Kohala Hospital
Kohala Hospital in Kapaau, HI publishes cash prices for 183 common procedures listed here, from its own machine-readable price file updated Jul 23, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Hawaii median for 146 of 183 procedures and below it for 23. By typical cash price it ranks #11 of 13 Hawaii hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
54-383 Hospital Rd Collected Nov 4, 2026 Source price file Check a bill from this hospital (808) 889-6211
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CCN 121302 · CMS hospital register
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Kohala Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Kohala Hospital in Kapaau, HI:
- Apr 14, 2023 Met requirements
- Jul 17, 2026 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 Hawaii | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $389.35 | $599.00 | — | 36% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS PORT | $389.35 | $599.00 | $18.84–$718.80 | 36% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS PORT | $389.35 | $599.00 | — | 36% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $389.35 | $599.00 | $18.84–$718.80 | 36% above | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS PORT | $389.35 | $599.00 | — | — | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS | $389.35 | $599.00 | — | — | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS | $323.70 | $498.00 | — | 34% above | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS | $323.70 | $498.00 | $17.34–$597.60 | 34% above | 35% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE MIN 3 VIEWS | $323.70 | $498.00 | — | — | 35% |
| Chest X-ray, 2 views CPT 71046 CHEST INSP/EXP 2 VIEWS | $351.00 | $540.00 | $20.37–$648.00 | 37% above | 35% |
| Chest X-ray, 2 views CPT 71046 CHEST INSP/EXP 2 VIEWS | $351.00 | $540.00 | — | 37% above | 35% |
| Chest X-ray, 2 views CPT 71046 CHEST PA LAT 2 VIEWS | $351.00 | $540.00 | $20.37–$648.00 | 37% above | 35% |
| Chest X-ray, 2 views CPT 71046 CHEST PA LAT 2 VIEWS | $351.00 | $540.00 | — | 37% above | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST INSP/EXP 2 VIEWS | $351.00 | $540.00 | — | — | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST PA LAT 2 VIEWS | $351.00 | $540.00 | — | — | 35% |
| Chest X-ray, single view CPT 71045 CHEST AP ONLY PORT 1 VIEW | $292.50 | $450.00 | $13.07–$540.00 | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST PA ONLY 1 VIEW | $292.50 | $450.00 | $13.07–$540.00 | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST SPEC 1 VIEW | $292.50 | $450.00 | — | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST SPEC 1 VIEW | $292.50 | $450.00 | $13.07–$540.00 | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST AP ONLY PORT 1 VIEW | $292.50 | $450.00 | — | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST AP 1 VIEW | $292.50 | $450.00 | $13.07–$540.00 | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST AP 1 VIEW | $292.50 | $450.00 | — | 34% above | 35% |
| Chest X-ray, single view CPT 71045 CHEST PA ONLY 1 VIEW | $292.50 | $450.00 | — | 34% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 CHEST SPEC 1 VIEW | $292.50 | $450.00 | — | — | 35% |
| Chest X-ray, single view inpatient CPT 71045 CHEST PA ONLY 1 VIEW | $292.50 | $450.00 | — | — | 35% |
| Chest X-ray, single view inpatient CPT 71045 CHEST AP 1 VIEW | $292.50 | $450.00 | — | — | 35% |
| Chest X-ray, single view inpatient CPT 71045 CHEST AP ONLY PORT 1 VIEW | $292.50 | $450.00 | — | — | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE | $351.00 | $540.00 | — | 47% above | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE | $351.00 | $540.00 | $17.04–$648.00 | 47% above | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE PORT COMPLETE | $351.00 | $540.00 | — | 47% above | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE PORT COMPLETE | $351.00 | $540.00 | $17.04–$648.00 | 47% above | 35% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE PORT COMPLETE | $351.00 | $540.00 | — | — | 35% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE | $351.00 | $540.00 | — | — | 35% |
| Elbow X-ray, 2 views CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS | $293.15 | $451.00 | — | 46% above | 35% |
| Elbow X-ray, 2 views CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS | $293.15 | $451.00 | $17.04–$541.20 | 46% above | 35% |
| Elbow X-ray, 2 views CPT 73070 ELBOW (2 VIEWS) | $293.15 | $451.00 | $17.04–$541.20 | 46% above | 35% |
| Elbow X-ray, 2 views CPT 73070 ELBOW (2 VIEWS) | $293.15 | $451.00 | — | 46% above | 35% |
| Elbow X-ray, 2 views inpatient CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS | $293.15 | $451.00 | — | — | 35% |
| Elbow X-ray, 2 views inpatient CPT 73070 ELBOW (2 VIEWS) | $293.15 | $451.00 | — | — | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS | $351.65 | $541.00 | — | 40% above | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS | $351.65 | $541.00 | $18.84–$649.20 | 40% above | 35% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW MIN 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS | $463.45 | $713.00 | $25.96–$855.60 | 30% above | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS | $463.45 | $713.00 | — | 30% above | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN 3 VIEWS | $463.45 | $713.00 | — | — | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS | $293.15 | $451.00 | — | 30% above | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS | $293.15 | $451.00 | $17.04–$541.20 | 30% above | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS | $293.15 | $451.00 | — | — | 35% |
| Hand X-ray, 2 views CPT 73120 HAND (2 VIEWS) | $293.15 | $451.00 | — | 21% above | 35% |
| Hand X-ray, 2 views CPT 73120 HAND (2 VIEWS) | $293.15 | $451.00 | $17.55–$541.20 | 21% above | 35% |
