Archbold Mitchell
Listed in its price file as “John D Archbold Memorial Hospital INC Mitchell”.
Archbold Mitchell in Camilla, GA publishes cash prices for 313 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Georgia median for 187 of 309 procedures and above it for 101. By typical cash price it ranks #35 of 96 Georgia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
90 Stephens Street, Camilla, GA 31730 Collected Oct 30, 2026 Source price file Check a bill from this hospital (229) 336-5284
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CCN 111331 · CMS hospital register NPI 1700830247
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Archbold Mitchell 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.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WITH AND WITHOUT CONTRAST | $2,031.00 | $3,385.00 | — | 8% above | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WITH AND WITHOUT CONTRAST | $2,031.00 | $3,385.00 | — | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN - 2 VWS ONLY FLAT & ERECT RADIOLOGIC EXAM | $207.60 | $346.00 | — | 23% below | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN - 2 VWS ONLY FLAT & ERECT RADIOLOGIC EXAM | $207.60 | $346.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 BILATERAL ANKLES COMPLETE RADIOLOGIC EXAM | $291.60 | $486.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE COMPLETE RADIOLOGIC EXAM | $291.60 | $486.00 | — | 8% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 BILATERAL ANKLES COMPLETE RADIOLOGIC EXAM | $291.60 | $486.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE COMPLETE RADIOLOGIC EXAM | $291.60 | $486.00 | — | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY WITHOUT CONTRAST | $1,121.40 | $1,869.00 | — | 5% above | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY WITHOUT CONTRAST | $1,121.40 | $1,869.00 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHOGRAM RADIOLOGIC EXAM | $350.40 | $584.00 | — | 2% above | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHOGRAM RADIOLOGIC EXAM | $350.40 | $584.00 | — | — | 40% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $172.20 | $287.00 | — | 59% below | 40% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE | $172.20 | $287.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $141.60 | $236.00 | — | 59% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED | $141.60 | $236.00 | — | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN & PELVIS W/WO CONTRAST | $3,080.40 | $5,134.00 | — | 36% above | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN & PELVIS W/WO CONTRAST | $3,080.40 | $5,134.00 | — | — | 40% |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD WITH & WITHOUT CONTRAST | $1,308.00 | $2,180.00 | — | 17% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WITH & WITHOUT CONTRAST | $1,308.00 | $2,180.00 | — | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK WITH & WITHOUT CONTRAST | $1,714.80 | $2,858.00 | — | 2% above | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WITH & WITHOUT CONTRAST | $1,714.80 | $2,858.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CONTRAST | $2,538.60 | $4,231.00 | — | 71% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CONTRAST | $2,538.60 | $4,231.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS WITHOUT CONTRAST | $1,548.00 | $2,580.00 | — | 26% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS WITHOUT CONTRAST | $1,548.00 | $2,580.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS WITH CONTRAST | $2,418.00 | $4,030.00 | — | at median | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS WITH CONTRAST | $2,418.00 | $4,030.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS WITH/WITHOUT CONTRAST | $2,732.40 | $4,554.00 | — | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 UROGRAM CT ABDOMEN & PELVIS WITH/WO CONTRAST | $2,732.40 | $4,554.00 | — | 7% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS WITH/WITHOUT CONTRAST | $2,732.40 | $4,554.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 UROGRAM CT ABDOMEN & PELVIS WITH/WO CONTRAST | $2,732.40 | $4,554.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST | $1,787.40 | $2,979.00 | — | 6% above | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH CONTRAST | $1,787.40 | $2,979.00 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WITHOUT CONTRAST | $1,157.40 | $1,929.00 | — | 8% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WITHOUT CONTRAST | $1,157.40 | $1,929.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL AREA WITHOUT CONTRAST | $1,176.00 | $1,960.00 | — | 14% above | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL AREA WITHOUT CONTRAST | $1,176.00 | $1,960.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WITHOUT CONTRAST | $1,177.20 | $1,962.00 | — | at median | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WITHOUT CONTRAST STROKE PROTOCOL | $1,177.20 | $1,962.00 | — | at median | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WITHOUT CONTRAST STROKE PROTOCOL | $1,177.20 | $1,962.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WITHOUT CONTRAST | $1,177.20 | $1,962.00 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAST ONLY | $1,425.00 | $2,375.00 | — | at median | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH CONTRAST ONLY | $1,425.00 | $2,375.00 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WITH/WITHOUT CONTRAST | $1,907.40 | $3,179.00 | — | 4% above | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WITH/WITHOUT CONTRAST | $1,907.40 | $3,179.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WITHOUT CONTRAST | $457.20 | $762.00 | — | 65% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WITHOUT CONTRAST | $457.20 | $762.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WITHOUT CONTRAST | $1,701.00 | $2,835.00 | — | 41% above | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WITHOUT CONTRAST | $1,701.00 | $2,835.00 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST | $1,828.80 | $3,048.00 | — | 14% above | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST | $1,828.80 | $3,048.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID ARTERIES IMAGINGBILATERAL | $372.60 | $621.00 | — | 28% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID ARTERIES IMAGINGBILATERAL | $372.60 | $621.00 | — | — | 40% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX WITH AND WITHOUT CONTRAST | $1,583.40 | $2,639.00 | — | 6% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX WITH AND WITHOUT CONTRAST | $1,583.40 | $2,639.00 | — | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 BILATERAL CHEST DECUBITUS RADIOLOGIC EXAM | $334.80 | $558.00 | — | — | 40% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS (FRONTAL & LATERAL) RADIOLOGIC EXAM | $334.80 | $558.00 | — | 49% above | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 BILATERAL CHEST DECUBITUS RADIOLOGIC EXAM | $334.80 | $558.00 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS (FRONTAL & LATERAL) RADIOLOGIC EXAM | $334.80 | $558.00 | — | — | 40% |
| Chest X-ray, single view CPT 71045 AP CHEST RADIOLOGIC EXAM | $123.00 | $205.00 | — | 27% below | 40% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW (FRONTAL) RADIOLOGIC EXAM | $123.00 | $205.00 | — | 27% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 AP CHEST RADIOLOGIC EXAM | $123.00 | $205.00 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW (FRONTAL) RADIOLOGIC EXAM | $123.00 | $205.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE RADIOLOGIC EXAM | $235.80 | $393.00 | — | 2% below | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE RADIOLOGIC EXAM | $235.80 | $393.00 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA SCAN BONE DENSITY 1+SITES | $298.20 | $497.00 | — | 23% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA SCAN BONE DENSITY 1+SITES | $298.20 | $497.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WITHOUT CONTRAST | $707.40 | $1,179.00 | — | 30% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WITHOUT CONTRAST | $707.40 | $1,179.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX WITH CONTRAST | $1,414.20 | $2,357.00 | — | 8% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX WITH CONTRAST | $1,414.20 | $2,357.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAM DIGITAL BILATERAL | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 TOMOSYNTHESIS DX BI MAMMO W/CAD SAMEDAY (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC BILATERAL DIGITAL CALL BACK | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 TOMOSYNTHESIS DX BI BREAST MAMMO W/O CAD (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 TOMOSYNTHESIS DX BI MAMMO W/CAD CALLBACK (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAM DIGITAL BILATERAL | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 TOMOSYNTHESIS DX BI BREAST MAMMO W/O CAD (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 TOMOSYNTHESIS DX BI MAMMO W/CAD CALLBACK (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 TOMOSYNTHESIS DX BI MAMMO W/CAD SAMEDAY (EXPLDS) | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC BILATERAL DIGITAL CALL BACK | $235.80 | $393.00 | — | — | 40% |
| Diagnostic mammogram, one breast CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/CAD CALLBACK (EXPLDS) | $181.80 | $303.00 | — | 26% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/O CAD (EXPLDS) | $181.80 | $303.00 | — | 26% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/CAD SAMEDAY CALLBACK (EXPLDS) | $181.80 | $303.00 | — | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC UNILATERAL DIGITAL CALL BACK | $181.80 | $303.00 | — | 26% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC MAMMOGRAM DIGITAL UNILATERAL | $181.80 | $303.00 | — | 26% below | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/CAD CALLBACK (EXPLDS) | $181.80 | $303.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/O CAD (EXPLDS) | $181.80 | $303.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 TOMOSYNTHESIS DX UNI MAMMO W/CAD SAMEDAY CALLBACK (EXPLDS) | $181.80 | $303.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC MAMMOGRAM DIGITAL UNILATERAL | $181.80 | $303.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC UNILATERAL DIGITAL CALL BACK | $181.80 | $303.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 U/S - EXTR VNS BILAT | $880.80 | $1,468.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VEIN COMPLETE EXT BILAT | $880.80 | $1,468.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VEIN COMPLETE EXT BILAT | $880.80 | $1,468.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 U/S - EXTR VNS BILAT | $880.80 | $1,468.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $1,680.00 | $2,800.00 | — | 8% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE | $1,680.00 | $2,800.00 | — | — | 40% |
| Elbow X-ray, 2 views both sides CPT 73070 BILAT ELBOW AP LATERAL RADIOLOGIC EXAM | $199.20 | $332.00 | — | — | 40% |
| Elbow X-ray, 2 views CPT 73070 ELBOW AP LATERAL RADIOLOGIC EXAM | $199.20 | $332.00 | — | 3% above | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 BILAT ELBOW AP LATERAL RADIOLOGIC EXAM | $199.20 | $332.00 | — | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 ELBOW AP LATERAL RADIOLOGIC EXAM | $199.20 | $332.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 BILATERAL ELBOW COMPLETE RADIOLOGIC EXAM | $231.00 | $385.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW 4 VIEWS RADIOLOGIC EXAM | $231.00 | $385.00 | — | 12% below | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 BILATERAL ELBOW COMPLETE RADIOLOGIC EXAM | $231.00 | $385.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW 4 VIEWS RADIOLOGIC EXAM | $231.00 | $385.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS/SELLA/POST FOSSA | $496.80 | $828.00 | — | 54% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS/SELLA/POSTERIOR | $496.80 | $828.00 | — | 54% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS/SELLA/POSTERIOR | $496.80 | $828.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS/SELLA/POST FOSSA | $496.80 | $828.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES RADIOLOGIC EXAM | $301.80 | $503.00 | — | 2% below | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES RADIOLOGIC EXAM | $301.80 | $503.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 BILATERAL FOREARM RADIOLOGIC EXAM | $217.80 | $363.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM AP LAT RADIOLOGIC EXAM | $217.80 | $363.00 | — | at median | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 BILATERAL FOREARM RADIOLOGIC EXAM | $217.80 | $363.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM AP LAT RADIOLOGIC EXAM | $217.80 | $363.00 | — | — | 40% |
| Hand X-ray, 2 views both sides CPT 73120 BILATERAL HAND COMPLETE RADIOLOGIC EXAM | $178.20 | $297.00 | — | — | 40% |
