Hospital

Choctaw Regional Medical Center

Choctaw Regional Medical Center in Ackerman, MS publishes cash prices for 255 common procedures listed here, from its own machine-readable price file updated Oct 12, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Mississippi median for 129 of 255 procedures and above it for 118. By typical cash price it ranks #28 of 59 Mississippi hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

8613 MS Highway 12, Ackerman, MS, 39735-8917 Collected Oct 30, 2026 Source price file Check a bill from this hospital (662) 285-6235

Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CCN 251334 · CMS hospital register NPI 1568879864

Financial assistance

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

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

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Choctaw Regional Medical Center in Ackerman, MS:

Jul 14, 2026 Corrective action plan requested

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT,RIGHT	$205.01	$292.87	$79.39–$175.00	10% above	30%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT,LEFT	$205.01	$292.87	$79.39–$175.00	10% above	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RT,RIGHT	$205.01	$292.87	$79.39–$175.00	—	30%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LT,LEFT	$205.01	$292.87	$79.39–$175.00	—	30%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX SCAN EXTRACRANIAL ARTERIES (CA	$707.62	$1,010.88	$165.99–$207.48	74% above	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DUPLEX SCAN EXTRACRANIAL ARTERIES (CA	$707.62	$1,010.88	$165.99–$207.48	—	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS PA + LAT	$63.00	$90.00	$29.36–$175.00	55% below	30%
Chest X-ray, 2 views CPT 71046 CX CHEST 2 VIEWS PA + LAT	$63.00	$90.00	$29.36–$175.00	55% below	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS PA + LAT	$63.00	$90.00	$29.36–$175.00	—	30%
Chest X-ray, 2 views inpatient CPT 71046 CX CHEST 2 VIEWS PA + LAT	$63.00	$90.00	$29.36–$175.00	—	30%
Chest X-ray, single view CPT 71045 CX CHEST SNGL VIEW AP /PORT	$52.50	$75.00	$22.61–$175.00	50% below	30%
Chest X-ray, single view CPT 71045 XR CHEST SNGL VIEW AP /PORT	$52.50	$75.00	$22.61–$175.00	50% below	30%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SNGL VIEW AP /PORT	$52.50	$75.00	$22.61–$175.00	—	30%
Chest X-ray, single view inpatient CPT 71045 CX CHEST SNGL VIEW AP /PORT	$52.50	$75.00	$22.61–$175.00	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CX CLAVICLE RT,RIGHT	$35.00	$50.00	$29.42–$175.00	68% below	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CX CLAVICLE LT,LEFT	$35.00	$50.00	$29.42–$175.00	68% below	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT,RIGHT	$35.00	$50.00	$29.42–$175.00	68% below	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT,LEFT	$35.00	$50.00	$29.42–$175.00	68% below	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CX CLAVICLE LT,LEFT	$35.00	$50.00	$29.42–$175.00	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT,RIGHT	$35.00	$50.00	$29.42–$175.00	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT,LEFT	$35.00	$50.00	$29.42–$175.00	—	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CX CLAVICLE RT,RIGHT	$35.00	$50.00	$29.42–$175.00	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL COMPLETE	$277.20	$396.00	$79.39–$175.00	19% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL COMPLETE	$277.20	$396.00	$79.39–$175.00	—	30%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ARTERIAL IMAGING BOTH EXTREMITIES LOW	$698.88	$998.40	$175.00–$259.55	50% above	30%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ARTERIAL IMAGING BOTH EXTREMITIES LOW	$698.88	$998.40	$175.00–$259.55	—	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS DOPPLER LOWER EXTREMITIES BILA	$577.08	$824.40	$161.25–$201.56	31% above	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS DOPPLER LOWER EXTREMITIES BILA	$577.08	$824.40	$161.25–$201.56	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMPLETE	$471.88	$674.12	$175.00–$414.96	51% below	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO COMPLETE	$471.88	$674.12	$175.00–$414.96	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPLT MIN 3	$63.00	$90.00	$41.34–$175.00	58% below	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 CX FACIAL BONES COMPLT MIN 3	$63.00	$90.00	$41.34–$175.00	58% below	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 CX FACIAL BONES COMPLT MIN 3	$63.00	$90.00	$41.34–$175.00	—	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPLT MIN 3	$63.00	$90.00	$41.34–$175.00	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT,RIGHT	$48.97	$69.96	$25.68–$175.00	57% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT,LEFT	$48.97	$69.96	$25.68–$175.00	57% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CX FOREARM 2 VIEWS LT,LEFT	$48.97	$69.96	$25.68–$175.00	57% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CX FOREARM 2 VIEWS RT,RIGHT	$48.97	$69.96	$25.68–$175.00	57% below	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT,LEFT	$48.97	$69.96	$25.68–$175.00	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CX FOREARM 2 VIEWS RT,RIGHT	$48.97	$69.96	$25.68–$175.00	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CX FOREARM 2 VIEWS LT,LEFT	$48.97	$69.96	$25.68–$175.00	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT,RIGHT	$48.97	$69.96	$25.68–$175.00	—	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 CX KNEE 4+ VIEWS LT,LEFT	$56.00	$80.00	$43.46–$175.00	61% below	30%
Knee X-ray, complete, 4 or more views one side CPT 73564 CX KNEE 4+ VIEWS RT,RIGHT	$56.00	$80.00	$43.46–$175.00	61% below	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CX KNEE 4+ VIEWS LT,LEFT	$56.00	$80.00	$43.46–$175.00	—	30%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CX KNEE 4+ VIEWS RT,RIGHT	$56.00	$80.00	$43.46–$175.00	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN SINGLE ORGAN/QUAD LIMITED/ L	$254.52	$363.60	$76.73–$175.00	5% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN SINGLE ORGAN/QUAD LIMITED/ L	$254.52	$363.60	$76.73–$175.00	—	30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY NON VASCULAR LIMITED	$273.00	$390.00	$58.12–$175.00	35% above	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY NON VASCULAR LIMITED	$273.00	$390.00	$58.12–$175.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CX TIBIA/FIBULA 2 VIEWS RT,RIGHT	$42.00	$60.00	$27.69–$175.00	67% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RT,RIGHT	$42.00	$60.00	$27.69–$175.00	67% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CX TIBIA/FIBULA 2 VIEWS LT,LEFT	$42.00	$60.00	$27.69–$175.00	67% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LT,LEFT	$42.00	$60.00	$27.69–$175.00	67% below	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CX TIBIA/FIBULA 2 VIEWS RT,RIGHT	$42.00	$60.00	$27.69–$175.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CX TIBIA/FIBULA 2 VIEWS LT,LEFT	$42.00	$60.00	$27.69–$175.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RT,RIGHT	$42.00	$60.00	$27.69–$175.00	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LT,LEFT	$42.00	$60.00	$27.69–$175.00	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CX SPINE CERV COMPLT W/OBLIQ	$95.90	$137.00	$48.54–$175.00	48% below	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERV COMPLT W/OBLIQ	$130.20	$186.00	$48.54–$175.00	30% below	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CX SPINE CERV COMPLT W/OBLIQ	$95.90	$137.00	$48.54–$175.00	—	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERV COMPLT W/OBLIQ	$130.20	$186.00	$48.54–$175.00	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED STUDY	$149.52	$213.60	$46.11–$175.00	29% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED STUDY	$149.52	$213.60	$46.11–$175.00	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NONOBSTETRIC)	$258.38	$369.11	$79.39–$175.00	19% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC (NONOBSTETRIC)	$258.38	$369.11	$79.39–$175.00	—	30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS COMPLETE	$306.10	$437.28	$79.39–$175.00	12% below	30%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS COMPLETE	$306.10	$437.28	$79.39–$175.00	—	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/PA CHEST LT,LEFT	$81.20	$116.00	$37.03–$175.00	51% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/PA CHEST RT,RIGHT	$81.20	$116.00	$37.03–$175.00	51% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CX RIBS UNILAT W/PA CHEST LT,LEFT	$84.00	$120.00	$37.03–$175.00	49% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CX RIBS UNILAT W/PA CHEST RT,RIGHT	$84.00	$120.00	$37.03–$175.00	49% below	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/PA CHEST RT,RIGHT	$81.20	$116.00	$37.03–$175.00	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/PA CHEST LT,LEFT	$81.20	$116.00	$37.03–$175.00	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CX RIBS UNILAT W/PA CHEST LT,LEFT	$84.00	$120.00	$37.03–$175.00	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CX RIBS UNILAT W/PA CHEST RT,RIGHT	$84.00	$120.00	$37.03–$175.00	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3+ VIEWS	$56.70	$81.00	$33.39–$175.00	60% below	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES 3+ VIEWS	$56.70	$81.00	$33.39–$175.00	—	30%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS RT,RIGHT	$37.80	$54.00	$25.25–$175.00	66% below	30%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) MIN 2+ VIEWS LT,LEFT	$37.80	$54.00	$25.25–$175.00	66% below	30%
Toe X-ray, 2 or more views one side CPT 73660 CX TOE(S) 2+ VIEWS LT,LEFT	$42.00	$60.00	$25.25–$175.00	62% below	30%
Toe X-ray, 2 or more views one side CPT 73660 CX TOE(S) 2+ VIEWS RT,RIGHT	$42.00	$60.00	$25.25–$175.00	62% below	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) MIN 2+ VIEWS LT,LEFT	$37.80	$54.00	$25.25–$175.00	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS RT,RIGHT	$37.80	$54.00	$25.25–$175.00	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 CX TOE(S) 2+ VIEWS RT,RIGHT	$42.00	$60.00	$25.25–$175.00	—	30%
Toe X-ray, 2 or more views inpatient one side CPT 73660 CX TOE(S) 2+ VIEWS LT,LEFT	$42.00	$60.00	$25.25–$175.00	—	30%