| Hand X-ray, 2 views inpatient CPT 73120 HAND (2 VIEWS) | $293.15 | $451.00 | — | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL MIN 2 VIEWS | $292.50 | $450.00 | $17.03–$540.00 | 71% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL MIN 2 VIEWS | $292.50 | $450.00 | — | 71% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL MIN 2 VIEWS | $292.50 | $450.00 | — | — | 35% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $351.65 | $541.00 | $18.84–$649.20 | 22% above | 35% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS | $351.65 | $541.00 | — | 22% above | 35% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE W OBLIQUES 4>VIEWS | $366.60 | $564.00 | $22.13–$676.80 | 18% above | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 KNEE W OBLIQUES 4>VIEWS | $366.60 | $564.00 | — | 18% above | 35% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE W OBLIQUES 4>VIEWS | $366.60 | $564.00 | — | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB, 2 VIEWS | $289.25 | $445.00 | $18.46–$534.00 | 29% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB PORT, 2 VIEWS | $289.25 | $445.00 | $18.46–$534.00 | 29% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB PORT, 2 VIEWS | $289.25 | $445.00 | — | 29% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB, 2 VIEWS | $289.25 | $445.00 | — | 29% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIB/FIB PORT, 2 VIEWS | $289.25 | $445.00 | — | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIB/FIB, 2 VIEWS | $289.25 | $445.00 | — | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE 4 OR 5 VIEWS | $469.30 | $722.00 | $29.64–$866.40 | 47% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE 4 OR 5 VIEWS | $469.30 | $722.00 | — | 47% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE 4 OR 5 VIEWS | $469.30 | $722.00 | — | — | 35% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE PORT | $293.15 | $451.00 | $15.15–$541.20 | 2% above | 35% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE | $293.15 | $451.00 | — | 2% above | 35% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE | $293.15 | $451.00 | $15.15–$541.20 | 2% above | 35% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE PORT | $293.15 | $451.00 | — | 2% above | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE | $293.15 | $451.00 | — | — | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE PORT | $293.15 | $451.00 | — | — | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIS COMP PORT | $469.30 | $722.00 | — | 4% below | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIS COMP PORT | $469.30 | $722.00 | $50.35–$866.40 | 4% below | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIS COMP PORT | $469.30 | $722.00 | — | — | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VIEWS | $337.35 | $519.00 | $18.84–$622.80 | 41% above | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VIEWS | $337.35 | $519.00 | — | 41% above | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2 VIEWS | $337.35 | $519.00 | — | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W CHEST MIN 3 VIEWS | $351.65 | $541.00 | — | 33% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W CHEST MIN 3 VIEWS | $351.65 | $541.00 | $21.96–$649.20 | 33% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 RIBS UNI W CHEST MIN 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS | $351.65 | $541.00 | $18.84–$649.20 | 59% above | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS | $351.65 | $541.00 | — | 59% above | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS | $351.65 | $541.00 | — | — | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS PORT | $386.75 | $595.00 | — | 31% above | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS PORT | $386.75 | $595.00 | $20.40–$714.00 | 31% above | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 1-3 VIEWS PORT | $386.75 | $595.00 | — | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> | $292.50 | $450.00 | — | 4% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> | $292.50 | $450.00 | $15.87–$540.00 | 4% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/> | $292.50 | $450.00 | — | — | 35% |
| Toe X-ray, 2 or more views CPT 73660 TOES MIN 2 VIEWS | $285.35 | $439.00 | — | 83% above | 35% |
| Toe X-ray, 2 or more views CPT 73660 TOES MIN 2 VIEWS | $285.35 | $439.00 | $13.91–$526.80 | 83% above | 35% |
| Toe X-ray, 2 or more views inpatient CPT 73660 TOES MIN 2 VIEWS | $285.35 | $439.00 | — | — | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS, MIN 2 VIEWS | $293.15 | $451.00 | $18.84–$541.20 | 65% above | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS, MIN 2 VIEWS | $293.15 | $451.00 | — | 65% above | 35% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS, MIN 2 VIEWS | $293.15 | $451.00 | — | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $255.45 | $393.00 | $93.10–$471.60 | 42% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $255.45 | $393.00 | — | 42% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $255.45 | $393.00 | — | — | 35% |
| Wrist X-ray, 2 views CPT 73100 WRIST (2 VIEWS) | $293.15 | $451.00 | — | 29% above | 35% |
| Wrist X-ray, 2 views CPT 73100 WRIST (2 VIEWS) | $293.15 | $451.00 | $16.41–$541.20 | 29% above | 35% |
| Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS PORT | $293.15 | $451.00 | — | 29% above | 35% |
| Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS PORT | $293.15 | $451.00 | $16.41–$541.20 | 29% above | 35% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST (2 VIEWS) | $293.15 | $451.00 | — | — | 35% |
| Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS PORT | $293.15 | $451.00 | — | — | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS | $351.65 | $541.00 | — | 34% above | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS | $351.65 | $541.00 | $17.34–$649.20 | 34% above | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS | $351.65 | $541.00 | — | 34% above | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS | $351.65 | $541.00 | $17.34–$649.20 | 34% above | 35% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILAT W/ OR W/O PELVIS 2-3 VIEWS | $271.70 | $418.00 | — | 7% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP UNILAT W/ OR W/O PELVIS 2-3 VIEWS | $271.70 | $418.00 | $20.87–$501.60 | 7% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP UNILAT W/ OR W/O PELVIS 2-3 VIEWS | $271.70 | $418.00 | — | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW | $209.95 | $323.00 | $18.26–$387.60 | 4% below | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW | $209.95 | $323.00 | — | 4% below | 35% |
| X-ray of the abdomen, 1 view CPT 74018 KUB AP 1 VW | $262.60 | $404.00 | $18.26–$484.80 | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 KUB AP 1 VW | $262.60 | $404.00 | — | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW | $262.60 | $404.00 | $18.26–$484.80 | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN AP 1 VIEW | $262.60 | $404.00 | — | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN AP 1 VIEW | $262.60 | $404.00 | $18.26–$484.80 | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW | $262.60 | $404.00 | — | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 KUB PORT AP 1 VW | $262.60 | $404.00 | $18.26–$484.80 | 20% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 KUB PORT AP 1 VW | $262.60 | $404.00 | — | 20% above | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW | $209.95 | $323.00 | — | — | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 KUB PORT AP 1 VW | $262.60 | $404.00 | — | — | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 KUB AP 1 VW | $262.60 | $404.00 | — | — | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN AP 1 VIEW | $262.60 | $404.00 | — | — | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW | $262.60 | $404.00 | — | — | 35% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE (2 VIEWS) | $293.15 | $451.00 | $16.41–$541.20 | 56% above | 35% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE (2 VIEWS) | $293.15 | $451.00 | — | 56% above | 35% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE (2 VIEWS) | $293.15 | $451.00 | — | — | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VWS | $314.60 | $484.00 | — | 89% above | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VWS | $314.60 | $484.00 | $14.98–$580.80 | 89% above | 35% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS MIN 2 VWS | $314.60 | $484.00 | — | — | 35% |
| X-ray of the foot, 2 views CPT 73620 FOOT (2 VIEWS) | $293.15 | $451.00 | $16.41–$541.20 | 50% above | 35% |
| X-ray of the foot, 2 views CPT 73620 FOOT (2 VIEWS) | $293.15 | $451.00 | — | 50% above | 35% |
| X-ray of the foot, 2 views CPT 73620 FOOT PORT, 2 VIEWS | $293.15 | $451.00 | $16.41–$541.20 | 50% above | 35% |
| X-ray of the foot, 2 views CPT 73620 FOOT PORT, 2 VIEWS | $293.15 | $451.00 | — | 50% above | 35% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT PORT, 2 VIEWS | $293.15 | $451.00 | — | — | 35% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT (2 VIEWS) | $293.15 | $451.00 | — | — | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS | $293.15 | $451.00 | $19.08–$541.20 | 25% above | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS | $293.15 | $451.00 | — | 25% above | 35% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS | $293.15 | $451.00 | — | — | 35% |
| X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS | $351.65 | $541.00 | $19.08–$649.20 | 28% above | 35% |
| X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS | $351.65 | $541.00 | — | 28% above | 35% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE (1-2) VIEWS | $293.15 | $451.00 | $17.04–$541.20 | 36% above | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE (1-2) VIEWS | $293.15 | $451.00 | — | 36% above | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2 VIEWS PORT | $293.15 | $451.00 | $17.04–$541.20 | 36% above | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2 VIEWS PORT | $293.15 | $451.00 | — | 36% above | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 2 VIEWS PORT | $293.15 | $451.00 | — | — | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE (1-2) VIEWS | $293.15 | $451.00 | — | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS | $351.65 | $541.00 | $21.96–$649.20 | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS | $351.65 | $541.00 | — | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS | $351.65 | $541.00 | — | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS PORT | $351.65 | $541.00 | — | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS PORT | $351.65 | $541.00 | $21.96–$649.20 | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS | $351.65 | $541.00 | $21.96–$649.20 | 25% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2 VIEWS PORT | $351.65 | $541.00 | — | — | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 LS SPINE MIN 4 VIEWS | $469.30 | $722.00 | $32.35–$866.40 | 6% above | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 LS SPINE MIN 4 VIEWS | $469.30 | $722.00 | — | 6% above | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LS SPINE MIN 4 VIEWS | $469.30 | $722.00 | — | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS PORT | $351.65 | $541.00 | $21.34–$649.20 | 45% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS PORT | $351.65 | $541.00 | — | 45% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS | $351.65 | $541.00 | $21.34–$649.20 | 45% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS | $351.65 | $541.00 | — | 45% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VIEWS