| Hand X-ray, 2 views CPT 73120 HAND AP & LATERAL RADIOLOGIC EXAM | $178.20 | $297.00 | — | 17% below | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 BILATERAL HAND COMPLETE RADIOLOGIC EXAM | $178.20 | $297.00 | — | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 HAND AP & LATERAL RADIOLOGIC EXAM | $178.20 | $297.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 BILATERAL CALCANEOUS RADIOLOGIC EXAM | $204.60 | $341.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEOUS-2VWS RADIOLOGIC EXAM | $204.60 | $341.00 | — | at median | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 BILATERAL CALCANEOUS RADIOLOGIC EXAM | $204.60 | $341.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CALCANEOUS-2VWS RADIOLOGIC EXAM | $204.60 | $341.00 | — | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 BILATERAL KNEES COMPLETE RADIOLOGIC EXAM | $288.60 | $481.00 | — | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 XR KNEE W/SUNRISE BILATERAL LT AND RT | $288.60 | $481.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 BILATERAL KNEES COMPLETE RADIOLOGIC EXAM | $288.60 | $481.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR KNEE W/SUNRISE BILATERAL LT AND RT | $288.60 | $481.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE COMPLETE 4 + VIEWS BILATERAL LT AND RT | $320.40 | $534.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 BILATERAL KNEES W/PATELLA RADIOLOGIC EXAM | $320.40 | $534.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 BILATERAL KNEES W/PATELLA RADIOLOGIC EXAM | $320.40 | $534.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE COMPLETE 4 + VIEWS BILATERAL LT AND RT | $320.40 | $534.00 | — | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY WITHOUT CONTRAST | $1,067.40 | $1,779.00 | — | 4% above | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY WITHOUT CONTRAST | $1,067.40 | $1,779.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S GALLBLADDER | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S SPLEEN | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S LIVER | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S PANCREAS | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 RIGHT UPPER QUADRANT ULTRASOUND | $618.60 | $1,031.00 | — | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S LIVER | $618.60 | $1,031.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S PANCREAS | $618.60 | $1,031.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED | $618.60 | $1,031.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S SPLEEN | $618.60 | $1,031.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S GALLBLADDER | $618.60 | $1,031.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 RIGHT UPPER QUADRANT ULTRASOUND | $618.60 | $1,031.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SOFT TISSUE AXILLA | $160.80 | $268.00 | — | 63% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 U/S EXTREMITY NON VASCULAR LIMITED ANATOMIC SITE | $160.80 | $268.00 | — | 63% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 U/S EXTREMITY NON VASCULAR LIMITED ANATOMIC SITE | $160.80 | $268.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SOFT TISSUE AXILLA | $160.80 | $268.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT LUNG SCAN | $70.80 | $118.00 | — | 72% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT LUNG SCAN | $70.80 | $118.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 BILATERAL TIBIA FIBULA RADIOLOGIC EXAM | $244.20 | $407.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA AND FIBULA RADIOLOGIC EXAM | $244.20 | $407.00 | — | 2% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 BILATERAL TIBIA FIBULA RADIOLOGIC EXAM | $244.20 | $407.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIBIA AND FIBULA RADIOLOGIC EXAM | $244.20 | $407.00 | — | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WITHOUT CONTRAST | $1,876.80 | $3,128.00 | — | 22% above | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WITHOUT CONTRAST | $1,876.80 | $3,128.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 BILATERAL MRI LOWER JOINTS WITHOUT CONTRAST | $1,490.40 | $2,484.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST | $1,490.40 | $2,484.00 | — | 2% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 BILATERAL MRI LOWER JOINTS WITHOUT CONTRAST | $1,490.40 | $2,484.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXTREMITY JOINT WITHOUT CONTRAST | $1,490.40 | $2,484.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXTREMITY JOINT WITH WITHOUT CONTRAST | $2,473.80 | $4,123.00 | — | 1% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTREMITY JOINT WITH WITHOUT CONTRAST | $2,473.80 | $4,123.00 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WITHOUT CONTRAST | $1,486.80 | $2,478.00 | — | 19% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MRCP MRI ABDOMEN WITHOUT CONTRAST | $1,486.80 | $2,478.00 | — | 19% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WITHOUT CONTRAST | $1,486.80 | $2,478.00 | — | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP MRI ABDOMEN WITHOUT CONTRAST | $1,486.80 | $2,478.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WITH WITHOUT CONTRAST | $2,478.00 | $4,130.00 | — | 17% above | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WITH WITHOUT CONTRAST | $2,478.00 | $4,130.00 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI LIMITED BRAIN W/O CONTRAST | $1,979.40 | $3,299.00 | — | 32% above | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $1,979.40 | $3,299.00 | — | 32% above | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI LIMITED BRAIN W/O CONTRAST | $1,979.40 | $3,299.00 | — | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST | $1,979.40 | $3,299.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST | $2,301.60 | $3,836.00 | — | 4% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST | $2,301.60 | $3,836.00 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WITHOUT CONTRAST | $1,546.20 | $2,577.00 | — | 10% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WITHOUT CONTRAST | $1,546.20 | $2,577.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WITH AND WITHOUT CONTRAST | $2,566.80 | $4,278.00 | — | 8% above | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WITH AND WITHOUT CONTRAST | $2,566.80 | $4,278.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WITHOUT CONTRAST | $1,611.60 | $2,686.00 | — | 9% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WITHOUT CONTRAST | $1,611.60 | $2,686.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WITH WITHOUT CONTRAST | $2,014.20 | $3,357.00 | — | 15% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WITH WITHOUT CONTRAST | $2,014.20 | $3,357.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WITHOUT CONTRAST | $1,864.80 | $3,108.00 | — | 6% above | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WITHOUT CONTRAST | $1,864.80 | $3,108.00 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WITH WITH AND WITOUT CONTRAST | $2,047.20 | $3,412.00 | — | 4% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WITH WITH AND WITOUT CONTRAST | $2,047.20 | $3,412.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WITHOUT CONTRAST | $1,228.20 | $2,047.00 | — | 28% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WITHOUT CONTRAST | $1,228.20 | $2,047.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 BILATERAL MRI UPPER JOINTS WITHOUT CONTRAST | $1,366.80 | $2,278.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXTREMITY JOINT WITHOUT CONTRAST | $1,366.80 | $2,278.00 | — | 12% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 BILATERAL MRI UPPER JOINTS WITHOUT CONTRAST | $1,366.80 | $2,278.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXTREMITY JOINT WITHOUT CONTRAST | $1,366.80 | $2,278.00 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE AP LAB OBLIQUES RADIOLOGIC EXAM | $422.40 | $704.00 | — | at median | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE AP LAB OBLIQUES RADIOLOGIC EXAM | $422.40 | $704.00 | — | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK WITH CONTRAST | $1,288.80 | $2,148.00 | — | 16% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK WITH CONTRAST | $1,288.80 | $2,148.00 | — | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WITHOUT CONTRAST | $1,057.20 | $1,762.00 | — | 7% above | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WITHOUT CONTRAST | $1,057.20 | $1,762.00 | — | — | 40% |
| Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK RADIOLOGIC EXAM | $151.80 | $253.00 | — | 25% below | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK RADIOLOGIC EXAM | $151.80 | $253.00 | — | — | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WITHOUT CONTRAST | $1,524.00 | $2,540.00 | — | 19% above | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WITHOUT CONTRAST | $1,524.00 | $2,540.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S LIMITED PELVIS | $180.60 | $301.00 | — | 46% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S LIMITED PELVIS | $180.60 | $301.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIS NON OB | $180.60 | $301.00 | — | 63% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIS NON OB | $180.60 | $301.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S OB >14 WKS SINGLE FETUS | $298.80 | $498.00 | — | 45% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U/S OB >14 WKS SINGLE FETUS | $298.80 | $498.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 WKS SINGLE FETUS | $259.80 | $433.00 | — | 46% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 WKS SINGLE FETUS | $259.80 | $433.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED ONE OR > FETUSES | $411.00 | $685.00 | — | 43% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED ONE OR > FETUSES | $411.00 | $685.00 | — | — | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL RADIOLOGIC EXAM | $271.20 | $452.00 | — | 19% above | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL RADIOLOGIC EXAM | $271.20 | $452.00 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILATERAL AND CHEST PA RADIOLOGIC EXAM | $311.40 | $519.00 | — | 4% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILATERAL AND CHEST PA RADIOLOGIC EXAM | $311.40 | $519.00 | — | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAM BILATERAL INC CAD | $114.00 | $190.00 | — | — | 40% |
| Screening mammogram, both breasts CPT 77067 BI SCREENING MAMMO (EXPLDS) | $114.00 | $190.00 | — | 49% below | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAM BILATERAL INC CAD | $114.00 | $190.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BI SCREENING MAMMO (EXPLDS) | $114.00 | $190.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 BILATERAL SHOULDERS RADIOLOGIC EXAM | $249.60 | $416.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 BILATERAL HUMERUS 2 VIEWS RADIOLOGIC EXAM | $249.60 | $416.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER COMPLETE RADIOLOGIC EXAM | $249.60 | $416.00 | — | 15% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 BILATERAL HUMERUS 2 VIEWS RADIOLOGIC EXAM | $249.60 | $416.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 BILATERAL SHOULDERS RADIOLOGIC EXAM | $249.60 | $416.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER COMPLETE RADIOLOGIC EXAM | $249.60 | $416.00 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMPLETE RADIOLOGIC EXAM | $126.60 | $211.00 | — | 62% below | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES COMPLETE RADIOLOGIC EXAM | $126.60 | $211.00 | — | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL AP AND LATERAL RADIOLOGIC EXAM | $213.60 | $356.00 | — | 1% above | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL AP AND LATERAL RADIOLOGIC EXAM | $213.60 | $356.00 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 REAL-TIME VIDEOTAPE-ESOPHOGRAM RADIOLOGIC EXAM | $171.60 | $286.00 | — | 47% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 REAL-TIME VIDEOTAPE-ESOPHOGRAM RADIOLOGIC EXAM | $171.60 | $286.00 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 FEMUR AP & LATERAL RADIOLOGIC EXAM | $99.60 | $166.00 | — | 56% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 FEMUR AP & LATERAL RADIOLOGIC EXAM | $99.60 | $166.00 | — | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WITHOUT CONTRAST | $1,617.60 | $2,696.00 | — | 25% above | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WITHOUT CONTRAST | $1,617.60 | $2,696.00 | — | — | 40% |
| Toe X-ray, 2 or more views CPT 73660 TOES 2 VIEW RADIOLOGIC EXAM | $205.20 | $342.00 | — | 13% above | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 TOES 2 VIEW RADIOLOGIC EXAM | $205.20 | $342.00 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 U/S NON OB TRANSVAGINAL | $438.60 | $731.00 | — | 10% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 U/S NON OB TRANSVAGINAL | $438.60 | $731.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 U/S OB TRANSVAGINAL | $472.80 | $788.00 | — | 23% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 U/S OB TRANSVAGINAL | $472.80 | $788.00 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 U/S COMPLETE ABDOMEN | $754.20 | $1,257.00 | — | 3% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 U/S COMPLETE ABDOMEN | $754.20 | $1,257.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 U/S SCROTUM AND CONTENTS | $697.80 | $1,163.00 | — | 16% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S SCROTUM AND CONTENTS | $697.80 | $1,163.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK | $419.40 | $699.00 | — | 31% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S THYROID | $419.40 | $699.00 | — | 31% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S THYROID | $419.40 | $699.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK | $419.40 | $699.00 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WITH ESOPHOGRAM RADIOLOGIC EXAM | $273.60 | $456.00 | — | 30% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI RADIOLOGIC EXAM | $273.60 | $456.00 | — | 30% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI WITH ESOPHOGRAM RADIOLOGIC EXAM | $273.60 | $456.00 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI RADIOLOGIC EXAM | $273.60 | $456.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS 2 VIEWS RADIOLOGIC EXAM | $171.60 | $286.00 | — | 27% below | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS 2 VIEWS RADIOLOGIC EXAM | $171.60 | $286.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX VEIN LIMITED | $595.20 | $992.00 | — | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 U/S - EXTR VNS UNIL | $595.20 | $992.00 | — | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX VEIN LIMITED | $595.20 | $992.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 U/S - EXTR VNS UNIL | $595.20 | $992.00 | — | — | 40% |
| Wrist X-ray, 2 views both sides CPT 73100 BILATERAL WRIST AP LATERAL RADIOLOGIC EXAM | $93.60 | $156.00 | — | — | 40% |