Transvaginal pelvic ultrasound CPT 76830 US UTERUS TRANSVAGINAL	$420.00	$600.00	$79.39–$175.00	37% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 US UTERUS TRANSVAGINAL	$420.00	$600.00	$79.39–$175.00	—	30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$293.92	$419.89	$79.39–$175.00	25% below	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$293.92	$419.89	$79.39–$175.00	—	30%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM + CONTENTS	$266.00	$380.00	$79.39–$175.00	2% below	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM + CONTENTS	$266.00	$380.00	$79.39–$175.00	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK THYROID	$378.00	$540.00	$79.39–$175.00	38% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK THYROID	$378.00	$540.00	$79.39–$175.00	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+ VIEWS RT,RIGHT	$56.00	$80.00	$28.27–$175.00	54% below	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 CX HUMERUS 2+ VIEWS RT,RIGHT	$56.00	$80.00	$28.27–$175.00	54% below	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 CX HUMERUS 2+ VIEWS RT,RIGHT	$56.00	$80.00	$28.27–$175.00	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+ VIEWS RT,RIGHT	$56.00	$80.00	$28.27–$175.00	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER UPPER EXTREMITY- LT,LEFT	$378.00	$540.00	$79.39–$175.00	14% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER UPPER EXTREMITY- RT,RIGHT	$378.00	$540.00	$79.39–$175.00	14% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER LOWER EXTREMITY- LT,LEFT	$378.00	$540.00	$79.39–$175.00	14% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DOPPLER LOWER EXTREMITY- RT,RIGHT	$378.00	$540.00	$79.39–$175.00	14% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER UPPER EXTREMITY- LT,LEFT	$378.00	$540.00	$79.39–$175.00	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER LOWER EXTREMITY- LT,LEFT	$378.00	$540.00	$79.39–$175.00	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER LOWER EXTREMITY- RT,RIGHT	$378.00	$540.00	$79.39–$175.00	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DOPPLER UPPER EXTREMITY- RT,RIGHT	$378.00	$540.00	$79.39–$175.00	—	30%
Wrist X-ray, 2 views one side CPT 73100 CX WRIST 2 VIEWS RT,RIGHT	$38.50	$55.00	$30.28–$175.00	67% below	30%
Wrist X-ray, 2 views one side CPT 73100 CX WRIST 2 VIEWS LT,LEFT	$38.50	$55.00	$30.28–$175.00	67% below	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 CX WRIST 2 VIEWS RT,RIGHT	$38.50	$55.00	$30.28–$175.00	—	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 CX WRIST 2 VIEWS LT,LEFT	$38.50	$55.00	$30.28–$175.00	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3+ VIEWS LT,LEFT	$52.50	$75.00	$37.52–$175.00	58% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CX WRIST 3+ VIEWS LT,LEFT	$52.50	$75.00	$37.52–$175.00	58% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CX WRIST 3+ VIEWS RT,RIGHT	$52.50	$75.00	$37.52–$175.00	58% below	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CX WRIST 3+ VIEWS RT,RIGHT	$52.50	$75.00	$37.52–$175.00	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3+ VIEWS LT,LEFT	$52.50	$75.00	$37.52–$175.00	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CX WRIST 3+ VIEWS LT,LEFT	$52.50	$75.00	$37.52–$175.00	—	30%
X-ray of the abdomen, 1 view CPT 74018 XR ABD SNGL AP VIEW (KUB)	$45.50	$65.00	$26.35–$175.00	65% below	30%
X-ray of the abdomen, 1 view CPT 74018 CX ABD SNGL AP VIEW (KUB)	$45.50	$65.00	$26.35–$175.00	65% below	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD SNGL AP VIEW (KUB)	$45.50	$65.00	$26.35–$175.00	—	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 CX ABD SNGL AP VIEW (KUB)	$45.50	$65.00	$26.35–$175.00	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2+ VIEWS RT,RIGHT	$37.80	$54.00	$34.46–$175.00	66% below	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 CX FINGER 2+ VIEWS RT,RIGHT	$49.00	$70.00	$34.46–$175.00	56% below	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2+ VIEWS RT,RIGHT	$37.80	$54.00	$34.46–$175.00	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 CX FINGER 2+ VIEWS RT,RIGHT	$49.00	$70.00	$34.46–$175.00	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3+ VIEWS LT,LEFT	$45.50	$65.00	$30.04–$175.00	63% below	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CX FOOT 3+ VIEWS RT,RIGHT	$45.50	$65.00	$30.04–$175.00	63% below	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CX FOOT 3+ VIEWS LT,LEFT	$45.50	$65.00	$30.04–$175.00	63% below	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3+ VIEWS RT,RIGHT	$45.50	$65.00	$30.04–$175.00	63% below	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CX FOOT 3+ VIEWS LT,LEFT	$45.50	$65.00	$30.04–$175.00	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3+ VIEWS LT,LEFT	$45.50	$65.00	$30.04–$175.00	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CX FOOT 3+ VIEWS RT,RIGHT	$45.50	$65.00	$30.04–$175.00	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3+ VIEWS RT,RIGHT	$45.50	$65.00	$30.04–$175.00	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2/3 VIEWS	$63.00	$90.00	$35.69–$175.00	56% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 CX SPINE LUMBOSACRAL 2/3 VIEWS	$63.00	$90.00	$35.69–$175.00	56% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2/3 VIEWS	$63.00	$90.00	$35.69–$175.00	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 CX SPINE LUMBOSACRAL 2/3 VIEWS	$63.00	$90.00	$35.69–$175.00	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 CX SPINE THOR 2 VIEWS	$63.00	$90.00	$29.32–$175.00	51% below	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THOR 2 VIEWS	$63.00	$90.00	$29.32–$175.00	51% below	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THOR 2 VIEWS	$63.00	$90.00	$29.32–$175.00	—	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 CX SPINE THOR 2 VIEWS	$63.00	$90.00	$29.32–$175.00	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLT MINI 3	$63.00	$90.00	$32.92–$175.00	54% below	30%
X-ray of the nasal bones, 3 or more views CPT 70160 CX NASAL BONES COMPLT MIN 3V	$63.00	$90.00	$32.92–$175.00	54% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 CX NASAL BONES COMPLT MIN 3V	$63.00	$90.00	$32.92–$175.00	—	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLT MINI 3	$63.00	$90.00	$32.92–$175.00	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERV 2/3 VIEWS	$63.00	$90.00	$35.12–$175.00	54% below	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CX SPINE CERV 2/3 VIEWS	$63.00	$90.00	$35.12–$175.00	54% below	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERV 2/3 VIEWS	$63.00	$90.00	$35.12–$175.00	—	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CX SPINE CERV 2/3 VIEWS	$63.00	$90.00	$35.12–$175.00	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS	$45.50	$65.00	$24.86–$175.00	67% below	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 CX PELVIS 1 OR 2 VIEWS	$58.80	$84.00	$24.86–$175.00	57% below	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1/2 VIEWS	$45.50	$65.00	$24.86–$175.00	—	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 CX PELVIS 1 OR 2 VIEWS	$58.80	$84.00	$24.86–$175.00	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$117.60	$168.00	$34.76–$175.00	16% below	30%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$117.60	$168.00	$34.76–$175.00	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALTV	$29.40	$42.00	$4.77–$175.00	10% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALTV	$29.40	$42.00	$4.77–$175.00	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$26.46	$37.80	$4.66–$175.00	2% below	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$26.46	$37.80	$4.66–$175.00	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$122.50	$175.00	$42.87–$175.00	14% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$122.50	$175.00	$42.87–$175.00	—	30%
Albumin blood test CPT 82040 ALBUMIN SERUM	$35.28	$50.40	$4.46–$175.00	18% above	30%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$35.28	$50.40	$4.46–$175.00	—	30%
Aldosterone blood test CPT 82088 ALDOSTERONE/RENIN ACTIVITY RATIO	$148.68	$212.40	$36.68–$175.00	37% above	30%
Aldosterone blood test CPT 82088 ALDOSTERONE	$148.68	$212.40	$36.68–$175.00	37% above	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$148.68	$212.40	$36.68–$175.00	—	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE/RENIN ACTIVITY RATIO	$148.68	$212.40	$36.68–$175.00	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$21.00	$30.00	$4.66–$175.00	30% below	30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOS	$42.00	$60.00	$4.66–$175.00	40% above	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$21.00	$30.00	$4.66–$175.00	—	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOS	$42.00	$60.00	$4.66–$175.00	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 FIRE ANT IGE	$29.40	$42.00	$4.70–$175.00	131% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET IGE	$29.40	$42.00	$4.70–$175.00	131% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE FACED HORNET IGE	$29.40	$42.00	$4.70–$175.00	131% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW HORNET IGE	$29.40	$42.00	$4.70–$175.00	131% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IGE	$29.40	$42.00	$4.70–$175.00	131% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY, PORK IGE	$37.10	$53.00	$4.70–$175.00	192% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY, VENISON	$37.10	$53.00	$4.70–$175.00	192% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY, BEEF	$37.10	$53.00	$4.70–$175.00	192% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY, LAMB	$37.10	$53.00	$4.70–$175.00	192% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGY	$52.50	$75.00	$4.70–$175.00	313% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 SULFAMATHOXAZOLE	$102.20	$146.00	$4.70–$175.00	705% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 MOLD ALLERGY	$115.50	$165.00	$4.70–$175.00	809% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL, INSECT VENOM	$148.68	$212.40	$4.70–$175.00	1071% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 HYPERSENS PNEUMONITIS PANEL ASSC CHARG	$276.50	$395.00	$4.70–$175.00	2077% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ENVIRONMENTAL ALLERGY SCREENING	$504.00	$720.00	$4.70–$175.00	3869% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY RAP6 PANEL	$504.00	$720.00	$4.70–$175.00	3869% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIRE ANT IGE	$29.40	$42.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE FACED HORNET IGE	$29.40	$42.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP IGE	$29.40	$42.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET IGE	$29.40	$42.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW HORNET IGE	$29.40	$42.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY, PORK IGE	$37.10	$53.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY, BEEF	$37.10	$53.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY, LAMB	$37.10	$53.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY, VENISON	$37.10	$53.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGY	$52.50	$75.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SULFAMATHOXAZOLE	$102.20	$146.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOLD ALLERGY	$115.50	$165.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL, INSECT VENOM	$148.68	$212.40	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HYPERSENS PNEUMONITIS PANEL ASSC CHARG	$276.50	$395.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENVIRONMENTAL ALLERGY SCREENING	$504.00	$720.00	$4.70–$175.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY RAP6 PANEL	$504.00	$720.00	$4.70–$175.00	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER	$66.50	$95.00	$15.09–$175.00	32% above	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER	$66.50	$95.00	$15.09–$175.00	—	30%
Ammonia blood test CPT 82140 AMMONIA	$37.10	$53.00	$13.11–$175.00	49% below	30%
