Geisinger Community Medical Center
Geisinger Community Medical Center in Scranton, PA publishes cash prices for 249 common procedures listed here, from its own machine-readable price file updated Jul 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 203 of 241 procedures and below it for 38. By typical cash price it ranks #75 of 108 Pennsylvania hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1800 Mulberry Street, Scranton, PA 18510 Collected Nov 3, 2026 Source price file Check a bill from this hospital (570) 703-8000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 390001 · CMS hospital register NPI 1366444507
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Geisinger Community Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Geisinger Community Medical Center in Scranton, PA:
- Jul 27, 2023 Met requirements
- Apr 4, 2025 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN WO/W CONTRAST | $3,952.00 | $7,904.00 | $1.00–$7,113.60 | 109% above | 50% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN WO/W CONTRAST | $3,952.00 | $7,904.00 | $3,952.00–$22,980.00 | — | 50% |
| Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS | $349.50 | $699.00 | $1.00–$629.10 | 7% above | 50% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS | $349.50 | $699.00 | $349.50–$22,980.00 | — | 50% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS | $407.00 | $814.00 | $1.00–$732.60 | 12% above | 50% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS | $407.00 | $814.00 | $407.00–$22,980.00 | — | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC ART DOP UPR/LWR EXTR 1-2 LVLS | $1,129.50 | $2,259.00 | $1.00–$2,033.10 | 152% above | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC ART DOP UPR/LWR EXTR 1-2 LVLS | $1,129.50 | $2,259.00 | $1,129.50–$22,980.00 | — | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST | $2,291.00 | $4,582.00 | $1.00–$4,123.80 | 94% above | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY W/O CONTRAST | $2,291.00 | $4,582.00 | $2,291.00–$22,980.00 | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS SINGLE CONTRAST STUDY | $620.00 | $1,240.00 | $1.00–$1,116.00 | 35% above | 50% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS SINGLE CONTRAST STUDY | $620.00 | $1,240.00 | $620.00–$22,980.00 | — | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE/JOINT SCAN WHOLE BODY | $2,330.00 | $4,660.00 | $1.00–$4,194.00 | 90% above | 50% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE/JOINT SCAN WHOLE BODY | $2,330.00 | $4,660.00 | $2,330.00–$22,980.00 | — | 50% |
| Breast ultrasound, complete, one breast CPT 76641 HC US BREAST COMPLETE | $882.50 | $1,765.00 | $1.00–$1,588.50 | 61% above | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE | $882.50 | $1,765.00 | $1.00–$1,588.50 | 61% above | 50% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST COMPLETE | $882.50 | $1,765.00 | $882.50–$22,980.00 | — | 50% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE | $882.50 | $1,765.00 | $882.50–$22,980.00 | — | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST LIMITED | $594.00 | $1,188.00 | $1.00–$1,069.20 | 29% above | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED | $594.00 | $1,188.00 | $1.00–$1,069.20 | 29% above | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST LIMITED | $594.00 | $1,188.00 | $594.00–$22,980.00 | — | 50% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED | $594.00 | $1,188.00 | $594.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN & PELVIS W/CONTRAST | $4,187.00 | $8,374.00 | $1.00–$7,536.60 | 40% above | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN & PELVIS WO/W CONTRAST | $4,609.00 | $9,218.00 | $1.00–$8,296.20 | 54% above | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN & PELVIS W/CONTRAST | $4,187.00 | $8,374.00 | $4,187.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN & PELVIS WO/W CONTRAST | $4,609.00 | $9,218.00 | $4,609.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the head CPT 70496 HC CTA HEAD W/CONTRAST | $2,133.00 | $4,266.00 | $1.00–$3,839.40 | 25% above | 50% |
| CT angiography (CTA) of the head CPT 70496 HC CTA HEAD WO/W CONTRAST | $2,245.00 | $4,490.00 | $1.00–$4,041.00 | 31% above | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD W/CONTRAST | $2,133.00 | $4,266.00 | $2,133.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CTA HEAD WO/W CONTRAST | $2,245.00 | $4,490.00 | $2,245.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the neck CPT 70498 HC CTA NECK W/CONTRAST | $3,358.00 | $6,716.00 | $1.00–$6,044.40 | 101% above | 50% |
| CT angiography (CTA) of the neck CPT 70498 HC CTA NECK WO/W CONTRAST | $3,716.50 | $7,433.00 | $1.00–$6,689.70 | 122% above | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK W/CONTRAST | $3,358.00 | $6,716.00 | $3,358.00–$22,980.00 | — | 50% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CTA NECK WO/W CONTRAST | $3,716.50 | $7,433.00 | $3,716.50–$22,980.00 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST W/CONTRAST | $3,756.00 | $7,512.00 | $1.00–$6,760.80 | 96% above | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST WO/W CONTRAST | $4,026.50 | $8,053.00 | $1.00–$7,247.70 | 110% above | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST W/CONTRAST | $3,756.00 | $7,512.00 | $3,756.00–$22,980.00 | — | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST WO/W CONTRAST | $4,026.50 | $8,053.00 | $4,026.50–$22,980.00 | — | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CTA HEART W/3D IMAGE & CONTRAST | $2,095.00 | $4,190.00 | $1.00–$3,771.00 | 6% above | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CTA HEART W/3D IMAGE & CONTRAST | $2,095.00 | $4,190.00 | $2,095.00–$22,980.00 | — | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HEART W/O CONTRAST W/CA TEST | $114.00 | $228.00 | $1.00–$1,243.00 | 36% below | 50% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HEART W/O CONTRAST W/CA TEST | $114.00 | $228.00 | $114.00–$22,980.00 | — | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD AND PELVIS W/O CONTRAST | $2,767.00 | $5,534.00 | $1.00–$4,980.60 | 33% above | 50% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD AND PELVIS W/O CONTRAST | $2,767.00 | $5,534.00 | $2,767.00–$22,980.00 | — | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W/CONTRAST | $3,987.50 | $7,975.00 | $1.00–$7,177.50 | 34% above | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W/CONTRAST | $3,987.50 | $7,975.00 | $3,987.50–$22,980.00 | — | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS WO/W CONTRAST | $4,389.50 | $8,779.00 | $1.00–$7,901.10 | 47% above | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS WO/W CONTRAST | $4,389.50 | $8,779.00 | $4,389.50–$22,980.00 | — | 50% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/CONTRAST | $3,383.50 | $6,767.00 | $1.00–$6,090.30 | 104% above | 50% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/CONTRAST | $3,383.50 | $6,767.00 | $3,383.50–$22,980.00 | — | 50% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST | $2,430.50 | $4,861.00 | $1.00–$4,374.90 | 115% above | 50% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST | $2,430.50 | $4,861.00 | $2,430.50–$22,980.00 | — | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST | $2,666.50 | $5,333.00 | $1.00–$4,799.70 | 137% above | 50% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST | $2,666.50 | $5,333.00 | $2,666.50–$22,980.00 | — | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,418.00 | $2,836.00 | $1.00–$2,552.40 | 31% above | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN W/O CONTRAST | $1,418.00 | $2,836.00 | $1,418.00–$22,980.00 | — | 50% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD OR BRAIN W/CONTRAST | $1,526.50 | $3,053.00 | $1.00–$2,747.70 | 13% above | 50% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD OR BRAIN W/CONTRAST | $1,526.50 | $3,053.00 | $1,526.50–$22,980.00 | — | 50% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN WO/W CONTRAST | $2,018.50 | $4,037.00 | $1.00–$3,633.30 | 21% above | 50% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN WO/W CONTRAST | $2,018.50 | $4,037.00 | $2,018.50–$22,980.00 | — | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST | $2,532.00 | $5,064.00 | $1.00–$4,557.60 | 120% above | 50% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST | $2,532.00 | $5,064.00 | $2,532.00–$22,980.00 | — | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $2,683.50 | $5,367.00 | $1.00–$4,830.30 | 128% above | 50% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST | $2,683.50 | $5,367.00 | $2,683.50–$22,980.00 | — | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONTRAST | $1,732.00 | $3,464.00 | $1.00–$3,117.60 | 2% above | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/CONTRAST | $1,732.00 | $3,464.00 | $1,732.00–$22,980.00 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUP EXTRAC/CAROTID BILAT COMPLETE | $2,719.00 | $5,438.00 | $1.00–$4,894.20 | — | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUP EXTRAC/CAROTID BILAT COMPLETE | $2,719.00 | $5,438.00 | $2,719.00–$22,980.00 | — | 50% |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX WO/W CONTRAST | $3,660.50 | $7,321.00 | $1.00–$6,588.90 | 128% above | 50% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX WO/W CONTRAST | $3,660.50 | $7,321.00 | $3,660.50–$22,980.00 | — | 50% |
| Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS | $378.50 | $757.00 | $1.00–$681.30 | 17% above | 50% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS | $378.50 | $757.00 | $378.50–$22,980.00 | — | 50% |
| Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW | $258.50 | $517.00 | $1.00–$465.30 | 37% above | 50% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW | $258.50 | $517.00 | $258.50–$22,980.00 | — | 50% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE | $423.50 | $847.00 | $1.00–$762.30 | 48% above | 50% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE | $423.50 | $847.00 | $423.50–$22,980.00 | — | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE | $1,391.00 | $2,782.00 | $1.00–$2,503.80 | 91% above | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE | $1,391.00 | $2,782.00 | $1,391.00–$22,980.00 | — | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL | $403.50 | $807.00 | $1.00–$726.30 | 48% above | 50% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL | $403.50 | $807.00 | $403.50–$22,980.00 | — | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL | $269.50 | $539.00 | $1.00–$485.10 | 49% above | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY/PERIPHERAL | $269.50 | $539.00 | $269.50–$22,980.00 | — | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST THORAX W/O CONTRAST | $2,759.50 | $5,519.00 | $1.00–$4,967.10 | 151% above | 50% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST THORAX W/O CONTRAST | $2,759.50 | $5,519.00 | $2,759.50–$22,980.00 | — | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST THORAX W/CONTRAST | $3,414.50 | $6,829.00 | $1.00–$6,146.10 | 140% above | 50% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST THORAX W/CONTRAST | $3,414.50 | $6,829.00 | $3,414.50–$22,980.00 | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO BILATERAL | $516.50 | $1,033.00 | $1.00–$929.70 | — | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO BILATERAL | $516.50 | $1,033.00 | $516.50–$22,980.00 | — | 50% |
| Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO UNI ALL VIEWS CAD | $440.50 | $881.00 | $1.00–$792.90 | 39% above | 50% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO UNI ALL VIEWS CAD | $440.50 | $881.00 | $440.50–$22,980.00 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC ART DUPLEX LWR EXTR BILAT COMPLETE | $3,019.50 | $6,039.00 | $1.00–$5,435.10 | — | 50% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC ART DUPLEX LWR EXTR BILAT COMPLETE | $3,019.50 | $6,039.00 | $3,019.50–$22,980.00 | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VENOUS DUPLEX BILAT STUDY COMPLETE | $2,483.50 | $4,967.00 | $1.00–$4,470.30 | — | 50% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VENOUS DUPLEX BILAT STUDY COMPLETE | $2,483.50 | $4,967.00 | $2,483.50–$22,980.00 | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC 2D TTE DOPPLER COLOR FLOW CPL | $4,151.00 | $8,302.00 | $1.00–$7,471.80 | 121% above | 50% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC 2D TTE DOPPLER COLOR FLOW CPL | $4,151.00 | $8,302.00 | $4,151.00–$22,980.00 | — | 50% |
| Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS | $375.00 | $750.00 | $1.00–$675.00 | 23% above | 50% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS | $375.00 | $750.00 | $375.00–$22,980.00 | — | 50% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS | $433.50 | $867.00 | $1.00–$780.30 | 25% above | 50% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS | $433.50 | $867.00 | $433.50–$22,980.00 | — | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT SELLA W/O CONTRAST | $2,432.00 | $4,864.00 | $1.00–$4,377.60 | 124% above | 50% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT SELLA W/O CONTRAST | $2,432.00 | $4,864.00 | $2,432.00–$22,980.00 | — | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES COMPLETE MIN 3 VIEWS | $450.00 | $900.00 | $1.00–$810.00 | 9% above | 50% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES COMPLETE MIN 3 VIEWS | $450.00 | $900.00 | $450.00–$22,980.00 | — | 50% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS | $357.50 | $715.00 | $1.00–$643.50 | 28% above | 50% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS | $357.50 | $715.00 | $357.50–$22,980.00 | — | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING | $3,103.00 | $6,206.00 | $1.00–$5,585.40 | 153% above | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING | $3,103.00 | $6,206.00 | $3,103.00–$22,980.00 | — | 50% |
| Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS | $352.00 | $704.00 | $1.00–$633.60 | 26% above | 50% |
| Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS | $352.00 | $704.00 | $352.00–$22,980.00 | — | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS | $307.50 | $615.00 | $1.00–$553.50 | 16% above | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS | $307.50 | $615.00 | $307.50–$22,980.00 | — | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLP STD UN W/MIN HR O2 RES TAM | $488.00 | $976.00 | $1.00–$878.40 | 20% below | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLP STD UN W/MIN HR O2 RES TAM | $488.00 | $976.00 | $488.00–$22,980.00 | — | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM W/CPAP | $4,304.50 | $8,609.00 | $1.00–$7,748.10 | 37% above | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM W/CPAP | $4,304.50 | $8,609.00 | $4,304.50–$22,980.00 | — | 50% |
| Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS | $451.50 | $903.00 | $1.00–$812.70 | 13% above | 50% |
| Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS | $451.50 | $903.00 | $451.50–$22,980.00 | — | 50% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE COMPLETE 4 > VIEWS | $508.50 | $1,017.00 | $1.00–$915.30 | 16% above | 50% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE COMPLETE 4 > VIEWS | $508.50 | $1,017.00 | $508.50–$22,980.00 | — | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTR W/O CONTRAST | $2,331.50 | $4,663.00 | $1.00–$4,196.70 | 121% above | 50% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTR W/O CONTRAST | $2,331.50 | $4,663.00 | $2,331.50–$22,980.00 | — | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $747.00 | $1,494.00 | $1.00–$1,344.60 | 23% above | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED | $747.00 | $1,494.00 | $747.00–$22,980.00 | — | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US XTREMITY NON-VASC LIMITED | $1,182.00 | $2,364.00 | $1.00–$2,127.60 | 200% above | 50% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US XTREMITY NON-VASC LIMITED | $1,182.00 | $2,364.00 | $1,182.00–$22,980.00 | — | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LUNG CANCER SCR W/O CONT | $326.50 | $653.00 | $1.00–$1,243.00 | 18% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LUNG CANCER SCR W/O CONT | $326.50 | $653.00 | $326.50–$22,980.00 | — | 50% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR TIBIA FIBULA 2 VIEWS | $412.50 | $825.00 | $1.00–$742.50 | 24% above | 50% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR TIBIA FIBULA 2 VIEWS | $412.50 | $825.00 | $412.50–$22,980.00 | — | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD W/O CONTRAST | $4,302.00 | $8,604.00 | $1.00–$7,743.60 | 139% above | 50% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD W/O CONTRAST | $4,302.00 | $8,604.00 | $4,302.00–$22,980.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST CAD BILAT W/CONTRAST | $3,730.00 | $7,460.00 | $1.00–$6,714.