| Wrist X-ray, 2 views CPT 73100 WRIST AP LATERAL RADIOLOGIC EXAM | $93.60 | $156.00 | — | 51% below | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 BILATERAL WRIST AP LATERAL RADIOLOGIC EXAM | $93.60 | $156.00 | — | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST AP LATERAL RADIOLOGIC EXAM | $93.60 | $156.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 BILATERAL WRIST COMPLETE RADIOLOGIC EXAM | $103.80 | $173.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPLETE RADIOLOGIC EXAM | $103.80 | $173.00 | — | 56% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 BILATERAL WRIST COMPLETE RADIOLOGIC EXAM | $103.80 | $173.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST COMPLETE RADIOLOGIC EXAM | $103.80 | $173.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILATERAL 2-3 VIEWS RADIOLOGIC EXAM | $142.20 | $237.00 | — | 25% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP UNILATERAL 2-3 VIEWS RADIOLOGIC EXAM | $142.20 | $237.00 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN - 1 VIEW RADIOLOGIC EXAM | $108.00 | $180.00 | — | 50% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN - 1 VIEW RADIOLOGIC EXAM | $108.00 | $180.00 | — | — | 40% |
| X-ray of the ankle, 2 views both sides CPT 73600 BILATERAL ANKLES AP LATERAL RADIOLOGIC EXAM | $274.20 | $457.00 | — | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE AP & LATERAL RADIOLOGIC EXAM | $274.20 | $457.00 | — | 30% above | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 BILATERAL ANKLES AP LATERAL RADIOLOGIC EXAM | $274.20 | $457.00 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE AP & LATERAL RADIOLOGIC EXAM | $274.20 | $457.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER 2 VIEWS RADIOLOGIC EXAM | $213.60 | $356.00 | — | 8% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER 2 VIEWS RADIOLOGIC EXAM | $213.60 | $356.00 | — | — | 40% |
| X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $87.60 | $146.00 | — | 53% below | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS | $87.60 | $146.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 BILATERAL FEET RADIOLOGIC EXAM | $280.80 | $468.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS AP OBL LATERAL RADIOLOGIC EXAM | $280.80 | $468.00 | — | 8% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 BILATERAL FEET RADIOLOGIC EXAM | $280.80 | $468.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS AP OBL LATERAL RADIOLOGIC EXAM | $280.80 | $468.00 | — | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 HAND-INCLUDING FINGERS 3 VIEWS RADIOLOGIC EXAM | $201.60 | $336.00 | — | 5% below | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND-INCLUDING FINGERS 3 VIEWS RADIOLOGIC EXAM | $201.60 | $336.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 BILATERAL KNEES AP & LATERAL RADIOLOGIC EXAM | $251.40 | $419.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE AP LAT ONLY RADIOLOGIC EXAM | $251.40 | $419.00 | — | 27% above | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 BILATERAL KNEES AP & LATERAL RADIOLOGIC EXAM | $251.40 | $419.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE AP LAT ONLY RADIOLOGIC EXAM | $251.40 | $419.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE AP LATERAL RADIOLOGIC EXAM | $360.00 | $600.00 | — | 5% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE AP LATERAL RADIOLOGIC EXAM | $360.00 | $600.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE COMPLETE RADIOLOGIC EXAM | $499.20 | $832.00 | — | 7% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE COMPLETE RADIOLOGIC EXAM | $499.20 | $832.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE AP AND LATERAL RADIOLOGIC EXAM | $356.40 | $594.00 | — | 33% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE AP AND LATERAL RADIOLOGIC EXAM | $356.40 | $594.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES RADIOLOGIC EXAM | $204.00 | $340.00 | — | 13% below | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES RADIOLOGIC EXAM | $204.00 | $340.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP AND LATERAL RADIOLOGIC EXAM | $310.20 | $517.00 | — | 9% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE AP AND LATERAL RADIOLOGIC EXAM | $310.20 | $517.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP RADIOLOGIC EXAM | $153.60 | $256.00 | — | 26% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP RADIOLOGIC EXAM | $153.60 | $256.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX RADIOLOGIC EXAM | $233.40 | $389.00 | — | 11% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM COCCYX RADIOLOGIC EXAM | $233.40 | $389.00 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH PLASMA {REF LAB} | $138.60 | $231.00 | — | 19% below | 40% |
| ACTH blood test inpatient CPT 82024 ACTH PLASMA {REF LAB} | $138.60 | $231.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT {ALT} SERUM | $39.60 | $66.00 | — | 24% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT {ALT} SERUM | $39.60 | $66.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT {AST} SERUM | $25.80 | $43.00 | — | 17% below | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT {AST} SERUM | $25.80 | $43.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $219.60 | $366.00 | — | 21% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $219.60 | $366.00 | — | — | 40% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $21.00 | $35.00 | — | 42% below | 40% |
| Albumin blood test CPT 82040 ALBUMIN | $23.40 | $39.00 | — | 35% below | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM | $21.00 | $35.00 | — | — | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $23.40 | $39.00 | — | — | 40% |
| Aldosterone blood test CPT 82088 ALDOSTERONE LC/MS | $229.20 | $382.00 | — | 40% above | 40% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE LC/MS | $229.20 | $382.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOS | $10.80 | $18.00 | — | 75% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $31.80 | $53.00 | — | 28% below | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOS | $10.80 | $18.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $31.80 | $53.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND (TREE NUT) F20 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP (SHELLFISH) F338 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA (MOLD) M6 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON (FISH) F41 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT F4 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS (MOLD) M3 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK (FOOD) F26 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW HORNET VENOM (INSECT) I5 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS (GRASS POLLEN) G17 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM CHRYSOGENUM (MOLD) M1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT F13 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP VENOM (INSECT) I4 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT (TREE NUT) F256 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK (TREE POLLEN) T7 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 NETTLE (WEED POLLEN) W20 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUTTON (FOOD) F88 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY (TREE POLLEN) T70 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA (FISH) F40 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE PROTEINS (EPIDERMAL) E72 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN JUNIPER (TREE POLLEN) T6 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (GRASS POLLEN) G6 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEF (FOOD) F27 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS (GRASS POLLEN) G10 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS (GRASS POLLEN) G2 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE DANDER (EPIDERMAL) E3 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOX-ELDER (TREE POLLEN) T1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEYBEE VENOM (INSECT) I1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE FACED HORNET VENOM (INSECT) I2 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY PECAN (TREE POLLEN) T22 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT (TREE NUT) F18 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW (TREE NUT) F202 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (TREE NUT) F17 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN F14 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (EPIDERMAL) E1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM (TREE POLLEN) T8 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM (MOLD) M2 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE F1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH GERMAN (INSECT) I6 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (EPIDERMAL) E5 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COD (FISH) F3 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. PTERONYSSINUS (DUST MITE) D1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON PIGWEED (WEED POLLEN) W14 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. FARINAE (DUST MITE) D2 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED (WEED POLLEN) W1 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COWS MILK F2 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP (SHELLFISH) F24 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON SILVER BIRCH (TREE POLLEN) T3 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON WASP VENOM (YELLOW JACKET; INSECT) I3 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL (WEED POLLEN) W18 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Gal-alpha-13-gal (alpha-gal component) o215 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED F10 | $21.00 | $35.00 | — | 26% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHIZOPUS M11 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW DOCK/SHEEP SORREL RW 23 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELONS RF329 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT T10 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO F25 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY F44 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE G5 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE W11 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE T213 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEAS F12 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEARS F94 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS G3 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGES F33 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS M4 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX K82 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB QUARTERS W10 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS G8 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEY BEE I2 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS E70 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FIRE ANT I70 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRABS F23 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN G202 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS E85 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN F83 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARMINE RED DYE F340 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BUMBLE BEE RI205 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLES F49 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Stemphylium m10 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium m9 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 English plantain (weed pollen) w9 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood (tree pollen) t14 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cocklebur (weed pollen) w13 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Candida m5 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aureobasidium pullulans m12 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Acarus siro (dust mite) d70 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT F201 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO RF 203 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DANDELION W8 | $27.00 | $45.00 | — | 4% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE (f5) IgE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH (t3) IgE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (G6) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM (T8) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHOSPORIUM HALODES (M8) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT (F31) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 POTATO (F35) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS (COCKSFOOT) (G3) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN (F15) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CELERY (F85) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ACARUS SIRO (D70) IGE Q | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEAR (F94) IGE Q | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA (M6) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE (F215) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE (T10) IGE | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE (F33) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PARSLEY (F86) | $29.40 | $49.00 | — | 4% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN (W9) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM MONILIFORME (M9) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS (E70) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY/PECAN TREE (T22) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE DANDER (E3) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST (GREER) (H1) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST(HOLLISTER-STIER)(H2)IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS (G10) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS (KENTUCKY BLUE) (G8) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT (F18) IGE W/REFL COMPONENT Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AUREOBASIDIUM PULLULANS (M12) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE (F49) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT (F256) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO (F203) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT (F201) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT (F13) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT (RF345) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (F17) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT (F202) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT (F18) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND (F20) | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHIZOPUS NIGRICANS (M11) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT (RF253) IGE** Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WORMWOOD (W5) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY (T70) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH (T15) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM BOTRYOSUM (M10) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL (W18) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE (W11) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH PIGWEED (W14) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH MARSH ELDER (W16) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE (RT213) IGE** Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED SPINY IGE* Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM (M1) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT (F201) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEA (F12) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK (T7) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS (M4) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE (BOX ELDER) (T1) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE RED (ACER RUBRUM) IGE* Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTERS(GOOSE FOOT) (W10) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TREE NUT ALLERGY PANEL RFX COMPONENTS Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS (G17) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS (G2) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALBICANS (M5) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (E1) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN MEAT (F83) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM (M2) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR (W13) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH (I6) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED (SHORT) (W1) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN (F8) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD (T14) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES FARINAE (D2) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS(D1)IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (E5) IGE Q | $30.00 | $50.00 | — | 6% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEA (F12) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SD Q | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT (F256) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN (F78) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON (F41) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA (F40) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO (F25) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP (F24) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND (F20) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (F17) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN (F14) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT (F13) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT (F4) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH (F3) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW'S MILK (F2) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE (F1) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP (F338) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT (F202) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM (F207) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK (F26) IGE {REF LAB} | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON (RF329) IGE {REF LAB} | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY (F44) IGE | $34.20 | $57.00 | — | 21% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NETTLE (WEED POLLEN) W20 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUTTON (FOOD) F88 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MULBERRY (TREE POLLEN) T70 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE PROTEINS (EPIDERMAL) E72 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS (GRASS POLLEN) G2 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEYBEE VENOM (INSECT) I1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOX-ELDER (TREE POLLEN) T1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY PECAN (TREE POLLEN) T22 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON SILVER BIRCH (TREE POLLEN) T3 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON WASP VENOM (YELLOW JACKET; INSECT) I3 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED (WEED POLLEN) W1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COWS MILK F2 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON PIGWEED (WEED POLLEN) W14 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. FARINAE (DUST MITE) D2 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW (TREE NUT) F202 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COD (FISH) F3 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. PTERONYSSINUS (DUST MITE) D1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH GERMAN (INSECT) I6 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (EPIDERMAL) E5 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM (MOLD) M2 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE F1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT (TREE NUT) F18 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (TREE NUT) F17 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (EPIDERMAL) E1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM (TREE POLLEN) T8 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN JUNIPER (TREE POLLEN) T6 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS (GRASS POLLEN) G10 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL (WEED POLLEN) W18 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF (FOOD) F27 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE DANDER (EPIDERMAL) E3 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP (SHELLFISH) F24 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW HORNET VENOM (INSECT) I5 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE FACED HORNET VENOM (INSECT) I2 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT F4 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT (TREE NUT) F256 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA (FISH) F40 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (GRASS POLLEN) G6 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN F14 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED F10 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gal-alpha-13-gal (alpha-gal component) o215 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP (SHELLFISH) F338 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND (TREE NUT) F20 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON (FISH) F41 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA (MOLD) M6 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK (FOOD) F26 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS (MOLD) M3 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM CHRYSOGENUM (MOLD) M1 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS (GRASS POLLEN) G17 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT F13 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP VENOM (INSECT) I4 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK (TREE POLLEN) T7 | $21.00 | $35.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLES F49 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DANDELION W8 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO RF 203 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT F201 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Acarus siro (dust mite) d70 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aureobasidium pullulans m12 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Candida m5 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocklebur (weed pollen) w13 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood (tree pollen) t14 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English plantain (weed pollen) w9 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fusarium m9 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stemphylium m10 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUMBLE BEE RI205 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARMINE RED DYE F340 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN F83 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS E85 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN G202 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRABS F23 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIRE ANT I70 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS E70 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEY BEE I2 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS G8 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB QUARTERS W10 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX K82 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS M4 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGES F33 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS G3 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEARS F94 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAS F12 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE T213 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHIZOPUS M11 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE W11 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE G5 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY F44 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO F25 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT T10 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELONS RF329 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW DOCK/SHEEP SORREL RW 23 | $27.00 | $45.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA (M6) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH (t3) IgE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE (f5) IgE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARSLEY (F86) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE (F33) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LETTUCE (F215) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY (F85) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN (F15) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO (F35) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT (F31) | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE (T10) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM (T8) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHOSPORIUM HALODES (M8) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (G6) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS (COCKSFOOT) (G3) IGE | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ACARUS SIRO (D70) IGE Q | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR (F94) IGE Q | $29.40 | $49.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST (GREER) (H1) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT (F18) IGE W/REFL COMPONENT Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AUREOBASIDIUM PULLULANS (M12) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE (F49) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT (F256) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO (F203) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT (F201) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT (F13) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT (RF345) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (F17) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT (F202) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT (F18) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND (F20) | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHIZOPUS NIGRICANS (M11) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT (RF253) IGE** Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WORMWOOD (W5) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE MULBERRY (T70) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH (T15) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLIUM BOTRYOSUM (M10) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL (W18) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE (W11) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH PIGWEED (W14) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH MARSH ELDER (W16) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE (RT213) IGE** Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PIGWEED SPINY IGE* Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM NOTATUM (M1) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE NUT ALLERGY PANEL RFX COMPONENTS Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT (F201) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS (G17) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS (G2) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEA (F12) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANDIDA ALBICANS (M5) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (E1) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK (T7) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN MEAT (F83) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM (M2) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS (M4) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR (W13) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE RED (ACER RUBRUM) IGE* Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH (I6) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE (BOX ELDER) (T1) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED (SHORT) (W1) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTERS(GOOSE FOOT) (W10) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN (F8) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD (T14) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS (KENTUCKY BLUE) (G8) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES FARINAE (D2) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES PTERONYSSINUS(D1)IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS (G10) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (E5) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN (W9) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST(HOLLISTER-STIER)(H2)IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM MONILIFORME (M9) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS (E70) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY/PECAN TREE (T22) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE DANDER (E3) IGE Q | $30.00 | $50.