Ammonia blood test inpatient CPT 82140 AMMONIA	$37.10	$53.00	$13.11–$175.00	—	30%
Amylase blood test CPT 82150 AMYLASE	$26.46	$37.80	$5.83–$175.00	34% below	30%
Amylase blood test inpatient CPT 82150 AMYLASE	$26.46	$37.80	$5.83–$175.00	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP 1GG ABS	$42.00	$60.00	$11.66–$175.00	8% below	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODIES	$57.04	$81.48	$11.66–$175.00	24% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP 1GG ABS	$42.00	$60.00	$11.66–$175.00	—	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODIES	$57.04	$81.48	$11.66–$175.00	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIB	$57.04	$81.48	$10.88–$175.00	5% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIB	$57.04	$81.48	$10.88–$175.00	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP,CHF	$105.00	$150.00	$35.33–$175.00	2% below	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$105.00	$150.00	$35.33–$175.00	2% below	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 SEND-OUT BNP ORDER PBNP(INHOUSE)	$310.80	$444.00	$35.33–$175.00	191% above	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP,CHF	$105.00	$150.00	$35.33–$175.00	—	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$105.00	$150.00	$35.33–$175.00	—	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 SEND-OUT BNP ORDER PBNP(INHOUSE)	$310.80	$444.00	$35.33–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$33.60	$48.00	$7.76–$175.00	36% below	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE, EAR, THROAT	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE STERILE FLUID	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC (WOUND)	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM/LOWER RESPIRATORY	$85.68	$122.40	$7.76–$175.00	63% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL	$33.60	$48.00	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM/LOWER RESPIRATORY	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE STERILE FLUID	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC (WOUND)	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE, EAR, THROAT	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR	$85.68	$122.40	$7.76–$175.00	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE	$85.68	$122.40	$7.76–$175.00	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$73.92	$105.60	$7.61–$175.00	35% above	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$73.92	$105.60	$7.61–$175.00	—	30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$25.20	$36.00	$4.52–$175.00	7% above	30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$25.20	$36.00	$4.52–$175.00	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY(LEVEL IV)	$138.60	$198.00	$39.57–$175.00	72% above	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY	$302.40	$432.00	$39.57–$175.00	275% above	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY(LEVEL IV)	$138.60	$198.00	$39.57–$175.00	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY	$302.40	$432.00	$39.57–$175.00	—	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD PEDIATRIC (ARD)	$60.48	$86.40	$9.29–$175.00	33% below	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$60.48	$86.40	$9.29–$175.00	33% below	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD #2	$60.48	$86.40	$9.29–$175.00	33% below	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$60.48	$86.40	$9.29–$175.00	—	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD PEDIATRIC (ARD)	$60.48	$86.40	$9.29–$175.00	—	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD #2	$60.48	$86.40	$9.29–$175.00	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE VENOUS	$7.35	$10.50	$8.41–$175.00	8% below	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$8.82	$12.60	$8.41–$175.00	10% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD	$12.60	$18.00	$8.41–$525.00	58% above	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PF DRAWING BLOOD	$12.60	$18.00	$8.41–$175.00	58% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE VENOUS	$7.35	$10.50	$8.41–$175.00	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$8.82	$12.60	$8.41–$175.00	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAWING BLOOD	$12.60	$18.00	$8.41–$525.00	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PF DRAWING BLOOD	$12.60	$18.00	$8.41–$175.00	—	30%
Blood lead test CPT 83655 LEAD	$71.40	$102.00	$10.90–$175.00	73% above	30%
Blood lead test CPT 83655 LEAD URINE	$97.44	$139.20	$10.90–$175.00	135% above	30%
Blood lead test CPT 83655 LEAD, CAPILLARY BLOOD	$101.50	$145.00	$10.90–$175.00	145% above	30%
Blood lead test inpatient CPT 83655 LEAD	$71.40	$102.00	$10.90–$175.00	—	30%
Blood lead test inpatient CPT 83655 LEAD URINE	$97.44	$139.20	$10.90–$175.00	—	30%
Blood lead test inpatient CPT 83655 LEAD, CAPILLARY BLOOD	$101.50	$145.00	$10.90–$175.00	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY, SERUM	$26.60	$38.00	$6.77–$175.00	43% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY, SERUM	$26.60	$38.00	$6.77–$175.00	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLD TYPING ABO	$40.32	$57.60	$3.59–$175.00	25% below	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLD TYPING ABO	$40.32	$57.60	$3.59–$175.00	—	30%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$45.36	$64.80	$3.56–$175.00	47% above	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$45.36	$64.80	$3.56–$175.00	—	30%
C-peptide blood test CPT 84681 C-PEPTIDE	$58.80	$84.00	$18.73–$175.00	22% below	30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$58.80	$84.00	$18.73–$175.00	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (C-REACTIVE PROTEIN)	$57.62	$82.32	$4.66–$175.00	84% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (C-REACTIVE PROTEIN)	$57.62	$82.32	$4.66–$175.00	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 C-DIFF	$21.00	$30.00	$33.54–$175.00	62% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C-DIFF	$21.00	$30.00	$33.54–$175.00	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$53.76	$76.80	$18.73–$175.00	25% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$53.76	$76.80	$18.73–$175.00	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$58.80	$84.00	$18.73–$175.00	26% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$58.80	$84.00	$18.73–$175.00	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 SEND OUT TEST	$126.00	$180.00	$46.18–$175.00	186% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19, PCR IN-HOUSE	$126.00	$180.00	$46.18–$175.00	186% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 SEND OUT TEST	$126.00	$180.00	$46.18–$175.00	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19, PCR IN-HOUSE	$126.00	$180.00	$46.18–$175.00	—	30%
Calcium blood test, total CPT 82310 CALCIUM TOT	$37.80	$54.00	$4.64–$175.00	35% above	30%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOT	$37.80	$54.00	$4.64–$175.00	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA (CARCINOEMBRYONIC ANTIG)	$67.20	$96.00	$17.06–$175.00	31% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA (CARCINOEMBRYONIC ANTIG)	$67.20	$96.00	$17.06–$175.00	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGG	$81.20	$116.00	$11.59–$175.00	54% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGM	$81.20	$116.00	$11.59–$175.00	54% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER, IGM	$97.44	$139.20	$11.59–$175.00	84% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY IGG	$97.44	$139.20	$11.59–$175.00	84% above	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IGM	$81.20	$116.00	$11.59–$175.00	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IGG	$81.20	$116.00	$11.59–$175.00	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER, IGM	$97.44	$139.20	$11.59–$175.00	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY IGG	$97.44	$139.20	$11.59–$175.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA-AMP. PROBE, SWAB (GENPROBE)	$112.00	$160.00	$31.58–$175.00	67% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA-AMP. PROBE,URINE (GENPROBE)	$112.00	$160.00	$31.58–$175.00	67% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA-AMP. PROBE, ANAL/RECTAL	$112.00	$160.00	$31.58–$175.00	67% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA-AMP. PROBE, ORAL	$112.00	$160.00	$31.58–$175.00	67% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GEN PROBE CHLAMYDIA	$121.80	$174.00	$31.58–$175.00	81% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA-AMP. PROBE,URINE (GENPROBE)	$112.00	$160.00	$31.58–$175.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA-AMP. PROBE, SWAB (GENPROBE)	$112.00	$160.00	$31.58–$175.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA-AMP. PROBE, ORAL	$112.00	$160.00	$31.58–$175.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA-AMP. PROBE, ANAL/RECTAL	$112.00	$160.00	$31.58–$175.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GEN PROBE CHLAMYDIA	$121.80	$174.00	$31.58–$175.00	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$70.56	$100.80	$12.05–$175.00	32% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$70.56	$100.80	$12.05–$175.00	—	30%
Complete blood count (CBC) with differential CPT 85025 CL-CBC, LMC	$44.10	$63.00	$6.99–$175.00	13% above	30%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF	$58.10	$83.00	$6.99–$175.00	49% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CL-CBC, LMC	$44.10	$63.00	$6.99–$175.00	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF	$58.10	$83.00	$6.99–$175.00	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$100.10	$143.00	$9.50–$175.00	21% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$100.10	$143.00	$9.50–$175.00	—	30%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$30.24	$43.20	$14.67–$175.00	42% below	30%
Cortisol blood test, total CPT 82533 DEXAMETHASONE SUPPRESSION TEST	$129.50	$185.00	$14.67–$175.00	149% above	30%
Cortisol blood test, total CPT 82533 CORTISOL, SALIVARY	$302.40	$432.00	$14.67–$175.00	482% above	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$30.24	$43.20	$14.67–$175.00	—	30%
Cortisol blood test, total inpatient CPT 82533 DEXAMETHASONE SUPPRESSION TEST	$129.50	$185.00	$14.67–$175.00	—	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SALIVARY	$302.40	$432.00	$14.67–$175.00	—	30%
Creatine kinase (CK) blood test, total CPT 82550 CREATININE KINASE (CK)	$30.24	$43.20	$5.86–$175.00	25% below	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATININE KINASE (CK)	$30.24	$43.20	$5.86–$175.00	—	30%
Creatinine blood test CPT 82565 TEST CREATININE	$26.46	$37.80	$4.61–$175.00	11% below	30%
Creatinine blood test CPT 82565 CREATININE BLOOD	$26.46	$37.80	$4.61–$175.00	11% below	30%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$26.46	$37.80	$4.61–$175.00	—	30%