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI BREAST CAD BILAT WO/W CONTRAST | $4,144.50 | $8,289.00 | $1.00–$7,460.10 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST CAD BILAT W/CONTRAST | $3,730.00 | $7,460.00 | $3,730.00–$22,980.00 | — | 50% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI BREAST CAD BILAT WO/W CONTRAST | $4,144.50 | $8,289.00 | $4,144.50–$22,980.00 | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTR JOINT W/O CONTRAST | $2,388.50 | $4,777.00 | $1.00–$4,299.30 | 17% above | 50% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTR JOINT W/O CONTRAST | $2,388.50 | $4,777.00 | $2,388.50–$22,980.00 | — | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LWR EXTR JT WO/W CONTRAST | $3,367.50 | $6,735.00 | $1.00–$6,061.50 | 4% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LWR EXTR JT WO/W CONTRAST | $3,367.50 | $6,735.00 | $3,367.50–$22,980.00 | — | 50% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST | $3,799.00 | $7,598.00 | $1.00–$6,838.20 | 92% above | 50% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST | $3,799.00 | $7,598.00 | $3,799.00–$22,980.00 | — | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO/W CONTRAST | $8,293.50 | $16,587.00 | $1.00–$14,928.30 | 135% above | 50% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO/W CONTRAST | $8,293.50 | $16,587.00 | $8,293.50–$22,980.00 | — | 50% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST | $2,891.50 | $5,783.00 | $1.00–$5,204.70 | 59% above | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST | $2,891.50 | $5,783.00 | $2,891.50–$22,980.00 | — | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WO/W CONTRAST | $4,334.50 | $8,669.00 | $1.00–$7,802.10 | 49% above | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WO/W CONTRAST | $4,334.50 | $8,669.00 | $4,334.50–$22,980.00 | — | 50% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $2,386.50 | $4,773.00 | $1.00–$4,295.70 | 33% above | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST | $2,386.50 | $4,773.00 | $2,386.50–$22,980.00 | — | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE WO/W CONTRAST | $3,511.50 | $7,023.00 | $1.00–$6,320.70 | 7% above | 50% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE WO/W CONTRAST | $3,511.50 | $7,023.00 | $3,511.50–$22,980.00 | — | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST | $2,331.00 | $4,662.00 | $1.00–$4,195.80 | 13% above | 50% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST | $2,331.00 | $4,662.00 | $2,331.00–$22,980.00 | — | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE WO/W CONTRAST | $3,386.00 | $6,772.00 | $1.00–$6,094.80 | 16% above | 50% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE WO/W CONTRAST | $3,386.00 | $6,772.00 | $3,386.00–$22,980.00 | — | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST | $2,260.00 | $4,520.00 | $1.00–$4,068.00 | 29% above | 50% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST | $2,260.00 | $4,520.00 | $2,260.00–$22,980.00 | — | 50% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO/W CONTRAST | $8,356.00 | $16,712.00 | $1.00–$15,040.80 | 137% above | 50% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO/W CONTRAST | $8,356.00 | $16,712.00 | $8,356.00–$22,980.00 | — | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST | $3,773.00 | $7,546.00 | $1.00–$6,791.40 | 93% above | 50% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST | $3,773.00 | $7,546.00 | $3,773.00–$22,980.00 | — | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTR JT W/O CONTRAST | $3,792.50 | $7,585.00 | $1.00–$6,826.50 | 79% above | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTR JT W/O CONTRAST | $3,792.50 | $7,585.00 | $3,792.50–$22,980.00 | — | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR CERVICAL SPINE MIN 4 VIEWS | $595.50 | $1,191.00 | $1.00–$1,071.90 | 35% above | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR CERVICAL SPINE MIN 4 VIEWS | $595.50 | $1,191.00 | $595.50–$22,980.00 | — | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W/CONTRAST | $3,052.50 | $6,105.00 | $1.00–$5,494.50 | 126% above | 50% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W/CONTRAST | $3,052.50 | $6,105.00 | $3,052.50–$22,980.00 | — | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK W/O CONTRAST | $2,291.00 | $4,582.00 | $1.00–$4,123.80 | 112% above | 50% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK W/O CONTRAST | $2,291.00 | $4,582.00 | $2,291.00–$22,980.00 | — | 50% |
| Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE | $291.50 | $583.00 | $1.00–$524.70 | 4% above | 50% |
| Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE | $291.50 | $583.00 | $291.50–$22,980.00 | — | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARDIAL PERFUSION SPECT MULTI | $6,110.50 | $12,221.00 | $1.00–$10,998.90 | 56% above | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARDIAL PERFUSION SPECT MULTI | $6,110.50 | $12,221.00 | $6,110.50–$22,980.00 | — | 50% |
| OCT scan of the retina (optical coherence tomography) both sides CPT 92134 HC COMP OPHTH IMG POS RETINA I&R UNI/BI | $188.00 | $376.00 | $1.00–$338.40 | — | 50% |
| OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 HC COMP OPHTH IMG POS RETINA I&R UNI/BI | $188.00 | $376.00 | $188.00–$22,980.00 | — | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET IMAGE W/CT SKULL-THIGH | $11,789.00 | $23,578.00 | $1.00–$21,220.20 | 63% above | 50% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET IMAGE W/CT SKULL-THIGH | $11,789.00 | $23,578.00 | $11,789.00–$22,980.00 | — | 50% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONTRAST | $1,575.00 | $3,150.00 | $1.00–$2,835.00 | 44% above | 50% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS W/O CONTRAST | $1,575.00 | $3,150.00 | $1,575.00–$22,980.00 | — | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC NON OBSTETRICAL LIMITED | $840.50 | $1,681.00 | $1.00–$1,512.90 | 88% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC NON OBSTETRICAL LIMITED | $840.50 | $1,681.00 | $840.50–$22,980.00 | — | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON OBSTETRICAL COMPLETE | $1,121.00 | $2,242.00 | $1.00–$2,017.80 | 92% above | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON OBSTETRICAL COMPLETE | $1,121.00 | $2,242.00 | $1,121.00–$22,980.00 | — | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREG UTERUS >14 WEEKS SINGLE FETUS | $714.00 | $1,428.00 | $1.00–$1,285.20 | 16% above | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREG UTERUS >14 WEEKS SINGLE FETUS | $714.00 | $1,428.00 | $714.00–$22,980.00 | — | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US PREG UTERUS <14 WEEKS SINGLE FETUS | $589.50 | $1,179.00 | $1.00–$1,061.10 | 5% above | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US PREG UTERUS <14 WEEKS SINGLE FETUS | $589.50 | $1,179.00 | $589.50–$22,980.00 | — | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREG LTD 1 OR MORE FETUSES | $1,083.50 | $2,167.00 | $1.00–$1,950.30 | 103% above | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREG LTD 1 OR MORE FETUSES | $1,083.50 | $2,167.00 | $1,083.50–$22,980.00 | — | 50% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC XR RIBS UNILATERAL 2 VIEWS | $309.00 | $618.00 | $1.00–$556.20 | 8% below | 50% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC XR RIBS UNILATERAL 2 VIEWS | $309.00 | $618.00 | $309.00–$22,980.00 | — | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIB UNI W/PA CHEST MIN 3 VIEWS | $430.00 | $860.00 | $1.00–$774.00 | 5% above | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIB UNI W/PA CHEST MIN 3 VIEWS | $430.00 | $860.00 | $430.00–$22,980.00 | — | 50% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCREEN MAMMO BILAT CAD 2 VWS EA BRST | $405.00 | $810.00 | $1.00–$729.00 | — | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREEN MAMMO BILAT CAD 2 VWS EA BRST | $405.00 | $810.00 | $405.00–$22,980.00 | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS | $442.00 | $884.00 | $1.00–$795.60 | 30% above | 50% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS | $442.00 | $884.00 | $442.00–$22,980.00 | — | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUS PARA COMPLETE MIN 3 VIEWS | $425.00 | $850.00 | $1.00–$765.00 | at median | 50% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUS PARA COMPLETE MIN 3 VIEWS | $425.00 | $850.00 | $425.00–$22,980.00 | — | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL < 4 VIEWS | $352.00 | $704.00 | $1.00–$633.60 | 1% below | 50% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL < 4 VIEWS | $352.00 | $704.00 | $352.00–$22,980.00 | — | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM NOCTURNAL 6/>YRS | $3,828.50 | $7,657.00 | $1.00–$6,891.30 | 11% above | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM NOCTURNAL 6/>YRS | $3,828.50 | $7,657.00 | $3,828.50–$22,980.00 | — | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC 2D STRESS TTE COMPLETE | $2,498.50 | $4,997.00 | $1.00–$4,497.30 | 37% above | 50% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC 2D STRESS TTE COMPLETE | $2,498.50 | $4,997.00 | $2,498.50–$22,980.00 | — | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR SWALLOW FUNCTION W/VIDEO | $647.00 | $1,294.00 | $1.00–$1,164.60 | 10% above | 50% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR SWALLOW FUNCTION W/VIDEO | $647.00 | $1,294.00 | $647.00–$22,980.00 | — | 50% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS | $357.00 | $714.00 | $1.00–$642.60 | 10% below | 50% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS | $357.00 | $714.00 | $357.00–$22,980.00 | — | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $2,618.00 | $5,236.00 | $1.00–$4,712.40 | 123% above | 50% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT THORACIC SPINE W/O CONTRAST | $2,618.00 | $5,236.00 | $2,618.00–$22,980.00 | — | 50% |