PORT | $351.65 | $541.00 | — | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS | $399.10 | $614.00 | $17.04–$736.80 | 58% above | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS | $399.10 | $614.00 | — | 58% above | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VIEWS | $399.10 | $614.00 | — | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2-3 VIEWS | $351.65 | $541.00 | — | 27% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2-3 VIEWS | $351.65 | $541.00 | $19.78–$649.20 | 27% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C- SPINE AP & LAT ONLY | $351.65 | $541.00 | $19.78–$649.20 | 27% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C- SPINE AP & LAT ONLY | $351.65 | $541.00 | — | 27% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C- SPINE AP & LAT ONLY | $351.65 | $541.00 | — | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE 2-3 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS 1-2 VIEWS | $278.85 | $429.00 | $18.74–$514.80 | 41% above | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS 1-2 VIEWS | $278.85 | $429.00 | — | 41% above | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 AP PELVIS 1-2 VIEWS | $278.85 | $429.00 | — | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACROCOC SPINE, MIN 2 VIEWS | $351.65 | $541.00 | $18.84–$649.20 | 52% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS | $351.65 | $541.00 | $18.84–$649.20 | 52% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACROCOC SPINE, MIN 2 VIEWS | $351.65 | $541.00 | — | 52% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS | $351.65 | $541.00 | — | 52% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACROCOC SPINE, MIN 2 VIEWS | $351.65 | $541.00 | — | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS | $351.65 | $541.00 | — | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH LEVEL RIA 90 | $470.60 | $724.00 | $53.38–$868.80 | 122% above | 35% |
| ACTH blood test CPT 82024 ACTH LEVEL RIA 90 | $470.60 | $724.00 | — | 122% above | 35% |
| ACTH blood test inpatient CPT 82024 ACTH LEVEL RIA 90 | $470.60 | $724.00 | — | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $61.10 | $94.00 | $7.32–$112.80 | 28% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $61.10 | $94.00 | — | 28% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT | $61.10 | $94.00 | — | — | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $60.45 | $93.00 | $7.14–$111.60 | 21% above | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $60.45 | $93.00 | — | 21% above | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT | $60.45 | $93.00 | — | — | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $663.65 | $1,021.00 | $65.82–$1,225.20 | 33% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $663.65 | $1,021.00 | — | 33% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $663.65 | $1,021.00 | — | — | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHTASE | $60.45 | $93.00 | — | 21% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHTASE | $60.45 | $93.00 | $7.15–$111.60 | 21% above | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHTASE | $60.45 | $93.00 | — | — | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM | $154.05 | $237.00 | $23.18–$284.40 | 20% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM | $154.05 | $237.00 | — | 20% above | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN SERUM | $154.05 | $237.00 | — | — | 35% |
| Ammonia blood test CPT 82140 AMMONIA | $149.50 | $230.00 | $20.14–$276.00 | 10% above | 35% |
| Ammonia blood test CPT 82140 AMMONIA | $149.50 | $230.00 | — | 10% above | 35% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $149.50 | $230.00 | — | — | 35% |
| Amylase blood test CPT 82150 AMYLASE | $74.10 | $114.00 | $8.96–$136.80 | 9% above | 35% |
| Amylase blood test CPT 82150 AMYLASE | $74.10 | $114.00 | — | 9% above | 35% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $74.10 | $114.00 | — | — | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM | $138.45 | $213.00 | — | 9% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM | $138.45 | $213.00 | $16.70–$255.60 | 9% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA AB | $184.60 | $284.00 | — | 45% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA AB | $184.60 | $284.00 | $16.70–$340.80 | 45% above | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM | $138.45 | $213.00 | — | — | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA AB | $184.60 | $284.00 | — | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP | $310.70 | $478.00 | $28.46–$573.60 | 23% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP | $310.70 | $478.00 | — | 23% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PROBNP | $310.70 | $478.00 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID | $98.80 | $152.00 | — | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP | $98.80 | $152.00 | $11.90–$182.40 | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP | $98.80 | $152.00 | — | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT | $98.80 | $152.00 | $11.90–$182.40 | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT | $98.80 | $152.00 | — | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT SPUTUM | $98.80 | $152.00 | $11.90–$182.40 | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT SPUTUM | $98.80 | $152.00 | — | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT MISC | $98.80 | $152.00 | $11.90–$182.40 | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT MISC | $98.80 | $152.00 | — | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID | $98.80 | $152.00 | $11.90–$182.40 | 9% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT SPUTUM | $98.80 | $152.00 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT MISC | $98.80 | $152.00 