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SD Q | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN (F78) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA (F40) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO (F25) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT (F256) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY (F44) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON (F41) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON (RF329) IGE {REF LAB} | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK (F26) IGE {REF LAB} | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM (F207) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP (F24) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT (F202) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH (F3) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT (F4) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEA (F12) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT (F13) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN (F14) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (F17) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND (F20) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP (F338) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE (F1) IGE | $34.20 | $57.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW'S MILK (F2) IGE | $34.20 | $57.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL SERUM AFP. | $37.20 | $62.00 | — | 58% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER {REF LAB} | $92.40 | $154.00 | — | 5% above | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL SERUM AFP. | $37.20 | $62.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TUMOR MARKER {REF LAB} | $92.40 | $154.00 | — | — | 40% |
| Ammonia blood test CPT 82140 AMMONIA | $75.60 | $126.00 | — | 14% below | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $75.60 | $126.00 | — | — | 40% |
| Amylase blood test CPT 82150 AMYLASE URINE 24HR | $100.80 | $168.00 | — | 31% above | 40% |
| Amylase blood test CPT 82150 AMYLASE SERUM | $100.80 | $168.00 | — | 31% above | 40% |
| Amylase blood test CPT 82150 AMYLASE URINE RANDOM | $100.80 | $168.00 | — | 31% above | 40% |
| Amylase blood test CPT 82150 AMYLASE BODY FLUID | $100.80 | $168.00 | — | 31% above | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID | $100.80 | $168.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE URINE 24HR | $100.80 | $168.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE URINE RANDOM | $100.80 | $168.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE SERUM | $100.80 | $168.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY (IGG) | $128.40 | $214.00 | — | 36% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IGG | $128.40 | $214.00 | — | 36% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY (IGG) | $128.40 | $214.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IGG | $128.40 | $214.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN IFA | $32.40 | $54.00 | — | 65% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SYMPHONY IGG | $63.60 | $106.00 | — | 31% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $133.80 | $223.00 | — | 46% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN IFA | $32.40 | $54.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 SYMPHONY IGG | $63.60 | $106.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES | $133.80 | $223.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP | $136.80 | $228.00 | — | 13% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP | $136.80 | $228.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE {SURGERY} | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BDY FLUID CULT NOT CSF | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BONE MARROW CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BIOPSY CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RESPIRATORY CULTURE | $77.40 | $129.00 | — | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BONE MARROW CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BDY FLUID CULT NOT CSF | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BIOPSY CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RESPIRATORY CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE | $77.40 | $129.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE {SURGERY} | $77.40 | $129.00 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL 1 {BASIC} | $127.20 | $212.00 | — | 7% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL 1 {BASIC} | $127.20 | $212.00 | — | — | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN NEONATAL | $26.40 | $44.00 | — | 38% below | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $40.80 | $68.00 | — | 4% below | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN NEONATAL | $26.40 | $44.00 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $40.80 | $68.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY LEVEL 4 | $205.80 | $343.00 | — | 145% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW ASPIRATE | $205.80 | $343.00 | — | 145% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK | $205.80 | $343.00 | — | 145% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW BIOPSY | $205.80 | $343.00 | — | 145% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW BIOPSY | $205.80 | $343.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW ASPIRATE | $205.80 | $343.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK | $205.80 | $343.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY LEVEL 4 | $205.80 | $343.00 | — | — | 40% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FAN #1 | $165.00 | $275.00 | — | 9% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FAN #1 | $165.00 | $275.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collect venous blood venipuncture | $15.00 | $25.00 | — | 12% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collect venous blood venipuncture | $15.00 | $25.00 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD | $27.60 | $46.00 | — | 25% below | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD | $27.60 | $46.00 | — | — | 40% |
| Blood lead test CPT 83655 LEAD (VENOUS). | $31.20 | $52.00 | — | 54% below | 40% |
| Blood lead test CPT 83655 LEAD 24-HOUR URINE | $31.20 | $52.00 | — | 54% below | 40% |
| Blood lead test CPT 83655 LEAD (VENOUS) | $31.20 | $52.00 | — | 54% below | 40% |
| Blood lead test inpatient CPT 83655 LEAD 24-HOUR URINE | $31.20 | $52.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD (VENOUS) | $31.20 | $52.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD (VENOUS). | $31.20 | $52.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM | $60.60 | $101.00 | — | 38% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM | $60.60 | $101.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BO ABO Group | $10.20 | $17.00 | — | 82% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO | $147.00 | $245.00 | — | 165% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BO ABO Group | $10.20 | $17.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $147.00 | $245.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN BLOOD POST | $32.40 | $54.00 | — | at median | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 PD SERUM BUN | $32.40 | $54.00 | — | at median | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN BLOOD | $32.40 | $54.00 | — | at median | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 PD SERUM BUN | $32.40 | $54.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN BLOOD | $32.40 | $54.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN BLOOD POST | $32.40 | $54.00 | — | — | 40% |
| C-peptide blood test CPT 84681 C-PEPTIDE | $76.20 | $127.00 | — | 26% below | 40% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE | $76.20 | $127.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $70.80 | $118.00 | — | 19% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $70.80 | $118.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE DNA | $156.00 | $260.00 | — | 77% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE DNA | $156.00 | $260.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $123.60 | $206.00 | — | 29% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $123.60 | $206.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $96.60 | $161.00 | — | 31% below | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $96.60 | $161.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 RNA (COVID-19) QUALITATIVE NAAT | $153.00 | $255.00 | — | 77% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CORONAVIRUS 2 (SARS-COV-2) | $168.00 | $280.00 | — | 95% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS PCR | $168.00 | $280.00 | — | 95% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 RNA (COVID-19) QUALITATIVE NAAT | $153.00 | $255.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CORONAVIRUS 2 (SARS-COV-2) | $168.00 | $280.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS PCR | $168.00 | $280.00 | — | — | 40% |
| Calcium blood test, total CPT 82310 CALCIUM. | $26.40 | $44.00 | — | 11% below | 40% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM | $26.40 | $44.00 | — | 11% below | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM. | $26.40 | $44.00 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM | $26.40 | $44.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA1) | $171.60 | $286.00 | — | 73% above | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA1) | $171.60 | $286.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER VIRUS ANTIBODY (IGM) | $53.40 | $89.00 | — | 27% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER VIRUS ANTIBODY (IGG) | $66.60 | $111.00 | — | 9% below | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER VIRUS ANTIBODY (IGM) | $53.40 | $89.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER VIRUS ANTIBODY (IGG) | $66.60 | $111.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS TMA CONJUNCTIVA | $28.20 | $47.00 | — | 65% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS UROGENITAL | $43.20 | $72.00 | — | 46% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS TMA THROAT | $46.20 | $77.00 | — | 42% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C.TRACHOMATIS RNA UROGEN {REF LAB} | $51.00 | $85.00 | — | 36% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA - PCR | $56.40 | $94.00 | — | 30% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA SWAB | $56.40 | $94.00 | — | 30% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS TMA CONJUNCTIVA | $28.20 | $47.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS UROGENITAL | $43.20 | $72.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS TMA THROAT | $46.20 | $77.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C.TRACHOMATIS RNA UROGEN {REF LAB} | $51.00 | $85.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA SWAB | $56.40 | $94.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA - PCR | $56.40 | $94.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $99.60 | $166.00 | — | 31% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $99.60 | $166.00 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF | $92.40 | $154.00 | — | 49% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF | $92.40 | $154.00 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFFERENTIAL | $81.00 | $135.00 | — | 44% above | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFFERENTIAL | $81.00 | $135.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC PANEL 2 {COMPREHENSIVE} | $138.00 | $230.00 | — | 3% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 METABOLIC PANEL 2 {COMPREHENSIVE} | $138.00 | $230.00 | — | — | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL SERUM | $153.00 | $255.00 | — | 49% above | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM | $153.00 | $255.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL | $60.60 | $101.00 | — | 18% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK | $61.20 | $102.00 | — | 19% above | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL | $60.60 | $101.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK | $61.20 | $102.00 | — | — | 40% |
| Creatinine blood test CPT 82565 PD SERUM CREATININE | $42.60 | $71.00 | — | 106% above | 40% |
| Creatinine blood test CPT 82565 CREATININE SERUM | $60.60 | $101.00 | — | 193% above | 40% |
| Creatinine blood test inpatient CPT 82565 PD SERUM CREATININE | $42.60 | $71.00 | — | — | 40% |