| Toe X-ray, 2 or more views CPT 73660 HC XR TOES MIN 2 VIEWS | $332.50 | $665.00 | $1.00–$598.50 | 19% above | 50% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOES MIN 2 VIEWS | $332.50 | $665.00 | $332.50–$22,980.00 | — | 50% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OBSTETRIC | $594.00 | $1,188.00 | $1.00–$1,069.20 | 6% above | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OBSTETRIC | $594.00 | $1,188.00 | $594.00–$22,980.00 | — | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US PREG UTERUS TRANSVAGINAL W/DOCUM | $1,063.00 | $2,126.00 | $1.00–$1,913.40 | 92% above | 50% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREG UTERUS TRANSVAGINAL W/DOCUM | $1,063.00 | $2,126.00 | $1,063.00–$22,980.00 | — | 50% |
| Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE | $933.00 | $1,866.00 | $1.00–$1,679.40 | 19% above | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE | $933.00 | $1,866.00 | $933.00–$22,980.00 | — | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM & CONTENTS | $1,051.00 | $2,102.00 | $1.00–$1,891.80 | 71% above | 50% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM & CONTENTS | $1,051.00 | $2,102.00 | $1,051.00–$22,980.00 | — | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US SOFT TISSUE HEAD/NECK | $818.50 | $1,637.00 | $1.00–$1,473.30 | 43% above | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US SOFT TISSUE HEAD/NECK | $818.50 | $1,637.00 | $818.50–$22,980.00 | — | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR UPPER GI SINGLE CONTRAST STUDY | $771.00 | $1,542.00 | $1.00–$1,387.80 | 23% above | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR UPPER GI SINGLE CONTRAST STUDY | $771.00 | $1,542.00 | $771.00–$22,980.00 | — | 50% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 HC XR HUMERUS BILATERAL MIN 2 VIEWS | $387.50 | $775.00 | $1.00–$697.50 | — | 50% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HC XR HUMERUS BILATERAL MIN 2 VIEWS | $387.50 | $775.00 | $387.50–$22,980.00 | — | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC VENOUS DUPLEX UNI STUDY LMTD | $1,832.00 | $3,664.00 | $1.00–$3,297.60 | 186% above | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC VENOUS DUPLEX UNI STUDY LMTD | $1,832.00 | $3,664.00 | $1,832.00–$22,980.00 | — | 50% |
| Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS | $379.00 | $758.00 | $1.00–$682.20 | 38% above | 50% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS | $379.00 | $758.00 | $379.00–$22,980.00 | — | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS | $398.00 | $796.00 | $1.00–$716.40 | 24% above | 50% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS | $398.00 | $796.00 | $398.00–$22,980.00 | — | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIP UNI W/PELVIS 2-3 VIEWS | $479.00 | $958.00 | $1.00–$862.20 | 35% above | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIP UNI W/PELVIS 2-3 VIEWS | $479.00 | $958.00 | $479.00–$22,980.00 | — | 50% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW | $273.50 | $547.00 | $1.00–$492.30 | 2% below | 50% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW | $273.50 | $547.00 | $273.50–$22,980.00 | — | 50% |
| X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS | $346.00 | $692.00 | $1.00–$622.80 | 2% above | 50% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS | $346.00 | $692.00 | $346.00–$22,980.00 | — | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS MIN 2 VIEWS | $264.50 | $529.00 | $1.00–$476.10 | 9% above | 50% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS MIN 2 VIEWS | $264.50 | $529.00 | $264.50–$22,980.00 | — | 50% |
| X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS | $336.50 | $673.00 | $1.00–$605.70 | 4% above | 50% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS | $336.50 | $673.00 | $336.50–$22,980.00 | — | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT COMPLETE MIN 3 VIEWS | $367.00 | $734.00 | $1.00–$660.60 | 1% above | 50% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT COMPLETE MIN 3 VIEWS | $367.00 | $734.00 | $367.00–$22,980.00 | — | 50% |
| X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS | $393.00 | $786.00 | $1.00–$707.40 | 32% above | 50% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS | $393.00 | $786.00 | $393.00–$22,980.00 | — | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS | $395.50 | $791.00 | $1.00–$711.90 | 40% above | 50% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS | $395.50 | $791.00 | $395.50–$22,980.00 | — | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR LUMBAR SPINE 2-3 VIEWS | $389.50 | $779.00 | $1.00–$701.10 | 7% above | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR LUMBAR SPINE 2-3 VIEWS | $389.50 | $779.00 | $389.50–$22,980.00 | — | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 HC XR LUMBAR SPINE MIN 4 VIEWS | $561.50 | $1,123.00 | $1.00–$1,010.70 | 24% above | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC XR LUMBAR SPINE MIN 4 VIEWS | $561.50 | $1,123.00 | $561.50–$22,980.00 | — | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR THORACIC SPINE 2 VIEWS | $420.50 | $841.00 | $1.00–$756.90 | 15% above | 50% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR THORACIC SPINE 2 VIEWS | $420.50 | $841.00 | $420.50–$22,980.00 | — | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES | $328.50 | $657.00 | $1.00–$591.30 | 21% above | 50% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES | $328.50 | $657.00 | $328.50–$22,980.00 | — | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR CERVICAL SPINE 2-3 VIEWS | $411.00 | $822.00 | $1.00–$739.80 | 24% above | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR CERVICAL SPINE 2-3 VIEWS | $411.00 | $822.00 | $411.00–$22,980.00 | — | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1 OR 2 VIEWS | $320.00 | $640.00 | $1.00–$576.00 | 9% above | 50% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1 OR 2 VIEWS | $320.00 | $640.00 | $320.00–$22,980.00 | — | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR SACRUM & COCCYX MIN 2 VIEWS | $429.00 | $858.00 | $1.00–$772.20 | 28% above | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR SACRUM & COCCYX MIN 2 VIEWS | $429.00 | $858.00 | $429.00–$22,980.00 | — | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE | $21.50 | $43.00 | $1.00–$38.70 | 43% above | 50% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE | $21.50 | $43.00 | $21.50–$22,980.00 | — | 50% |
| Urine pregnancy test, read by color change CPT 81025 HC PREGNANCY TEST URINE POC | $60.50 | $121.00 | $1.00–$108.90 | 64% above | 50% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC PREGNANCY TEST URINE POC | $60.50 | $121.00 | $60.50–$22,980.00 | — | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BREAST BX STEREOTACTIC 1ST LESION | $5,647.50 | $11,295.00 | $1.00–$10,165.50 | 44% above | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BREAST BX STEREOTACTIC 1ST LESION | $5,647.50 | $11,295.00 | $5,647.50–$22,980.00 | — | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLSD TX DSTL ANKLE FX W/O MAN (ED) | $1,151.50 | $2,303.00 | $1.00–$2,072.70 | 74% above | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLSD TX DSTL ANKLE FX W/O MAN (ED) | $1,151.50 | $2,303.00 | $1,151.50–$22,980.00 | — | 50% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLSD TX METATARSAL FX W/O MAN (ED) | $571.50 | $1,143.00 | $1.00–$1,964.00 | 10% above | 50% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLSD TX METATARSAL FX W/O MAN (ED) | $571.50 | $1,143.00 | $571.50–$22,980.00 | — | 50% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HC LT HEART ART/VENTRICLE ANGIO | $22,340.00 | $44,680.00 | $1.00–$40,212.00 | 153% above | 50% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC LT HEART ART/VENTRICLE ANGIO | $22,340.00 | $44,680.00 | $16,086.00–$40,212.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION (ED) | $2,708.00 | $5,416.00 | $1.00–$4,874.40 | 85% above | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION | $2,708.00 | $5,416.00 | $1.00–$4,874.40 | 85% above | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION | $2,708.00 | $5,416.00 | $2,708.00–$22,980.00 | — | 50% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION (ED) | $2,708.00 | $5,416.00 | $2,708.00–$22,980.00 | — | 50% |
| Catheter ablation for atrial fibrillation CPT 93656 HC EP EVAL FIB PULM VEIN ISOL W/IMAGING | $70,123.50 | $140,247.00 | $1.00–$126,222.30 | 126% above | 50% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP EVAL FIB PULM VEIN ISOL W/IMAGING | $70,123.50 | $140,247.00 | $16,086.00–$126,222.30 | — | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION | $2,332.50 | $4,665.00 | $1.00–$6,812.57 | 91% above | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION | $2,332.50 | $4,665.00 | $2,332.50–$22,980.00 | — | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLSD TX DISTAL RDL FX W/O MAN (ED) | $805.00 | $1,610.00 | $1.00–$1,964.00 | 21% above | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLSD TX DISTAL RDL FX W/O MAN (ED) | $805.00 | $1,610.00 | $805.00–$22,980.00 | — | 50% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY W/ENDO US EXAM | $3,208.00 | $6,416.00 | $1.00–$5,774.40 | 38% above | 50% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC COLONOSCOPY W/ENDO US EXAM | $3,208.00 | $6,416.00 | $3,208.00–$22,980.00 | — | 50% |