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT BODY FLUID | $98.80 | $152.00 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP | $98.80 | $152.00 | — | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT THROAT | $98.80 | $152.00 | — | — | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE | $92.30 | $142.00 | $11.70–$170.40 | 10% above | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE | $92.30 | $142.00 | — | 10% above | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE | $92.30 | $142.00 | — | — | 35% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOT | $46.80 | $72.00 | $6.94–$86.40 | at median | 35% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOT | $46.80 | $72.00 | — | at median | 35% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOT | $46.80 | $72.00 | — | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV GROSS MICRO EXAM | $254.80 | $392.00 | — | at median | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV GROSS MICRO EXAM | $254.80 | $392.00 | $40.64–$470.40 | at median | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV GROSS MICRO EXAM | $254.80 | $392.00 | — | — | 35% |
| Blood culture for bacteria CPT 87040 CULT BLOOD | $100.10 | $154.00 | $14.27–$184.80 | at median | 35% |
| Blood culture for bacteria CPT 87040 CULT BLOOD | $100.10 | $154.00 | — | at median | 35% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD | $100.10 | $154.00 | — | — | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD | $36.40 | $56.00 | — | 1% below | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD | $36.40 | $56.00 | $5.42–$67.20 | 1% below | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD | $36.40 | $56.00 | — | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM | $87.10 | $134.00 | $10.38–$160.80 | 10% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL URINE | $87.10 | $134.00 | $10.38–$160.80 | 10% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL URINE | $87.10 | $134.00 | — | 10% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM | $87.10 | $134.00 | — | 10% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM | $87.10 | $134.00 | — | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL URINE | $87.10 | $134.00 | — | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN | $45.50 | $70.00 | — | 21% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN | $45.50 | $70.00 | $5.45–$84.00 | 21% above | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN | $45.50 | $70.00 | — | — | 35% |
| C-peptide blood test CPT 84681 C-PEPTIDE 90 | $190.45 | $293.00 | $28.75–$351.60 | 19% above | 35% |
| C-peptide blood test CPT 84681 C-PEPTIDE 90 | $190.45 | $293.00 | — | 19% above | 35% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE 90 | $190.45 | $293.00 | — | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP) | $53.95 | $83.00 | — | 71% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP) | $53.95 | $83.00 | $7.15–$99.60 | 71% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (CRP) | $53.95 | $83.00 | — | — | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY | $326.95 | $503.00 | $50.27–$603.60 | 9% above | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY | $326.95 | $503.00 | — | 9% above | 35% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY | $326.95 | $503.00 | — | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID 19 AMP PRB - HIGH THROUGHPUT TECH - 90 | $206.70 | $318.00 | $51.31–$381.60 | 176% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID 19 AMP PRB - HIGH THROUGHPUT TECH - 90 | $206.70 | $318.00 | — | 176% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID 19 AMP PRB - HIGH THROUGHPUT TECH - 90 | $206.70 | $318.00 | — | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA | $401.05 | $617.00 | $48.50–$740.40 | 263% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA | $401.05 | $617.00 | — | 263% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA | $401.05 | $617.00 | — | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC RISK/LIPID PROFILE | $122.20 | $188.00 | $18.51–$225.60 | 5% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC RISK/LIPID PROFILE | $122.20 | $188.00 | — | 5% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIAC RISK/LIPID PROFILE | $122.20 | $188.00 | — | — | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC W DIFF | $89.05 | $137.00 | — | 45% above | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC W DIFF | $89.05 | $137.00 | $10.74–$164.40 | 45% above | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W DIFF | $89.05 | $137.00 | — | — | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC WO DIFF | $67.60 | $104.00 | $8.95–$124.80 | 42% above | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC WO DIFF | $67.60 | $104.00 | — | 42% above | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WO DIFF | $67.60 | $104.00 | — | — | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROF | $114.40 | $176.00 | — | 18% above | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROF | $114.40 | $176.00 | $14.61–$211.20 | 18% above | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PROF | $114.40 | $176.00 | — | — | 35% |
| Cortisol blood test, total CPT 82533 CORTISOL SERUM/PLASMA RIA | $198.90 | $306.00 | — | 46% above | 35% |