| Creatinine blood test inpatient CPT 82565 CREATININE SERUM | $60.60 | $101.00 | — | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB(IGG) {REF LAB} | $97.20 | $162.00 | — | at median | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB(IGG) {REF LAB} | $97.20 | $162.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE | $111.00 | $185.00 | — | 15% above | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE | $111.00 | $185.00 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE | $58.20 | $97.00 | — | 41% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE | $58.20 | $97.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 9 MECONIUM | $64.80 | $108.00 | — | 49% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NIDA-5 DRUG SCREEN PANEL {DOT} {CHAIN} | $64.80 | $108.00 | — | 49% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 INTEGRITY CHECK URINE *268 | $71.40 | $119.00 | — | 44% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITORING OXYCODONE WITH CONFIRMATION URINE | $91.80 | $153.00 | — | 28% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG ABUSE SCREEN - 5 (SERUM) NC | $100.80 | $168.00 | — | 21% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 7 {NON CHAIN} | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MEDICAL PROFESSIONAL DRUG SCREEN | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 COC DRUG PANEL 3526 (COCPL) | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 5 NON CHAIN | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DAU6 NON CHAIN OF CUSTODY W/O THC | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN PANEL 6 NON CHAIN | $150.00 | $250.00 | — | 17% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NIDA-5 DRUG SCREEN PANEL {DOT} {CHAIN} | $64.80 | $108.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 9 MECONIUM | $64.80 | $108.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 INTEGRITY CHECK URINE *268 | $71.40 | $119.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MONITORING OXYCODONE WITH CONFIRMATION URINE | $91.80 | $153.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG ABUSE SCREEN - 5 (SERUM) NC | $100.80 | $168.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 7 {NON CHAIN} | $150.00 | $250.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DAU6 NON CHAIN OF CUSTODY W/O THC | $150.00 | $250.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COC DRUG PANEL 3526 (COCPL) | $150.00 | $250.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 5 NON CHAIN | $150.00 | $250.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN PANEL 6 NON CHAIN | $150.00 | $250.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEDICAL PROFESSIONAL DRUG SCREEN | $150.00 | $250.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES PANEL 1 | $34.20 | $57.00 | — | 62% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES PANEL 1 | $34.20 | $57.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGG ANTIBODIES | $42.00 | $70.00 | — | 42% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGM ANTIBODIES | $42.00 | $70.00 | — | 42% below | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGG ANTIBODIES | $42.00 | $70.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGM ANTIBODIES | $42.00 | $70.00 | — | — | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL LEVEL | $113.40 | $189.00 | — | 5% below | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL LEVEL | $113.40 | $189.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE | $79.20 | $132.00 | — | 37% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE | $79.20 | $132.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL | $184.80 | $308.00 | — | 16% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL | $184.80 | $308.00 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $75.00 | $125.00 | — | at median | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $75.00 | $125.00 | — | — | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $89.40 | $149.00 | — | at median | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $89.40 | $149.00 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM | $103.80 | $173.00 | — | 20% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM | $103.80 | $173.00 | — | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3FREE | $83.40 | $139.00 | — | 14% below | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3FREE | $83.40 | $139.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $78.00 | $130.00 | — | 3% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $78.00 | $130.00 | — | — | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE {REF LAB} | $91.80 | $153.00 | — | 43% below | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE {REF LAB} | $91.80 | $153.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT | $35.40 | $59.00 | — | 24% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT | $35.40 | $59.00 | — | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $382.20 | $637.00 | — | 52% above | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $382.20 | $637.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2HR PP | $24.60 | $41.00 | — | 44% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2HR PP | $24.60 | $41.00 | — | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL FIRST 3 SPEC | $70.20 | $117.00 | — | 6% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL FIRST 3 SPEC | $70.20 | $117.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE TMA CONJUNCTIVA | $28.20 | $47.00 | — | 65% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE TMA THROAT | $74.40 | $124.00 | — | 9% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE RNA UROGEN {REF LAB} | $74.40 | $124.00 | — | 9% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE RNA UROGENITAL | $74.40 | $124.00 | — | 9% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GC PCR | $82.20 | $137.00 | — | 1% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA DNA SWAB | $82.20 | $137.00 | — | 1% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE TMA CONJUNCTIVA | $28.20 | $47.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE TMA THROAT | $74.40 | $124.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE RNA UROGEN {REF LAB} | $74.40 | $124.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE RNA UROGENITAL | $74.40 | $124.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA DNA SWAB | $82.20 | $137.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GC PCR | $82.20 | $137.00 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN EIA STOOL {REF LAB} | $69.00 | $115.00 | — | 45% below | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ANTIGEN EIA STOOL {REF LAB} | $69.00 | $115.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 | $191.40 | $319.00 | — | 44% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QN REAL-TIME PCR | $412.80 | $688.00 | — | 21% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 | $191.40 | $319.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QN REAL-TIME PCR | $412.80 | $688.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV COMBI PT | $84.00 | $140.00 | — | 22% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV COMBI PT | $84.00 | $140.00 | — | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV - HIGH RISK | $78.60 | $131.00 | — | 33% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV - HIGH RISK | $78.60 | $131.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $48.60 | $81.00 | — | 10% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $48.60 | $81.00 | — | — | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $21.00 | $35.00 | — | 9% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $21.00 | $35.00 | — | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL {REF LAB} | $76.20 | $127.00 | — | 16% below | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL {REF LAB} | $76.20 | $127.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG | $27.60 | $46.00 | — | 58% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $47.40 | $79.00 | — | 27% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG | $27.60 | $46.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $47.40 | $79.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY | $108.60 | $181.00 | — | 10% below | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY | $108.60 | $181.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL RNA QUANTITATIVE REAL-TIME PCR {REF LAB} | $138.60 | $231.00 | — | 50% below | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL RNA QUANTITATIVE REAL-TIME PCR {REF LAB} | $138.60 | $231.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 (IGG) TYPE SPECIFIC AB | $71.40 | $119.00 | — | 6% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER | $71.40 | $119.00 | — | 6% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG TYPE-SPECIFIC AB | $71.40 | $119.00 | — | 6% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 (IGG) TYPE SPECIFIC AB | $71.40 | $119.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM TITER | $71.40 | $119.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGG TYPE-SPECIFIC AB | $71.40 | $119.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG TYPE-SPECIFIC AB (INHINITION) | $43.20 | $72.00 | — | 31% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 (IGG) TYPE SPECIFIC AB | $43.20 | $72.00 | — | 31% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG TYPE-SPECIFIC AB | $43.20 | $72.00 | — | 31% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG INHIBITION IA | $43.20 | $72.00 | — | 31% below | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG INHIBITION IA | $43.20 | $72.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG TYPE-SPECIFIC AB (INHINITION) | $43.20 | $72.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 (IGG) TYPE SPECIFIC AB | $43.20 | $72.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG TYPE-SPECIFIC AB | $43.20 | $72.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY | $104.40 | $174.00 | — | 17% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY | $104.40 | $174.00 | — | — | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $136.80 | $228.00 | — | at median | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $136.80 | $228.00 | — | — | 40% |
| Insulin blood test CPT 83525 INSULIN. | $46.80 | $78.00 | — | 36% below | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN. | $46.80 | $78.00 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 IRON | $46.20 | $77.00 | — | 9% below | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $46.20 | $77.00 | — | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING+%SAT | $50.40 | $84.00 | — | 12% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING+%SAT | $50.40 | $84.00 | — | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $63.60 | $106.00 | — | 27% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $63.60 | $106.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LEUTINIZING HORMONE | $65.40 | $109.00 | — | 7% below | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LEUTINIZING HORMONE | $65.40 | $109.00 | — | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $25.80 | $43.00 | — | 74% below | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID | $51.60 | $86.00 | — | 4% above | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SERUM | $51.60 | $86.00 | — | 4% above | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH SERUM | $51.60 | $86.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID | $51.60 | $86.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $106.80 | $178.00 | — | 11% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $106.80 | $178.00 | — | — | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $92.40 | $154.00 | — | 13% below | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $92.40 | $154.00 | — | — | 40% |
| Lyme disease antibody test CPT 86618 LYME AB SCREEN | $217.20 | $362.00 | — | 110% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 LYME AB SCREEN | $217.20 | $362.00 | — | — | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $87.60 | $146.00 | — | 95% above | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24HR | $87.60 | $146.00 | — | 95% above | 40% |
| Magnesium blood test CPT 83735 UR MAGNESIUM RANDOM | $87.60 | $146.00 | — | 95% above | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $87.60 | $146.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 UR MAGNESIUM RANDOM | $87.60 | $146.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE 24HR | $87.60 | $146.00 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 MEASLES AB(IGG) IMMUNE | $42.00 | $70.00 | — | 47% below | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB(IGG) IMMUNE | $42.00 | $70.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST (MSPOT) | $45.00 | $75.00 | — | 19% below | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST (MSPOT) | $45.00 | $75.00 | — | — | 40% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS AB(IGG)IMMUNE | $37.20 | $62.00 | — | 33% below | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS AB(IGG)IMMUNE | $37.20 | $62.00 | — | — | 40% |
| Obstetric blood test panel CPT 80055 PRENATAL W/HBSAG NO HIV {SPLITS} (PREN4) | $173.40 | $289.00 | — | 40% above | 40% |
| Obstetric blood test panel inpatient CPT 80055 PRENATAL W/HBSAG NO HIV {SPLITS} (PREN4) | $173.40 | $289.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE. | $82.20 | $137.00 | — | at median | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE. | $82.20 | $137.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC | $94.80 | $158.00 | — | 6% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL. | $174.60 | $291.00 | — | 73% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC | $94.80 | $158.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL. | $174.60 | $291.00 | — | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN PREP PAP DIAGNOSTIC | $75.60 | $126.00 | — | 48% above | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN PREP PAP DIAGNOSTIC | $75.60 | $126.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 POST-SURG {PTHIO} 3 | $153.00 | $255.00 | — | at median | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 FINAL {PTHIO} 4 | $153.00 | $255.00 | — | at median | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 SURG {PTHIO} 2 | $153.00 | $255.00 | — | at median | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $153.00 | $255.00 | — | at median | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PRE-OP {PTHIO} 1 | $153.00 | $255.00 | — | at median | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT. | $169.80 | $283.00 | — | 11% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 SURG {PTHIO} 2 | $153.00 | $255.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PRE-OP {PTHIO} 1 | $153.00 | $255.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 POST-SURG {PTHIO} 3 | $153.00 | $255.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 FINAL {PTHIO} 4 | $153.00 | $255.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $153.00 | $255.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT. | $169.80 | $283.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT {REF LAB} | $61.80 | $103.00 | — | 26% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT- LA SCREEN | $61.80 | $103.00 | — | 26% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT ACTIVATED | $61.80 | $103.00 | — | 26% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT | $68.40 | $114.00 | — | 40% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT ACTIVATED | $61.80 | $103.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT- LA SCREEN | $61.80 | $103.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT {REF LAB} | $61.80 | $103.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT | $68.40 | $114.00 | — | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE SERUM | $80.40 | $134.00 | — | 130% above | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE SERUM | $80.40 | $134.00 | — | — | 40% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $61.20 | $102.00 | — | 81% above | 40% |