| Colonoscopy with polyp removal CPT 45385 HC COLON-SNARE REMOVAL-TUM/POL/LES | $3,170.00 | $6,340.00 | $1.00–$6,326.00 | 25% above | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC COLON-SNARE REMOVAL-TUM/POL/LES | $3,170.00 | $6,340.00 | $3,170.00–$22,980.00 | — | 50% |
| Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BX SGL/MULTI | $2,521.00 | $5,042.00 | $1.00–$6,326.00 | 14% above | 50% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BX SGL/MULTI | $2,521.00 | $5,042.00 | $2,521.00–$22,980.00 | — | 50% |
| Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEX DIAGNOSTIC | $2,336.00 | $4,672.00 | $1.00–$6,326.00 | 56% above | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEX DIAGNOSTIC | $2,336.00 | $4,672.00 | $2,336.00–$22,980.00 | — | 50% |
| Coronary stent placement, one artery CPT 92928 HC PRQ CARD STENT W/ANGIO ART/BRANCH | $33,155.00 | $66,310.00 | $1.00–$59,679.00 | 64% above | 50% |
| Coronary stent placement, one artery inpatient CPT 92928 HC PRQ CARD STENT W/ANGIO ART/BRANCH | $33,155.00 | $66,310.00 | $16,086.00–$59,679.00 | — | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC RMV IMPACTED EAR WAX W/LAV UNI (ED) | $377.50 | $755.00 | $1.00–$1,964.00 | 170% above | 50% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC RMV IMPACTED EAR WAX W/LAV UNI (ED) | $377.50 | $755.00 | $377.50–$22,980.00 | — | 50% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED EAR WAX (ED) | $360.00 | $720.00 | $1.00–$1,964.00 | 168% above | 50% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE IMPACTED EAR WAX (ED) | $360.00 | $720.00 | $360.00–$22,980.00 | — | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JT L/S 1 LVL | $4,636.50 | $9,273.00 | $1.00–$8,345.70 | 222% above | 50% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JT L/S 1 LVL | $4,636.50 | $9,273.00 | $4,636.50–$22,980.00 | — | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLEX DIAGNOSTIC | $2,887.50 | $5,775.00 | $1.00–$5,197.50 | 149% above | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLEX DIAGNOSTIC | $2,887.50 | $5,775.00 | $2,887.50–$22,980.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE/SINGLE (ED) | $1,074.00 | $2,148.00 | $1.00–$1,964.00 | 110% above | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D SIMPLE ABSCESS | $1,074.00 | $2,148.00 | $1.00–$1,933.20 | 110% above | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D SIMPLE ABSCESS | $1,074.00 | $2,148.00 | $1,074.00–$22,980.00 | — | 50% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE/SINGLE (ED) | $1,074.00 | $2,148.00 | $1,074.00–$22,980.00 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC TENDON SHEATH/LIGAMENT INJ | $1,071.50 | $2,143.00 | $1.00–$1,928.70 | 88% above | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC TENDON SHEATH/LIGAMENT INJ (ED) | $1,071.50 | $2,143.00 | $1.00–$1,964.00 | 88% above | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC TENDON SHEATH/LIGAMENT INJ (ED) | $1,071.50 | $2,143.00 | $1,071.50–$22,980.00 | — | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC TENDON SHEATH/LIGAMENT INJ | $1,071.50 | $2,143.00 | $1,071.50–$22,980.00 | — | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHRO MAJOR JNT W/O US GUID (ED) | $1,709.50 | $3,419.00 | $1.00–$3,077.10 | 265% above | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHRO MAJOR JNT W/O US GUID (ED) | $1,709.50 | $3,419.00 | $1,709.50–$22,980.00 | — | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHRO INT JNT W/O US GUID (ED) | $1,377.00 | $2,754.00 | $1.00–$2,478.60 | 289% above | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHRO INT JNT W/O US GUID (ED) | $1,377.00 | $2,754.00 | $1,377.00–$22,980.00 | — | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ JT/BURSA WO US SM (ED) | $733.00 | $1,466.00 | $1.00–$1,964.00 | 78% above | 50% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ JT/BURSA WO US SM (ED) | $733.00 | $1,466.00 | $733.00–$22,980.00 | — | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC INT RPR SCP/AX/TRK 2.5CM/< (ED) | $1,549.00 | $3,098.00 | $1.00–$2,788.20 | 164% above | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC INT RPR SCP/AX/TRK 2.5CM/< (ED) | $1,549.00 | $3,098.00 | $1,549.00–$22,980.00 | — | 50% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HEART CATH | $9,860.50 | $19,721.00 | $1.00–$17,748.90 | 51% above | 50% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HEART CATH | $9,860.50 | $19,721.00 | $9,860.50–$22,980.00 | — | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INTRLM L/S INJ W/IG | $1,849.00 | $3,698.00 | $1.00–$3,328.20 | 12% below | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INTRLM L/S INJ W/IG | $1,849.00 | $3,698.00 | $1,849.00–$22,980.00 | — | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC INTRLM L/S INJ W/O IG | $1,259.50 | $2,519.00 | $1.00–$2,882.50 | 34% below | 50% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INTRLM L/S INJ W/O IG | $1,259.50 | $2,519.00 | $1,259.50–$22,980.00 | — | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC FORAMEN EPIDURAL L/S INJ/SGL | $1,604.50 | $3,209.00 | $1.00–$2,888.10 | 16% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC FORAMEN EPIDURAL L/S INJ/SGL | $1,604.50 | $3,209.00 | $1,604.50–$22,980.00 | — | 50% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION OF NAIL PLATE SMPL (ED) | $1,117.50 | $2,235.00 | $1.00–$2,011.50 | 137% above | 50% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION OF NAIL PLATE SMPL | $1,117.50 | $2,235.00 | $1.00–$2,011.50 | 137% above | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION OF NAIL PLATE SMPL | $1,117.50 | $2,235.00 | $1,117.50–$22,980.00 | — | 50% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION OF NAIL PLATE SMPL (ED) | $1,117.50 | $2,235.00 | $1,117.50–$22,980.00 | — | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 HC N BLOCK INJ OCCIPITAL (ED) | $1,272.00 | $2,544.00 | $1.00–$2,289.60 | 125% above | 50% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC N BLOCK INJ OCCIPITAL (ED) | $1,272.00 | $2,544.00 | $1,272.00–$22,980.00 | — | 50% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSERT/RPL HRT PM ATRIAL/VENTR | $14,044.00 | $28,088.00 | $1.00–$34,063.09 | 10% above | 50% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT/RPL HRT PM ATRIAL/VENTR | $14,044.00 | $28,088.00 | $14,044.00–$25,279.20 | — | 50% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING (ED) | $4,210.00 | $8,420.00 | $1.00–$7,578.00 | 150% above | 50% |
| Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING | $4,210.00 | $8,420.00 | $1.00–$7,578.00 | 150% above | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING (ED) | $4,210.00 | $8,420.00 | $4,210.00–$22,980.00 | — | 50% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABD PARACENTESIS W/IMAGING | $4,210.00 | $8,420.00 | $4,210.00–$22,980.00 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXC NAIL/MATRIX PERMANENT (ED) | $1,447.50 | $2,895.00 | $1.00–$2,605.50 | 74% above | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXC NAIL/MATRIX PERMANENT | $1,447.50 | $2,895.00 | $1.00–$2,605.50 | 74% above | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXC NAIL/MATRIX PERMANENT | $1,447.50 | $2,895.00 | $1,447.50–$22,980.00 | — | 50% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXC NAIL/MATRIX PERMANENT (ED) | $1,447.50 | $2,895.00 | $1,447.50–$22,980.00 | — | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISION & RMVL FOREIGN BODY SIMPLE | $1,402.50 | $2,805.00 | $1.00–$2,524.50 | 158% above | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INCISN & RMVL FOREIGN BDY SIMPLE (ED) | $1,402.50 | $2,805.00 | $1.00–$2,524.50 | 158% above | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISN & RMVL FOREIGN BDY SIMPLE (ED) | $1,402.50 | $2,805.00 | $1,402.50–$22,980.00 | — | 50% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INCISION & RMVL FOREIGN BODY SIMPLE | $1,402.50 | $2,805.00 | $1,402.50–$22,980.00 | — | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLONOSCOPY CA SCRN NOT HI RSK | $2,336.00 | $4,672.00 | $1.00–$4,204.80 | 54% above | 50% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLONOSCOPY CA SCRN NOT HI RSK | $2,336.00 | $4,672.00 | $2,336.00–$22,980.00 | — | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND | $2,336.00 | $4,672.00 | $1.00–$6,326.00 | 36% above | 50% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND | $2,336.00 | $4,672.00 | $2,336.00–$22,980.00 | — | 50% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST (ED) | $722.50 | $1,445.00 | $1.00–$1,964.00 | 74% above | 50% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY FOREARM CAST (ED) | $722.50 | $1,445.00 | $722.50–$22,980.00 | — | 50% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT STATIC (ED) | $940.50 | $1,881.00 | $1.00–$1,964.00 | 199% above | 50% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT STATIC (ED) | $940.50 | $1,881.00 | $940.50–$22,980.00 | — | 50% |
