 | $427.20 | $712.00 | $100.16–$658.17 | 29% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal 76830 | $427.20 | $712.00 | $100.16–$658.17 | 29% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $427.20 | $712.00 | $100.16–$658.17 | 29% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $427.20 | $712.00 | $100.16–$658.17 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 BCE US Transvaginal 76830 | $427.20 | $712.00 | $100.16–$658.17 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal 76830 | $427.20 | $712.00 | $100.16–$658.17 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 BCE US Pregnancy Transvaginal 76817 | $206.40 | $344.00 | $100.16–$317.92 | 59% below | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 BCE US Pregnancy Transvaginal 76817 | $206.40 | $344.00 | $100.16–$317.92 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 BCE US Abdomen Complete 76700 | $619.20 | $1,032.00 | $100.16–$953.98 | 21% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete 76700 | $619.20 | $1,032.00 | $100.16–$953.98 | 21% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 BCE US Abdomen Complete 76700 | $619.20 | $1,032.00 | $100.16–$953.98 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete 76700 | $619.20 | $1,032.00 | $100.16–$953.98 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 76870 CPT Add On | $368.18 | $613.63 | $100.16–$613.64 | 40% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) 76870 | $398.40 | $664.00 | $100.16–$613.64 | 35% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 BCE US, Scrotum and contents 76870 | $398.40 | $664.00 | $100.16–$613.64 | 35% below | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 76870 CPT Add On | $368.18 | $613.63 | $100.16–$613.64 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 BCE US, Scrotum and contents 76870 | $398.40 | $664.00 | $100.16–$613.64 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) 76870 | $398.40 | $664.00 | $100.16–$613.64 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue of Head and Neck 76536 | $420.60 | $701.00 | $100.16–$648.00 | 33% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 BCE US Soft Tissue of head & neck 76536 | $420.60 | $701.00 | $100.16–$648.00 | 33% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue of Head and Neck 76536 | $420.60 | $701.00 | $100.16–$648.00 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 BCE US Soft Tissue of head & neck 76536 | $420.60 | $701.00 | $100.16–$648.00 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 BCE XR Upper GI Without KUB 74240 | $462.60 | $771.00 | $167.39–$712.12 | 36% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI without KUB 74240 | $462.60 | $771.00 | $167.39–$712.12 | 36% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI without KUB 74240 | $462.60 | $771.00 | $167.39–$712.12 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 BCE XR Upper GI Without KUB 74240 | $462.60 | $771.00 | $167.39–$712.12 | — | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 BCE XR Humerus, min of 2 views 73060 | $258.00 | $430.00 | $82.79–$396.85 | 26% below | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR Humerus Minimum 2 Views Bl 73060 | $258.00 | $430.00 | $82.79–$396.85 | 26% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left 73060 | $258.00 | $430.00 | $82.79–$396.85 | 26% below | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR Humerus Minimum 2 Views Bl 73060 | $258.00 | $430.00 | $82.79–$396.85 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 BCE XR Humerus, min of 2 views 73060 | $258.00 | $430.00 | $82.79–$396.85 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left 73060 | $258.00 | $430.00 | $82.79–$396.85 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Extremity Unilat 93971 | $406.80 | $678.00 | $100.16 | 48% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 BCE US Venous Doppler Extremity Unilat 93971 | $406.80 | $678.00 | $100.16 | 48% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ED US Duplex Scan Extremity Veins, Unilat 93971 | $419.40 | $699.00 | $100.16 | 47% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Extremity Unilat 93971 | $406.80 | $678.00 | $100.16 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 BCE US Venous Doppler Extremity Unilat 93971 | $406.80 | $678.00 | $100.16 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 ED US Duplex Scan Extremity Veins, Unilat 93971 | $419.40 | $699.00 | $100.16 | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 1 View Bilateral 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 2 Views Bilateral 73100 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views CPT 73100 BCE XR Wrist, 2 views 73100 | $254.40 | $424.00 | $82.79–$392.72 | 14% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 1 View Left 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | 14% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right 73100 | $254.40 | $424.00 | $82.79–$392.72 | 14% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left 73100 | $254.40 | $424.00 | $82.79–$392.72 | 14% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 1 View Right 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | 14% below | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 2 Views Bilateral 73100 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 1 View Bilateral 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 BCE XR Wrist, 2 views 73100 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 1 View Right 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 1 View Left 73100 -52 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left 73100 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right 73100 | $254.40 | $424.00 | $82.79–$392.72 | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Bilateral 73110 | $258.00 | $430.00 | $82.79–$397.04 | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 BCE XR Wrist, complete min of 3 views 73110 | $258.00 | $430.00 | $82.79–$397.04 | 30% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Right 73110 | $258.00 | $430.00 | $82.79–$397.04 | 30% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Left 73110 | $258.00 | $430.00 | $82.79–$397.04 | 30% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Bilateral 73110 | $258.00 | $430.00 | $82.79–$397.04 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 BCE XR Wrist, complete min of 3 views 73110 | $258.00 | $430.00 | $82.79–$397.04 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Right 73110 | $258.00 | $430.00 | $82.79–$397.04 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Left 73110 | $258.00 | $430.00 | $82.79–$397.04 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Left 73502 | $189.00 | $315.00 | $82.79–$299.74 | 49% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Right 73502 | $189.00 | $315.00 | $82.79–$299.74 | 49% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right 73502 | $189.00 | $315.00 | $82.79–$299.74 | 49% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left 73502 | $189.00 | $315.00 | $82.79–$299.74 | 49% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 BCE XR Hip, Unilateral, w Pelvis 2-3 Views 73502 | $189.00 | $315.00 | $82.79–$299.74 | 49% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 BCE XR Hip, Unilateral, w Pelvis 2-3 Views 73502 | $189.00 | $315.00 | $82.79–$299.74 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left 73502 | $189.00 | $315.00 | $82.79–$299.74 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Right 73502 | $189.00 | $315.00 | $82.79–$299.74 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right 73502 | $189.00 | $315.00 | $82.79–$299.74 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/ Pelvis Left 73502 | $189.00 | $315.00 | $82.79–$299.74 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 BCE Radiologic examination, abdomen; 1 view 74018 | $160.20 | $267.00 | $82.79–$254.98 | 53% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View 74018 | $160.20 | $267.00 | $82.79–$254.98 | 53% below | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR abdomen 1 view 74018 | $160.20 | $267.00 | $82.79–$254.98 | 53% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR abdomen 1 view 74018 | $160.20 | $267.00 | $82.79–$254.98 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View 74018 | $160.20 | $267.00 | $82.79–$254.98 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 BCE Radiologic examination, abdomen; 1 view 74018 | $160.20 | $267.00 | $82.79–$254.98 | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral 73600 | $181.20 | $302.00 | $82.79–$279.11 | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 BCE XR Ankle 2 Views 73600 | $181.20 | $302.00 | $82.79–$279.11 | 39% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right 73600 | $181.20 | $302.00 | $82.79–$279.11 | 39% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left 73600 | $181.20 | $302.00 | $82.79–$279.11 | 39% below | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral 73600 | $181.20 | $302.00 | $82.79–$279.11 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 BCE XR Ankle 2 Views 73600 | $181.20 | $302.00 | $82.79–$279.11 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right 73600 | $181.20 | $302.00 | $82.79–$279.11 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left 73600 | $181.20 | $302.00 | $82.79–$279.11 | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 BCE XR Finger, min 2 views 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | 25% below | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 BCE XR Finger, min 2 views 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Right 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Left 73140 | $180.60 | $301.00 | $82.79–$277.87 | — | 40% |
| X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral 73620 | $250.80 | $418.00 | $82.79–$387.00 | — | 40% |
| X-ray of the foot, 2 views CPT 73620 BCE XR Foot Complete 73620 | $250.80 | $418.00 | $82.79–$387.00 | 25% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right 73620 | $250.80 | $418.00 | $82.79–$387.00 | 25% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left 73620 | $250.80 | $418.00 | $82.79–$387.00 | 25% below | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral 73620 | $250.80 | $418.00 | $82.79–$387.00 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 BCE XR Foot Complete 73620 | $250.80 | $418.00 | $82.79–$387.00 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right 73620 | $250.80 | $418.00 | $82.79–$387.00 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left 73620 | $250.80 | $418.00 | $82.79–$387.00 | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Bilateral 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 BCE XR Foot, complete, min 3 views 73630 | $318.60 | $531.00 | $82.79–$491.01 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete min 3 views Left 73630 | $318.60 | $531.00 | $82.79–$491.01 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete min 3 views Rt 73630 | $318.60 | $531.00 | $82.79–$491.01 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Left 73630 | $318.60 | $531.00 | $82.79–$491.01 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Right 73630 | $318.60 | $531.00 | $82.79–$491.01 | 14% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Bilateral 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 BCE XR Foot, complete, min 3 views 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete min 3 views Rt 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Left 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete min 3 views Left 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Right 73630 | $318.60 | $531.00 | $82.79–$491.01 | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Bilateral 73130 | $277.20 | $462.00 | $82.79–$427.15 | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 BCE XR Hand, min 3 views 73130 | $277.20 | $462.00 | $82.79–$427.15 | 28% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Left 73130 | $277.20 | $462.00 | $82.79–$427.15 | 28% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Right 73130 | $277.20 | $462.00 | $82.79–$427.15 | 28% below | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Bilateral 73130 | $277.20 | $462.00 | $82.79–$427.15 | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 BCE XR Hand, min 3 views 73130 | $277.20 | $462.00 | $82.79–$427.15 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Left 73130 | $277.20 | $462.00 | $82.79–$427.15 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Right 73130 | $277.20 | $462.00 | $82.79–$427.15 | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral 73560 | $228.00 | $380.00 | $82.79–$350.52 | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 BCE XR Knee, 1 or 2 views 73560 | $228.00 | $380.00 | $82.79–$350.52 | 23% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right 73560 | $228.00 | $380.00 | $82.79–$350.52 | 23% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left 73560 | $228.00 | $380.00 | $82.79–$350.52 | 23% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral 73560 | $228.00 | $380.00 | $82.79–$350.52 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 BCE XR Knee, 1 or 2 views 73560 | $228.00 | $380.00 | $82.79–$350.52 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right 73560 | $228.00 | $380.00 | $82.79–$350.52 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left 73560 | $228.00 | $380.00 | $82.79–$350.52 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views 72100 | $265.20 | $442.00 | $100.16–$408.63 | 40% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 BCE XR Spine, lumbosacral, 2 or 3 views 72100 | $265.20 | $442.00 | $100.16–$408.63 | 40% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 BCE XR Spine, lumbosacral, 2 or 3 views 72100 | $265.20 | $442.00 | $100.16–$408.63 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views 72100 | $265.20 | $442.00 | $100.16–$408.63 | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V 72110 | $355.80 | $593.00 | $100.16–$547.69 | 37% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 BCE XR Spine Lumbosacral Min 4 views 72110 | $355.80 | $593.00 | $100.16–$547.69 | 37% below | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 BCE XR Spine Lumbosacral Min 4 views 72110 | $355.80 | $593.00 | $100.16–$547.69 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V 72110 | $355.80 | $593.00 | $100.16–$547.69 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $100.16–$360.65 | 42% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 BCE XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $100.16–$360.65 | 42% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 BCE XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $100.16–$360.65 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views 72070 | $234.00 | $390.00 | $100.16–$360.65 | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views 70160 | $184.80 | $308.00 | $82.79–$284.40 | 33% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 BCE XR nasal bones, complete, minimum of 3 views 70160 | $184.80 | $308.00 | $82.79–$284.40 | 33% below | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 BCE XR nasal bones, complete, minimum of 3 views 70160 | $184.80 | $308.00 | $82.79–$284.40 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views 70160 | $184.80 | $308.00 | $82.79–$284.40 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 BCE XR Spine, cervical; 2 or 3 views 72040 | $254.40 | $424.00 | $82.79–$392.28 | 30% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views 72040 | $254.40 | $424.00 | $82.79–$392.28 | 30% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views 72040 | $254.40 | $424.00 | $82.79–$392.28 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 BCE XR Spine, cervical; 2 or 3 views 72040 | $254.40 | $424.00 | $82.79–$392.28 | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 BCE XR Pelvis, 1 or 2 views 72170 | $223.80 | $373.00 | $100.16–$345.14 | 29% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views 72170 | $223.80 | $373.00 | $100.16–$345.14 | 29% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis AP Only 72170 | $223.80 | $373.00 | $100.16–$345.14 | 29% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis AP Only 72170 | $223.80 | $373.00 | $100.16–$345.14 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 BCE XR Pelvis, 1 or 2 views 72170 | $223.80 | $373.00 | $100.16–$345.14 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views 72170 | $223.80 | $373.00 | $100.16–$345.14 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views 72220 | $227.40 | $379.00 | $82.79–$349.97 | 26% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 BCE XR sacrum/coccyx, minimum of 2 views 72220 | $227.40 | $379.00 | $82.79–$349.97 | 26% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 BCE XR sacrum/coccyx, minimum of 2 views 72220 | $227.40 | $379.00 | $82.79–$349.97 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx Minimum 2 Views 72220 | $227.40 | $379.00 | $82.79–$349.97 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) 82024 | $221.40 | $369.00 | $144.14–$304.73 | 4% above | 40% |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic hormone (ACTH) 82024 | $221.40 | $369.00 | $144.14–$304.73 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $225.60 | $376.00 | $25.38–$53.67 | 340% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $225.60 | $376.00 | $25.38–$53.67 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $219.60 | $366.00 | $26.92–$56.91 | 326% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $219.60 | $366.00 | $26.92–$56.91 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP ACUTE PROF | $592.80 | $988.00 | $187.92–$397.31 | 55% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP ACUTE PROF | $592.80 | $988.00 | $187.92–$397.31 | — | 40% |