Creatinine blood test inpatient CPT 82565 TEST CREATININE	$26.46	$37.80	$4.61–$175.00	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AB	$168.00	$240.00	$12.95–$175.00	273% above	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AB	$168.00	$240.00	$12.95–$175.00	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER (IN-HOUSE)	$103.32	$147.60	$9.16–$175.00	65% above	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER (IN-HOUSE)	$103.32	$147.60	$9.16–$175.00	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$80.50	$115.00	$20.01–$175.00	6% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$80.50	$115.00	$20.01–$175.00	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AEL - DRUG SCREEN CONFIRMATION SEND OUT	$50.40	$72.00	$55.93–$175.00	3% below	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SERUM DRUG SCREEN	$175.00	$250.00	$55.93–$175.00	237% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GAMMA-HYDROXYBUTYRIC ACID, URINE	$420.00	$600.00	$55.93–$175.00	709% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AEL - DRUG SCREEN CONFIRMATION SEND OUT	$50.40	$72.00	$55.93–$175.00	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SERUM DRUG SCREEN	$175.00	$250.00	$55.93–$175.00	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GAMMA-HYDROXYBUTYRIC ACID, URINE	$420.00	$600.00	$55.93–$175.00	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$80.64	$115.20	$6.31–$175.00	30% above	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$80.64	$115.20	$6.31–$175.00	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VIRAL CAPSID IGG	$26.04	$37.20	$16.33–$175.00	54% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EB VIRUS ANTI- VCA TITERS IGG&IGM	$42.00	$60.00	$16.33–$175.00	25% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID IGM	$58.80	$84.00	$16.33–$175.00	5% above	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR PANEL	$368.76	$526.80	$16.33–$175.00	557% above	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VIRAL CAPSID IGG	$26.04	$37.20	$16.33–$175.00	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EB VIRUS ANTI- VCA TITERS IGG&IGM	$42.00	$60.00	$16.33–$175.00	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID IGM	$58.80	$84.00	$16.33–$175.00	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR PANEL	$368.76	$526.80	$16.33–$175.00	—	30%
Estradiol blood test CPT 82670 ESTRADIOL	$232.68	$332.40	$25.15–$175.00	174% above	30%
Estradiol blood test CPT 82670 ESTRADIOL FREE	$572.04	$817.20	$25.15–$175.00	575% above	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$232.68	$332.40	$25.15–$175.00	—	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL FREE	$572.04	$817.20	$25.15–$175.00	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$136.08	$194.40	$16.72–$175.00	76% above	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$136.08	$194.40	$16.72–$175.00	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN,FECAL	$175.00	$250.00	$17.67–$175.00	39% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN,FECAL	$175.00	$250.00	$17.67–$175.00	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$64.68	$92.40	$12.27–$175.00	5% below	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$64.68	$92.40	$12.27–$175.00	—	30%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$56.28	$80.40	$8.75–$175.00	5% above	30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$56.28	$80.40	$8.75–$175.00	—	30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$52.08	$74.40	$13.23–$175.00	at median	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$52.08	$74.40	$13.23–$175.00	—	30%
Free T3 thyroid hormone test CPT 84481 FT3	$16.80	$24.00	$15.25–$175.00	69% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 FT3	$16.80	$24.00	$15.25–$175.00	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$21.00	$30.00	$8.12–$175.00	40% below	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FT4	$55.27	$78.96	$8.12–$175.00	59% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$21.00	$30.00	$8.12–$175.00	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FT4	$55.27	$78.96	$8.12–$175.00	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$14.70	$21.00	$6.48–$175.00	50% below	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$14.70	$21.00	$6.48–$175.00	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$242.20	$346.00	$175.00	37% above	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$242.20	$346.00	$175.00	—	30%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 HOUR	$58.80	$84.00	$11.58–$175.00	12% below	30%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR	$73.50	$105.00	$11.58–$175.00	10% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 HOUR	$58.80	$84.00	$11.58–$175.00	—	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 HOUR	$73.50	$105.00	$11.58–$175.00	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GEN PROBE GONORRHEA	$121.80	$174.00	$31.58–$175.00	111% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GEN PROBE GONORRHEA	$121.80	$174.00	$31.58–$175.00	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI IGM (SEND-OUT)	$42.00	$60.00	$15.17–$175.00	15% below	30%
H. pylori antibody blood test CPT 86677 H PYLORI	$52.92	$75.60	$15.17–$175.00	7% above	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM (SEND-OUT)	$42.00	$60.00	$15.17–$175.00	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI	$52.92	$75.60	$15.17–$175.00	—	30%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL AG (SEND OUT)	$126.00	$180.00	$12.94–$175.00	77% above	30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL AG (SEND OUT)	$126.00	$180.00	$12.94–$175.00	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD	$189.00	$270.00	$76.59–$175.00	9% below	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD (TELEHEALTH)	$458.64	$655.20	$76.59–$175.00	122% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD	$189.00	$270.00	$76.59–$175.00	—	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD (TELEHEALTH)	$458.64	$655.20	$76.59–$175.00	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV RAPID (EMPLOYEE NEEDLESTICK ONLY)	$35.00	$50.00	$12.34–$175.00	17% below	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV RAPID (EMPLOYEE NEEDLESTICK ONLY)	$35.00	$50.00	$12.34–$175.00	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 & 2	$67.20	$96.00	$21.67–$175.00	68% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG & AB 4TH GEN W/REFLEX	$158.76	$226.80	$21.67–$175.00	297% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 & 2	$67.20	$96.00	$21.67–$175.00	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG & AB 4TH GEN W/REFLEX	$158.76	$226.80	$21.67–$175.00	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA, HISK RISK, ANAL RECTAL	$105.00	$150.00	$31.58–$175.00	134% above	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMA VIRUS (HPV)	$176.40	$252.00	$31.58–$175.00	294% above	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, PAP	$176.40	$252.00	$31.58–$175.00	294% above	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA, HISK RISK, ANAL RECTAL	$105.00	$150.00	$31.58–$175.00	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HUMAN PAPILLOMA VIRUS (HPV)	$176.40	$252.00	$31.58–$175.00	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, PAP	$176.40	$252.00	$31.58–$175.00	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$70.56	$100.80	$8.74–$175.00	57% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$70.56	$100.80	$8.74–$175.00	—	30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY-TOT	$40.32	$57.60	$10.85–$175.00	8% below	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY-TOT	$40.32	$57.60	$10.85–$175.00	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$68.54	$97.92	$9.67–$175.00	56% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB IMMUN, PRE-EMPLOYMENT	$68.54	$97.92	$9.67–$175.00	56% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B IMMUNIZATION	$109.20	$156.00	$9.67–$175.00	148% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB IMMUN, PRE-EMPLOYMENT	$68.54	$97.92	$9.67–$175.00	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$68.54	$97.92	$9.67–$175.00	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B IMMUNIZATION	$109.20	$156.00	$9.67–$175.00	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN	$50.40	$72.00	$9.30–$175.00	12% above	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN	$50.40	$72.00	$9.30–$175.00	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY (SCREEN)	$55.30	$79.00	$12.84–$175.00	5% below	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY (SCREEN)	$55.30	$79.00	$12.84–$175.00	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL LOAD	$246.96	$352.80	$38.56–$175.00	53% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPTATIS C VIRAL LOAD (CONFIRM)	$382.20	$546.00	$38.56–$175.00	136% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL LOAD	$246.96	$352.80	$38.56–$175.00	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPTATIS C VIRAL LOAD (CONFIRM)	$382.20	$546.00	$38.56–$175.00	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SELECT I IGG	$30.98	$44.25	$11.87–$175.00	5% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SELECT I IGG	$30.98	$44.25	$11.87–$175.00	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SELECT II IGG	$37.17	$53.10	$17.42–$175.00	4% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1&2 IGG	$158.76	$226.80	$17.42–$175.00	310% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SELECT II IGG	$37.17	$53.10	$17.42–$175.00	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1&2 IGG	$158.76	$226.80	$17.42–$175.00	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP CARDIAC 120766	$28.70	$41.00	$11.66–$175.00	6% below	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP CARDIAC 120766	$28.70	$41.00	$11.66–$175.00	—	30%
Homocysteine blood test CPT 83090 HOMOCYSTEINE (SERUM)	$196.56	$280.80	$16.13–$175.00	89% above	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE (SERUM)	$196.56	$280.80	$16.13–$175.00	—	30%
Insulin blood test CPT 83525 INSULIN FREE ASSOCIATED CHARGE	$33.60	$48.00	$10.29–$175.00	30% below	30%
Insulin blood test CPT 83525 INSULIN FREE	$56.00	$80.00	$10.29–$175.00	16% above	30%
Insulin blood test CPT 83525 INSULIN	$120.96	$172.80	$10.29–$175.00	151% above	30%
Insulin blood test CPT 83525 INSULIN, RANDOM (PLASMA)	$120.96	$172.80	$10.29–$175.00	151% above	30%
Insulin blood test inpatient CPT 83525 INSULIN FREE ASSOCIATED CHARGE	$33.60	$48.00	$10.29–$175.00	—	30%
Insulin blood test inpatient CPT 83525 INSULIN FREE	$56.00	$80.00	$10.29–$175.00	—	30%
Insulin blood test inpatient CPT 83525 INSULIN	$120.96	$172.80	$10.29–$175.00	—	30%
Insulin blood test inpatient CPT 83525 INSULIN, RANDOM (PLASMA)	$120.96	$172.80	$10.29–$175.00	—	30%
Iron blood test (serum iron) CPT 83540 IRON	$45.36	$64.80	$5.82–$175.00	33% above	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$45.36	$64.80	$5.82–$175.00	—	30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$60.48	$86.40	$7.87–$175.00	51% above	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$60.48	$86.40	$7.87–$175.00	—	30%
Kidney function blood test panel CPT 80069 RENAL PANEL	$90.72	$129.60	$7.81–$175.00	19% above	30%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$90.72	$129.60	$7.81–$175.00	—	30%