| Potassium blood test CPT 84132 POTASSIUM WHOLE BLOOD | $61.20 | $102.00 | — | 81% above | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM WHOLE BLOOD | $61.20 | $102.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $61.20 | $102.00 | — | — | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE | $71.40 | $119.00 | — | 26% below | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $71.40 | $119.00 | — | — | 40% |
| Prolactin blood test CPT 84146 PROLACTIN | $115.80 | $193.00 | — | 2% below | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $115.80 | $193.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME {REF LAB} | $54.00 | $90.00 | — | 38% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $54.60 | $91.00 | — | 40% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME {REF LAB} | $54.00 | $90.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $54.60 | $91.00 | — | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 OB URINE DRUG SCREEN 12 | $130.80 | $218.00 | — | 82% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 MEDICAL DRUG SCREEN - MDSAF | $130.80 | $218.00 | — | 82% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 MEDICAL DRUG SCREEN - MDSAF | $130.80 | $218.00 | — | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 OB URINE DRUG SCREEN 12 | $130.80 | $218.00 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Infect antigen influenza | $27.60 | $46.00 | — | 62% below | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Infect antigen influenza | $27.60 | $46.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infect antigen immuno strep group A | $27.60 | $46.00 | — | 62% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Infect antigen immuno strep group A | $27.60 | $46.00 | — | — | 40% |
| Renin blood test CPT 84244 PLASMA RENIN ACTIVITY LC/MS/MS | $196.20 | $327.00 | — | 88% above | 40% |
| Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY LC/MS/MS | $196.20 | $327.00 | — | — | 40% |
| Rh blood typing CPT 86901 BO RH TYPE | $10.20 | $17.00 | — | 78% below | 40% |
| Rh blood typing CPT 86901 RH | $46.80 | $78.00 | — | at median | 40% |
| Rh blood typing inpatient CPT 86901 BO RH TYPE | $10.20 | $17.00 | — | — | 40% |
| Rh blood typing inpatient CPT 86901 RH | $46.80 | $78.00 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 RF IGA | $28.20 | $47.00 | — | 63% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RF IGM | $28.20 | $47.00 | — | 63% below | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF IGM | $28.20 | $47.00 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF IGA | $28.20 | $47.00 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG ANTIBODY | $40.20 | $67.00 | — | 42% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB (IGG) IMMUNE | $59.40 | $99.00 | — | 14% below | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG ANTIBODY | $40.20 | $67.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB (IGG) IMMUNE | $59.40 | $99.00 | — | — | 40% |
| Sodium blood test CPT 84295 SODIUM | $6.00 | $10.00 | — | 82% below | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM | $6.00 | $10.00 | — | — | 40% |
| Stool ova and parasites exam CPT 87177 O&P CONCENTRATE AND PERMANENT SMEAR {REF LAB} | $37.20 | $62.00 | — | 54% below | 40% |
| Stool ova and parasites exam inpatient CPT 87177 O&P CONCENTRATE AND PERMANENT SMEAR {REF LAB} | $37.20 | $62.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL | $27.60 | $46.00 | — | 27% below | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL | $27.60 | $46.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM ABS TOTAL (IGG/IGM) | $69.00 | $115.00 | — | 3% above | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM ABS TOTAL (IGG/IGM) | $69.00 | $115.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SERUM {REF LAB} | $27.00 | $45.00 | — | 36% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 INFANT RPR | $51.60 | $86.00 | — | 22% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $57.00 | $95.00 | — | 34% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL SERUM {REF LAB} | $27.00 | $45.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 INFANT RPR | $51.60 | $86.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF | $57.00 | $95.00 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS 1 TUBE {ATL Z36970} (QF1I) | $40.80 | $68.00 | — | 75% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS 4 TUBES INCUBATED {REF LAB} | $57.00 | $95.00 | — | 66% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS 1 TUBE {ATL Z36970} (QF1I) | $40.80 | $68.00 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS 4 TUBES INCUBATED {REF LAB} | $57.00 | $95.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $136.80 | $228.00 | — | 4% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE | $136.80 | $228.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LKM-1 ANTIBODY (IGG) | $63.00 | $105.00 | — | 32% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL (LC-1) ABS | $70.80 | $118.00 | — | 23% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODIES {REF LAB} | $70.80 | $118.00 | — | 23% below | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM-1 ANTIBODY (IGG) | $63.00 | $105.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODIES {REF LAB} | $70.80 | $118.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER CYTOSOL (LC-1) ABS | $70.80 | $118.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $96.60 | $161.00 | — | 9% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $96.60 | $161.00 | — | — | 40% |
| Total IgE blood test CPT 82785 TOTAL IGE A-IGE;T | $75.60 | $126.00 | — | at median | 40% |
| Total IgE blood test CPT 82785 IGE {REF LAB} | $87.60 | $146.00 | — | 16% above | 40% |
| Total IgE blood test inpatient CPT 82785 TOTAL IGE A-IGE;T | $75.60 | $126.00 | — | — | 40% |
| Total IgE blood test inpatient CPT 82785 IGE {REF LAB} | $87.60 | $146.00 | — | — | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL | $28.20 | $47.00 | — | 2% below | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL | $28.20 | $47.00 | — | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 T4 {THYROXINE} | $49.80 | $83.00 | — | 2% below | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 {THYROXINE} | $49.80 | $83.00 | — | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL {REF LAB} | $28.80 | $48.00 | — | 66% below | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL {REF LAB} | $28.80 | $48.00 | — | — | 40% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $150.60 | $251.00 | — | 71% above | 40% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $150.60 | $251.00 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 SURESWAB T.VAGINALITS RNA | $91.20 | $152.00 | — | at median | 40% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG | $159.60 | $266.00 | — | 75% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 SURESWAB T.VAGINALITS RNA | $91.20 | $152.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG | $159.60 | $266.00 | — | — | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $35.40 | $59.00 | — | 11% below | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $35.40 | $59.00 | — | — | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN T HI SENSITIVITY (TNTHS) | $175.80 | $293.00 | — | 40% above | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN T HI SENSITIVITY (TNTHS) | $175.80 | $293.00 | — | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID SERUM | $32.40 | $54.00 | — | 37% below | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID SERUM | $32.40 | $54.00 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMP (UACPR) (UACOM) | $127.20 | $212.00 | — | 107% above | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMP (UACPR) (UACOM) | $127.20 | $212.00 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO | $50.40 | $84.00 | — | 39% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO | $50.40 | $84.00 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 UA ED | $45.60 | $76.00 | — | 24% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA ED | $45.60 | $76.00 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE | $84.00 | $140.00 | — | 2% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $84.00 | $140.00 | — | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALB URINE 24HR | $54.60 | $91.00 | — | 3% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALB URINE RANDOM | $54.60 | $91.00 | — | 3% below | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB URINE RANDOM | $54.60 | $91.00 | — | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB URINE 24HR | $54.60 | $91.00 | — | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test | $14.40 | $24.00 | — | 82% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY URINE | $43.80 | $73.00 | — | 45% below | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test | $14.40 | $24.00 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY URINE | $43.80 | $73.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 B12 {VITAMIN} | $99.60 | $166.00 | — | 23% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12 {VITAMIN} | $99.60 | $166.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 QUESTASSURED (TM) 25-HYDROXYVITAMIN D (D2D3) {REF LAB} | $88.80 | $148.00 | — | 5% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH TOTAL | $98.40 | $164.00 | — | 6% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 QUESTASSURED (TM) 25-HYDROXYVITAMIN D (D2D3) {REF LAB} | $88.80 | $148.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-OH TOTAL | $98.40 | $164.00 | — | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 125-DIHYDROXY LC/MS/MS {REF LAB} | $88.20 | $147.00 | — | 34% below | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 125-DIHYDROXY LC/MS/MS {REF LAB} | $88.20 | $147.00 | — | — | 40% |
| Zinc blood test CPT 84630 ZINC. | $65.40 | $109.00 | — | at median | 40% |
| Zinc blood test inpatient CPT 84630 ZINC. | $65.40 | $109.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TOTAL QN | $119.40 | $199.00 | — | at median | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT | $131.40 | $219.00 | — | 10% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TOTAL QN | $119.40 | $199.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT | $131.40 | $219.00 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 METATARSAL | $150.00 | $250.00 | — | 81% below | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 METATARSAL | $150.00 | $250.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 DISTAL RADIAL FX | $313.80 | $523.00 | — | 40% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 DISTAL RADIAL FX | $313.80 | $523.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED EAR WAX UNILATERAL | $61.80 | $103.00 | — | 40% below | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED EAR WAX UNILATERAL | $61.80 | $103.00 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 EAR-IMPACTED CERUMEN REMOVAL; ONE EAR | $61.80 | $103.00 | — | 83% below | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 Remove Impacted Cerumen Requiring Instrumentation - Unilateral | $57.60 | $96.00 | — | 84% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 EAR-IMPACTED CERUMEN REMOVAL; ONE EAR | $61.80 | $103.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove Impacted Cerumen Requiring Instrumentation - Unilateral | $57.60 | $96.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Incision & drainage abscess simple/single | $130.20 | $217.00 | — | 78% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS; SIMPLE OR SINGLE | $375.00 | $625.00 | — | 38% below | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & drainage abscess simple/single | $130.20 | $217.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE OF ABSCESS; SIMPLE OR SINGLE | $375.00 | $625.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT OR BURSA INJECTION ASPIRATION AND/OR INJECTION | $247.80 | $413.00 | — | 73% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT OR BURSA INJECTION ASPIRATION AND/OR INJECTION | $247.80 | $413.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $201.00 | $335.00 | — | 73% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $201.00 | $335.00 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE SCALP AXILL TRUNK AND/OR EXTREM (EXCLUDING HANDS/FEET); 2.5CM OR LESS | $368.40 | $614.00 | — | 12% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE SCALP AXILL TRUNK AND/OR EXTREM (EXCLUDING HANDS/FEET); 2.5CM OR LESS | $368.40 | $614.00 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE; SIMPLE SINGLE | $210.60 | $351.00 | — | 67% below | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE; SIMPLE SINGLE | $210.60 | $351.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXICION OF NAIL AND NAIL MATRIX PARTIAL OR COMPLETE (EG INGROWN OR DEFORMED NAIL FOR PERMANENT REMOVAL | $394.80 | $658.00 | — | 58% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXICION OF NAIL AND NAIL MATRIX PARTIAL OR COMPLETE (EG INGROWN OR DEFORMED NAIL FOR PERMANENT REMOVAL | $394.80 | $658.