| Albumin blood test CPT 82040 Albumin Level | $121.80 | $203.00 | $17.87–$37.78 | 227% above | 40% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $121.80 | $203.00 | $17.87–$37.78 | — | 40% |
| Aldosterone blood test CPT 82088 Aldosterone Urine | $397.20 | $662.00 | $121.28–$256.41 | 204% above | 40% |
| Aldosterone blood test CPT 82088 Serum Aldosterone | $397.20 | $662.00 | $121.28–$256.41 | 204% above | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Urine | $397.20 | $662.00 | $121.28–$256.41 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Serum Aldosterone | $397.20 | $662.00 | $121.28–$256.41 | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $199.20 | $332.00 | $22.58–$47.73 | 309% above | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $199.20 | $332.00 | $22.58–$47.73 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC | $39.60 | $66.00 | $25.53–$53.98 | 65% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, eac | $49.20 | $82.00 | $25.53–$53.98 | 105% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC | $39.60 | $66.00 | $25.53–$53.98 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen specific IgE; quantitative or semiquantitative, eac | $49.20 | $82.00 | $25.53–$53.98 | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker | $163.20 | $272.00 | $75.66–$159.98 | 37% above | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker | $163.20 | $272.00 | $75.66–$159.98 | — | 40% |
| Ammonia blood test CPT 82140 Ammonia Level | $214.20 | $357.00 | $69.66–$147.27 | 51% above | 40% |
| Ammonia blood test inpatient CPT 82140 Ammonia Level | $214.20 | $357.00 | $69.66–$147.27 | — | 40% |
| Amylase blood test CPT 82150 Amylase Level Body Fluid | $205.80 | $343.00 | $56.87–$120.21 | 170% above | 40% |
| Amylase blood test CPT 82150 Amylase Level Urine | $205.80 | $343.00 | $56.87–$120.21 | 170% above | 40% |
| Amylase blood test CPT 82150 Amylase Level 24 Hour Urine | $205.80 | $343.00 | $56.87–$120.21 | 170% above | 40% |
| Amylase blood test CPT 82150 Urine Amylase | $205.80 | $343.00 | $56.87–$120.21 | 170% above | 40% |
| Amylase blood test CPT 82150 Serum Amylase | $205.80 | $343.00 | $56.87–$120.21 | 170% above | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Level 24 Hour Urine | $205.80 | $343.00 | $56.87–$120.21 | — | 40% |
| Amylase blood test inpatient CPT 82150 Urine Amylase | $205.80 | $343.00 | $56.87–$120.21 | — | 40% |
| Amylase blood test inpatient CPT 82150 Serum Amylase | $205.80 | $343.00 | $56.87–$120.21 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Level Urine | $205.80 | $343.00 | $56.87–$120.21 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Level Body Fluid | $205.80 | $343.00 | $56.87–$120.21 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide | $96.00 | $160.00 | $63.86–$135.00 | 81% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide | $96.00 | $160.00 | $63.86–$135.00 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen | $228.00 | $380.00 | $53.67–$113.46 | 196% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen | $228.00 | $380.00 | $53.67–$113.46 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide | $337.80 | $563.00 | $103.46–$218.73 | 116% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Brain Natriuretic Peptide | $337.80 | $563.00 | $103.46–$218.73 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Streptococcus A Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, bacterial; w/isolation presumptive ID of isolates 87070 | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Nasopharyngeal/Nasal 87070 | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Laboratory Water Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Group A Strep Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture. | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $208.20 | $347.00 | $68.99–$145.85 | 211% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Streptococcus A Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Laboratory Water Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Group A Strep Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture, bacterial; w/isolation presumptive ID of isolates 87070 | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture, Nasopharyngeal/Nasal 87070 | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture. | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture | $208.20 | $347.00 | $68.99–$145.85 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $334.80 | $558.00 | $48.55–$102.65 | 60% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $334.80 | $558.00 | $48.55–$102.65 | — | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Body Fluid | $63.60 | $106.00 | $20.06–$42.41 | 11% above | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin, Total (Pre-Transf Rxn) | $159.60 | $266.00 | $20.06–$42.41 | 180% above | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin, Total (Post Transf Rxn) | $159.60 | $266.00 | $20.06–$42.41 | 180% above | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $159.60 | $266.00 | $20.06–$42.41 | 180% above | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Body Fluid | $63.60 | $106.00 | $20.06–$42.41 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total (Pre-Transf Rxn) | $159.60 | $266.00 | $20.06–$42.41 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $159.60 | $266.00 | $20.06–$42.41 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total (Post Transf Rxn) | $159.60 | $266.00 | $20.06–$42.41 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Level IV 88305 | $358.80 | $598.00 | $49.37–$262.78 | 21% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology Level IV 88305 | $358.80 | $598.00 | $49.37–$262.78 | — | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture | $264.00 | $440.00 | $89.85–$189.95 | 29% above | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture. | $264.00 | $440.00 | $89.85–$189.95 | 29% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture. | $264.00 | $440.00 | $89.85–$189.95 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $264.00 | $440.00 | $89.85–$189.95 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE 36415 | $22.80 | $38.00 | $10.77–$6,746.00 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $22.80 | $38.00 | $10.77–$6,746.00 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ED COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE 36415 | $22.80 | $38.00 | $10.77–$6,746.00 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $22.80 | $38.00 | $10.77–$6,746.00 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Charge | $22.80 | $38.00 | $10.77–$6,746.00 | 26% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Charge | $22.80 | $38.00 | $10.77–$6,746.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $22.80 | $38.00 | $10.77–$6,746.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE 36415 | $22.80 | $38.00 | $10.77–$6,746.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ED COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE 36415 | $22.80 | $38.00 | $10.77–$6,746.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $22.80 | $38.00 | $10.77–$6,746.00 | — | 40% |
| Blood glucose (sugar) test CPT 82947 Blood Glucose, Capillary | $94.80 | $158.00 | $20.27–$42.86 | 127% above | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Random | $105.60 | $176.00 | $20.27–$42.86 | 153% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Blood Glucose, Capillary | $94.80 | $158.00 | $20.27–$42.86 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Random | $105.60 | $176.00 | $20.27–$42.86 | — | 40% |
| Blood lead test CPT 83655 Lead Level | $100.20 | $167.00 | $43.52–$91.99 | 115% above | 40% |
| Blood lead test inpatient CPT 83655 Lead Level | $100.20 | $167.00 | $43.52–$91.99 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Human Chorionic Gonadotropin Quantitative | $147.70 | $246.17 | $49.62–$104.92 | 8% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Human Chorionic Gonadotropin Qualitative | $159.60 | $266.00 | $49.62–$104.92 | 16% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta HCG Qualitative Istat | $159.60 | $266.00 | $49.62–$104.92 | 16% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta Human Chorionic Gonadotropin Quantitative | $147.70 | $246.17 | $49.62–$104.92 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta Human Chorionic Gonadotropin Qualitative | $159.60 | $266.00 | $49.62–$104.92 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta HCG Qualitative Istat | $159.60 | $266.00 | $49.62–$104.92 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Group by Blood Center 86900 | $76.20 | $127.00 | $30.37–$116.38 | 14% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Interpretation | $102.60 | $171.00 | $30.37–$116.38 | 16% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Group by Blood Center 86900 | $76.20 | $127.00 | $30.37–$116.38 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Interpretation | $102.60 | $171.00 | $30.37–$116.38 | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $121.80 | $203.00 | $21.70–$45.90 | 124% above | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $121.80 | $203.00 | $21.70–$45.90 | — | 40% |
| C-peptide blood test CPT 84681 Glucagon Level | $274.80 | $458.00 | $66.58–$140.76 | 277% above | 40% |
| C-peptide blood test inpatient CPT 84681 Glucagon Level | $274.80 | $458.00 | $66.58–$140.76 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $189.60 | $316.00 | $37.36–$78.96 | 272% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $189.60 | $316.00 | $37.36–$78.96 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin PCR | $69.60 | $116.00 | $147.01–$310.80 | 60% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Infectious agent detection by nucleic acid; Clostridium difficile, toxin gene(s) 87493 | $256.20 | $427.00 | $147.01–$310.80 | 46% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin PCR | $69.60 | $116.00 | $147.01–$310.80 | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Infectious agent detection by nucleic acid; Clostridium difficile, toxin gene(s) 87493 | $256.20 | $427.00 | $147.01–$310.80 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 86301 | $349.80 | $583.00 | $69.92–$147.82 | 163% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $349.80 | $583.00 | $69.92–$147.82 | 163% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $349.80 | $583.00 | $69.92–$147.82 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 86301 | $349.80 | $583.00 | $69.92–$147.82 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $303.00 | $505.00 | $77.40–$163.64 | 99% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 | $303.00 | $505.00 | $77.40–$163.64 | 99% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 | $303.00 | $505.00 | $77.40–$163.64 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 | $303.00 | $505.00 | $77.40–$163.64 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus (COVID-19) PCR | $96.00 | $160.00 | $525.03–$1,110.00 | 8% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid COVID-19, RNA | $112.20 | $187.00 | $525.03–$1,110.00 | 26% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 COVID-19 Ql RT-PCR | $280.20 | $467.00 | $525.03–$1,110.00 | 214% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus (COVID-19) PCR | $96.00 | $160.00 | $525.03–$1,110.00 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid COVID-19, RNA | $112.20 | $187.00 | $525.03–$1,110.00 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 COVID-19 Ql RT-PCR | $280.20 | $467.00 | $525.03–$1,110.00 | — | 40% |
| Calcium blood test, total CPT 82310 Calcium | $159.00 | $265.00 | $19.01–$40.20 | 172% above | 40% |
| Calcium blood test, total inpatient CPT 82310 Calcium | $159.00 | $265.00 | $19.01–$40.20 | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $273.60 | $456.00 | $83.51–$176.57 | 105% above | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen | $273.60 | $456.00 | $83.51–$176.57 | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG | $133.80 | $223.00 | $53.52–$113.15 | 113% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Antibody | $133.80 | $223.00 | $53.52–$113.15 | 113% above | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG | $133.80 | $223.00 | $53.52–$113.15 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Antibody | $133.80 | $223.00 | $53.52–$113.15 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia RNA by TMA | $201.00 | $335.00 | $75.78–$160.21 | 62% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Wet Prep | $201.00 | $335.00 | $75.78–$160.21 | 62% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Rapid DNA | $201.00 | $335.00 | $75.78–$160.21 | 62% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia RNA by TMA | $201.00 | $335.00 | $75.78–$160.21 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Rapid DNA | $201.00 | $335.00 | $75.78–$160.21 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Wet Prep | $201.00 | $335.00 | $75.78–$160.21 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $296.40 | $494.00 | $67.21–$142.08 | 100% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $296.40 | $494.00 | $67.21–$142.08 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Auto Diff | $125.40 | $209.00 | $43.42–$91.82 | 37% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Auto Diff | $125.40 | $209.00 | $43.42–$91.82 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/ Indices | $165.00 | $275.00 | $32.53–$68.76 | 76% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC Auto No Diff | $165.00 | $275.00 | $32.53–$68.76 | 76% above | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC Auto No Diff | $165.00 | $275.00 | $32.53–$68.76 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/ Indices | $165.00 | $275.00 | $32.53–$68.76 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $447.60 | $746.00 | $71.54–$151.26 | 78% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $447.60 | $746.00 | $71.54–$151.26 | — | 40% |
| Cortisol blood test, total CPT 82533 Cortisol Level | $199.80 | $333.00 | $75.93–$160.54 | 139% above | 40% |
| Cortisol blood test, total CPT 82533 Cortisol A.M. | $199.80 | $333.00 | $75.93–$160.54 | 139% above | 40% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol A.M. | $199.80 | $333.00 | $75.93–$160.54 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Level | $199.80 | $333.00 | $75.93–$160.54 | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $187.80 | $313.00 | $48.99–$103.56 | 194% above | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $187.80 | $313.00 | $48.99–$103.56 | — | 40% |
| Creatinine blood test CPT 82565 Creatinine IStat | $88.80 | $148.00 | $24.66–$52.13 | 66% above | 40% |
| Creatinine blood test CPT 82565 Creatinine POCT | $135.96 | $226.60 | $24.66–$52.13 | 154% above | 40% |
| Creatinine blood test CPT 82565 Creatinine | $147.00 | $245.00 | $24.66–$52.13 | 175% above | 40% |