LH (luteinizing hormone) test CPT 83002 LH	$161.28	$230.40	$16.67–$175.00	90% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$161.28	$230.40	$16.67–$175.00	—	30%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$143.64	$205.20	$10.41–$175.00	155% above	30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$143.64	$205.20	$10.41–$175.00	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$37.80	$54.00	$5.44–$175.00	28% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$37.80	$54.00	$5.44–$175.00	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$44.10	$63.00	$6.20–$175.00	15% above	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$44.10	$63.00	$6.20–$175.00	—	30%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$90.72	$129.60	$7.35–$175.00	37% above	30%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$90.72	$129.60	$7.35–$175.00	—	30%
Lyme disease antibody test CPT 86618 LYME DISEASE AB W/ REFLEX	$196.56	$280.80	$15.33–$175.00	276% above	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB W/ REFLEX	$196.56	$280.80	$15.33–$175.00	—	30%
Magnesium blood test CPT 83735 MAGNESIUM	$37.80	$54.00	$6.03–$175.00	7% above	30%
Magnesium blood test CPT 83735 URINE MAGNESIUM 24 HOUR	$49.00	$70.00	$6.03–$175.00	38% above	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$37.80	$54.00	$6.03–$175.00	—	30%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM 24 HOUR	$49.00	$70.00	$6.03–$175.00	—	30%
Measles (rubeola) antibody test CPT 86765 ANTIB RUBEOLA	$28.70	$41.00	$11.59–$175.00	24% below	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY (MMR)	$75.60	$108.00	$11.59–$175.00	99% above	30%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIB RUBEOLA	$28.70	$41.00	$11.59–$175.00	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY (MMR)	$75.60	$108.00	$11.59–$175.00	—	30%
Mumps immunity blood test CPT 86735 ANTIB MUMPS	$32.20	$46.00	$11.75–$175.00	35% below	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IgM	$45.36	$64.80	$11.75–$175.00	8% below	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IgG	$45.36	$64.80	$11.75–$175.00	8% below	30%
Mumps immunity blood test CPT 86735 MUMPS IGM	$76.30	$109.00	$11.75–$175.00	54% above	30%
Mumps immunity blood test inpatient CPT 86735 ANTIB MUMPS	$32.20	$46.00	$11.75–$175.00	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IgM	$45.36	$64.80	$11.75–$175.00	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IgG	$45.36	$64.80	$11.75–$175.00	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGM	$76.30	$109.00	$11.75–$175.00	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE & TOTAL	$16.80	$24.00	$16.55–$175.00	70% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE & TOTAL	$16.80	$24.00	$16.55–$175.00	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$70.56	$100.80	$16.55–$175.00	10% below	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$70.56	$100.80	$16.55–$175.00	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP WITH REFLEX HPV	$70.56	$100.80	$23.95–$175.00	114% above	30%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP W/HPV	$189.00	$270.00	$23.95–$175.00	473% above	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP WITH REFLEX HPV	$70.56	$100.80	$23.95–$175.00	—	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP W/HPV	$189.00	$270.00	$23.95–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP	$70.56	$100.80	$18.23–$175.00	132% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP W IMAGING	$70.56	$100.80	$18.23–$175.00	132% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP SMEAR	$70.56	$100.80	$18.23–$175.00	132% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP	$77.00	$110.00	$18.23–$175.00	153% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP W/ REFLEX HPV	$189.00	$270.00	$18.23–$175.00	522% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP W/ HPV	$189.00	$270.00	$18.23–$175.00	522% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP, GC & CHLAM	$217.00	$310.00	$18.23–$175.00	614% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP, GC,CHL,HPV	$217.00	$310.00	$18.23–$175.00	614% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP, GC & CHLAM	$217.00	$310.00	$18.23–$175.00	614% above	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP SMEAR	$70.56	$100.80	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP W IMAGING	$70.56	$100.80	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP	$70.56	$100.80	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP	$77.00	$110.00	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP W/ REFLEX HPV	$189.00	$270.00	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP W/ HPV	$189.00	$270.00	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP, GC,CHL,HPV	$217.00	$310.00	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SUREPATH PAP, GC & CHLAM	$217.00	$310.00	$18.23–$175.00	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP, GC & CHLAM	$217.00	$310.00	$18.23–$175.00	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$45.36	$64.80	$37.15–$175.00	65% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$45.36	$64.80	$37.15–$175.00	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$41.16	$58.80	$5.41–$175.00	5% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$41.16	$58.80	$5.41–$175.00	—	30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$14.70	$21.00	$4.27–$175.00	46% below	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$14.70	$21.00	$4.27–$175.00	—	30%
Potassium blood test CPT 84132 POTASSIUM SERUM	$35.28	$50.40	$4.28–$175.00	30% above	30%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$35.28	$50.40	$4.28–$175.00	—	30%
Progesterone blood test CPT 84144 PROGESTERONE	$40.32	$57.60	$18.77–$175.00	53% below	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$40.32	$57.60	$18.77–$175.00	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$166.32	$237.60	$17.44–$175.00	78% above	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$166.32	$237.60	$17.44–$175.00	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR (PROTHROMBIN TIME)	$60.48	$86.40	$3.86–$175.00	121% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR (PROTHROMBIN TIME)	$60.48	$86.40	$3.86–$175.00	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 INDUSTRIAL DRUG SCREEN	$24.50	$35.00	$11.34–$175.00	32% below	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN 12 PANEL	$42.84	$61.20	$11.34–$175.00	19% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN VALIDATION	$42.84	$61.20	$11.34–$175.00	19% above	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 INDUSTRIAL DRUG SCREEN	$24.50	$35.00	$11.34–$175.00	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN VALIDATION	$42.84	$61.20	$11.34–$175.00	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN 12 PANEL	$42.84	$61.20	$11.34–$175.00	—	30%
Rapid flu test (influenza antigen) CPT 87804 FLU A	$24.50	$35.00	$14.90–$175.00	15% below	30%
Rapid flu test (influenza antigen) CPT 87804 FLU A AND B	$24.50	$35.00	$14.90–$175.00	15% below	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A,B	$29.40	$42.00	$14.90–$175.00	1% above	30%
Rapid flu test (influenza antigen) CPT 87804 CL-FLU SWAB, DR. PROSSER	$35.00	$50.00	$14.90–$175.00	21% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 FLU A	$24.50	$35.00	$14.90–$175.00	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 FLU A AND B	$24.50	$35.00	$14.90–$175.00	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A,B	$29.40	$42.00	$14.90–$175.00	—	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 CL-FLU SWAB, DR. PROSSER	$35.00	$50.00	$14.90–$175.00	—	30%
Renin blood test CPT 84244 RENAL	$101.50	$145.00	$19.79–$175.00	54% above	30%
Renin blood test CPT 84244 RENIN	$108.36	$154.80	$19.79–$175.00	65% above	30%
Renin blood test inpatient CPT 84244 RENAL	$101.50	$145.00	$19.79–$175.00	—	30%
Renin blood test inpatient CPT 84244 RENIN	$108.36	$154.80	$19.79–$175.00	—	30%
Rh blood typing CPT 86901 BB RH TYPE	$40.32	$57.60	$3.59–$175.00	8% above	30%
Rh blood typing inpatient CPT 86901 BB RH TYPE	$40.32	$57.60	$3.59–$175.00	—	30%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN	$44.52	$63.60	$5.10–$175.00	36% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN	$44.52	$63.60	$5.10–$175.00	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IgG (MMR)	$45.36	$64.80	$12.95–$175.00	11% above	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$60.90	$87.00	$12.95–$175.00	49% above	30%
Rubella antibody test (immunity check) CPT 86762 ANTIB RUBELLA	$60.90	$87.00	$12.95–$175.00	49% above	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$60.90	$87.00	$12.95–$175.00	49% above	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$63.00	$90.00	$12.95–$175.00	54% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IgG (MMR)	$45.36	$64.80	$12.95–$175.00	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$60.90	$87.00	$12.95–$175.00	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIB RUBELLA	$60.90	$87.00	$12.95–$175.00	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM	$60.90	$87.00	$12.95–$175.00	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER	$63.00	$90.00	$12.95–$175.00	—	30%
Sodium blood test CPT 84295 SODIUM SERUM	$25.20	$36.00	$4.33–$175.00	25% below	30%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$25.20	$36.00	$4.33–$175.00	—	30%
Stool ova and parasites exam CPT 87177 OCP	$126.00	$180.00	$8.01–$175.00	202% above	30%
Stool ova and parasites exam inpatient CPT 87177 OCP	$126.00	$180.00	$8.01–$175.00	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 CL-OCCULT BLOOD, FECES- SCREENING	$20.30	$29.00	$3.94–$175.00	3% below	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 CL-OCCULT BLOOD, FECES- SCREENING	$20.30	$29.00	$3.94–$175.00	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS IGG ANTIBODY	$52.50	$75.00	$11.92–$175.00	37% above	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB BY TP-PA	$118.44	$169.20	$11.92–$175.00	208% above	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS IGG ANTIBODY	$52.50	$75.00	$11.92–$175.00	—	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB BY TP-PA	$118.44	$169.20	$11.92–$175.00	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$52.50	$75.00	$3.84–$175.00	112% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$52.50	$75.00	$3.84–$175.00	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$138.60	$198.00	$55.78–$175.00	32% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$138.60	$198.00	$55.78–$175.00	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$73.50	$105.00	$23.23–$175.00	9% below	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE & TOTAL,SHBG PANEL	$181.44	$259.20	$23.23–$175.00	124% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$73.50	$105.00	$23.23–$175.00	—	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE FREE & TOTAL,SHBG PANEL	$181.44	$259.20	$23.23–$175.00	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI LIVER/KIDNEY MICROSOMAL ANTIBODY	$88.20	$126.00	$13.10–$175.00	216% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$93.24	$133.20	$13.10–$175.00	234% above	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI LIVER/KIDNEY MICROSOMAL ANTIBODY	$88.20	$126.00	$13.10–$175.00	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY	$93.24	$133.20	$13.10–$175.00	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$84.00	$120.00	$15.12–$175.00	60% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$84.00	$120.00	$15.12–$175.00	—	30%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$42.00	$60.00	$14.81–$175.00	15% below	30%