| Short leg cast (below the knee) CPT 29405 HC APPLY LOWER LEG CAST (ED) | $382.00 | $764.00 | $1.00–$1,964.00 | 27% below | 50% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLY LOWER LEG CAST (ED) | $382.00 | $764.00 | $382.00–$22,980.00 | — | 50% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT (ED) | $1,302.50 | $2,605.00 | $1.00–$2,344.50 | 182% above | 50% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT (ED) | $1,302.50 | $2,605.00 | $1,302.50–$22,980.00 | — | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SMP WND RPR TRUNK 2.5CM/< (ED) | $1,207.00 | $2,414.00 | $1.00–$2,172.60 | 135% above | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SMP WND RPR TRUNK 2.5CM/< (ED) | $1,207.00 | $2,414.00 | $1,207.00–$22,980.00 | — | 50% |
| Skin biopsy, punch, one lesion CPT 11104 HC BX PUNCH SKIN SINGLE LESION | $1,036.50 | $2,073.00 | $1.00–$1,865.70 | 57% above | 50% |
| Skin biopsy, punch, one lesion CPT 11104 HC BX PUNCH SKIN SINGLE LESION (ED) | $1,036.50 | $2,073.00 | $1.00–$1,964.00 | 57% above | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC BX PUNCH SKIN SINGLE LESION (ED) | $1,036.50 | $2,073.00 | $1,036.50–$22,980.00 | — | 50% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC BX PUNCH SKIN SINGLE LESION | $1,036.50 | $2,073.00 | $1,036.50–$22,980.00 | — | 50% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVE SKN TAGS </=15 LSN (ED) | $1,332.50 | $2,665.00 | $1.00–$2,398.50 | 121% above | 50% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVE SKN TAGS </=15 LSN (ED) | $1,332.50 | $2,665.00 | $1,332.50–$22,980.00 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DX SPINAL PUNCT LUMBAR (ED) | $1,953.50 | $3,907.00 | $1.00–$3,516.30 | 60% above | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DX SPINAL PUNCT LUMBAR (CL) | $1,953.50 | $3,907.00 | $1.00–$3,516.30 | 60% above | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DX SPINAL PUNCT LUMBAR (ED) | $1,953.50 | $3,907.00 | $1,953.50–$22,980.00 | — | 50% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DX SPINAL PUNCT LUMBAR (CL) | $1,953.50 | $3,907.00 | $1,953.50–$22,980.00 | — | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SMP WND RPR TRUNK 2.6-7.5CM (ED) | $1,494.00 | $2,988.00 | $1.00–$2,689.20 | 183% above | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SMP WND RPR TRUNK 2.6-7.5CM (ED) | $1,494.00 | $2,988.00 | $1,494.00–$22,980.00 | — | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SMP WND RPR FACE 2.5CM/< (ED) | $1,499.50 | $2,999.00 | $1.00–$2,699.10 | 194% above | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SMP WND RPR FACE 2.5CM/< (ED) | $1,499.50 | $2,999.00 | $1,499.50–$22,980.00 | — | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BX TANGNTL SKIN SINGLE LESN (ED) | $953.00 | $1,906.00 | $1.00–$1,964.00 | 68% above | 50% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC BX TANGNTL SKIN SINGLE LESN (ED) | $953.00 | $1,906.00 | $953.00–$22,980.00 | — | 50% |
| Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/IMAGING (ED) | $2,768.00 | $5,536.00 | $1.00–$4,982.40 | 88% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 HC ASPIRATE PLEURA W/IMAGING | $2,768.00 | $5,536.00 | $1.00–$4,982.40 | 88% above | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC ASPIRATE PLEURA W/IMAGING | $2,768.00 | $5,536.00 | $2,768.00–$22,980.00 | — | 50% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC ASPIRATE PLEURA W/IMAGING (ED) | $2,768.00 | $5,536.00 | $2,768.00–$22,980.00 | — | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER POINT 1/2 MUSCL INJ (ED) | $894.00 | $1,788.00 | $1.00–$1,964.00 | 65% above | 50% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC TRIGGER POINT 1/2 MUSCL INJ (ED) | $894.00 | $1,788.00 | $894.00–$22,980.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 HC BX BREAST 1ST LESN US IMAGE BILAT | $5,054.50 | $10,109.00 | $1.00–$9,098.10 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC BX BREAST 1ST LESION US IMAGE RT | $5,054.50 | $10,109.00 | $1.00–$9,098.10 | 41% above | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC BX BREAST 1ST LESION US IMAGE LT | $5,054.50 | $10,109.00 | $1.00–$9,098.10 | 41% above | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient both sides CPT 19083 HC BX BREAST 1ST LESN US IMAGE BILAT | $5,054.50 | $10,109.00 | $5,054.50–$22,980.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC BX BREAST 1ST LESION US IMAGE RT | $5,054.50 | $10,109.00 | $5,054.50–$22,980.00 | — | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC BX BREAST 1ST LESION US IMAGE LT | $5,054.50 | $10,109.00 | $5,054.50–$22,980.00 | — | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UGI ENDO BAL DIL ESOPH <30MM | $2,782.00 | $5,564.00 | $1.00–$6,326.00 | 19% below | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC UGI ENDO BAL DIL ESOPH <30MM | $2,782.00 | $5,564.00 | $2,782.00–$22,980.00 | — | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC UGI ENDO BIOPSY SGL/MULTI | $2,523.00 | $5,046.00 | $1.00–$6,326.00 | 16% above | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC UGI ENDO BIOPSY SGL/MULTI | $2,523.00 | $5,046.00 | $2,523.00–$22,980.00 | — | 50% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UGI ENDO SCOPE W/SUBMUCOSL INJ | $2,523.00 | $5,046.00 | $1.00–$4,541.40 | 3% below | 50% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC UGI ENDO SCOPE W/SUBMUCOSL INJ | $2,523.00 | $5,046.00 | $2,523.00–$22,980.00 | — | 50% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC UGI END SNARE RMV TMR/PLYP/LSN | $3,532.00 | $7,064.00 | $1.00–$6,357.60 | 12% above | 50% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC UGI END SNARE RMV TMR/PLYP/LSN | $3,532.00 | $7,064.00 | $3,532.00–$22,980.00 | — | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC UGI EGD W/BALLOON DILATE GW | $3,020.50 | $6,041.00 | $1.00–$6,326.00 | 22% above | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC UGI EGD W/BALLOON DILATE GW | $3,020.50 | $6,041.00 | $3,020.50–$22,980.00 | — | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC UGI ENDO DIAGNOSTIC COMPLEX | $2,257.00 | $4,514.00 | $1.00–$6,326.00 | 19% above | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC UGI ENDO DIAGNOSTIC COMPLEX | $2,257.00 | $4,514.00 | $2,257.00–$22,980.00 | — | 50% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC UGI W/DRAIN OF CYST | $6,982.50 | $13,965.00 | $1.00–$19,785.08 | 17% below | 50% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC UGI W/DRAIN OF CYST | $6,982.50 | $13,965.00 | $6,982.50–$22,980.00 | — | 50% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS ABLATION RF 1ST VEIN | $3,293.50 | $6,587.00 | $1.00–$10,290.24 | 65% below | 50% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS ABLATION RF 1ST VEIN | $3,293.50 | $6,587.00 | $3,293.50–$22,980.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DBRDMNT TISS/FS 1ST 20SQCM/< | $1,118.00 | $2,236.00 | $1.00–$2,012.40 | 4% above | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DBRDMNT TISS/FS 1ST 20SQCM/< (ED) | $1,118.00 | $2,236.00 | $1.00–$2,012.40 | 4% above | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DBRDMNT TISS/FS 1ST 20SQCM/< | $1,118.00 | $2,236.00 | $1,118.00–$22,980.00 | — | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DBRDMNT TISS/FS 1ST 20SQCM/< (ED) | $1,118.00 | $2,236.00 | $1,118.00–$22,980.00 | — | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION | $935.00 | $1,870.00 | $1.00–$1,683.00 | 1% below | 50% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION | $935.00 | $1,870.00 | $935.00–$22,980.00 | — | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TX | $257.50 | $515.00 | $1.00–$713.65 | 15% above | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TX | $257.50 | $515.00 | $257.50–$22,980.00 | — | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE FIRST 30-74 MIN (ED) | $4,417.50 | $8,835.00 | $1.00–$7,951.50 | 135% above | 50% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE FIRST 30-74 MIN (ED) | $4,417.50 | $8,835.00 | $4,417.50–$22,980.00 | — | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG | $1,272.50 | $2,545.00 | $1.00–$2,290.50 | 67% above | 50% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG | $1,272.50 | $2,545.00 | $1,272.50–$22,980.00 | — | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG TRACING ONLY | $227.00 | $454.00 | $1.00–$408.60 | 30% above | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG TRACING ONLY | $227.00 | $454.00 | $227.00–$22,980.00 | — | 50% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY | $1,073.00 | $2,146.00 | $1.00–$2,798.64 | 15% below | 50% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ELECTROCONVULSIVE THERAPY | $1,073.00 | $2,146.00 | $350.00–$22,980.00 | — | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER LEVEL 1 | $520.00 | $1,040.00 | $1.00–$1,964.00 | 71% above | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER LEVEL 1 | $520.00 | $1,040.00 | $520.00–$22,980.00 | — | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER LEVEL 2 | $627.50 | $1,255.00 | $1.00–$1,964.00 | 31% above | 50% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER LEVEL 2 | $627.50 | $1,255.00 | $627.50–$22,980.00 | — | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER LEVEL 3 | $1,145.00 | $2,290.00 | $1.00–$2,061.00 | 54% above | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER LEVEL 3 | $1,145.00 | $2,290.00 | $1,145.00–$22,980.00 | — | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER LEVEL 4 | $1,885.00 | $3,770.00 | $1.00–$3,393.00 | 54% above | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER LEVEL 4 | $1,885.00 | $3,770.00 | $1,885.00–$22,980.00 | — | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER LEVEL 5 | $2,892.50 | $5,785.00 | $1.00–$5,206.50 | 81% above | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER LEVEL 5 | $2,892.50 | $5,785.00 | $2,892.50–$22,980.00 | — | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIO STRESS TEST | $1,183.00 | $2,366.00 | $1.00–$2,129.40 | 25% above | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIO STRESS TEST W/NUCLEAR | $1,183.00 | $2,366.00 | $1.00–$2,129.40 | 25% above | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIO STRESS TEST | $1,183.00 | $2,366.00 | $1,183.00–$22,980.00 | — | 50% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIO STRESS TEST W/NUCLEAR | $1,183.00 | $2,366.00 | $1,183.00–$22,980.00 | — | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRAT INIT 31-60 MIN W/HL | $722.00 | $1,444.00 | $1.00–$1,299.60 | 66% above | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRAT INIT 31-60 MIN W/HL | $722.00 | $1,444.00 | $722.00–$22,980.00 | — | 50% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INF TX/DX UP TO 1 HR W/HL | $868.00 | $1,736.00 | $1.00–$1,562.40 | 93% above | 50% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INF TX/DX UP TO 1 HR W/HL | $868.00 | $1,736.00 | $868.00–$22,980.00 | — | 50% |
| IV push of a medicine, first drug CPT 96374 HC TX IV PUSH INITIAL W/HL | $694.50 | $1,389.00 | $1.00–$1,250.10 | 111% above | 50% |
| IV push of a medicine, first drug inpatient CPT 96374 HC TX IV PUSH INITIAL W/HL | $694.50 | $1,389.00 | $694.50–$22,980.00 | — | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC TX/PRO/DX SC/IM INJ | $244.00 | $488.00 | $1.00–$439.20 | 98% above | 50% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC TX/PRO/DX SC/IM INJ | $244.00 | $488.00 | $244.00–$22,980.00 | — | 50% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CNDCTN TEST 7-8 STUDIES | $2,071.50 | $4,143.00 | $1.00–$3,728.70 | 42% above | 50% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NERVE CNDCTN TEST 7-8 STUDIES | $2,071.50 | $4,143.00 | $2,071.50–$22,980.00 | — | 50% |
| New patient office visit, about 30 minutes CPT 99203 HC NEW PT LEVEL 3 | $255.00 | $510.00 | $1.00–$459.00 | 7% above | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC NEW PT LEVEL 3 | $255.00 | $510.00 | $255.00–$22,980.00 | — | 50% |
| New patient office visit, about 45 minutes CPT 99204 HC NEW PT LEVEL 4 | $267.50 | $535.00 | $1.00–$481.50 | 11% below | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC NEW PT LEVEL 4 | $267.50 | $535.00 | $267.50–$22,980.00 | — | 50% |
| New patient office visit, about 60 minutes CPT 99205 HC NEW PT LEVEL 5 | $280.00 | $560.00 | $1.00–$504.00 | 46% below | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC NEW PT LEVEL 5 | $280.00 | $560.00 | $280.00–$22,980.00 | — | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC NEW PT LEVEL 2 | $242.50 | $485.00 | $1.00–$436.50 | 33% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC NEW PT LEVEL 2 | $242.50 | $485.00 | $242.50–$22,980.00 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC TOBACCO-USE COUNSEL 3-10 MIN (ED) | $47.50 | $95.00 | $1.00–$1,964.00 | 4% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC TOBACCO-USE COUNSEL 3-10 MIN | $47.50 | $95.00 | $1.00–$122.11 | 4% above | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC TOBACCO-USE COUNSEL 3-10 MIN | $47.50 | $95.00 | $47.50–$22,980.00 | — | 50% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC TOBACCO-USE COUNSEL 3-10 MIN (ED) | $47.50 | $95.00 | $47.50–$22,980.00 | — | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC EST PT LEVEL 5 | $280.00 | $560.00 | $1.00–$504.00 | 3% above | 50% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC EST PT LEVEL 5 | $280.00 | $560.00 | $280.00–$22,980.00 | — | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC EST PT LEVEL 3 | $255.00 | $510.00 | $1.00–$459.00 | 38% above | 50% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC EST PT LEVEL 3 | $255.00 | $510.00 | $255.00–$22,980.00 | — | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC EST PT LEVEL 4 | $267.50 | $535.00 | $1.00–$481.50 | 33% above | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC EST PT LEVEL 4 | $267.50 | $535.00 | $267.50–$22,980.00 | — | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC EST PT LEVEL 2 | $242.50 | $485.00 | $1.00–$436.50 | 50% above | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC EST PT LEVEL 2 | $242.50 | $485.00 | $242.50–$22,980.00 | — | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OP CONSULT LEVEL 3 | $255.00 | $510.00 | $1.00–$459.00 | 38% above | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 HC OP CONSULT LEVEL 3 | $255.00 | $510.00 | $255.00–$22,980.00 | — | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OP CONSULT LEVEL 4 | $267.50 | $535.00 | $1.00–$481.50 | 3% above | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HC OP CONSULT LEVEL 4 | $267.50 | $535.00 | $267.50–$22,980.00 | — | 50% |
| Spirometry (breathing test) CPT 94010 HC PEAK FLOW MEASRMNT/ROUTINE SPIROMETRY | $578.00 | $1,156.00 | $1.00–$1,040.40 | 92% above | 50% |
| Spirometry (breathing test) inpatient CPT 94010 HC PEAK FLOW MEASRMNT/ROUTINE SPIROMETRY | $578.00 | $1,156.00 | $578.00–$22,980.00 | — | 50% |
| Spirometry before and after a bronchodilator CPT 94060 HC SPIRO-PRE/POST BRONCHODILATOR | $1,081.00 | $2,162.00 | $1.00–$1,945.80 | 66% above | 50% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIRO-PRE/POST BRONCHODILATOR | $1,081.00 | $2,162.00 | $1,081.00–$22,980.00 | — | 50% |
| Visual field test, extended CPT 92083 HC VISUAL FIELD EXAM EXTENDED | $391.00 | $782.00 | $1.00–$703.80 | 41% above | 50% |
| Visual field test, extended inpatient CPT 92083 HC VISUAL FIELD EXAM EXTENDED | $391.00 | $782.00 | $391.00–$22,980.00 | — | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 mRNA Vaccine 12 years and above Pfizer 30 MCG/0.3ML Susy 0.3 mL Syringe | $120.00 | $240.00 | $1.00–$216.00 | 26% below | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 mRNA Vaccine 12 years and above Pfizer 30 MCG/0.3ML Susy 0.3 mL Syringe | $120.00 | $240.00 | $120.00–$22,980.00 | — | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vaccine Live 1350 PFU/0.5ML Susr 1 Each Vial | $155.00 | $310.00 | $1.00–$279.00 | 25% below | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vaccine Live 1350 PFU/0.5ML Susr 1 Each Vial | $155.00 | $310.00 | $155.00–$22,980.00 | — | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphth acell pertus tetanus 25-58-10 LF-MCG/0.5 Susp 0.5 mL Syringe | $22.50 | $45.00 | $1.00–$40.50 | 34% below | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphth acell pertus tetanus 25-58-10 LF-MCG/0.5 Susp 0.5 mL Syringe | $22.50 | $45.00 | $22.50–$22,980.00 | — | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTaP-Hepatitis B Recomb-IPV Susy 0.5 mL Syringe | $90.00 | $180.00 | $1.00–$162.00 | 8% above | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTaP-Hepatitis B Recomb-IPV Susy 0.5 mL Syringe | $90.00 | $180.00 | $90.00–$22,980.00 | — | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTaP-IPV-Hib Susr 1 Each Package | $85.50 | $171.00 | $1.00–$153.90 | 3% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DTaP-IPV-Hib Susr 1 Each Package | $85.50 | $171.00 | $85.50–$22,980.00 | — | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine trivalent 0.5 ML Susy 0.5 mL Syringe | $67.50 | $135.00 | $1.00–$121.50 | 1% above | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine trivalent 0.5 ML Susy 0.5 mL Syringe | $67.50 | $135.00 | $67.50–$22,980.00 | — | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-Valent Recomb Vaccine Susy 0.5 mL