| Creatinine blood test CPT 82565 Creatinine POC | $147.00 | $245.00 | $24.66–$52.13 | 175% above | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine IStat | $88.80 | $148.00 | $24.66–$52.13 | — | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine POCT | $135.96 | $226.60 | $24.66–$52.13 | — | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $147.00 | $245.00 | $24.66–$52.13 | — | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine POC | $147.00 | $245.00 | $24.66–$52.13 | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG | $279.60 | $466.00 | $61.20–$129.39 | 273% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibody | $279.60 | $466.00 | $61.20–$129.39 | 273% above | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibody | $279.60 | $466.00 | $61.20–$129.39 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG | $279.60 | $466.00 | $61.20–$129.39 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $303.00 | $505.00 | $75.92–$160.49 | 78% above | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $303.00 | $505.00 | $75.92–$160.49 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate | $28.20 | $47.00 | $83.10–$175.70 | 81% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate | $28.20 | $47.00 | $83.10–$175.70 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug test any number of drug classes instrumented chemistry analyzers immunoassay 80307 | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiaz Urine Screen | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Toxicology Drug Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screening Test | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiate Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen G0479 | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturate Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | 246% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screening Test | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturate Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen G0479 | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Toxicology Drug Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiaz Urine Screen | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug test any number of drug classes instrumented chemistry analyzers immunoassay 80307 | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiate Screen Urine | $214.80 | $358.00 | $101.69–$214.97 | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $202.80 | $338.00 | $44.14–$93.32 | 27% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $202.80 | $338.00 | $44.14–$93.32 | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Antibody; Epstein-Barr virus (VCA) 86665 | $243.60 | $406.00 | $70.84–$149.79 | 182% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus Antibody Panel | $243.60 | $406.00 | $70.84–$149.79 | 182% above | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus Antibody Panel | $243.60 | $406.00 | $70.84–$149.79 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Antibody; Epstein-Barr virus (VCA) 86665 | $243.60 | $406.00 | $70.84–$149.79 | — | 40% |
| Estradiol blood test CPT 82670 Estradiol | $287.40 | $479.00 | $83.02–$175.49 | 132% above | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol | $287.40 | $479.00 | $83.02–$175.49 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $284.40 | $474.00 | $68.47–$144.76 | 82% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone | $284.40 | $474.00 | $68.47–$144.76 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $183.60 | $306.00 | $60.88–$128.72 | 120% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $183.60 | $306.00 | $60.88–$128.72 | — | 40% |
| Fibrinogen blood test CPT 85384 Fibrinogen | $178.80 | $298.00 | $67.16–$141.96 | 107% above | 40% |
| Fibrinogen blood test CPT 85384 Fibrinogen; activity 85384 | $178.80 | $298.00 | $67.16–$141.96 | 107% above | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen | $178.80 | $298.00 | $67.16–$141.96 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen; activity 85384 | $178.80 | $298.00 | $67.16–$141.96 | — | 40% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $223.80 | $373.00 | $60.83–$128.61 | 180% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $223.80 | $373.00 | $60.83–$128.61 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $307.20 | $512.00 | $76.67–$162.08 | 120% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free | $307.20 | $512.00 | $76.67–$162.08 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Throxine Free | $213.00 | $355.00 | $57.53–$121.61 | 184% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $213.00 | $355.00 | $57.53–$121.61 | 184% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Throxine Free | $213.00 | $355.00 | $57.53–$121.61 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free | $213.00 | $355.00 | $57.53–$121.61 | — | 40% |
| Free testosterone test CPT 84402 Testosterone Free | $622.20 | $1,037.00 | $65.56–$138.62 | 487% above | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free | $622.20 | $1,037.00 | $65.56–$138.62 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $178.80 | $298.00 | $27.74–$58.65 | 204% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $178.80 | $298.00 | $27.74–$58.65 | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL 80050 | $295.80 | $493.00 | $121.58–$257.04 | 34% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL 80050 | $295.80 | $493.00 | $121.58–$257.04 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea RNA by TMA | $166.20 | $277.00 | $68.30–$144.40 | 28% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae 87591 | $166.20 | $277.00 | $68.30–$144.40 | 28% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae 87591 | $166.20 | $277.00 | $68.30–$144.40 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea RNA by TMA | $166.20 | $277.00 | $68.30–$144.40 | — | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody | $160.80 | $268.00 | $69.27–$146.45 | 27% above | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody | $160.80 | $268.00 | $69.27–$146.45 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Viral Load | $298.20 | $497.00 | $196.20–$414.82 | 2% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV Viral Load | $298.20 | $497.00 | $196.20–$414.82 | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result 86703 | $158.40 | $264.00 | $61.92–$130.91 | 95% above | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 Rapid Ab Scrn | $158.40 | $264.00 | $61.92–$130.91 | 95% above | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 Rapid Ab Scrn | $158.40 | $264.00 | $61.92–$130.91 | — | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 Antibody; HIV-1 and HIV-2, single result 86703 | $158.40 | $264.00 | $61.92–$130.91 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 and HIV-2 87389 | $184.80 | $308.00 | $160.62–$339.56 | 36% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 and HIV-2 87389 | $184.80 | $308.00 | $160.62–$339.56 | — | 40% |
| Hemoglobin blood test CPT 85018 H and H | $58.09 | $96.82 | $18.35–$38.79 | 34% above | 40% |
| Hemoglobin blood test CPT 85018 zzH&H iSTAT | $63.00 | $105.00 | $18.35–$38.79 | 45% above | 40% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $66.60 | $111.00 | $18.35–$38.79 | 53% above | 40% |
| Hemoglobin blood test inpatient CPT 85018 H and H | $58.09 | $96.82 | $18.35–$38.79 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 zzH&H iSTAT | $63.00 | $105.00 | $18.35–$38.79 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $66.60 | $111.00 | $18.35–$38.79 | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody (HBcAb); total 86704 | $250.20 | $417.00 | $54.33–$114.86 | 242% above | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTAL W/REFL IGM | $250.20 | $417.00 | $54.33–$114.86 | 242% above | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL W/REFL IGM | $250.20 | $417.00 | $54.33–$114.86 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody (HBcAb); total 86704 | $250.20 | $417.00 | $54.33–$114.86 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $198.00 | $330.00 | $52.71–$111.44 | 210% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody | $198.00 | $330.00 | $52.71–$111.44 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $163.20 | $272.00 | $54.60–$115.43 | 133% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen | $163.20 | $272.00 | $54.60–$115.43 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody IgM + IgG | $254.40 | $424.00 | $71.40–$150.97 | 194% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody IgM + IgG | $254.40 | $424.00 | $71.40–$150.97 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C 87522 | $172.80 | $288.00 | $198.12–$418.86 | 28% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA, QN, Real-Time PCR | $380.40 | $634.00 | $198.12–$418.86 | 58% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C 87522 | $172.80 | $288.00 | $198.12–$418.86 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA, QN, Real-Time PCR | $380.40 | $634.00 | $198.12–$418.86 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Antibody; herpes simplex, type 1 86695 | $80.40 | $134.00 | $59.33–$125.41 | 12% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IGG,TYPE SPECIFIC AB | $80.40 | $134.00 | $59.33–$125.41 | 12% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IGG,TYPE SPECIFIC AB | $80.40 | $134.00 | $59.33–$125.41 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Antibody; herpes simplex, type 1 86695 | $80.40 | $134.00 | $59.33–$125.41 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 Antibody | $80.40 | $134.00 | $57.98–$122.57 | 3% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Antibody; herpes simplex, type 2 86696 | $80.40 | $134.00 | $57.98–$122.57 | 3% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 1/2 AB (IGM), W/RFL TO TITER | $80.40 | $134.00 | $57.98–$122.57 | 3% below | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1/2 AB (IGM), W/RFL TO TITER | $80.40 | $134.00 | $57.98–$122.57 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Antibody; herpes simplex, type 2 86696 | $80.40 | $134.00 | $57.98–$122.57 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 Antibody | $80.40 | $134.00 | $57.98–$122.57 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP, HS, Cardiac Risk | $103.80 | $173.00 | $43.00–$90.90 | 32% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) 86141 | $103.80 | $173.00 | $43.00–$90.90 | 32% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-reactive protein; high sensitivity (hsCRP) 86141 | $103.80 | $173.00 | $43.00–$90.90 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP, HS, Cardiac Risk | $103.80 | $173.00 | $43.00–$90.90 | — | 40% |
| Insulin blood test CPT 83525 Insulin Level Total | $243.00 | $405.00 | $44.53–$94.13 | 253% above | 40% |
| Insulin blood test inpatient CPT 83525 Insulin Level Total | $243.00 | $405.00 | $44.53–$94.13 | — | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $194.40 | $324.00 | $35.37–$74.78 | 175% above | 40% |
| Iron blood test (serum iron) CPT 83540 Total Iron | $194.40 | $324.00 | $35.37–$74.78 | 175% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $194.40 | $324.00 | $35.37–$74.78 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Total Iron | $194.40 | $324.00 | $35.37–$74.78 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron & TIBC | $214.20 | $357.00 | $39.42–$83.34 | 139% above | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total | $214.20 | $357.00 | $39.42–$83.34 | 139% above | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron & TIBC | $214.20 | $357.00 | $39.42–$83.34 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total | $214.20 | $357.00 | $39.42–$83.34 | — | 40% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $395.40 | $659.00 | $108.94–$230.33 | 123% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $395.40 | $659.00 | $108.94–$230.33 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $122.40 | $204.00 | $66.11–$139.75 | 13% below | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone | $122.40 | $204.00 | $66.11–$139.75 | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $169.33 | $282.22 | $57.67–$121.94 | 77% above | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid POCT | $169.33 | $282.22 | $57.67–$121.94 | 77% above | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactate Level - POC | $183.60 | $306.00 | $57.67–$121.94 | 92% above | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid POCT | $169.33 | $282.22 | $57.67–$121.94 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $169.33 | $282.22 | $57.67–$121.94 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate Level - POC | $183.60 | $306.00 | $57.67–$121.94 | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $171.00 | $285.00 | $31.27–$66.12 | 284% above | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid | $171.00 | $285.00 | $31.27–$66.12 | 284% above | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid | $171.00 | $285.00 | $31.27–$66.12 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $171.00 | $285.00 | $31.27–$66.12 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $186.00 | $310.00 | $52.79–$111.60 | 179% above | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, PLEURAL FLUID | $186.00 | $310.00 | $52.79–$111.60 | 179% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, PLEURAL FLUID | $186.00 | $310.00 | $52.79–$111.60 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $186.00 | $310.00 | $52.79–$111.60 | — | 40% |
| Liver function blood test panel CPT 80076 LIVER | $410.40 | $684.00 | $79.94–$169.00 | 112% above | 40% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $410.40 | $684.00 | $79.94–$169.00 | 112% above | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER | $410.40 | $684.00 | $79.94–$169.00 | — | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $410.40 | $684.00 | $79.94–$169.00 | — | 40% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB W/REFL TO BLOT (IGG, IGM) | $176.40 | $294.00 | $75.92–$160.49 | 113% above | 40% |
| Lyme disease antibody test CPT 86618 LYMES | $176.40 | $294.00 | $75.92–$160.49 | 113% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB W/REFL TO BLOT (IGG, IGM) | $176.40 | $294.00 | $75.92–$160.49 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYMES | $176.40 | $294.00 | $75.92–$160.49 | — | 40% |
| Magnesium blood test CPT 83735 U Magnesium | $158.40 | $264.00 | $42.43–$89.69 | 260% above | 40% |
| Magnesium blood test CPT 83735 Urine Magnesium | $158.40 | $264.00 | $42.43–$89.69 | 260% above | 40% |
| Magnesium blood test CPT 83735 Serum Magnesium | $158.40 | $264.00 | $42.43–$89.69 | 260% above | 40% |
| Magnesium blood test inpatient CPT 83735 Urine Magnesium | $158.40 | $264.00 | $42.43–$89.69 | — | 40% |
| Magnesium blood test inpatient CPT 83735 Serum Magnesium | $158.40 | $264.00 | $42.43–$89.69 | — | 40% |
| Magnesium blood test inpatient CPT 83735 U Magnesium | $158.40 | $264.00 | $42.43–$89.69 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies IgG | $100.20 | $167.00 | $52.65–$111.32 | 228% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles Antibody | $100.20 | $167.00 | $52.65–$111.32 | 228% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Antiboy; rubeola 86765 | $100.20 | $167.00 | $52.65–$111.32 | 228% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody | $100.20 | $167.00 | $52.65–$111.32 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies IgG | $100.20 | $167.00 | $52.65–$111.32 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Antiboy; rubeola 86765 | $100.20 | $167.00 | $52.65–$111.32 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $105.60 | $176.00 | $35.94–$75.98 | 24% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening 86308 | $105.60 | $176.00 | $35.94–$75.98 | 24% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $105.60 | $176.00 | $35.94–$75.98 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile antibodies; screening 86308 | $105.60 | $176.00 | $35.94–$75.98 | — | 40% |
| Mumps immunity blood test CPT 86735 ANTIBODY MUMPS | $95.40 | $159.00 | $64.95–$137.31 | 59% above | 40% |
| Mumps immunity blood test CPT 86735 Mumps Virus Antibody (IGG) | $100.20 | $167.00 | $64.95–$137.31 | 67% above | 40% |
| Mumps immunity blood test CPT 86735 Mumps Antibodies, IgM | $111.00 | $185.00 | $64.95–$137.31 | 85% above | 40% |
| Mumps immunity blood test CPT 86735 Antibody; mumps 86735 | $111.00 | $185.00 | $64.95–$137.31 | 85% above | 40% |
| Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS | $95.40 | $159.00 | $64.95–$137.31 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody (IGG) | $100.20 | $167.00 | $64.95–$137.31 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgM | $111.00 | $185.00 | $64.95–$137.31 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Antibody; mumps 86735 | $111.00 | $185.00 | $64.95–$137.31 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free 84154 | $147.00 | $245.00 | $65.22–$137.90 | 30% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (Free and Total) | $298.20 | $497.00 | $65.22–$137.90 | 164% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate specific antigen (PSA); free 84154 | $147.00 | $245.00 | $65.22–$137.90 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA (Free and Total) | $298.20 | $497.00 | $65.22–$137.90 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen | $147.00 | $245.00 | $65.78–$139.06 | 71% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen | $147.00 | $245.00 | $65.78–$139.06 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Intraoprative PTH | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH IntraOp | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact and Calcium | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) 83970 | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 iPTH | $358.80 | $598.00 | $115.38–$243.93 | 75% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Intraoprative PTH | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 iPTH | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (parathyroid hormone) 83970 | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact and Calcium | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH IntraOp | $358.80 | $598.00 | $115.38–$243.93 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $148.80 | $248.00 | $43.55–$92.05 | 198% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $148.80 | $248.00 | $43.55–$92.05 | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $149.40 | $249.00 | $24.00–$50.74 | 140% above | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $149.40 | $249.00 | $24.00–$50.74 | — | 40% |
| Potassium blood test CPT 84132 Potassium Level | $125.40 | $209.00 | $24.00–$50.76 | 109% above | 40% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $125.40 | $209.00 | $24.00–$50.76 | — | 40% |
| Progesterone blood test CPT 84144 Progesterone 84144 | $37.20 | $62.00 | $69.82–$147.65 | 64% below | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone 84144 | $37.20 | $62.00 | $69.82–$147.65 | — | 40% |
| Prolactin blood test CPT 84146 Prolactin Level | $255.00 | $425.00 | $83.06–$175.60 | 131% above | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin Level | $255.00 | $425.00 | $83.06–$175.60 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR Hemochron | $123.60 | $206.00 | $30.31–$64.09 | 169% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR Istat | $123.60 | $206.00 | $30.31–$64.09 | 169% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $123.60 | $206.00 | $30.31–$64.09 | 169% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $123.60 | $206.00 | $30.31–$64.09 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR Hemochron | $123.60 | $206.00 | $30.31–$64.09 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR Istat | $123.60 | $206.00 | $30.31–$64.09 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Scrn (Rapid), Ur.SV | $155.40 | $259.00 | $61.07–$129.10 | 46% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Scrn (Rapid), Ur.SV | $155.40 | $259.00 | $61.07–$129.10 | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/B Antigen | $115.80 | $193.00 | $57.41–$121.38 | 24% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Flu | $115.80 | $193.00 | $57.41–$121.38 | 24% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A/B Antigen | $115.80 | $193.00 | $57.41–$121.38 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Flu | $115.80 | $193.00 | $57.41–$121.38 | — | 40% |
| Renin blood test CPT 84244 Plasma Renin Act, LC/MS/MS | $348.00 | $580.00 | $79.93–$168.99 | 239% above | 40% |
| Renin blood test CPT 84244 Plasma Renin Act, LC/MS/MS 84244 | $348.00 | $580.00 | $79.93–$168.99 | 239% above | 40% |
| Renin blood test inpatient CPT 84244 Plasma Renin Act, LC/MS/MS 84244 | $348.00 | $580.00 | $79.93–$168.99 | — | 40% |
| Renin blood test inpatient CPT 84244 Plasma Renin Act, LC/MS/MS | $348.00 | $580.00 | $79.93–$168.99 | — | 40% |
| Rh blood typing CPT 86901 RH Type | $76.20 | $127.00 | $26.04–$55.06 | 19% above | 40% |
| Rh blood typing CPT 86901 Anti-D | $76.20 | $127.00 | $26.04–$55.06 | 19% above | 40% |
| Rh blood typing CPT 86901 RH Type by Blood Center 86901 | $76.20 | $127.00 | $26.04–$55.06 | 19% above | 40% |
| Rh blood typing inpatient CPT 86901 RH Type | $76.20 | $127.00 | $26.04–$55.06 | — | 40% |
| Rh blood typing inpatient CPT 86901 RH Type by Blood Center 86901 | $76.20 | $127.00 | $26.04–$55.06 | — | 40% |
| Rh blood typing inpatient CPT 86901 Anti-D | $76.20 | $127.00 | $26.04–$55.06 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $153.00 | $255.00 | $37.78–$79.87 | 235% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor | $153.00 | $255.00 | $37.78–$79.87 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 MMR Titer | $100.20 | $167.00 | $43.31–$91.60 | 118% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody | $100.20 | $167.00 | $43.31–$91.60 | 118% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies Diagnostic | $100.20 | $167.00 | $43.31–$91.60 | 118% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MMR Titer | $100.20 | $167.00 | $43.31–$91.60 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies Diagnostic | $100.20 | $167.00 | $43.31–$91.60 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody | $100.20 | $167.00 | $43.31–$91.60 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR | $61.80 | $103.00 | $29.76–$62.93 | 1% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR | $61.80 | $103.00 | $29.76–$62.93 | — | 40% |
| Sodium blood test CPT 84295 Sodium Level | $115.20 | $192.00 | $21.03–$44.50 | 85% above | 40% |
| Sodium blood test CPT 84295 CG8 - POC | $115.20 | $192.00 | $21.03–$44.50 | 85% above | 40% |
| Sodium blood test inpatient CPT 84295 CG8 - POC | $115.20 | $192.00 | $21.03–$44.50 | — | 40% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $115.20 | $192.00 | $21.03–$44.50 | — | 40% |
| Stool ova and parasites exam CPT 87177 Ova and Parasite Smear | $100.20 | $167.00 | $48.42–$102.38 | 46% above | 40% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites Exam | $100.20 | $167.00 | $48.42–$102.38 | 46% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Parasites Exam | $100.20 | $167.00 | $48.42–$102.38 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite Smear | $100.20 | $167.00 | $48.42–$102.38 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HP Blood Occult Stool | $84.00 | $140.00 | $17.82–$37.68 | 120% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool for Occult Blood POC | $85.20 | $142.00 | $17.82–$37.68 | 123% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool | $102.60 | $171.00 | $17.82–$37.68 | 169% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool. | $102.60 | $171.00 | $17.82–$37.68 | 169% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HP Blood Occult Stool | $84.00 | $140.00 | $17.82–$37.68 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool for Occult Blood POC | $85.20 | $142.00 | $17.82–$37.68 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool | $102.60 | $171.00 | $17.82–$37.68 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool. | $102.60 | $171.00 | $17.82–$37.68 | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Screen | $165.00 | $275.00 | $67.16–$141.96 | 273% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab | $165.00 | $275.00 | $67.16–$141.96 | 273% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS | $165.00 | $275.00 | $67.16–$141.96 | 273% above | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab | $165.00 | $275.00 | $67.16–$141.96 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS | $165.00 | $275.00 | $67.16–$141.96 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Screen | $165.00 | $275.00 | $67.16–$141.96 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL | $111.00 | $185.00 | $32.40–$68.51 | 171% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Test | $111.00 | $185.00 | $32.40–$68.51 | 171% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $111.00 | $185.00 | $32.40–$68.51 | 171% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Test | $111.00 | $185.00 | $32.40–$68.51 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF | $111.00 | $185.00 | $32.40–$68.51 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL | $111.00 | $185.00 | $32.40–$68.51 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon-TB Gold | $158.40 | $264.00 | $82.36–$174.12 | 20% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon-TB Gold | $158.40 | $264.00 | $82.36–$174.12 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testost Total | $278.40 | $464.00 | $87.13–$184.22 | 181% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Free, Bioavailable and Total, M | $278.40 | $464.00 | $87.13–$184.22 | 181% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Free, Bioavailable and Total, M | $278.40 | $464.00 | $87.13–$184.22 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testost Total | $278.40 | $464.00 | $87.13–$184.22 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Anti-Microsomal Antibody | $120.60 | $201.00 | $57.08–$120.69 | 45% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibodies (TPO) | $120.60 | $201.00 | $57.08–$120.69 | 45% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (eg, thyroid or liver-kidney), each 8 | $120.60 | $201.00 | $57.08–$120.69 | 45% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibodies (eg, thyroid or liver-kidney), each 8 | $120.60 | $201.00 | $57.08–$120.69 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Anti-Microsomal Antibody | $120.60 | $201.00 | $57.08–$120.69 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibodies (TPO) | $120.60 | $201.00 | $57.08–$120.69 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 zzTSH/FT4 | $338.40 | $564.00 | $70.53–$149.14 | 208% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $338.40 | $564.00 | $70.53–$149.14 | 208% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Rflx Free T4 | $338.40 | $564.00 | $70.53–$149.14 | 208% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Rflx Free T4 | $338.40 | $564.00 | $70.53–$149.14 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 zzTSH/FT4 | $338.40 | $564.00 | $70.53–$149.14 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $338.40 | $564.00 | $70.53–$149.14 | — | 40% |
| Total IgE blood test CPT 82785 Immunoglobulin E | $183.60 | $306.00 | $59.30–$125.35 | 125% above | 40% |
| Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE 82785 | $183.60 | $306.00 | $59.30–$125.35 | 125% above | 40% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E | $183.60 | $306.00 | $59.30–$125.35 | — | 40% |
| Total IgE blood test inpatient CPT 82785 Gammaglobulin (immunoglobulin); IgE 82785 | $183.60 | $306.00 | $59.30–$125.35 | — | 40% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $135.00 | $225.00 | $24.25–$51.23 | 142% above | 40% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $135.00 | $225.00 | $24.25–$51.23 | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 Thyroid Panel | $172.20 | $287.00 | $43.48–$91.91 | 115% above | 40% |
| Total thyroxine (T4) blood test CPT 84436 TOTAL T4 | $172.20 | $287.00 | $43.48–$91.91 | 115% above | 40% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine | $172.20 | $287.00 | $43.48–$91.91 | 115% above | 40% |
| Total thyroxine (T4) blood test CPT 84436 Free Thyroxine Index | $172.20 | $287.00 | $43.48–$91.91 | 115% above | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroid Panel | $172.20 | $287.00 | $43.48–$91.91 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Free Thyroxine Index | $172.20 | $287.00 | $43.48–$91.91 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine | $172.20 | $287.00 | $43.48–$91.91 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4 | $172.20 | $287.00 | $43.48–$91.91 | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine | $272.40 | $454.00 | $72.29–$152.83 | 118% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine Total | $272.40 | $454.00 | $72.29–$152.83 | 118% above | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine | $272.40 | $454.00 | $72.29–$152.83 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine Total | $272.40 | $454.00 | $72.29–$152.83 | — | 40% |
| Transferrin blood test CPT 84466 Transferrin 84466 | $207.60 | $346.00 | $50.84–$107.48 | 74% above | 40% |
| Transferrin blood test inpatient CPT 84466 Transferrin 84466 | $207.60 | $346.00 | $50.84–$107.48 | — | 40% |
| Triglycerides blood test CPT 84478 Triglyceride Body Fluid | $208.20 | $347.00 | $29.81–$63.03 | 201% above | 40% |
| Triglycerides blood test CPT 84478 Triglycerides | $208.20 | $347.00 | $29.81–$63.03 | 201% above | 40% |
| Triglycerides blood test CPT 84478 Triglyceride Body Fluid 84478 | $208.20 | $347.00 | $29.81–$63.03 | 201% above | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid | $208.20 | $347.00 | $29.81–$63.03 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $208.20 | $347.00 | $29.81–$63.03 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid 84478 | $208.20 | $347.00 | $29.81–$63.03 | — | 40% |
| Troponin test, quantitative CPT 84484 Troponin I POCT | $276.25 | $460.41 | $79.99–$169.13 | 143% above | 40% |
| Troponin test, quantitative CPT 84484 Troponin I -POC | $276.25 | $460.41 | $79.99–$169.13 | 143% above | 40% |
| Troponin test, quantitative CPT 84484 Troponin I - POC | $298.80 | $498.00 | $79.99–$169.13 | 162% above | 40% |
| Troponin test, quantitative CPT 84484 Troponin-I (High Sensitivity) | $298.80 | $498.00 | $79.99–$169.13 | 162% above | 40% |
| Troponin test, quantitative CPT 84484 Troponin | $298.80 | $498.00 | $79.99–$169.13 | 162% above | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I POCT | $276.25 | $460.41 | $79.99–$169.13 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I -POC | $276.25 | $460.41 | $79.99–$169.13 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin I - POC | $298.80 | $498.00 | $79.99–$169.13 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I (High Sensitivity) | $298.80 | $498.00 | $79.99–$169.13 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin | $298.80 | $498.00 | $79.99–$169.13 | — | 40% |
| Uric acid blood test CPT 84550 Uric Acid | $139.20 | $232.00 | $22.84–$48.25 | 78% above | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $139.20 | $232.00 | $22.84–$48.25 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis With Microscopy | $127.20 | $212.00 | $34.30–$72.50 | 36% above | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis With Microscopy | $127.20 | $212.00 | $34.30–$72.50 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis | $82.20 | $137.00 | $26.99–$57.05 | 69% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick | $82.20 | $137.00 | $26.99–$57.05 | 69% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA w/Reflex to Micro if Indicated-SV | $82.20 | $137.00 | $26.99–$57.05 | 69% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis | $82.20 | $137.00 | $26.99–$57.05 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick | $82.20 | $137.00 | $26.99–$57.05 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA w/Reflex to Micro if Indicated-SV | $82.20 | $137.00 | $26.99–$57.05 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture. | $240.00 | $400.00 | $52.89–$111.81 | 86% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine 87086 | $240.00 | $400.00 | $52.89–$111.81 | 86% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $240.00 | $400.00 | $52.89–$111.81 | 86% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Culture, bacterial; quantitative colony count, urine 87086 | $240.00 | $400.00 | $52.89–$111.81 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $240.00 | $400.00 | $52.89–$111.81 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture. | $240.00 | $400.00 | $52.89–$111.81 | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin | $82.80 | $138.00 | $41.57–$87.86 | 62% above | 40% |