Total IgE blood test CPT 82785 FOOD ALLERGY SCREENING	$262.50	$375.00	$14.81–$175.00	432% above	30%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$42.00	$60.00	$14.81–$175.00	—	30%
Total IgE blood test inpatient CPT 82785 FOOD ALLERGY SCREENING	$262.50	$375.00	$14.81–$175.00	—	30%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM	$31.92	$45.60	$3.92–$175.00	17% above	30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM	$31.92	$45.60	$3.92–$175.00	—	30%
Total thyroxine (T4) blood test CPT 84436 TOTAL T4	$48.80	$69.72	$6.18–$175.00	32% above	30%
Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4	$48.80	$69.72	$6.18–$175.00	—	30%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$22.68	$32.40	$12.76–$175.00	53% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$22.68	$32.40	$12.76–$175.00	—	30%
Transferrin blood test CPT 84466 TRANSFERRIN	$50.40	$72.00	$11.48–$175.00	6% above	30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$50.40	$72.00	$11.48–$175.00	—	30%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMPLIFIED, URINE	$175.00	$250.00	$31.58–$175.00	268% above	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS AMPLIFIED, URINE	$175.00	$250.00	$31.58–$175.00	—	30%
Troponin test, quantitative CPT 84484 TROPONIN I	$126.00	$180.00	$11.22–$175.00	59% above	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$126.00	$180.00	$11.22–$175.00	—	30%
Uric acid blood test CPT 84550 URIC ACID	$50.40	$72.00	$4.07–$175.00	61% above	30%
Uric acid blood test inpatient CPT 84550 URIC ACID	$50.40	$72.00	$4.07–$175.00	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$38.50	$55.00	$2.85–$175.00	24% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$38.50	$55.00	$2.85–$175.00	—	30%
Urinalysis with microscope exam, manual CPT 81000 .UA DIPSTICK W/MICRO	$14.70	$21.00	$3.62–$175.00	26% below	30%
Urinalysis with microscope exam, manual inpatient CPT 81000 .UA DIPSTICK W/MICRO	$14.70	$21.00	$3.62–$175.00	—	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICROSCOPY	$17.50	$25.00	$2.03–$175.00	16% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICROSCOPY	$17.50	$25.00	$2.03–$175.00	—	30%
Urinalysis without microscope exam, manual CPT 81002 CL-URINALYSIS DR. PROSSER - W/O MICRO	$21.00	$30.00	$3.13–$175.00	44% above	30%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS W/O MICRO	$21.00	$30.00	$3.13–$175.00	44% above	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS W/O MICRO	$21.00	$30.00	$3.13–$175.00	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 CL-URINALYSIS DR. PROSSER - W/O MICRO	$21.00	$30.00	$3.13–$175.00	—	30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$52.42	$74.88	$7.26–$175.00	27% above	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$52.42	$74.88	$7.26–$175.00	—	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN/CREAT RATIO	$35.28	$50.40	$5.20–$175.00	15% above	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN/CREAT, IN-HOUSE	$35.28	$50.40	$5.20–$175.00	15% above	30%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN, 24 HR	$98.78	$141.12	$5.20–$175.00	221% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN/CREAT, IN-HOUSE	$35.28	$50.40	$5.20–$175.00	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN/CREAT RATIO	$35.28	$50.40	$5.20–$175.00	—	30%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE MICROALBUMIN, 24 HR	$98.78	$141.12	$5.20–$175.00	—	30%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY, URINE	$17.64	$25.20	$7.75–$175.00	56% below	30%
Urine pregnancy test, read by color change CPT 81025 CL-U/A PREG DR. PROSSER	$21.00	$30.00	$7.75–$175.00	48% below	30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY, URINE	$17.64	$25.20	$7.75–$175.00	—	30%
Urine pregnancy test, read by color change inpatient CPT 81025 CL-U/A PREG DR. PROSSER	$21.00	$30.00	$7.75–$175.00	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$80.64	$115.20	$13.57–$175.00	27% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$80.64	$115.20	$13.57–$175.00	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D TOTAL	$105.00	$150.00	$26.64–$175.00	54% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 & D3	$158.76	$226.80	$26.64–$175.00	132% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 2,3 25-HYDROXY	$172.90	$247.00	$26.64–$175.00	153% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D TOTAL	$105.00	$150.00	$26.64–$175.00	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 & D3	$158.76	$226.80	$26.64–$175.00	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 2,3 25-HYDROXY	$172.90	$247.00	$26.64–$175.00	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D3 (1,25-OH)	$172.90	$247.00	$34.65–$175.00	40% above	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D3 (1,25-OH)	$172.90	$247.00	$34.65–$175.00	—	30%
Zinc blood test CPT 84630 ZINC, SERUM	$37.80	$54.00	$10.25–$175.00	34% below	30%
Zinc blood test CPT 84630 ZINC 24 HR URINE	$110.04	$157.20	$10.25–$175.00	92% above	30%
Zinc blood test inpatient CPT 84630 ZINC, SERUM	$37.80	$54.00	$10.25–$175.00	—	30%
Zinc blood test inpatient CPT 84630 ZINC 24 HR URINE	$110.04	$157.20	$10.25–$175.00	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG QUANTITATIVE	$22.68	$32.40	$13.55–$175.00	69% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG QUANTITATIVE	$22.68	$32.40	$13.55–$175.00	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TRMT CLSD DISTAL FIBU FX W/O FIXATION	$188.30	$269.00	$175.00–$422.33	at median	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TRMT CLSD DISTAL FIBU FX W/O FIXATION	$188.30	$269.00	$175.00–$422.33	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TRMT CLOSED METATARSAL FX	$126.00	$180.00	$175.00–$286.46	43% below	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$306.60	$438.00	$175.00–$525.00	39% above	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PF CLOSED TX OF METACARPAL RX W/MANI	$306.60	$438.00	$175.00–$286.46	39% above	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TRMT CLOSED METATARSAL FX	$126.00	$180.00	$175.00–$286.46	—	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FRACTURE	$306.60	$438.00	$175.00–$525.00	—	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PF CLOSED TX OF METACARPAL RX W/MANI	$306.60	$438.00	$175.00–$286.46	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$175.00	$250.00	$141.59–$501.93	70% below	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$175.00	$250.00	$141.59–$501.93	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREA DISTAL	$189.00	$270.00	$175.00–$461.98	8% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLO TX DIST RAD FX WO MANIP	$307.44	$439.20	$175.00–$525.00	49% above	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREA DISTAL	$189.00	$270.00	$175.00–$461.98	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLO TX DIST RAD FX WO MANIP	$307.44	$439.20	$175.00–$525.00	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CRYO/ELECTRODES(1 LESION)	$38.50	$55.00	$59.72–$175.00	69% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PF DESTRCT-ANY METHD-BEN LES WIANE 1	$92.40	$132.00	$53.75–$175.00	26% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CRYO/ELECTRODES(1 LESION)	$38.50	$55.00	$59.72–$175.00	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PF DESTRCT-ANY METHD-BEN LES WIANE 1	$92.40	$132.00	$53.75–$175.00	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 PF REM. OF IMP. CERUMEN, IRR/LAVAGE, UNI	$52.50	$75.00	$13.17–$175.00	8% below	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMP. CERUMEN, LAVAGE UNI	$66.50	$95.00	$14.63–$525.00	17% above	30%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REM.IMP.CER/LAVAGE, UNILATERAL	$28.00	$40.00	$13.17–$175.00	51% below	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 PF REM. OF IMP. CERUMEN, IRR/LAVAGE, UNI	$52.50	$75.00	$13.17–$175.00	—	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL OF IMP. CERUMEN, LAVAGE UNI	$66.50	$95.00	$14.63–$525.00	—	30%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REM.IMP.CER/LAVAGE, UNILATERAL	$28.00	$40.00	$13.17–$175.00	—	30%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN REQ. INSTRUMEN	$105.00	$150.00	$43.58–$175.00	29% above	30%
Earwax removal with instruments, one ear CPT 69210 PF REMOVAL IMPACTED CERUMEN REQ. INSTRUM	$126.00	$180.00	$39.22–$175.00	55% above	30%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN REQ. INSTRUMENT	$126.00	$180.00	$43.58–$525.00	55% above	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN REQ. INSTRUMEN	$105.00	$150.00	$43.58–$175.00	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN REQ. INSTRUMENT	$126.00	$180.00	$43.58–$525.00	—	30%
Earwax removal with instruments, one ear inpatient CPT 69210 PF REMOVAL IMPACTED CERUMEN REQ. INSTRUM	$126.00	$180.00	$39.22–$175.00	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 PF I&D ABSCESS SIMPL/SNGL	$280.00	$400.00	$104.14–$175.00	44% above	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPL/SNGL	$297.50	$425.00	$115.71–$525.00	53% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PF I&D ABSCESS SIMPL/SNGL	$280.00	$400.00	$104.14–$175.00	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPL/SNGL	$297.50	$425.00	$115.71–$525.00	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF MAJOR JOINT INJ - HIP/KNEE/SHOULDER	$245.00	$350.00	$56.06–$175.00	at median	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ MAJOR JOINT	$341.60	$488.00	$62.29–$525.00	39% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION MAJOR JOINT, HIP, KNEE, SH.	$341.60	$488.00	$62.29–$233.10	39% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PF MAJOR JOINT INJ - HIP/KNEE/SHOULDER	$245.00	$350.00	$56.06–$175.00	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJECTION MAJOR JOINT, HIP, KNEE, SH.	$341.60	$488.00	$62.29–$233.10	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ MAJOR JOINT	$341.60	$488.00	$62.29–$525.00	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLO SCLP/TRUNK 2.5 CM/LESS	$280.00	$400.00	$175.00–$525.00	18% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLO SCLP/TRUNK 2.5 CM/LESS	$280.00	$400.00	$175.00–$525.00	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF LESION/BENIGN	$245.00	$350.00	$113.78–$537.76	35% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF LESION/BENIGN	$245.00	$350.00	$113.78–$537.76	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXICISION OF LESION	$63.00	$90.00	$126.51–$537.76	84% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXICISION OF LESION	$63.00	$90.00	$126.51–$537.76	—	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PART/SIMPLE; SINGLE	$175.00	$250.00	$100.46–$525.00	5% above	30%