| Cortisol blood test, total CPT 82533 CORTISOL SERUM/PLASMA RIA | $198.90 | $306.00 | $22.53–$367.20 | 46% above | 35% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM/PLASMA RIA | $198.90 | $306.00 | — | — | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL | $74.10 | $114.00 | — | 9% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL | $74.10 | $114.00 | $9.01–$136.80 | 9% above | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL | $74.10 | $114.00 | — | — | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $47.45 | $73.00 | $7.07–$87.60 | 36% above | 35% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $47.45 | $73.00 | — | 36% above | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD | $47.45 | $73.00 | — | — | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $116.35 | $179.00 | $14.06–$214.80 | 9% above | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $116.35 | $179.00 | — | 9% above | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT | $116.35 | $179.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATES BLOOD | $107.25 | $165.00 | — | 13% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATES BLOOD | $107.25 | $165.00 | $47.89–$198.00 | 13% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL BLOOD | $134.55 | $207.00 | $47.89–$248.40 | 41% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL BLOOD | $134.55 | $207.00 | — | 41% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90 | $209.95 | $323.00 | $47.89–$387.60 | 121% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90 | $209.95 | $323.00 | — | 121% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN TYLENOL | $247.00 | $380.00 | — | 159% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN TYLENOL | $247.00 | $380.00 | $47.89–$456.00 | 159% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN FENTANYL SO | $371.80 | $572.00 | $47.89–$686.40 | 291% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN FENTANYL SO | $371.80 | $572.00 | — | 291% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE-8 | $432.90 | $666.00 | — | 355% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE-8 | $432.90 | $666.00 | $47.89–$799.20 | 355% above | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATES BLOOD | $107.25 | $165.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL BLOOD | $134.55 | $207.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90 | $209.95 | $323.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN TYLENOL | $247.00 | $380.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN FENTANYL SO | $371.80 | $572.00 | — | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE-8 | $432.90 | $666.00 | — | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $63.70 | $98.00 | $9.69–$117.60 | at median | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $63.70 | $98.00 | — | at median | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $63.70 | $98.00 | — | — | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGM 90 | $165.75 | $255.00 | — | 19% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGG 90 | $165.75 | $255.00 | — | 19% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGG 90 | $165.75 | $255.00 | $25.07–$306.00 | 19% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGM 90 | $165.75 | $255.00 | $25.07–$306.00 | 19% above | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 E-B VIRUS AB IGG 90 | $165.75 | $255.00 | — | — | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 E-B VIRUS AB IGM 90 | $165.75 | $255.00 | — | — | 35% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL RIA | $131.30 | $202.00 | — | 9% above | 35% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL RIA | $131.30 | $202.00 | $15.81–$242.40 | 9% above | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN LEVEL RIA | $131.30 | $202.00 | — | — | 35% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $98.80 | $152.00 | — | 23% above | 35% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $98.80 | $152.00 | $11.74–$182.40 | 23% above | 35% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY | $98.80 | $152.00 | — | — | 35% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID-SERUM | $133.90 | $206.00 | — | at median | 35% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID-SERUM | $133.90 | $206.00 | $20.32–$247.20 | at median | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID-SERUM | $133.90 | $206.00 | — | — | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4 | $92.95 | $143.00 | $12.46–$171.60 | 18% above | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4 | $92.95 | $143.00 | — | 18% above | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE T4 | $92.95 | $143.00 | — | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA | $401.05 | $617.00 | $48.50–$740.40 | 263% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA | $401.05 | $617.00 | — | 263% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA | $401.05 | $617.00 | — | — | 35% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB | $177.45 | $273.00 | — | 23% above | 35% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB | $177.45 | $273.00 | $20.05–$327.60 | 23% above | 35% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB | $177.45 | $273.00 | — | — | 35% |
| H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL | $110.50 | $170.00 | $16.58–$204.00 | 9% above | 35% |
| H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL | $110.50 | $170.00 | — | 9% above | 35% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG EIA STOOL | $110.50 | $170.00 | — | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C HPLC | $99.45 | $153.00 | — | 9% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C HPLC | $99.45 | $153.00 | $13.42–$183.60 | 9% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C HPLC | $99.45 | $153.00 | — | — | 35% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $28.60 | $44.00 | $3.27–$52.80 | 10% above | 35% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $28.60 | $44.00 | — | 10% above | 35% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $28.60 | $44.00 | — | — | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB | $98.80 | $152.00 | — | at median | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB | $98.80 | $152.00 | $14.84–$182.40 | at median | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB | $98.80 | $152.00 | — | — | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $130.65 | $201.00 | $19.73–$241.20 | at median | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $130.65 | $201.00 | — | at median | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB | $130.65 | $201.00 | — | — | 35% |