| Urine microalbumin (albumin) test CPT 82043 Albumin Level 24 Hour Urine | $152.40 | $254.00 | $41.57–$87.86 | 199% above | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin | $82.80 | $138.00 | $41.57–$87.86 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Level 24 Hour Urine | $152.40 | $254.00 | $41.57–$87.86 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test POC | $220.80 | $368.00 | $44.01–$93.07 | 173% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Urine | $265.20 | $442.00 | $44.01–$93.07 | 228% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test- Point Of Care | $265.20 | $442.00 | $44.01–$93.07 | 228% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 HCG Qual Urine | $265.20 | $442.00 | $44.01–$93.07 | 228% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test POC | $220.80 | $368.00 | $44.01–$93.07 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test- Point Of Care | $265.20 | $442.00 | $44.01–$93.07 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Beta Human Chorionic Gonadotropin Qualitative Urine | $265.20 | $442.00 | $44.01–$93.07 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG Qual Urine | $265.20 | $442.00 | $44.01–$93.07 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $217.80 | $363.00 | $62.29–$131.70 | 140% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $217.80 | $363.00 | $62.29–$131.70 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $352.80 | $588.00 | $83.53–$176.60 | 196% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D HYDROXY | $352.80 | $588.00 | $83.53–$176.60 | 196% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D HYDROXY | $352.80 | $588.00 | $83.53–$176.60 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $352.80 | $588.00 | $83.53–$176.60 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1,25 | $307.80 | $513.00 | $117.03–$247.43 | 100% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1,25 | $307.80 | $513.00 | $117.03–$247.43 | — | 40% |
| Zinc blood test CPT 84630 Zinc 84630 | $93.60 | $156.00 | $44.44–$93.97 | 37% above | 40% |
| Zinc blood test inpatient CPT 84630 Zinc 84630 | $93.60 | $156.00 | $44.44–$93.97 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $159.60 | $266.00 | $83.69–$176.91 | 42% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Human Chorionic Gonadotropin Quantitative | $159.60 | $266.00 | $83.69–$176.91 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY UNDER AGE 12 42830 | $9,174.00 | $15,290.00 | $2,607.00–$5,511.00 | 145% above | 40% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY UNDER AGE 12 42830 | $9,174.00 | $15,290.00 | $2,607.00–$5,511.00 | — | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRODESIS ANTERIOR INTERBODY CERVICAL BELOW C2 22551 | $10,647.60 | $17,746.00 | $5,772.00–$12,203.00 | 52% above | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRODESIS ANTERIOR INTERBODY CERVICAL BELOW C2 22551 | $10,647.60 | $17,746.00 | $5,772.00–$12,203.00 | — | 40% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY FOR RUPTURED APPENDIX 44960 | $3,342.00 | $5,570.00 | $1,988.00–$15,999.00 | 1% above | 40% |
| Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY FOR RUPTURED APPENDIX 44960 | $3,342.00 | $5,570.00 | $1,988.00–$15,999.00 | — | 40% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY INCIDENTAL DURING INTRA-ABDOMINAL SURGERY 44950 | $10,658.40 | $17,764.00 | $2,607.00–$6,892.72 | 84% above | 40% |
| Appendectomy, open surgery CPT 44950 ED APPENDECTOMY INCIDENTAL DURING INTRA-ABDOMINAL SURGERY 44950 | $10,658.40 | $17,764.00 | $2,607.00–$6,892.72 | 84% above | 40% |
| Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY INCIDENTAL DURING INTRA-ABDOMINAL SURGERY 44950 | $10,658.40 | $17,764.00 | $2,607.00–$6,892.72 | — | 40% |
| Appendectomy, open surgery inpatient CPT 44950 ED APPENDECTOMY INCIDENTAL DURING INTRA-ABDOMINAL SURGERY 44950 | $10,658.40 | $17,764.00 | $2,607.00–$6,892.72 | — | 40% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED KNEE ANTERIOR CRUCIATE LIGAMENT REPAIR/RECONSTRUCTION 29888 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | 183% above | 40% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED KNEE ANTERIOR CRUCIATE LIGAMENT REPAIR/RECONSTRUCTION 29888 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR 29827 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | 317% above | 40% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR 29827 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MA Bx Breast 1St Lesion Strtctc 19081 | $2,118.00 | $3,530.00 | $1,477.10–$3,361.00 | 39% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BCE MA Bx Breast 1St Lesion Strtctc 19081 | $2,118.00 | $3,530.00 | $1,477.10–$3,361.00 | 39% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY BREAST WITH PLACEMENT OF BREAST LOCALIZATION DEVICES/STEREOTACTIC ; FIRST LESION 19081 | $2,668.20 | $4,447.00 | $1,477.10–$3,361.00 | 24% below | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MA Bx Breast 1St Lesion Strtctc 19081 | $2,118.00 | $3,530.00 | $1,477.10–$3,361.00 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BCE MA Bx Breast 1St Lesion Strtctc 19081 | $2,118.00 | $3,530.00 | $1,477.10–$3,361.00 | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY BREAST WITH PLACEMENT OF BREAST LOCALIZATION DEVICES/STEREOTACTIC ; FIRST LESION 19081 | $2,668.20 | $4,447.00 | $1,477.10–$3,361.00 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION 27786 | $514.20 | $857.00 | $214.85–$3,361.00 | 10% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ED CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION | $514.20 | $857.00 | $214.85–$3,361.00 | 10% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION 27786 | $514.20 | $857.00 | $214.85–$3,361.00 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ED CLOSED TREATMENT DISTAL FIBULA W/O MANIPULATION | $514.20 | $857.00 | $214.85–$3,361.00 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ED CLSD TRMT OF METATARSAL FRACTURE; W/O MANIPULATION, EACH | $499.20 | $832.00 | $214.85–$3,361.00 | 78% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION 28470 | $499.20 | $832.00 | $214.85–$3,361.00 | 78% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ED CLSD TRMT OF METATARSAL FRACTURE; W/O MANIPULATION, EACH | $499.20 | $832.00 | $214.85–$3,361.00 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION 28470 | $499.20 | $832.00 | $214.85–$3,361.00 | — | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNIONECTOMY; W/SESAMOIDECTOMY; W/DISTAL METATARSAL OSTEOTOMY 28296 | $9,685.80 | $16,143.00 | $2,948.97–$6,366.00 | 131% above | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 BUNIONECTOMY; W/SESAMOIDECTOMY; W/DISTAL METATARSAL OSTEOTOMY 28296 | $9,685.80 | $16,143.00 | $2,948.97–$6,366.00 | — | 40% |
| Bunion correction with removal of part of the big toe joint CPT 28292 BUNIONECTOMY; W/SESAMOIDECTOMY; W/RESEC. PROXIMAL PHALANX BASE 28292 | $5,703.00 | $9,505.00 | $2,872.00–$6,071.00 | 38% above | 40% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 BUNIONECTOMY; W/SESAMOIDECTOMY; W/RESEC. PROXIMAL PHALANX BASE 28292 | $5,703.00 | $9,505.00 | $2,872.00–$6,071.00 | — | 40% |
| Cardiac catheterization with coronary angiogram CPT 93458 LHC CORONARY ANGIOGRAPHY 93458 CL | $11,151.60 | $18,586.00 | $2,968.76–$8,020.00 | 6% above | 40% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 LHC CORONARY ANGIOGRAPHY 93458 CL | $11,151.60 | $18,586.00 | $2,968.76–$8,020.00 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion, elective, electrical conversion of arrhythmia; external 92960 | $1,219.80 | $2,033.00 | $592.94–$8,726.00 | 8% below | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION; ELECTIVE 92960 CL | $1,219.80 | $2,033.00 | $592.94–$8,726.00 | 8% below | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion, elective, electrical conversion of arrhythmia; external 92960 | $1,219.80 | $2,033.00 | $592.94–$8,726.00 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION; ELECTIVE 92960 CL | $1,219.80 | $2,033.00 | $592.94–$8,726.00 | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION;MEDIAN NERVE AT CARPAL TUNNEL 64721 | $5,897.40 | $9,829.00 | $1,759.07–$6,366.00 | 90% above | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND/OR TRANSPOSITION;MEDIAN NERVE AT CARPAL TUNNEL 64721 | $5,897.40 | $9,829.00 | $1,759.07–$6,366.00 | — | 40% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX 57500 | $2,905.80 | $4,843.00 | $732.42–$3,361.00 | 151% above | 40% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX 57500 | $2,905.80 | $4,843.00 | $732.42–$3,361.00 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION-SURGICAL EXCISION-OLDER THAN 28 DAYS 54161 | $6,208.80 | $10,348.00 | $1,855.67–$5,511.00 | 66% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION-SURGICAL EXCISION-OLDER THAN 28 DAYS 54161 | $6,208.80 | $10,348.00 | $1,855.67–$5,511.00 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP OR RING BLOCK 54150 | $5,328.60 | $8,881.00 | $1,590.00–$3,697.00 | 333% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP OR RING BLOCK 54150 | $5,328.60 | $8,881.00 | $1,590.00–$3,697.00 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION 25600 | $787.20 | $1,312.00 | $214.85–$3,361.00 | 74% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION | $787.20 | $1,312.00 | $214.85–$3,361.00 | 74% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION | $787.20 | $1,312.00 | $214.85–$3,361.00 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED REDUCTION OF DISTAL RADIUS FRACTURE W/O MANIPULATION 25600 | $787.20 | $1,312.00 | $214.85–$3,361.00 | — | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLEXIBLE; WITH REMOVAL OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE 45385 | $3,429.00 | $5,715.00 | $1,075.12–$3,538.00 | 162% above | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLEXIBLE; WITH REMOVAL OF TUMOR/POLYP/LESION BY SNARE TECHNIQUE 45385 | $3,429.00 | $5,715.00 | $1,075.12–$3,538.00 | — | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEXIBLE; WITH BIOPSY; SINGLE OR MULTIPLE 45380 | $3,429.00 | $5,715.00 | $1,075.12–$3,538.00 | 140% above | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEXIBLE; WITH BIOPSY; SINGLE OR MULTIPLE 45380 | $3,429.00 | $5,715.00 | $1,075.12–$3,538.00 | — | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEXIBLE; DIAGNOSTIC; INCL. COLLECTION OF SPECIMENS 45378 | $2,599.80 | $4,333.00 | $832.67–$3,538.00 | 69% above | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEXIBLE; DIAGNOSTIC; INCL. COLLECTION OF SPECIMENS 45378 | $2,599.80 | $4,333.00 | $832.67–$3,538.00 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY OF CERVIX WITH LOOP ELECTRODE BIOPSY 57460 | $3,598.20 | $5,997.00 | $1,590.00–$3,697.00 | 2% above | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY OF CERVIX WITH LOOP ELECTRODE BIOPSY 57460 | $3,598.20 | $5,997.00 | $1,590.00–$3,697.00 | — | 40% |
| Coronary stent placement, one artery CPT 92928 STENT(DES OR BMS) CORONARY; SINGLE 92928 | $11,998.20 | $19,997.00 | $6,931.00–$15,999.00 | 3% above | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 STENT(DES OR BMS) CORONARY; SINGLE 92928 | $11,998.20 | $19,997.00 | $6,931.00–$15,999.00 | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY URETERAL STENT INSERTION 52332 | $9,874.80 | $16,458.00 | $3,176.11–$12,028.00 | 127% above | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY URETERAL STENT INSERTION 52332 | $9,874.80 | $16,458.00 | $3,176.11–$12,028.00 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY 52000 | $2,071.20 | $3,452.00 | $622.36–$7,101.00 | 83% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY 52000 | $2,071.20 | $3,452.00 | $622.36–$7,101.00 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE; NON-OBSTETRICAL 58120 | $8,320.80 | $13,868.00 | $1,590.00–$3,697.00 | 105% above | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE; NON-OBSTETRICAL 58120 | $8,320.80 | $13,868.00 | $1,590.00–$3,697.00 | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY-GENERAL ANESTHESIA 69436 | $4,541.40 | $7,569.00 | $1,389.42–$6,891.00 | 33% above | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY-GENERAL ANESTHESIA 69436 | $4,541.40 | $7,569.00 | $1,389.42–$6,891.00 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY-LOCAL OR TOPICAL ANESTHESIA 69433 | $1,729.80 | $2,883.00 | $501.27–$5,469.00 | 101% above | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY-LOCAL OR TOPICAL ANESTHESIA 69433 | $1,729.80 | $2,883.00 | $501.27–$5,469.00 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 ED Removal Impacted Cerumen Using Irrigation/lavage 69209 | $205.20 | $342.00 | $55.73–$3,361.00 | 84% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE; UNILATERAL 69209 | $205.20 | $342.00 | $55.73–$3,361.00 | 84% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED Removal Impacted Cerumen Using Irrigation/lavage 69209 | $205.20 | $342.00 | $55.73–$3,361.00 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE; UNILATERAL 69209 | $205.20 | $342.00 | $55.73–$3,361.00 | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 ED REMOVAL IMPACTED CERUMEN (SEPARATE PROCEDURE), ONE OR BOTH EARS | $225.00 | $375.00 | $55.73–$3,361.00 | 81% above | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN W/INST. UNILATERAL 69210 | $147.60 | $246.00 | $55.73–$3,361.00 | 19% above | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 ED REMOVAL IMPACTED CERUMEN (SEPARATE PROCEDURE), ONE OR BOTH EARS | $225.00 | $375.00 | $55.73–$3,361.00 | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN W/INST. UNILATERAL 69210 | $147.60 | $246.00 | $55.73–$3,361.00 | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 ENDOSCOPY NASAL ETHMOIDECTOMY TOTAL 31255 | $4,006.80 | $6,678.00 | $3,793.00–$8,020.00 | 22% below | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 ENDOSCOPY NASAL ETHMOIDECTOMY TOTAL 31255 | $4,006.80 | $6,678.00 | $3,793.00–$8,020.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY 31256 | $3,050.40 | $5,084.00 | $3,327.00–$8,726.00 | 11% below | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY 31256 | $3,050.40 | $5,084.00 | $3,327.00–$8,726.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL ENDOSCOPY W/MAXILLARY ANTROSTOMY W/REM.OF TISSUE MAXILLARY SINUS 31267 | $17,811.00 | $29,685.00 | $3,327.00–$12,028.00 | 265% above | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL ENDOSCOPY W/MAXILLARY ANTROSTOMY W/REM.OF TISSUE MAXILLARY SINUS 31267 | $17,811.00 | $29,685.00 | $3,327.00–$12,028.00 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. CERVICAL/THORACIC W/IMAGE 62321 | $1,989.60 | $3,316.00 | $630.04–$3,361.00 | 38% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. CERVICAL/THORACIC W/IMAGE 62321 | $1,989.60 | $3,316.00 | $630.04–$3,361.00 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ DIAGNOSTIC/THERAPEUTIC AGENT PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDANCE LUMBAR/SACRAL 64493 | $1,336.80 | $2,228.00 | $830.42–$3,361.00 | 23% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ DIAGNOSTIC/THERAPEUTIC AGENT PARAVERTEBRAL FACET JOINT W/ IMAGE GUIDANCE LUMBAR/SACRAL 64493 | $1,336.80 | $2,228.00 | $830.42–$3,361.00 | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH; 3 CM TO 10 CM 49593 | $11,502.00 | $19,170.00 | $3,151.98–$8,726.00 | 45% above | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH; 3 CM TO 10 CM 49593 | $11,502.00 | $19,170.00 | $3,151.98–$8,726.00 | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH GREATER THAN 10 CM 49595 | $9,201.60 | $15,336.00 | $3,151.98–$7,101.00 | 2% above | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH GREATER THAN 10 CM 49595 | $9,201.60 | $15,336.00 | $3,151.98–$7,101.00 | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH LESS THAN 3 CM 49591 | $9,200.40 | $15,334.00 | $3,151.98–$8,020.00 | 51% above | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANT. ABD. HERNIA INITIAL INC. IMPLANT MESH LESS THAN 3 CM 49591 | $9,200.40 | $15,334.00 | $3,151.98–$8,020.00 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/COLLECTION OF SPECIMENS 45330 | $2,284.20 | $3,807.00 | $832.67–$3,361.00 | 165% above | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC W/COLLECTION OF SPECIMENS 45330 | $2,284.20 | $3,807.00 | $832.67–$3,361.00 | — | 40% |
| Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC 47562 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | 101% above | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY LAPAROSCOPIC 47562 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 CHOLECYSTECTOMY CHOLANGIOGRAM LAPRASCOPIC 47563 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | 99% above | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 CHOLECYSTECTOMY CHOLANGIOGRAM LAPRASCOPIC 47563 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | — | 40% |