Syringe | $260.00 | $520.00 | $1.00–$468.00 | 3% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-Valent Recomb Vaccine Susy 0.5 mL Syringe | $260.00 | $520.00 | $260.00–$22,980.00 | — | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis a-Hep b recomb vac 720-20 ELU-MCG/ML Susy 1 mL Syringe | $80.00 | $160.00 | $1.00–$144.00 | 11% below | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis a-Hep b recomb vac 720-20 ELU-MCG/ML Susy 1 mL Syringe | $80.00 | $160.00 | $80.00–$22,980.00 | — | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 1440 EL U/ML Susy 1 mL Syringe | $61.00 | $122.00 | $1.00–$109.80 | 32% below | 50% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 1440 EL U/ML Susy 1 mL Syringe | $61.00 | $122.00 | $61.00–$22,980.00 | — | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine 720 EL U/0.5ML Susy 0.5 mL Syringe | $35.00 | $70.00 | $1.00–$63.00 | 53% below | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine 720 EL U/0.5ML Susy 0.5 mL Syringe | $35.00 | $70.00 | $35.00–$22,980.00 | — | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vac Recombinant 10 MCG/ML Susp 1 mL Vial | $354.96 | $709.93 | $1.00–$638.94 | 331% above | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vac Recombinant 10 MCG/ML Susp 1 mL Vial | $354.96 | $709.93 | $354.96–$22,980.00 | — | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 hepatitis B vac Recomb Adj 20 MCG/0.5ML Sosy 0.5 mL Syringe | $147.50 | $295.00 | $1.00–$265.50 | 15% below | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 hepatitis B vac Recomb Adj 20 MCG/0.5ML Sosy 0.5 mL Syringe | $147.50 | $295.00 | $147.50–$22,980.00 | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus B Polysac Conj Vac 7.5 mcg/0.5ml Susp 0.5 mL Vial | $22.50 | $45.00 | $1.00–$40.50 | 73% below | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Haemophilus B Polysac Conj Vac 7.5 mcg/0.5ml Susp 0.5 mL Vial | $22.50 | $45.00 | $22.50–$22,980.00 | — | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus B Polysac Conj Vac 10 MCG Solr 1 Each Box | $90.00 | $180.00 | $1.00–$162.00 | 188% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus B Polysac Conj Vac 10 MCG Solr 1 Each Box | $90.00 | $180.00 | $90.00–$22,980.00 | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza Vac Split HIGH-DOSE Trivalent(65 years and older) 0.5 ML Susy 0.5 mL Syringe | $67.50 | $135.00 | $1.00–$121.50 | 23% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza Vac Split HIGH-DOSE Trivalent(65 years and older) 0.5 ML Susy 0.5 mL Syringe | $67.50 | $135.00 | $67.50–$22,980.00 | — | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles Mumps & Rubella Vac Solr 1 Each Vial | $87.50 | $175.00 | $1.00–$157.50 | 34% above | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles Mumps & Rubella Vac Susr 1 Each Vial | $87.50 | $175.00 | $1.00–$157.50 | 34% above | 50% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles Mumps & Rubella Vac Susr 1 Each Vial | $87.50 | $175.00 | $87.50–$22,980.00 | — | 50% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles Mumps & Rubella Vac Solr 1 Each Vial | $87.50 | $175.00 | $87.50–$22,980.00 | — | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles-mumps-rubella-varicell vac Susr 1 Each Vial | $252.50 | $505.00 | $1.00–$454.50 | 4% above | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles-mumps-rubella-varicell vac Susr 1 Each Vial | $252.50 | $505.00 | $252.50–$22,980.00 | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine Soln 0.5 mL Vial | $145.00 | $290.00 | $1.00–$261.00 | 55% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine Solr 1 Each Box | $145.00 | $290.00 | $1.00–$261.00 | 55% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal conjugate vaccine Soln 0.5 mL Vial | $145.00 | $290.00 | $145.00–$22,980.00 | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal conjugate vaccine Solr 1 Each Box | $145.00 | $290.00 | $145.00–$22,980.00 | — | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Group B vaccine Susy 0.5 mL Syringe | $205.00 | $410.00 | $1.00–$369.00 | 7% above | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Group B vaccine Susy 0.5 mL Syringe | $205.00 | $410.00 | $205.00–$22,980.00 | — | 50% |
| Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal Group B vaccine Susy 0.5 mL Syringe | $125.50 | $251.00 | $1.00–$225.90 | 36% below | 50% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Meningococcal Group B vaccine Susy 0.5 mL Syringe | $125.50 | $251.00 | $125.50–$22,980.00 | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20-Val Conj Vacc 0.5 ML Susy 0.5 mL Syringe | $245.00 | $490.00 | $1.00–$441.00 | 24% below | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal 20-Val Conj Vacc 0.5 ML Susy 0.5 mL Syringe | $245.00 | $490.00 | $245.00–$22,980.00 | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vac Polyvalent 25 MCG/0.5ML Sosy 0.5 mL Syringe | $122.50 | $245.00 | $1.00–$220.50 | 5% below | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vac Polyvalent 25 MCG/0.5ML Sosy 0.5 mL Syringe | $122.50 | $245.00 | $122.50–$22,980.00 | — | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus Vaccine Inactivated Susp 5 mL Vial | $40.00 | $80.00 | $1.00–$72.00 | 33% below | 50% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus Vaccine Inactivated Susp 5 mL Vial | $40.00 | $80.00 | $40.00–$22,980.00 | — | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab-alip 100 MG/ML Sosy 1 mL Syringe | $2,989.21 | $5,978.42 | $1.00–$5,380.58 | 150% above | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Nirsevimab-alip 100 MG/ML Sosy 1 mL Syringe | $2,989.21 | $5,978.42 | $1,100.03–$22,980.00 | — | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-alip 50 MG/0.5ML Sosy 0.5 mL Syringe | $2,989.21 | $5,978.42 | $1.00–$5,380.58 | 233% above | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab-alip 50 MG/0.5ML Sosy 0.5 mL Syringe | $2,989.21 | $5,978.42 | $1,100.03–$22,980.00 | — | 50% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine PCEC Susr 1 Each Vial | $342.50 | $685.00 | $1.00–$1,005.52 | 43% below | 50% |
| Rabies vaccine, one dose CPT 90675 Rabies Virus Vaccine HDC Susr 1 Each Vial | $342.50 | $685.00 | $1.00–$1,005.52 | 43% below | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine PCEC Susr 1 Each Vial | $342.50 | $685.00 | $342.50–$22,980.00 | — | 50% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Virus Vaccine HDC Susr 1 Each Vial | $342.50 | $685.00 | $342.50–$22,980.00 | — | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Vaccine Live Susp 1.5 mL Syringe | $95.00 | $190.00 | $1.00–$171.00 | 51% above | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus Vaccine Live Susp 1.5 mL Syringe | $95.00 | $190.00 | $95.00–$22,980.00 | — | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus Vac Live Pentavalent Soln 2 mL Plas Cont | $73.50 | $147.00 | $1.00–$132.30 | 11% below | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus Vac Live Pentavalent Soln 2 mL Plas Cont | $73.50 | $147.00 | $73.50–$22,980.00 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2.5-18.5 LF-MCG/0.5 Susp 0.5 mL Vial | $38.00 | $76.00 | $1.00–$68.40 | 32% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2.5-18.5 LF-MCG/0.5 Susy 0.5 mL Syringe | $38.00 | $76.00 | $1.00–$68.40 | 32% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2-15.5 LF-MCG/0.5 Susy 0.5 mL Syringe | $38.00 | $76.00 | $1.00–$68.40 | 32% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2.5-18.5 LF-MCG/0.5 Susy 0.5 mL Syringe | $38.00 | $76.00 | $38.00–$22,980.00 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2-15.5 LF-MCG/0.5 Susy 0.5 mL Syringe | $38.00 | $76.00 | $38.00–$22,980.00 | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus-Diphth-Acell Pertussis 5-2.5-18.5 LF-MCG/0.5 Susp 0.5 mL Vial | $38.00 | $76.00 | $38.00–$22,980.00 | — | 50% |
| Typhoid vaccine, oral capsules (Vivotif) CPT 90690 Typhoid Vaccine Cpdr 4 Each Disp Pack | $70.00 | $140.00 | $1.00–$126.00 | 47% above | 50% |
| Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 Typhoid Vaccine Cpdr 4 Each Disp Pack | $70.00 | $140.00 | $70.00–$22,980.00 | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN VACCINE SINGLE | $50.00 | $100.00 | $1.00–$234.65 | 22% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN VACCINE SINGLE | $50.00 | $100.00 | $50.00–$22,980.00 | — | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC ADMIN VACCINE EA ADD | $50.00 | $100.00 | $1.00–$90.00 | 86% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC ADMIN VACCINE EA ADD | $50.00 | $100.00 | $50.00–$22,980.00 | — | 50% |
| Yellow fever vaccine, live CPT 90717 Yellow Fever Vaccine Susr 1 Each Vial | $95.00 | $190.00 | $1.00–$171.00 | 58% below | 50% |
| Yellow fever vaccine, live inpatient CPT 90717 Yellow Fever Vaccine Susr 1 Each Vial | $95.00 | $190.00 | $95.00–$22,980.00 | — | 50% |
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.