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN BODY; SIMPLE SUBQ | $434.40 | $724.00 | — | 61% below | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION AND REMOVAL FOREIGN BODY; SIMPLE SUBQ | $434.40 | $724.00 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT | $268.20 | $447.00 | — | 30% below | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC - OT | $268.20 | $447.00 | — | 30% below | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT STATIC - OT | $268.20 | $447.00 | — | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT | $268.20 | $447.00 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT | $246.00 | $410.00 | — | 36% below | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT | $246.00 | $410.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP;NECK;AX;GEN;TRUNEXTREM;HANDS/FEET 2.5 CM OR LESS | $232.80 | $388.00 | — | 19% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP;NECK;AX;GEN;TRUNEXTREM;HANDS/FEET 2.5 CM OR LESS | $232.80 | $388.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $861.60 | $1,436.00 | — | 32% below | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $861.60 | $1,436.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR SCALPNECLAXGENTRUNK EXTREMHANDS/FEET 2.6-7.5CM | $306.00 | $510.00 | — | 23% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR SCALPNECLAXGENTRUNK EXTREMHANDS/FEET 2.6-7.5CM | $306.00 | $510.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FACEEARSLIDSNOSELIPSMUC MB 2.5 CM/< | $242.40 | $404.00 | — | 32% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FACEEARSLIDSNOSELIPSMUC MB 2.5 CM/< | $242.40 | $404.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION TRIGGER POINT | $167.40 | $279.00 | — | 86% below | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION TRIGGER POINT | $167.40 | $279.00 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSF BLD/BLD COMP | $671.40 | $1,119.00 | — | 13% below | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSF BLD/BLD COMP | $671.40 | $1,119.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN BAN/REBREATHER INITIAL | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN BAN/REBREATHER SUBSEQUENT | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HYPERTONIC SPUTUMINDUCT | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ABX NEB TX | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEB SUB TX | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEB INIT TX | $202.80 | $338.00 | — | 7% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HYPERTONIC SPUTUMINDUCT | $202.80 | $338.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN BAN/REBREATHER INITIAL | $202.80 | $338.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEB INIT TX | $202.80 | $338.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN BAN/REBREATHER SUBSEQUENT | $202.80 | $338.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEB SUB TX | $202.80 | $338.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ABX NEB TX | $202.80 | $338.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $167.40 | $279.00 | — | 12% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG | $167.40 | $279.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED - LEVEL 1 | $103.20 | $172.00 | — | 55% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED - LEVEL 1 | $103.20 | $172.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED - LEVEL 2 | $205.80 | $343.00 | — | 43% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED - LEVEL 2 | $205.80 | $343.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED - LEVEL 3 | $308.40 | $514.00 | — | 51% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED - LEVEL 3 | $308.40 | $514.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED - LEVEL 4 | $581.40 | $969.00 | — | 27% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED - LEVEL 4 | $581.40 | $969.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED - LEVEL 5 | $855.00 | $1,425.00 | — | 22% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED - LEVEL 5 | $855.00 | $1,425.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDR FIRST HOUR | $346.20 | $577.00 | — | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HR W/O GZ | $346.20 | $577.00 | — | 19% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HR W/O GZ | $346.20 | $577.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDR FIRST HOUR | $346.20 | $577.00 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV TX FIRST HOUR | $417.60 | $696.00 | — | 43% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV TX FIRST HOUR | $417.60 | $696.00 | — | — | 40% |
| IV push of a medicine, first drug CPT 96374 IV INJ FIRST | $132.60 | $221.00 | — | 36% below | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV INJ FIRST | $132.60 | $221.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION | $31.80 | $53.00 | — | 68% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 SUBQ IM INJ | $75.60 | $126.00 | — | 24% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION | $31.80 | $53.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SUBQ IM INJ | $75.60 | $126.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 MUSC RETRAIN EA 15 MIN - OT | $74.40 | $124.00 | — | 14% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 MUSC RETRAIN EA 15 MIN - PT | $74.40 | $124.00 | — | 14% above | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 MUSC RETRAIN EA 15 MIN - PT | $74.40 | $124.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 MUSC RETRAIN EA 15 MIN - OT | $74.40 | $124.00 | — | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 Office/outpatient visit new detailed | $98.40 | $164.00 | — | 37% below | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/outpatient visit new detailed | $98.40 | $164.00 | — | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 Office/outpatient visit new mod complex | $149.40 | $249.00 | — | 25% below | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/outpatient visit new mod complex | $149.40 | $249.00 | — | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 Office/outpatient visit new high complex | $195.60 | $326.00 | — | 19% below | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/outpatient visit new high complex | $195.60 | $326.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/outpatient visit new expanded prob | $67.80 | $113.00 | — | 50% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/outpatient visit new expanded prob | $67.80 | $113.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT NUTRITION | $45.00 | $75.00 | — | 24% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 LTD NUTR THERAPY | $45.00 | $75.00 | — | 24% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 LTD NUTR THERAPY | $45.00 | $75.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT NUTRITION | $45.00 | $75.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 EVAL LOW COMPLEX - OT | $143.40 | $239.00 | — | 16% below | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 EVAL LOW COMPLEX - OT | $143.40 | $239.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX | $277.20 | $462.00 | — | 33% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX | $277.20 | $462.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX | $166.80 | $278.00 | — | 5% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX | $166.80 | $278.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX | $222.00 | $370.00 | — | 26% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX | $222.00 | $370.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER EA 15 MIN - OT | $36.60 | $61.00 | — | 62% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THER EA 15 MIN - PT | $36.60 | $61.00 | — | 62% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THER EA 15 MIN - PT | $36.60 | $61.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THER EA 15 MIN - OT | $36.60 | $61.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN | $49.20 | $82.00 | — | 35% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXER EA 15 MIN - OT | $49.20 | $82.00 | — | 35% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXER EA 15 MIN - OT | $49.20 | $82.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN | $49.20 | $82.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/outpatient visitesthigh complex | $130.20 | $217.00 | — | 39% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/outpatient visitesthigh complex | $130.20 | $217.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/outpatient visit est exp prob | $61.80 | $103.00 | — | 59% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office/outpatient visit est exp prob | $61.80 | $103.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/outpatient visit est detailed | $94.20 | $157.00 | — | 45% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office/outpatient visit est detailed | $94.20 | $157.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/outpatient visit est prob foc | $38.40 | $64.00 | — | 69% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/outpatient visit est prob foc | $38.40 | $64.00 | — | — | 40% |
| Speech and language evaluation CPT 92523 EVALUATION OF SPEECH/SOUND/LANUAGE COMPRHENSION | $310.20 | $517.00 | — | 27% above | 40% |
| Speech and language evaluation inpatient CPT 92523 EVALUATION OF SPEECH/SOUND/LANUAGE COMPRHENSION | $310.20 | $517.00 | — | — | 40% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY | $100.80 | $168.00 | — | 27% below | 40% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY | $100.80 | $168.00 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 PULMONARY SCR | $225.00 | $375.00 | — | 8% below | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PULMONARY SCR | $225.00 | $375.00 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PRE/POST PFT | $394.20 | $657.00 | — | 5% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PRE/POST PFT | $394.20 | $657.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL TX EA 15 MIN - PT | $54.60 | $91.00 | — | 24% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL TX EA 15 MIN - OT | $54.60 | $91.00 | — | 24% below | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL TX EA 15 MIN - PT | $54.60 | $91.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL TX EA 15 MIN - OT | $54.60 | $91.00 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertuss (DTaP) ped 15 units-5 units-23 mcg/0.5 mL IM Susp 0.5 mL | $56.40 | $94.00 | — | 1% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertuss (DTaP) ped 15 units-5 units-23 mcg/0.5 mL IM Susp 0.5 mL | $56.40 | $94.00 | — | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine, inactivated preservative-free trivalent Sus UD | $40.20 | $67.00 | — | 4% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine, inactivated preservative-free trivalent Sus UD | $40.20 | $67.00 | — | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp 1 mL | $160.20 | $267.00 | — | at median | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp 1 mL | $160.20 | $267.00 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B pediatric vaccine 10 mcg/0.5 mL IM Susp 0.5 mL | $54.00 | $90.00 | — | 21% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B pediatric vaccine 10 mcg/0.5 mL IM Susp 0.5 mL | $54.00 | $90.00 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 7.5 mcg-125 mcg/0.5 mL IM Susp 0.5 mL | $58.20 | $97.00 | — | 28% below | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine 7.5 mcg-125 mcg/0.5 mL IM Susp 0.5 mL | $58.20 | $97.00 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine IM Inj | $44.40 | $74.00 | — | 18% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine IM Inj | $44.40 | $74.00 | — | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine Subcut Inj | $180.00 | $300.00 | — | at median | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine Subcut Inj | $180.00 | $300.00 | — | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal B vaccine recombinant, OMV, adjuvanted intramuscular suspension 0.5 mL | $433.80 | $723.00 | — | 5% below | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal B vaccine recombinant, OMV, adjuvanted intramuscular suspension 0.5 mL | $433.80 | $723.00 | — | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent conjugate vaccine IM Susp 0.5 mL | $439.20 | $732.00 | — | at median | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent conjugate vaccine IM Susp 0.5 mL | $439.20 | $732.00 | — | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine IM susp 0.5 mL | $523.20 | $872.00 | — | 6% below | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine IM susp 0.5 mL | $523.20 | $872.00 | — | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23-polyvalent vaccine Inj Soln 0.5 mL | $228.00 | $380.00 | — | 25% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23-polyvalent vaccine Inj Soln 0.5 mL | $228.00 | $380.00 | — | — | 40% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine, purified chick embryo cell 2.5 intl units IM Inj | $805.20 | $1,342.00 | — | 2% above | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, purified chick embryo cell 2.5 intl units IM Inj | $805.20 | $1,342.00 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids (Td) adult/adolescent 5 units-2 units/0.5 mL IM Susp 0.5 mL | $72.00 | $120.00 | — | 48% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoids (Td) adult/adolescent 5 units-2 units/0.5 mL IM Susp 0.5 mL | $72.00 | $120.00 | — | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertussis (Boostrix Tdap) IM Susp 0.5 mL | $88.20 | $147.00 | — | 10% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertussis (Boostrix Tdap) IM Susp 0.5 mL | $88.20 | $147.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization admin 1 vaccine | $31.80 | $53.00 | — | 34% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION VACCINE ADMIN | $93.60 | $156.00 | — | 94% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization admin 1 vaccine | $31.80 | $53.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION VACCINE ADMIN | $93.60 | $156.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDITIONAL VACCINE | $48.60 | $81.00 | — | 25% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADDITIONAL VACCINE | $48.60 | $81.00 | — | — | 40% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://hospitalpricedisclosure.com/download.aspx?pi=6A9Tvh1Xp4FdNkBVhNfrkA*-*