Nail removal (partial or complete), one nail CPT 11730 PF AVULSION NAIL PART/SIMPLE; SINGLE	$206.50	$295.00	$90.41–$175.00	24% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PART/SIMPLE; SINGLE	$175.00	$250.00	$100.46–$525.00	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 PF AVULSION NAIL PART/SIMPLE; SINGLE	$206.50	$295.00	$90.41–$175.00	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL, NAIL MATRIX, PART/COMP	$367.50	$525.00	$142.32–$525.00	4% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF EXC. OF NAIL, NAIL MATRIX, PART/COMP	$416.50	$595.00	$128.09–$263.00	9% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL, NAIL MATRIX, PART/COMP	$367.50	$525.00	$142.32–$525.00	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PF EXC. OF NAIL, NAIL MATRIX, PART/COMP	$416.50	$595.00	$128.09–$263.00	—	30%
Removal of a breast lump, open surgery CPT 19120 EXC CYST FIBRO BENIGN BREAST	$280.00	$400.00	$175.00–$2,973.43	84% below	30%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST FIBRO BENIGN BREAST	$280.00	$400.00	$175.00–$2,973.43	—	30%
Removal of a foreign object under the skin, simple CPT 10120 PF REMOVE FOREIGN BODY	$280.00	$400.00	$126.37–$189.55	at median	30%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY SIMPLE	$308.00	$440.00	$140.41–$525.00	10% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PF REMOVE FOREIGN BODY	$280.00	$400.00	$126.37–$189.55	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY SIMPLE	$308.00	$440.00	$140.41–$525.00	—	30%
Short arm cast (elbow to hand) CPT 29075 CAST/ELBOW - FINGER	$49.00	$70.00	$86.89–$212.40	69% below	30%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST/ELBOW - FINGER	$49.00	$70.00	$86.89–$212.40	—	30%
Short arm splint (forearm and hand) CPT 29125 PF APPLY FOREARM SPLING	$96.60	$138.00	$63.06–$175.00	24% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF FINGER SPLINT	$100.80	$144.00	$70.07–$525.00	20% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$457.80	$654.00	$70.07–$525.00	262% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 PF APPLY FOREARM SPLING	$96.60	$138.00	$63.06–$175.00	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF FINGER SPLINT	$100.80	$144.00	$70.07–$525.00	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$457.80	$654.00	$70.07–$525.00	—	30%
Short leg cast (below the knee) CPT 29405 CAST/BELOW KNEE-TOES	$59.50	$85.00	$78.73–$212.40	67% below	30%
Short leg cast (below the knee) inpatient CPT 29405 CAST/BELOW KNEE-TOES	$59.50	$85.00	$78.73–$212.40	—	30%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$96.60	$138.00	$73.84–$525.00	33% below	30%
Short leg splint (calf to foot) CPT 29515 PF APPLICATION LOWER LEG SPLINT	$100.80	$144.00	$66.72–$175.00	31% below	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$96.60	$138.00	$73.84–$525.00	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 PF APPLICATION LOWER LEG SPLINT	$100.80	$144.00	$66.72–$175.00	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CL-LAC SIMPLE 2.5 CM OR LESS	$227.50	$325.00	$91.29–$176.00	24% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPL REPR SCLP/TRUNK 2/5 CM/LESS	$245.00	$350.00	$101.14–$525.00	33% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 CL-LAC SIMPLE 2.5 CM OR LESS	$227.50	$325.00	$91.29–$176.00	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPL REPR SCLP/TRUNK 2/5 CM/LESS	$245.00	$350.00	$101.14–$525.00	—	30%
Skin biopsy, punch, one lesion CPT 11104 SKIN BIOPSY PUNCH, SINGLE LESION	$189.00	$270.00	$107.79–$308.71	21% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 SKIN BIOPSY PUNCH, SINGLE LESION	$189.00	$270.00	$107.79–$308.71	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCIS/MALG/LES/TR AR LEG .05CM <	$88.20	$126.00	$175.00–$537.76	76% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCIS/MALG/LES/TR AR LEG .05CM <	$88.20	$126.00	$175.00–$537.76	—	30%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS-UP TO 15	$175.00	$250.00	$82.76–$175.00	33% above	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS-UP TO 15	$175.00	$250.00	$82.76–$175.00	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPL REPR SCLP/TRUNK 2.6-7.5 CM	$174.72	$249.60	$111.00–$525.00	7% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPL REPR SCLP/TRUNK 2.6-7.5 CM	$174.72	$249.60	$111.00–$525.00	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC FACE/EAR/NOSE/LIP/EYELID 2.5CM OR <	$73.50	$105.00	$105.00–$207.00	60% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPL REPR FACE/MUCOUS 2.5/LESS	$126.00	$180.00	$105.00–$525.00	31% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF SIMPL REPR FACE/MUCOUS 2.5/LESS	$126.00	$180.00	$105.00–$207.00	31% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC FACE/EAR/NOSE/LIP/EYELID 2.5CM OR <	$73.50	$105.00	$105.00–$207.00	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPL REPR FACE/MUCOUS 2.5/LESS	$126.00	$180.00	$105.00–$525.00	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PF SIMPL REPR FACE/MUCOUS 2.5/LESS	$126.00	$180.00	$105.00–$207.00	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 CL-SHAVE BX SKIN, SCOOP, SINGLE	$105.00	$150.00	$84.98–$308.71	42% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 CL-SHAVE BX SKIN, SCOOP, SINGLE	$105.00	$150.00	$84.98–$308.71	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN & SUBSIQ	$122.50	$175.00	$104.00–$308.71	65% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN & SUBSIQ	$122.50	$175.00	$104.00–$308.71	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION, BIO/COMPLEX UP TO 1HR.	$420.00	$600.00	$115.76–$250.84	17% above	30%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INFUSION, BIO/COMPLEX UP TO 1HR.	$420.00	$600.00	$115.76–$250.84	—	30%
Critical care, first 30 to 74 minutes CPT 99291 PF CRITICAL CARE E&M 1ST 30-74 MINUTES	$717.36	$1,024.80	$175.00–$342.04	31% below	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE E&M 1ST 30-74 MINUTES	$980.00	$1,400.00	$175.00–$1,591.00	6% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PF CRITICAL CARE E&M 1ST 30-74 MINUTES	$717.36	$1,024.80	$175.00–$342.04	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE E&M 1ST 30-74 MINUTES	$980.00	$1,400.00	$175.00–$1,591.00	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 CL-EKG WITH INTERPRETATION & REPORT	$42.00	$60.00	$12.55–$175.00	at median	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 CL-EKG WITH INTERPRETATION & REPORT	$42.00	$60.00	$12.55–$175.00	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$58.80	$84.00	$6.00–$175.00	36% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$58.80	$84.00	$6.00–$175.00	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PF EMER VISIT E&M	$59.50	$85.00	$10.53–$175.00	42% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMER VST LVL 1, NO PROVIDER	$87.50	$125.00	$10.53–$637.00	15% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PF EMER VISIT E&M	$59.50	$85.00	$10.53–$175.00	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMER VST LVL 1, NO PROVIDER	$87.50	$125.00	$10.53–$637.00	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PF EMER VISIT E&M STRAIGHTFORWARD MDM	$84.00	$120.00	$38.67–$175.00	57% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMER VST STRAIGHTFORWARD MDM	$157.50	$225.00	$38.67–$743.00	19% below	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PF EMER VISIT E&M STRAIGHTFORWARD MDM	$84.00	$120.00	$38.67–$175.00	—	30%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMER VST STRAIGHTFORWARD MDM	$157.50	$225.00	$38.67–$743.00	—	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PF EMER VISIT E&M, LOW LEVEL MDM	$138.60	$198.00	$58.51–$175.00	61% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER VISIT LOW LEVEL MDM	$252.00	$360.00	$66.43–$955.00	30% below	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PF EMER VISIT E&M, LOW LEVEL MDM	$138.60	$198.00	$58.51–$175.00	—	30%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMER VISIT LOW LEVEL MDM	$252.00	$360.00	$66.43–$955.00	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PF EMER VISIT E&M MODERATE MDM	$261.80	$374.00	$111.33–$175.00	52% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMER VST MODERATE MDM	$437.50	$625.00	$113.10–$1,273.00	20% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PF EMER VISIT E&M MODERATE MDM	$261.80	$374.00	$111.33–$175.00	—	30%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMER VST MODERATE MDM	$437.50	$625.00	$113.10–$1,273.00	—	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PF EMER VISIT E&M HIGH LEVEL MDM	$385.00	$550.00	$163.49–$196.97	52% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMER VST HIGH LEVEL MDM	$630.00	$900.00	$164.14–$1,591.00	22% below	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PF EMER VISIT E&M HIGH LEVEL MDM	$385.00	$550.00	$163.49–$196.97	—	30%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMER VST HIGH LEVEL MDM	$630.00	$900.00	$164.14–$1,591.00	—	30%
Family therapy with the patient, 50 minutes CPT 90847 PSY FAMILY THERAPY W/ PATIENT PRESENT	$350.00	$500.00	$107.52–$175.00	120% above	30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PSY FAMILY THERAPY W/ PATIENT PRESENT	$350.00	$500.00	$107.52–$175.00	—	30%
Family therapy without the patient, 50 minutes CPT 90846 PSY FAMILY THER W/O PATIENT PRES 50 MIN	$315.00	$450.00	$103.76–$175.00	131% above	30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PSY FAMILY THER W/O PATIENT PRES 50 MIN	$315.00	$450.00	$103.76–$175.00	—	30%
Group psychotherapy session CPT 90853 PSY GROUP THERAPY	$294.00	$420.00	$29.24–$175.00	149% above	30%
Group psychotherapy session inpatient CPT 90853 PSY GROUP THERAPY	$294.00	$420.00	$29.24–$175.00	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CL-IV INFUSION, HYDRATION / FLUIDS	$84.00	$120.00	$29.51–$175.00	54% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION OUTPT. 31M TO 1HR	$127.68	$182.40	$29.51–$175.00	30% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION ER 31M TO 1HR	$127.68	$182.40	$29.51–$525.00	30% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CL-IV INFUSION, HYDRATION / FLUIDS	$84.00	$120.00	$29.51–$175.00	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION OUTPT. 31M TO 1HR	$127.68	$182.40	$29.51–$175.00	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION ER 31M TO 1HR	$127.68	$182.40	$29.51–$525.00	—	30%