| Hammertoe correction surgery CPT 28285 CORRECTION HAMMER TOE 28285 | $9,685.80 | $16,143.00 | $2,607.00–$5,511.00 | 177% above | 40% |
| Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMER TOE 28285 | $9,685.80 | $16,143.00 | $2,607.00–$5,511.00 | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL BY BANDING 46221 | $1,926.00 | $3,210.00 | $832.67–$3,361.00 | 116% above | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 ED HEMORRHOIDECTOMY INTERNAL BY BANDING 46221 | $2,062.20 | $3,437.00 | $832.67–$3,361.00 | 131% above | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL BY BANDING 46221 | $1,926.00 | $3,210.00 | $832.67–$3,361.00 | — | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 ED HEMORRHOIDECTOMY INTERNAL BY BANDING 46221 | $2,062.20 | $3,437.00 | $832.67–$3,361.00 | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL-SINGLE COLUMN 46255 | $5,023.20 | $8,372.00 | $2,558.08–$5,469.00 | 38% above | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL-SINGLE COLUMN 46255 | $5,023.20 | $8,372.00 | $2,558.08–$5,469.00 | — | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY W/ OR W/O GRAFT 27132 | $16,266.60 | $27,111.00 | $7,568.00–$15,999.00 | 353% above | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY W/ OR W/O GRAFT 27132 | $16,266.60 | $27,111.00 | $7,568.00–$15,999.00 | — | 40% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/ OR W/O REML OF TUBE(S) OR OVARY(S) 58150 | $3,342.00 | $5,570.00 | $4,486.00–$12,028.00 | 20% below | 40% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/ OR W/O REML OF TUBE(S) OR OVARY(S) 58150 | $3,342.00 | $5,570.00 | $4,486.00–$12,028.00 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 BCE HYSTEROSALPINGOGRAPHY 58340 | $2,118.00 | $3,530.00 | $1,481.00–$3,361.00 | 463% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROSALPINGOGRAPHY | $2,899.20 | $4,832.00 | $1,481.00–$3,361.00 | 671% above | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 BCE HYSTEROSALPINGOGRAPHY 58340 | $2,118.00 | $3,530.00 | $1,481.00–$3,361.00 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROSALPINGOGRAPHY | $2,899.20 | $4,832.00 | $1,481.00–$3,361.00 | — | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY WITH ENDOMETRIAL ABLATION 58563 | $15,055.80 | $25,093.00 | $4,127.00–$8,726.00 | 155% above | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY WITH ENDOMETRIAL ABLATION 58563 | $15,055.80 | $25,093.00 | $4,127.00–$8,726.00 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY WITH BIOPSY 58558 | $8,320.80 | $13,868.00 | $2,848.32–$6,366.00 | 75% above | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY WITH BIOPSY 58558 | $8,320.80 | $13,868.00 | $2,848.32–$6,366.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED INCISION AND DRAINAGE SIMPLE 10060 | $529.80 | $883.00 | $182.40–$6,071.00 | 18% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE SURGERY SIMPLE 10060 | $529.80 | $883.00 | $182.40–$6,071.00 | 18% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED INCISION AND DRAINAGE SIMPLE 10060 | $529.80 | $883.00 | $182.40–$6,071.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE SURGERY SIMPLE 10060 | $529.80 | $883.00 | $182.40–$6,071.00 | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INITIAL HERNIA INGUINAL-AGE 5 YEARS OR OLDER-REDUCIBLE 49505 | $10,658.40 | $17,764.00 | $3,011.00–$6,366.00 | 72% above | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL HERNIA INGUINAL-AGE 5 YEARS OR OLDER-REDUCIBLE 49505 | $10,658.40 | $17,764.00 | $3,011.00–$6,366.00 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION RECTUS SHEATH 20550 | $700.80 | $1,168.00 | $269.84–$3,361.00 | 74% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION RECTUS SHEATH 20550 | $700.80 | $1,168.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED ARTHROCENTESIS, ASPIRATION AND/OR INJ, MAJOR JOINT OR BURSA | $910.20 | $1,517.00 | $269.84–$3,361.00 | 54% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJECTION MAJOR JOINT/BURSA W/O ULTRASOUND GUIDANCE 20610 | $910.20 | $1,517.00 | $269.84–$3,361.00 | 54% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR Steroid Injection Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 258% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 BCE IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 258% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 258% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR Inj. Major Joint 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 258% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED ARTHROCENTESIS, ASPIRATION AND/OR INJ, MAJOR JOINT OR BURSA | $910.20 | $1,517.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJECTION MAJOR JOINT/BURSA W/O ULTRASOUND GUIDANCE 20610 | $910.20 | $1,517.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR Inj. Major Joint 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 BCE IR Asp &/or Inj Major Jt or Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR Steroid Injection Bursa 20610 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT 11981 | $2,325.60 | $3,876.00 | $116.38–$15,999.00 | 869% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT 11981 | $2,325.60 | $3,876.00 | $116.38–$15,999.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION INTERMEDIATE JOINT/BURSA W/O ULTRASOUND GUIDANCE 20605 | $713.40 | $1,189.00 | $269.84–$3,361.00 | 21% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED ASPIRATE/INJECT INTERMEDIATE JNT, BURSA/GANGLION | $756.00 | $1,260.00 | $269.84–$3,361.00 | 28% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 BCE XR Inj. Minor Joint 20605 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 260% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR Inj. Minor Joint 20605 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | 260% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATION INTERMEDIATE JOINT/BURSA W/O ULTRASOUND GUIDANCE 20605 | $713.40 | $1,189.00 | $269.84–$3,361.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED ASPIRATE/INJECT INTERMEDIATE JNT, BURSA/GANGLION | $756.00 | $1,260.00 | $269.84–$3,361.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 XR Inj. Minor Joint 20605 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 BCE XR Inj. Minor Joint 20605 | $2,118.00 | $3,530.00 | $269.84–$3,361.00 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT OR BURSA; W/O ULTRASOUND GUIDANCE 20600 | $313.80 | $523.00 | $269.84–$3,538.00 | 26% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED STEROID INJECTION JOINT | $313.80 | $523.00 | $269.84–$3,538.00 | 26% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT OR BURSA; W/O ULTRASOUND GUIDANCE 20600 | $313.80 | $523.00 | $269.84–$3,538.00 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED STEROID INJECTION JOINT | $313.80 | $523.00 | $269.84–$3,538.00 | — | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCAL REPAIR 29882 | $6,991.20 | $11,652.00 | $2,948.97–$12,028.00 | 22% above | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCAL REPAIR 29882 | $6,991.20 | $11,652.00 | $2,948.97–$12,028.00 | — | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCECTOMY 29881 | $9,685.80 | $16,143.00 | $2,872.00–$6,071.00 | 64% above | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MEDIAL OR LATERAL MENISCECTOMY 29881 | $9,685.80 | $16,143.00 | $2,872.00–$6,071.00 | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE W/MEDIAL AND LATERAL MENISCECTOMY 29880 | $9,685.80 | $16,143.00 | $2,948.97–$6,366.00 | 70% above | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE W/MEDIAL AND LATERAL MENISCECTOMY 29880 | $9,685.80 | $16,143.00 | $2,948.97–$6,366.00 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPY KNEE CHONDROPLASTY 29877 | $9,685.80 | $16,143.00 | $2,607.00–$5,511.00 | 115% above | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPY KNEE CHONDROPLASTY 29877 | $9,685.80 | $16,143.00 | $2,607.00–$5,511.00 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 APPENDECTOMY LAPAROSCOPIC 44970 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | 132% above | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 APPENDECTOMY LAPAROSCOPIC 44970 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 FUNDOPLICATION LAPAROSCOPIC 43280 | $17,892.60 | $29,821.00 | $5,689.00–$12,028.00 | 60% above | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 FUNDOPLICATION LAPAROSCOPIC 43280 | $17,892.60 | $29,821.00 | $5,689.00–$12,028.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR HERNIA INGUINAL LAPAROSCOPIC-INITIAL 49650 | $14,395.80 | $23,993.00 | $5,256.83–$12,028.00 | 16% above | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 REPAIR HERNIA INGUINAL LAPAROSCOPIC-INITIAL 49650 | $14,395.80 | $23,993.00 | $5,256.83–$12,028.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 REPAIR HERNIA INGUINAL LAPAROSCOPIC-RECURRENT 49651 | $13,741.20 | $22,902.00 | $5,256.83–$12,028.00 | 68% above | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 REPAIR HERNIA INGUINAL LAPAROSCOPIC-RECURRENT 49651 | $13,741.20 | $22,902.00 | $5,256.83–$12,028.00 | — | 40% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 REMOVAL GASTRIC BAND LAPAROSCOPIC-COMPONENT AND PORT 43774 | $10,045.20 | $16,742.00 | $3,489.16–$15,999.00 | 161% above | 40% |
| Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 REMOVAL GASTRIC BAND LAPAROSCOPIC-COMPONENT AND PORT 43774 | $10,045.20 | $16,742.00 | $3,489.16–$15,999.00 | — | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPARASCOPY WITH LYSIS OF ADHESIONS AND REMOVAL OF ADNEXAL STRUCTURES 58661 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | 91% above | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPARASCOPY WITH LYSIS OF ADHESIONS AND REMOVAL OF ADNEXAL STRUCTURES 58661 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE, TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $1,054.80 | $1,758.00 | $363.28–$6,891.00 | 98% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE-TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $1,054.80 | $1,758.00 | $363.28–$6,891.00 | 98% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE, TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $1,054.80 | $1,758.00 | $363.28–$6,891.00 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR WOUND 2.5 CM OR LESS SCALP/AXILLAE-TRUNK/EXTREMITIES EXCLUDING HAND/FOOT 12031 | $1,054.80 | $1,758.00 | $363.28–$6,891.00 | — | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH 93452 | $10,534.80 | $17,558.00 | $2,968.76–$12,028.00 | 13% above | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH 93452 | $10,534.80 | $17,558.00 | $2,968.76–$12,028.00 | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $1,266.00 | $2,110.00 | $630.04–$3,361.00 | 24% below | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/IMAGE 62323 | $1,266.00 | $2,110.00 | $630.04–$3,361.00 | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/O IMAGE 62322 | $1,989.60 | $3,316.00 | $830.42–$3,538.00 | 62% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION DIAG./THER. SUB. W/NEEDLE OR CATH. LUMBAR/SACRAL W/O IMAGE 62322 | $1,989.60 | $3,316.00 | $830.42–$3,538.00 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ CATH PLACE OF DISG/THERA SUBSTANCE EPIDURAL OR SUBARACHNOID LUMBAR/SACRAL PP 64483 | $2,118.00 | $3,530.00 | $830.42–$3,361.00 | 44% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ.ANESTHETIC AGENT AND/OR STEROID; LUMBAR/SACRAL 64483 | $2,460.60 | $4,101.00 | $830.42–$3,361.00 | 67% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ CATH PLACE OF DISG/THERA SUBSTANCE EPIDURAL OR SUBARACHNOID LUMBAR/SACRAL PP 64483 | $2,118.00 | $3,530.00 | $830.42–$3,361.00 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ.ANESTHETIC AGENT AND/OR STEROID; LUMBAR/SACRAL 64483 | $2,460.60 | $4,101.00 | $830.42–$3,361.00 | — | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY W/DECOMP.OF NERVE ROOTS W/EXCISION OF HERNIATED DISC/LUMBAR 63030 | $12,899.40 | $21,499.00 | $5,689.00–$12,028.00 | 47% above | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY W/DECOMP.OF NERVE ROOTS W/EXCISION OF HERNIATED DISC/LUMBAR 63030 | $12,899.40 | $21,499.00 | $5,689.00–$12,028.00 | — | 40% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRODESIS COMB. POSTERIOR INTERBODY TECH . W/LAMI OR DISC SIN. LUM. 22633 | $8,536.80 | $14,228.00 | $5,772.00–$19,956.00 | 58% below | 40% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRODESIS COMB. POSTERIOR INTERBODY TECH . W/LAMI OR DISC SIN. LUM. 22633 | $8,536.80 | $14,228.00 | $5,772.00–$19,956.00 | — | 40% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 LAMINECTOMY FACETECTOMY AND FORAMINOTOMY SINGLE VERTEBRAL SEGMENT;LUMBAR 63047 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | 132% above | 40% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAMINECTOMY FACETECTOMY AND FORAMINOTOMY SINGLE VERTEBRAL SEGMENT;LUMBAR 63047 | $20,528.40 | $34,214.00 | $5,689.00–$12,028.00 | — | 40% |
| Lumbar spinal fusion (posterior), one level CPT 22612 FUSION SPINE LUMBAR POSTERIOR 22612 | $37,065.60 | $61,776.00 | $5,772.00–$16,978.66 | 249% above | 40% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 FUSION SPINE LUMBAR POSTERIOR 22612 | $37,065.60 | $61,776.00 | $5,772.00–$16,978.66 | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL 19301 | $9,998.40 | $16,664.00 | $1,673.00–$3,697.00 | 112% above | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL 19301 | $9,998.40 | $16,664.00 | $1,673.00–$3,697.00 | — | 40% |
| Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE 19303 | $17,619.00 | $29,365.00 | $4,486.00–$12,028.00 | 191% above | 40% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE 19303 | $17,619.00 | $29,365.00 | $4,486.00–$12,028.00 | — | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISSED ABORTION-SURGICAL-FIRST TRIMESTER 59820 | $8,320.80 | $13,868.00 | $1,590.00–$3,697.00 | 129% above | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT OF MISSED ABORTION-SURGICAL-FIRST TRIMESTER 59820 | $8,320.80 | $13,868.00 | $1,590.00–$3,697.00 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESIONTRUNK 0.5CM OR LESS 11400 | $1,636.80 | $2,728.00 | $641.00–$3,361.00 | 103% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESIONTRUNK 0.5CM OR LESS 11400 | $1,636.80 | $2,728.00 | $641.00–$3,361.00 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 ED Excision Benign Lesion Facial 0.5cm or less 11440 | $2,257.80 | $3,763.00 | $641.00–$5,469.00 | 155% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION FACIAL 0.5CM OR LESS 11440 | $2,257.80 | $3,763.00 | $641.00–$5,469.00 | 155% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 ED Excision Benign Lesion Facial 0.5cm or less 11440 | $2,257.80 | $3,763.00 | $641.00–$5,469.00 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LESION FACIAL 0.5CM OR LESS 11440 | $2,257.80 | $3,763.00 | $641.00–$5,469.00 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE 11730 | $611.40 | $1,019.00 | $182.40–$3,361.00 | 116% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 ED AVULSION OF NAIL PLATE,PARTIAL OR COMPLETE,SIMPLE; SINGLE | $611.40 | $1,019.00 | $182.40–$3,361.00 | 116% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 ED AVULSION OF NAIL PLATE,PARTIAL OR COMPLETE,SIMPLE; SINGLE | $611.40 | $1,019.00 | $182.40–$3,361.00 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE 11730 | $611.40 | $1,019.00 | $182.40–$3,361.00 | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT/STEROID;GREATER OCCIPITAL NERVE 64405 | $1,017.60 | $1,696.00 | $269.84–$3,361.00 | 138% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION ANESTHETIC AGENT/STEROID;GREATER OCCIPITAL NERVE 64405 | $1,017.60 | $1,696.00 | $269.84–$3,361.00 | — | 40% |
| Pacemaker implant (dual chamber) CPT 33208 INSERTION OF NEW OR REPLACEMENT OF PERM. PACEMAKER W/TRANSVENOUS ELECTRODE ATRIAL AND VENT. 33208 | $12,213.60 | $20,356.00 | $5,689.00–$19,956.00 | 36% below | 40% |
| Pacemaker implant (dual chamber) CPT 33208 DUAL CHAMBER PPM; ATRIAL/VENT. 33208 | $12,213.60 | $20,356.00 | $5,689.00–$19,956.00 | 36% below | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 DUAL CHAMBER PPM; ATRIAL/VENT. 33208 | $12,213.60 | $20,356.00 | $5,689.00–$19,956.00 | — | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 INSERTION OF NEW OR REPLACEMENT OF PERM. PACEMAKER W/TRANSVENOUS ELECTRODE ATRIAL AND VENT. 33208 | $12,213.60 | $20,356.00 | $5,689.00–$19,956.00 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $1,720.80 | $2,868.00 | $825.87–$3,361.00 | 18% above | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS;FLUORO 49083 - CVIR | $1,720.80 | $2,868.00 | $825.87–$3,361.00 | 18% above | 40% |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis Diagnostic 75989 | $2,118.00 | $3,530.00 | $825.87–$3,361.00 | 45% above | 40% |
| Paracentesis with imaging guidance CPT 49083 BCE ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $2,118.00 | $3,530.00 | $825.87–$3,361.00 | 45% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $1,720.80 | $2,868.00 | $825.87–$3,361.00 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS;FLUORO 49083 - CVIR | $1,720.80 | $2,868.00 | $825.87–$3,361.00 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Diagnostic 75989 | $2,118.00 | $3,530.00 | $825.87–$3,361.00 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 BCE ABDOMINAL PARACENTESIS W/IMAGE GUIDANCE 49083 | $2,118.00 | $3,530.00 | $825.87–$3,361.00 | — | 40% |
| Partial knee replacement (one compartment) CPT 27446 ARTHROPLASTY KNEE CONDYLE AND PLATEA MEDIAL OR LATERAL COMPARTMENT 27446 | $37,065.60 | $61,776.00 | $7,568.00–$15,999.00 | 189% above | 40% |
| Partial knee replacement (one compartment) inpatient CPT 27446 ARTHROPLASTY KNEE CONDYLE AND PLATEA MEDIAL OR LATERAL COMPARTMENT 27446 | $37,065.60 | $61,776.00 | $7,568.00–$15,999.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL & MATRIX 11750 | $1,137.60 | $1,896.00 | $363.28–$3,361.00 | 123% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE | $1,137.60 | $1,896.00 | $363.28–$3,361.00 | 123% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE, (EG, INGROWN OR DEFORMED NAIL) FOR PERMANE | $1,137.60 | $1,896.00 | $363.28–$3,361.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL & MATRIX 11750 | $1,137.60 | $1,896.00 | $363.28–$3,361.00 | — | 40% |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE;NEEDLE OR PUNCTURE 55700 | $6,362.40 | $10,604.00 | $1,590.00–$3,361.00 | 142% above | 40% |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE;NEEDLE OR PUNCTURE 55700 | $6,362.40 | $10,604.00 | $1,590.00–$3,361.00 | — | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPARASCOPIC PROSTATECTOMY RETROPUBIC RADICAL 55866 | $23,120.40 | $38,534.00 | $5,689.00–$13,934.00 | 112% above | 40% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPARASCOPIC PROSTATECTOMY RETROPUBIC RADICAL 55866 | $23,120.40 | $38,534.00 | $5,689.00–$13,934.00 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION BY NEUROLYTIC AGT PARARVERT FACET JT W/IMAGE LUM/SAC SINGLE JT 64635 | $5,897.40 | $9,829.00 | $1,590.00–$3,697.00 | 110% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCTION BY NEUROLYTIC AGT PARARVERT FACET JT W/IMAGE LUM/SAC SINGLE JT 64635 | $5,897.40 | $9,829.00 | $1,590.00–$3,697.00 | — | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXCISION LIPOMA BREAST 19120 | $9,988.20 | $16,647.00 | $1,590.00–$3,697.00 | 103% above | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION LIPOMA BREAST 19120 | $9,988.20 | $16,647.00 | $1,590.00–$3,697.00 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY 10120 | $1,137.60 | $1,896.00 | $363.28–$5,469.00 | 114% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 ED INCISION AND REMOVAL OF FOREIGN BODY | $1,137.60 | $1,896.00 | $363.28–$5,469.00 | 114% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY 10120 | $1,137.60 | $1,896.00 | $363.28–$5,469.00 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 ED INCISION AND REMOVAL OF FOREIGN BODY | $1,137.60 | $1,896.00 | $363.28–$5,469.00 | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY-UNILATERAL 60220 | $16,435.80 | $27,393.00 | $3,359.00–$7,701.00 | 107% above | 40% |
| Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY-UNILATERAL 60220 | $16,435.80 | $27,393.00 | $3,359.00–$7,701.00 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CANCER SCREEN NOT HIGH RISK G0121 | $2,599.80 | $4,333.00 | $832.67–$3,361.00 | 232% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CANCER SCREEN NOT HIGH RISK G0121 | $2,599.80 | $4,333.00 | $832.67–$3,361.00 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREEN COLONOSCOPY IND. W/HIGH RISK G0105 | $2,599.80 | $4,333.00 | $832.67–$3,361.00 | 123% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CANCER SCREEN COLONOSCOPY IND. W/HIGH RISK G0105 | $2,599.80 | $4,333.00 | $832.67–$3,361.00 | — | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION W/ OR W/O CARTILAGE SCORING-CONTOURING-OR GRAFT 30520 | $8,052.00 | $13,420.00 | $2,933.28–$8,726.00 | 120% above | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION W/ OR W/O CARTILAGE SCORING-CONTOURING-OR GRAFT 30520 | $8,052.00 | $13,420.00 | $2,933.28–$8,726.00 | — | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY 50590 | $13,569.60 | $22,616.00 | $3,176.11–$12,028.00 | 96% above | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY 50590 | $13,569.60 | $22,616.00 | $3,176.11–$12,028.00 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 ED APPLICATION SPLINT FOREARM TO HAND | $350.40 | $584.00 | $116.38–$12,028.00 | 55% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT FOREARM TO HAND-STATIC 29125 | $405.60 | $676.00 | $116.38–$12,028.00 | 79% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 ED APPLICATION SPLINT FOREARM TO HAND | $350.40 | $584.00 | $116.38–$12,028.00 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT FOREARM TO HAND-STATIC 29125 | $405.60 | $676.00 | $116.38–$12,028.00 | — | 40% |
| Short leg cast (below the knee) CPT 29405 ED APPLICATION OF SHORT LEG CAST-BELOW KNEE TO TOES 29405 | $595.80 | $993.00 | $244.67–$5,469.00 | 76% above | 40% |
| Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST-BELOW KNEE TO TOES 29405 | $595.80 | $993.00 | $244.67–$5,469.00 | 76% above | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST-BELOW KNEE TO TOES 29405 | $595.80 | $993.00 | $244.67–$5,469.00 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 ED APPLICATION OF SHORT LEG CAST-BELOW KNEE TO TOES 29405 | $595.80 | $993.00 | $244.67–$5,469.00 | — | 40% |
| Short leg splint (calf to foot) CPT 29515 ED APPLICATION SHORT LEG SPLINT-CALF TO FOOT | $359.40 | $599.00 | $143.56–$12,028.00 | 32% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 ED APPLICATION SHORT LEG SPLINT-CALF TO FOOT | $359.40 | $599.00 | $143.56–$12,028.00 | — | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHROSCOPY SHOULDER FOR EXCISION OF DISTAL CLAVICLE 29824 | $9,685.80 | $16,143.00 | $2,948.97–$12,028.00 | 128% above | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY SHOULDER FOR EXCISION OF DISTAL CLAVICLE 29824 | $9,685.80 | $16,143.00 | $2,948.97–$12,028.00 | — | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER W/SUBACROMIAL DECOMPRESSION/ACROMIOPLASTY 29826 | $16,810.80 | $28,018.00 | $1,481.00–$12,028.00 | 221% above | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHOULDER W/SUBACROMIAL DECOMPRESSION/ACROMIOPLASTY 29826 | $16,810.80 | $28,018.00 | $1,481.00–$12,028.00 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED Simple repair, superficial; 2.5 cm or less 12001 | $310.80 | $518.00 | $182.40–$3,361.00 | 14% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GEITALIA-TRUNK-EXT. 2.5CM OR LESS 12001 | $310.80 | $518.00 | $182.40–$3,361.00 | 14% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GEITALIA-TRUNK-EXT. 2.5CM OR LESS 12001 | $310.80 | $518.00 | $182.40–$3,361.00 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED Simple repair, superficial; 2.5 cm or less 12001 | $310.80 | $518.00 | $182.40–$3,361.00 | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION 11104 | $903.00 | $1,505.00 | $363.28–$5,469.00 | 105% above | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION 11104 | $903.00 | $1,505.00 | $363.28–$5,469.00 | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS MULTIPLE FIBROCUTANEOUS ANY AREA UP TO 15 LESIONS 11200 | $853.20 | $1,422.00 | $182.40–$3,361.00 | 181% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS MULTIPLE FIBROCUTANEOUS ANY AREA UP TO 15 LESIONS 11200 | $853.20 | $1,422.00 | $182.40–$3,361.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 ED Spinal puncture, lumbar, diagnostic 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | 24% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | 24% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE; DIAGNOSTIC 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | 24% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $630.04–$3,361.00 | 103% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 BCE IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $630.04–$3,361.00 | 103% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE; DIAGNOSTIC 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED Spinal puncture, lumbar, diagnostic 62270 | $792.60 | $1,321.00 | $630.04–$3,361.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $630.04–$3,361.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 BCE IR Lumbar Puncture 62270 | $2,118.00 | $3,530.00 | $630.04–$3,361.00 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GENITALIA-TRUNK-EXT. 2.6CM TO 7.5CM 12002 | $325.80 | $543.00 | $182.40–$3,361.00 | 28% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED SIMPLE REPAIR WOUNDS SCALP,NECK,AXILLAE,GEITALIA,TRUNK,EXT. 2.6CM-7.5CM 12002 | $325.80 | $543.00 | $182.40–$3,361.00 | 28% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED SIMPLE REPAIR WOUNDS SCALP,NECK,AXILLAE,GEITALIA,TRUNK,EXT. 2.6CM-7.5CM 12002 | $325.80 | $543.00 | $182.40–$3,361.00 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR WOUNDS SCALP-NECK-AXILLAE-GENITALIA-TRUNK-EXT. 2.6CM TO 7.5CM 12002 | $325.80 | $543.00 | $182.40–$3,361.00 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED SIMPLE REPAIR OF WOUNDS-FACIAL, EARS, MUCOUS MEMBRANES 2.5CM OR LESS | $326.40 | $544.00 | $182.40–$3,361.00 | 16% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF WOUNDS-FACIAL-EARS-MUCOUS MEMBRANES 2.5CM OR LESS 12011 | $326.40 | $544.00 | $182.40–$3,361.00 | 16% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED SIMPLE REPAIR OF WOUNDS-FACIAL, EARS, MUCOUS MEMBRANES 2.5CM OR LESS | $326.40 | $544.00 | $182.40–$3,361.00 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF WOUNDS-FACIAL-EARS-MUCOUS MEMBRANES 2.5CM OR LESS 12011 | $326.40 | $544.00 | $182.40–$3,361.00 | — | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 CYSTOURETHROSCOPY WITH TRANSURETHRAL PROSTATECTOMY 52601 | $13,569.60 | $22,616.00 | $3,359.00–$7,101.00 | 94% above | 40% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 CYSTOURETHROSCOPY WITH TRANSURETHRAL PROSTATECTOMY 52601 | $13,569.60 | $22,616.00 | $3,359.00–$7,101.00 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION 11102 | $480.00 | $800.00 | $182.40–$12,028.00 | 33% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION 11102 | $480.00 | $800.00 | $182.40–$12,028.00 | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS; PLEURAL ASPIRATION 32555 | $2,243.40 | $3,739.00 | $572.34–$3,361.00 | 59% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE OR CATHETER ASPIRATION OF PLEURAL SPACE W/IMAGE 32555 | $2,243.40 | $3,739.00 | $572.34–$3,361.00 | 59% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS; PLEURAL ASPIRATION 32555 | $2,243.40 | $3,739.00 | $572.34–$3,361.00 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE OR CATHETER ASPIRATION OF PLEURAL SPACE W/IMAGE 32555 | $2,243.40 | $3,739.00 | $572.34–$3,361.00 | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY AGE 12 OR OVER 42821 | $4,311.00 | $7,185.00 | $2,933.28–$6,891.00 | 14% above | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY AGE 12 OR OVER 42821 | $4,311.00 | $7,185.00 | $2,933.28–$6,891.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY AGE 12 OR OVER 42826 | $8,052.00 | $13,420.00 | $2,872.00–$6,071.00 | 82% above | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY AGE 12 OR OVER 42826 | $8,052.00 | $13,420.00 | $2,872.00–$6,071.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY UNDER AGE 12 42825 | $13,871.40 | $23,119.00 | $2,607.00–$5,511.00 | 204% above | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY UNDER AGE 12 42825 | $13,871.40 | $23,119.00 | $2,607.00–$5,511.00 | — | 40% |
| Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMORAL PROSTHETIC REPLACEMENT 27130 | $39,876.60 | $66,461.00 | $7,568.00–$15,999.00 | 211% above | 40% |
| Total hip replacement inpatient CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMORAL PROSTHETIC REPLACEMENT 27130 | $39,876.60 | $66,461.00 | $7,568.00–$15,999.00 | — | 40% |
| Total knee replacement CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL AND LATERAL 27447 | $37,065.60 | $61,776.00 | $7,568.00–$15,999.00 | 186% above | 40% |
| Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL AND LATERAL 27447 | $37,065.60 | $61,776.00 | $7,568.00–$15,999.00 | — | 40% |
| Total shoulder replacement CPT 23472 TOTAL SHOULDER REPLACEMENT 23472 | $17,927.40 | $29,879.00 | $7,568.00–$16,978.66 | 2% above | 40% |
| Total shoulder replacement inpatient CPT 23472 TOTAL SHOULDER REPLACEMENT 23472 | $17,927.40 | $29,879.00 | $7,568.00–$16,978.66 | — | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL OR COMPLETE 60240 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | 73% above | 40% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL OR COMPLETE 60240 | $16,435.80 | $27,393.00 | $5,256.83–$12,028.00 | — | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION (EG. FOR TRIGGER FINGER) 26055 | $4,943.40 | $8,239.00 | $1,464.27–$3,361.00 | 105% above | 40% |
| Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION (EG. FOR TRIGGER FINGER) 26055 | $4,943.40 | $8,239.00 | $1,464.27–$3,361.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 ED INJECTION; SINGLE OR MULTIPLE TRIGGER POINTS, ONE OR TWO MUSCLE GROUPS | $528.60 | $881.00 | $269.84–$3,538.00 | 20% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TRIGGER POINT SINGLE 20552 | $895.20 | $1,492.00 | $269.84–$3,538.00 | 103% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED INJECTION; SINGLE OR MULTIPLE TRIGGER POINTS, ONE OR TWO MUSCLE GROUPS | $528.60 | $881.00 | $269.84–$3,538.