IV infusion of a medicine, first hour CPT 96365 CL-IV INFUSION FOR TX	$87.50	$125.00	$58.62–$175.00	62% below	30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR TX, ER UP TO 1HR	$237.30	$339.00	$58.62–$525.00	3% above	30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR TX OUTPT., UP TO 1 HR	$237.30	$339.00	$58.62–$175.00	3% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 CL-IV INFUSION FOR TX	$87.50	$125.00	$58.62–$175.00	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR TX, ER UP TO 1HR	$237.30	$339.00	$58.62–$525.00	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR TX OUTPT., UP TO 1 HR	$237.30	$339.00	$58.62–$175.00	—	30%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL ER	$122.50	$175.00	$33.25–$525.00	9% below	30%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL OUTPT.	$122.50	$175.00	$33.25–$175.00	9% below	30%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL OUTPT.	$122.50	$175.00	$33.25–$175.00	—	30%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL ER	$122.50	$175.00	$33.25–$525.00	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLINIC INJECTION	$25.90	$37.00	$13.98–$175.00	56% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM OR SUBCUTANEOUS ER	$44.52	$63.60	$13.98–$525.00	25% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM OR SUBCUTANEOUS OUTPT.	$53.42	$76.32	$13.98–$175.00	10% below	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CLINIC INJECTION	$25.90	$37.00	$13.98–$175.00	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM OR SUBCUTANEOUS ER	$44.52	$63.60	$13.98–$525.00	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM OR SUBCUTANEOUS OUTPT.	$53.42	$76.32	$13.98–$175.00	—	30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSY EVALUATION	$105.00	$150.00	$134.79–$225.45	39% below	30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSY EVALUATION	$105.00	$150.00	$134.79–$225.45	—	30%
New patient office visit, about 30 minutes CPT 99203 PF NEW PT VISIT LEVEL 3 WC	$175.00	$250.00	$98.03–$175.00	53% above	30%
New patient office visit, about 30 minutes inpatient CPT 99203 PF NEW PT VISIT LEVEL 3 WC	$175.00	$250.00	$98.03–$175.00	—	30%
New patient office visit, about 45 minutes CPT 99204 PF NEW PT VISIT LEVEL 4 WC	$245.00	$350.00	$150.88–$196.56	55% above	30%
New patient office visit, about 45 minutes inpatient CPT 99204 PF NEW PT VISIT LEVEL 4 WC	$245.00	$350.00	$150.88–$196.56	—	30%
New patient office visit, about 60 minutes CPT 99205 PF NEW PT VISIT LEVEL 5 WC	$315.00	$450.00	$175.00–$262.41	60% above	30%
New patient office visit, about 60 minutes inpatient CPT 99205 PF NEW PT VISIT LEVEL 5 WC	$315.00	$450.00	$175.00–$262.41	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 MDOT PHYSICAL NEW PATIENT	$70.00	$100.00	$35.47–$175.00	10% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF NEW PT VISIT LEVEL 2 WC	$105.00	$150.00	$68.74–$175.00	35% above	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 MDOT PHYSICAL NEW PATIENT	$70.00	$100.00	$35.47–$175.00	—	30%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF NEW PT VISIT LEVEL 2 WC	$105.00	$150.00	$68.74–$175.00	—	30%
Preventive checkup, new patient aged 18–39 CPT 99385 99385- PREV/WELL VISIT, NEW, AGE 18-39	$122.50	$175.00	$124.32–$175.00	at median	30%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385- PREV/WELL VISIT, NEW, AGE 18-39	$122.50	$175.00	$124.32–$175.00	—	30%
Preventive checkup, new patient aged 40–64 CPT 99386 99386- PREV/WELL VISIT, NEW, AGE 40-64	$147.00	$210.00	$144.22–$175.00	12% above	30%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386- PREV/WELL VISIT, NEW, AGE 40-64	$147.00	$210.00	$144.22–$175.00	—	30%
Preventive checkup, new patient aged 65 or older CPT 99387 99387- PREV/WELL VISIT, NEW, > 65	$157.50	$225.00	$156.18–$187.42	18% above	30%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387- PREV/WELL VISIT, NEW, > 65	$157.50	$225.00	$156.18–$187.42	—	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395- PREV/WELL VISIT, EST. 18-39 YRS	$108.50	$155.00	$104.54–$175.00	8% above	30%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395- PREV/WELL VISIT, EST. 18-39 YRS	$108.50	$155.00	$104.54–$175.00	—	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396- PREV/WELL VISIT, EST. 40-64 YRS	$112.00	$160.00	$111.78–$175.00	at median	30%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396- PREV/WELL VISIT, EST. 40-64 YRS	$112.00	$160.00	$111.78–$175.00	—	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397- PREV/WELL VISIT, EST. >65 YRS	$122.50	$175.00	$120.57–$175.00	1% below	30%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397- PREV/WELL VISIT, EST. >65 YRS	$122.50	$175.00	$120.57–$175.00	—	30%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSY CRISIS SERVICES, FIRST 60MIN	$266.00	$380.00	$154.54–$208.63	11% above	30%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSY CRISIS SERVICES, FIRST 60MIN	$266.00	$380.00	$154.54–$208.63	—	30%
Psychotherapy session, 30 minutes CPT 90832 PSY INDIVIDUAL THERAPY (30MIN)	$105.00	$150.00	$82.87–$175.00	7% above	30%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSY INDIVIDUAL THERAPY (30MIN)	$105.00	$150.00	$82.87–$175.00	—	30%
Psychotherapy session, 45 minutes CPT 90834 PSY INDIVIDUAL THERAPY (45MIN)	$140.00	$200.00	$109.87–$175.00	at median	30%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSY INDIVIDUAL THERAPY (45MIN)	$140.00	$200.00	$109.87–$175.00	—	30%
Psychotherapy session, 60 minutes CPT 90837 PSY INDIVIDUAL THERAPY 60+ MIN.	$189.00	$270.00	$134.79–$217.70	50% above	30%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSY INDIVIDUAL THERAPY 60+ MIN.	$189.00	$270.00	$134.79–$217.70	—	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 CL-SMOKING CESSATION (3-10 MINUTES)	$42.00	$60.00	$12.83–$175.00	26% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CL-SMOKING CESSATION (3-10 MINUTES)	$42.00	$60.00	$12.83–$175.00	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF ESTABLISHED PATIENT VISIT 5 WC	$344.40	$492.00	$131.57–$213.35	84% above	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF ESTABLISHED PATIENT VISIT 5 WC	$344.40	$492.00	$131.57–$213.35	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213- OV Est. Expanded Prob Foc.	$63.00	$90.00	$49.62–$175.00	42% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213- OV TELEHEALTH	$63.00	$90.00	$49.62–$175.00	42% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF ESTABLISHED PATIENT VISIT 3 WC	$169.40	$242.00	$65.84–$175.00	55% above	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213- OV TELEHEALTH	$63.00	$90.00	$49.62–$175.00	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213- OV Est. Expanded Prob Foc.	$63.00	$90.00	$49.62–$175.00	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF ESTABLISHED PATIENT VISIT 3 WC	$169.40	$242.00	$65.84–$175.00	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF ESTABLISHED PATIENT VISIT4 WC	$256.90	$367.00	$97.65–$175.00	93% above	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF ESTABLISHED PATIENT VISIT4 WC	$256.90	$367.00	$97.65–$175.00	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 MDOT PHYSICAL EST. PATIENT	$52.50	$75.00	$39.28–$175.00	29% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF ESTABLISHED PATIENT WC VISIT 2	$100.80	$144.00	$39.28–$175.00	36% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 MDOT PHYSICAL EST. PATIENT	$52.50	$75.00	$39.28–$175.00	—	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF ESTABLISHED PATIENT WC VISIT 2	$100.80	$144.00	$39.28–$175.00	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$105.00	$150.00	$84.35–$175.00	at median	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$105.00	$150.00	$84.35–$175.00	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Mississippi	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL-VARICELLA VIRUS VACCINE	$188.56	$269.37	$135.72–$175.00	26% above	30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV (4-6 YEARS OLD)	$52.50	$75.00	$175.00	31% above	30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV (4-6 YEARS OLD)	$52.50	$75.00	$175.00	—	30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CL-DTAP,HEPB,POLIO VACC-PRIVATE(PEDIARIX	$150.04	$214.34	$175.00	97% above	30%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 CL-FLU VACC FLUBLOK 2024-25	$126.00	$180.00	$42.75–$175.00	151% above	30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VAC	$67.24	$96.06	$175.00–$227.93	60% below	30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CL-HPV VACCINE-PRIVATE (GARDASIL)	$578.55	$826.50	$175.00–$227.93	241% above	30%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VAC	$67.24	$96.06	$175.00–$227.93	—	30%
Hepatitis A vaccine, adult dose CPT 90632 CL-HEPATITIS A VAC.-ADULT-HAVRIX-PRIVATE	$132.49	$189.27	$65.69–$175.00	81% above	30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CL-HEPATITIS A VAC.-PED (HAVRIX)-PRIVATE	$59.77	$85.38	$175.00	49% above	30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 CL-H.INFLUENZAE B-PRIVATE (PEDVAX HIB)	$48.74	$69.63	$26.23–$175.00	47% above	30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PEDVAX-HIB	$52.50	$75.00	$26.23–$175.00	58% above	30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PEDVAX-HIB	$52.50	$75.00	$26.23–$175.00	—	30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 INFLUENZA B VACC (HIB)	$7.00	$10.00	$11.15–$175.00	66% below	30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 INFLUENZA B VACC (HIB)	$7.00	$10.00	$11.15–$175.00	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE	$107.56	$153.66	$78.68–$175.00	82% above	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CL-MMR VACCINE - PRIVATE	$129.44	$184.91	$78.68–$175.00	119% above	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL-MEN. VAC. PRIVATE MENVEO/MENACTRA	$237.50	$339.29	$175.00–$176.71	8% above	30%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CL-MEN. VAC. PRIVATE BEXSERO	$237.50	$339.29	$175.00–$179.25	129% above	30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 CL-PNEUMONIA VACCINE 13, PRIV.-PREVNAR	$350.00	$500.00	$135.80–$257.99	at median	30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CL-ROTAVIRUS VACCINE-PRIVATE (ROTATEQ)	$155.90	$222.72	$175.00	158% above	30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VAC-PENTAVALENT 3 DOSE	$218.15	$311.64	$175.00	261% above	30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VAC-PENTAVALENT 3 DOSE	$218.15	$311.64	$175.00	—	30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL-SHINGRIX VACCINE	$230.41	$329.15	$151.41–$175.00	33% below	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL-TETANUS/DIPHTHERIA-PRIVATE (TD) >7YRS	$56.51	$80.73	$27.78–$175.00	14% below	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VAC-7YRS OR OLDER	$67.24	$96.06	$37.50–$175.00	26% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CL-ADMIN IMMUN. VACCINE	$28.00	$40.00	$19.73–$175.00	48% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACC ADMINISTRATION	$31.50	$45.00	$19.73–$175.00	42% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CL-ADMIN IMMUN. VACCINE	$28.00	$40.00	$19.73–$175.00	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACC ADMINISTRATION	$31.50	$45.00	$19.73–$175.00	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CL-ADMIN VAC/IMM EA ADD VACC	$24.50	$35.00	$13.08–$175.00	19% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC ADMINISTRATION ADDTL	$35.00	$50.00	$13.08–$175.00	16% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CL-ADMIN VAC/IMM EA ADD VACC	$24.50	$35.00	$13.08–$175.00	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACC ADMINISTRATION ADDTL	$35.00	$50.00	$13.08–$175.00	—	30%

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://www.choctawregional.com/wp-content/uploads/2026/10/471298267_choctaw-regional-medical-center_standardcharges.csv