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION TRIGGER POINT SINGLE 20552 | $895.20 | $1,492.00 | $269.84–$3,538.00 | — | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPARASCOPY WITH LYSIS OF ADHESIONS AND FULGURATION OF OVIDUCTS 58670 | $6,418.20 | $10,697.00 | $3,793.00–$8,020.00 | 30% above | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPARASCOPY WITH LYSIS OF ADHESIONS AND FULGURATION OF OVIDUCTS 58670 | $6,418.20 | $10,697.00 | $3,793.00–$8,020.00 | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST WITH PLACEMENT OF BREAST LOCALIZATION DEVICES/ULTRASOUND ; FIRST LESION 19083 | $2,981.40 | $4,969.00 | $1,477.10–$3,361.00 | 8% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST WITH PLACEMENT OF BREAST LOCALIZATION DEVICES/ULTRASOUND ; FIRST LESION 19083 | $2,981.40 | $4,969.00 | $1,477.10–$3,361.00 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPHAGOGASTRODUODENOSCOPY BALLOON DILATATION 43249 | $5,226.00 | $8,710.00 | $1,590.00–$3,361.00 | 256% above | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPHAGOGASTRODUODENOSCOPY BALLOON DILATATION 43249 | $5,226.00 | $8,710.00 | $1,590.00–$3,361.00 | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ESOPHAGOGASTRODUODENOSCOPY W/BIOPSY 43239 | $2,722.80 | $4,538.00 | $825.87–$3,538.00 | 130% above | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ESOPHAGOGASTRODUODENOSCOPY W/BIOPSY 43239 | $2,722.80 | $4,538.00 | $825.87–$3,538.00 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE W/SUBMUCOSAL INJ. 43236 | $2,722.80 | $4,538.00 | $825.87–$3,361.00 | 272% above | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE W/SUBMUCOSAL INJ. 43236 | $2,722.80 | $4,538.00 | $825.87–$3,361.00 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE W/REMOVAL OF TUMORS/POLYPS/LESIONS BY SNARE 43251 | $5,226.00 | $8,710.00 | $1,590.00–$3,361.00 | 359% above | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE W/REMOVAL OF TUMORS/POLYPS/LESIONS BY SNARE 43251 | $5,226.00 | $8,710.00 | $1,590.00–$3,361.00 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ESOPHAGOGASTRODUODENOSCOPY W/GUIDE WIRE DILATATION 43248 | $585.00 | $975.00 | $825.87–$3,361.00 | 20% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ESOPHAGOGASTRODUODENOSCOPY W/GUIDE WIRE DILATATION 43248 | $585.00 | $975.00 | $825.87–$3,361.00 | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE DIAGNOSTIC 43235 | $2,722.80 | $4,538.00 | $825.87–$3,538.00 | 87% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY; FLEXIBLE DIAGNOSTIC 43235 | $2,722.80 | $4,538.00 | $825.87–$3,538.00 | — | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETHROSCOPY W/URETEROSCOPY AND/OR PYELOSCOPY W/LITHOTRIPSY 52353 | $13,569.60 | $22,616.00 | $4,714.17–$12,028.00 | 82% above | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETHROSCOPY W/URETEROSCOPY AND/OR PYELOSCOPY W/LITHOTRIPSY 52353 | $13,569.60 | $22,616.00 | $4,714.17–$12,028.00 | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTOURETHROSCOPY W/URETEROSCOPY/PYELOSCOPY INC. LITHOTRIPSY AND STENT INSERTION 52356 | $13,569.60 | $22,616.00 | $2,607.00–$6,279.00 | 153% above | 40% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTOURETHROSCOPY W/URETEROSCOPY/PYELOSCOPY INC. LITHOTRIPSY AND STENT INSERTION 52356 | $13,569.60 | $22,616.00 | $2,607.00–$6,279.00 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY-UNILATERAL OR BILATERAL-INC. POST OP SEMEN EXAMINATION(S) 55250 | $6,208.80 | $10,348.00 | $1,855.67–$6,366.00 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY-UNILATERAL OR BILATERAL-INC. POST OP SEMEN EXAMINATION(S) 55250 | $6,208.80 | $10,348.00 | $1,855.67–$6,366.00 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS 17110 | $328.80 | $548.00 | $182.40–$5,511.00 | 64% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF BENIGN LESIONS UP TO 14 LESIONS 17110 | $328.80 | $548.00 | $182.40–$5,511.00 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20CM OR LESS 11042 | $1,137.60 | $1,896.00 | $363.28–$3,538.00 | 12% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20CM OR LESS 11042 | $1,137.60 | $1,896.00 | $363.28–$3,538.00 | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPEN REDUCTION INTERNAL FIXATION RADIUS EXTRA-ARTICULAR 25607 | $20,237.40 | $33,729.00 | $4,127.00–$8,726.00 | 155% above | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 OPEN REDUCTION INTERNAL FIXATION RADIUS EXTRA-ARTICULAR 25607 | $20,237.40 | $33,729.00 | $4,127.00–$8,726.00 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 1-2 UNITS | $850.20 | $1,417.00 | $395.50–$5,511.00 | 11% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Stop Time | $850.20 | $1,417.00 | $395.50–$5,511.00 | 11% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 3-4 UNITS | $893.40 | $1,489.00 | $395.50–$5,511.00 | 17% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 5-6 UNITS | $937.80 | $1,563.00 | $395.50–$5,511.00 | 23% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $947.40 | $1,579.00 | $395.50–$5,511.00 | 24% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, blood or blood components 36430 | $947.40 | $1,579.00 | $395.50–$5,511.00 | 24% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 7-8 UNITS | $984.60 | $1,641.00 | $395.50–$5,511.00 | 29% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 ED TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $1,028.40 | $1,714.00 | $395.50–$5,511.00 | 34% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 9-10 UNITS | $1,033.80 | $1,723.00 | $395.50–$5,511.00 | 35% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 11+ UNITS | $1,085.40 | $1,809.00 | $395.50–$5,511.00 | 42% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Stop Time | $850.20 | $1,417.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 1-2 UNITS | $850.20 | $1,417.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 3-4 UNITS | $893.40 | $1,489.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 5-6 UNITS | $937.80 | $1,563.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $947.40 | $1,579.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion, blood or blood components 36430 | $947.40 | $1,579.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 7-8 UNITS | $984.60 | $1,641.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED TRANSFUSION OF BLOOD OR BLOOD COMPONENTS 36430 | $1,028.40 | $1,714.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 9-10 UNITS | $1,033.80 | $1,723.00 | $395.50–$5,511.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 11+ UNITS | $1,085.40 | $1,809.00 | $395.50–$5,511.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges - RN -> Inhalation treatment Subsequent | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> MDI subsequent | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> MDI initial | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> Inhalation treatment Subsequent | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> Inhalation Treatment Initial | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> IPPB subsequent | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> IPPB initial | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges - RN -> Pressurized Non-Pressurized Inhalation Treatment | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Charges SV -> Sputum induction w/ inhalation treatment | $83.47 | $139.11 | $194.32 | 59% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE IPPB INITAL 94640 | $97.20 | $162.00 | $194.32 | 52% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE MDI INITIAL 94640 | $97.20 | $162.00 | $194.32 | 52% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE INHALATION TREATMENT SUBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | 52% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE IPPB SEBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | 52% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE MDI SUBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | 52% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 BCE Pressurized or nonpressurized inhalation treatment for acute airway obstruction 94640 | $100.20 | $167.00 | $194.32 | 51% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $682.80 | $1,138.00 | $194.32 | 236% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 RT Charges - RT -> Pressurized Non-Pressurized Inhalation Treatment | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 RT Charges - RT -> Each additional treatment (for this date of service) for pre | $81.04 | $135.06 | $194.32 | 60% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> MDI initial | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> Inhalation treatment Subsequent | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> Inhalation Treatment Initial | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> IPPB subsequent | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges - RN -> Pressurized Non-Pressurized Inhalation Treatment | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> IPPB initial | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges - RN -> Inhalation treatment Subsequent | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> MDI subsequent | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Charges SV -> Sputum induction w/ inhalation treatment | $83.47 | $139.11 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE MDI SUBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE INHALATION TREATMENT SUBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE IPPB SEBSEQUENT 94640 | $97.20 | $162.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE MDI INITIAL 94640 | $97.20 | $162.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE IPPB INITAL 94640 | $97.20 | $162.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 BCE Pressurized or nonpressurized inhalation treatment for acute airway obstruction 94640 | $100.20 | $167.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION | $682.80 | $1,138.00 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 RT Charges - RT -> Pressurized Non-Pressurized Inhalation Treatment | $81.04 | $135.06 | $194.32 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 RT Charges - RT -> Each additional treatment (for this date of service) for pre | $81.04 | $135.06 | $194.32 | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 ED Critical Care, eval & mgmt of critically injured pt, 99291 | $2,945.40 | $4,909.00 | $808.45–$9,348.00 | 16% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED Critical Care, eval & mgmt of critically injured pt, 99291 | $2,945.40 | $4,909.00 | $808.45–$9,348.00 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 RT Charges SV -> EEG | $735.57 | $1,225.95 | $285.96 | 20% below | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 BCE EEG 95816 | $885.00 | $1,475.00 | $285.96 | 4% below | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 RT Charges SV -> EEG | $735.57 | $1,225.95 | $285.96 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 BCE EEG 95816 | $885.00 | $1,475.00 | $285.96 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R 93005 | $142.80 | $238.00 | $55.73 | 47% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG w/o interp 93005 | $263.40 | $439.00 | $55.73 | 3% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG 93005 | $263.40 | $439.00 | $55.73 | 3% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 BCE EKG, at least 12 leads, tracing only 93005 | $263.40 | $439.00 | $55.73 | 3% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R 93005 | $142.80 | $238.00 | $55.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 BCE EKG, at least 12 leads, tracing only 93005 | $263.40 | $439.00 | $55.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG w/o interp 93005 | $263.40 | $439.00 | $55.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG 93005 | $263.40 | $439.00 | $55.73 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Level 1 | $208.80 | $348.00 | $80.89–$2,048.00 | 11% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED Visit Level 1 | $208.80 | $348.00 | $80.89–$2,048.00 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level 2 | $407.40 | $679.00 | $149.01–$2,048.00 | 6% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Visit Level 2 | $407.40 | $679.00 | $149.01–$2,048.00 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level 3 | $1,227.00 | $2,045.00 | $259.94–$3,067.00 | 59% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Visit Level 3 | $1,227.00 | $2,045.00 | $259.94–$3,067.00 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level 4 | $1,963.80 | $3,273.00 | $403.52–$6,143.00 | 52% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Visit Level 4 | $1,963.80 | $3,273.00 | $403.52–$6,143.00 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level 5 | $3,944.40 | $6,574.00 | $585.19–$10,230.00 | 122% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Visit Level 5 | $3,944.40 | $6,574.00 | $585.19–$10,230.00 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 US Echo Stress Test W/O Imaging 93017 | $933.60 | $1,556.00 | $285.96 | 25% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 BCE US Echo Stress Test W/O Imaging 93017 | $933.60 | $1,556.00 | $285.96 | 25% below | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 BCE US Echo Stress Test W/O Imaging 93017 | $933.60 | $1,556.00 | $285.96 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 US Echo Stress Test W/O Imaging 93017 | $933.60 | $1,556.00 | $285.96 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 96360 | $436.20 | $727.00 | $195.28 | at median | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS INFUSION; HYDRATION - INITIAL; 31 MINUTES TO 1 HOUR 96360 | $467.40 | $779.00 | $195.28 | 8% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED IV INFUSION HYDRATION, INITIAL 31 MINUTES TO 1 HOUR | $467.40 | $779.00 | $195.28 | 8% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS INFUSION; HYDRATION - INITIAL; 31 MINUTES TO 1 HOUR 96360-CL | $467.40 | $779.00 | $195.28 | 8% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 96360 | $436.20 | $727.00 | $195.28 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS INFUSION; HYDRATION - INITIAL; 31 MINUTES TO 1 HOUR 96360 | $467.40 | $779.00 | $195.28 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS INFUSION; HYDRATION - INITIAL; 31 MINUTES TO 1 HOUR 96360-CL | $467.40 | $779.00 | $195.28 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED IV INFUSION HYDRATION, INITIAL 31 MINUTES TO 1 HOUR | $467.40 | $779.00 | $195.28 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 96365 | $435.00 | $725.00 | $195.28 | 3% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Prophylaxis DX 1st > 1 hour 96365 | $452.40 | $754.00 | $195.28 | 1% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 ED IV INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS ; INITIAL, UP TO 1 | $466.20 | $777.00 | $195.28 | 4% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUSION FOR THERAPY PROPHYLAXIS OR DIAGNOSIS INITIAL UP TO 1 HOUR 96365 | $466.20 | $777.00 | $195.28 | 4% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 96365 | $435.00 | $725.00 | $195.28 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy/Prophylaxis DX 1st > 1 hour 96365 | $452.40 | $754.00 | $195.28 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INTRAVENOUS INFUSION FOR THERAPY PROPHYLAXIS OR DIAGNOSIS INITIAL UP TO 1 HOUR 96365 | $466.20 | $777.00 | $195.28 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 ED IV INFUSION, FOR THERAPY, PROPHYLAXIS, OR DIAGNOSIS ; INITIAL, UP TO 1 | $466.20 | $777.00 | $195.28 | — | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC PROPHYLACTIC./DIAG. INJECTION I.V. PUSH SINGLE OR INITIAL SUB./DRUG 96374 | $183.60 | $306.00 | $195.28 | 20% below | 40% |
| IV push of a medicine, first drug CPT 96374 THERAPEUTIC PROPHY./DIAG. INJECTION I.V. PUSH SINGLE OR INITIAL SUB./DRUG 96374 | $196.80 | $328.00 | $195.28 | 14% below | 40% |
| IV push of a medicine, first drug CPT 96374 ED THER/PROPH/DIAG INJ ; IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG | $196.80 | $328.00 | $195.28 | 14% below | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC PROPHYLACTIC./DIAG. INJECTION I.V. PUSH SINGLE OR INITIAL SUB./DRUG 96374 | $183.60 | $306.00 | $195.28 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC PROPHY./DIAG. INJECTION I.V. PUSH SINGLE OR INITIAL SUB./DRUG 96374 | $196.80 | $328.00 | $195.28 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 ED THER/PROPH/DIAG INJ ; IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG | $196.80 | $328.00 | $195.28 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR 96372 | $143.40 | $239.00 | $64.18 | 2% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR | $149.40 | $249.00 | $64.18 | 2% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOSTIC INJ. SUCUTANEOUS OR INTRAMUSCULAR 96372 | $211.80 | $353.00 | $64.18 | 44% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR 96372 | $143.40 | $239.00 | $64.18 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED THERAPUETIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION SUBCUATANEOUS OR INTRAMSUCULAR | $149.40 | $249.00 | $64.18 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOSTIC INJ. SUCUTANEOUS OR INTRAMUSCULAR 96372 | $211.80 | $353.00 | $64.18 | — | 40% |
| Spirometry (breathing test) CPT 94010 RT Charges SV -> PFT w/o Bronchodilator | $222.76 | $371.26 | $142.31 | 38% below | 40% |
| Spirometry (breathing test) CPT 94010 Spirometry w/graphic record, total/timed vital capacity, expiratory flow rate measurement(s), w +w/o | $275.40 | $459.00 | $142.31 | 23% below | 40% |
| Spirometry (breathing test) inpatient CPT 94010 RT Charges SV -> PFT w/o Bronchodilator | $222.76 | $371.26 | $142.31 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry w/graphic record, total/timed vital capacity, expiratory flow rate measurement(s), w +w/o | $275.40 | $459.00 | $142.31 | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 RT Charges SV -> PFT w/ Bronchodilator | $414.82 | $691.36 | $285.96 | 30% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Testing w/bronchodilator 94060 | $513.60 | $856.00 | $285.96 | 14% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT Charges SV -> PFT w/ Bronchodilator | $414.82 | $691.36 | $285.96 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Testing w/bronchodilator 94060 | $513.60 | $856.00 | $285.96 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) | $213.00 | $355.00 | $64.18 | 189% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED IMMUNIZATION ADMINISTRATION; ONE VACCINE (SINGLE OR COMBINATION VACCINE/TOXOID) | $213.00 | $355.00 | $64.18 | — | 40% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://mrfs.hyvehealthcare.com/USPI/510570864_texas-regional-medical-center,-llc_standardcharges.json