| Iron blood test (serum iron) CPT 83540 IRON TOT | $66.95 | $103.00 | $8.95–$123.60 | 71% above | 35% |
| Iron blood test (serum iron) CPT 83540 IRON TOT | $66.95 | $103.00 | — | 71% above | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON TOT | $66.95 | $103.00 | — | — | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $99.45 | $153.00 | — | 9% above | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $99.45 | $153.00 | $12.08–$183.60 | 9% above | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING | $99.45 | $153.00 | — | — | 35% |
| Kidney function blood test panel CPT 80069 RENAL PROFILE | $89.05 | $137.00 | $12.00–$164.40 | 28% above | 35% |
| Kidney function blood test panel CPT 80069 RENAL PROFILE | $89.05 | $137.00 | — | 28% above | 35% |
| Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE | $89.05 | $137.00 | — | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $98.80 | $152.00 | — | at median | 35% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $98.80 | $152.00 | $14.76–$182.40 | at median | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID | $98.80 | $152.00 | — | — | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $69.55 | $107.00 | — | 20% above | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $69.55 | $107.00 | $8.35–$128.40 | 20% above | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $69.55 | $107.00 | — | — | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $79.30 | $122.00 | $9.52–$146.40 | 9% above | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $79.30 | $122.00 | — | 9% above | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $79.30 | $122.00 | — | — | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM | $77.35 | $119.00 | $9.26–$142.80 | 24% above | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM | $77.35 | $119.00 | — | 24% above | 35% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $77.35 | $119.00 | — | — | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCRN SPECIFIC | $60.45 | $93.00 | — | 9% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCRN SPECIFIC | $60.45 | $93.00 | $7.15–$111.60 | 9% above | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCRN SPECIFIC | $60.45 | $93.00 | — | — | 35% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $155.35 | $239.00 | $21.14–$286.80 | 46% below | 35% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $155.35 | $239.00 | — | 46% below | 35% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $155.35 | $239.00 | — | — | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL | $169.00 | $260.00 | $25.42–$312.00 | 49% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL | $169.00 | $260.00 | — | 49% above | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL | $169.00 | $260.00 | — | — | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN) | $254.15 | $391.00 | $30.96–$469.20 | 30% above | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN) | $254.15 | $391.00 | — | 30% above | 35% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN) | $254.15 | $391.00 | — | — | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $377.00 | $580.00 | — | at median | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $377.00 | $580.00 | $57.04–$696.00 | at median | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $377.00 | $580.00 | — | — | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PART THRMPLSTN PTT | $55.25 | $85.00 | — | 16% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PART THRMPLSTN PTT | $55.25 | $85.00 | $8.30–$102.00 | 16% above | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PART THRMPLSTN PTT | $55.25 | $85.00 | — | — | 35% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $44.20 | $68.00 | $6.56–$81.60 | at median | 35% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $44.20 | $68.00 | — | at median | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $44.20 | $68.00 | — | — | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $36.40 | $56.00 | $5.43–$67.20 | 1% below | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $36.40 | $56.00 | — | 1% below | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $36.40 | $56.00 | — | — | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES | $79.95 | $123.00 | $8.98–$147.60 | 11% below | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES | $79.95 | $123.00 | — | 11% below | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES | $79.95 | $123.00 | — | — | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AG | $110.50 | $170.00 | $16.58–$204.00 | 19% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AG | $110.50 | $170.00 | — | 19% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $110.50 | $170.00 | $16.58–$204.00 | 19% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $110.50 | $170.00 | — | 19% above | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC | $110.50 | $170.00 | — | — | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA AG | $110.50 | $170.00 | — | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $110.50 | $170.00 | — | 99% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $110.50 | $170.00 | $16.58–$204.00 | 99% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID DIR GRP-A STREP SCREEN | $123.50 | $190.00 | $16.58–$228.00 | 123% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID DIR GRP-A STREP SCREEN | $123.50 | $190.00 | — | 123% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC | $110.50 | $170.00 | — | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID DIR GRP-A STREP SCREEN | $123.50 | $190.00 | — | — | 35% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $66.30 | $102.00 | — | 10% above | 35% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $66.30 | $102.00 | $7.85–$122.40 | 10% above | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT | $66.30 | $102.00 | — | — | 35% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES CONC & ID | $101.40 | $156.00 | — | 11% above | 35% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES CONC & ID | $101.40 | $156.00 | $12.30–$187.20 | 11% above | 35% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES CONC & ID | $101.40 | $156.00 | — | — | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $30.55 | $47.00 | — | 2% below | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $30.55 | $47.00 | $4.49–$56.40 | 2% below | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES | $30.55 | $47.00 | — | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD | $138.45 | $213.00 | $13.33–$255.60 | 45% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD | $138.45 | $213.00 | — | 45% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD | $138.45 | $213.00 | — | — | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD | $235.30 | $362.00 | $51.95–$434.40 | 15% below | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD | $235.30 | $362.00 | — | 15% below | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD | $235.30 | $362.00 | — | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $191.75 | $295.00 | — | 51% above | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $191.75 | $295.00 | $23.21–$354.00 | 51% above | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $191.75 | $295.00 | — | — | 35% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $79.30 | $122.00 | — | 32% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $79.30 | $122.00 | $9.50–$146.40 | 32% above | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL | $79.30 | $122.00 | — | — | 35% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG, AMP PROBE | $150.80 | $232.00 | — | at median | 35% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAG, AMP PROBE | $150.80 | $232.00 | $28.72–$278.40 | at median | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG, AMP PROBE | $150.80 | $232.00 | — | — | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN T | $102.05 | $157.00 | $13.60–$188.40 | 11% above | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN T | $102.05 | $157.00 | — | 11% above | 35% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN T | $102.05 | $157.00 | — | — | 35% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $52.00 | $80.00 | $6.25–$96.00 | 10% above | 35% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $52.00 | $80.00 | — | 10% above | 35% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD | $52.00 | $80.00 | — | — | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE | $37.05 | $57.00 | $4.37–$68.40 | 8% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED, W/ MICROSCOPY | $37.05 | $57.00 | $4.37–$68.40 | 8% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED, W/ MICROSCOPY | $37.05 | $57.00 | — | 8% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE | $37.05 | $57.00 | — | 8% above | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE | $37.05 | $57.00 | — | — | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTOMATED, W/ MICROSCOPY | $37.05 | $57.00 | — | — | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, REFLEX MICROSCOPIC | $26.00 | $40.00 | $3.10–$48.00 | 8% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 UA QUAL AUTO WO MICRO | $26.00 | $40.00 | $3.10–$48.00 | 8% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 UA QUAL AUTO WO MICRO | $26.00 | $40.00 | — | 8% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, REFLEX MICROSCOPIC | $26.00 | $40.00 | — | 8% above | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA QUAL AUTO WO MICRO | $26.00 | $40.00 | — | — | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, REFLEX MICROSCOPIC | $26.00 | $40.00 | — | — | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $29.25 | $45.00 | — | 61% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY | $29.25 | $45.00 | — | 61% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY | $29.25 | $45.00 | $3.54–$54.00 | 61% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $29.25 | $45.00 | $3.54–$54.00 | 61% above | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $29.25 | $45.00 | — | — | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY | $29.25 | $45.00 | — | — | 35% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $76.70 | $118.00 | $11.16–$141.60 | 4% above | 35% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $76.70 | $118.00 | — | 4% above | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE | $76.70 | $118.00 | — | — | 35% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE | $53.95 | $83.00 | $8.00–$99.60 | at median | 35% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE | $53.95 | $83.00 | — | at median | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE | $53.95 | $83.00 | — | — | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $138.45 | $213.00 | — | at median | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $138.45 | $213.00 | $20.83–$255.60 | at median | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $138.45 | $213.00 | — | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL | $224.90 | $346.00 | — | 3% below | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 OCCULT BLOOD | $224.90 | $346.00 | — | 3% below | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL | $224.90 | $346.00 | $40.91–$415.20 | 3% below | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 OCCULT BLOOD | $224.90 | $346.00 | $40.91–$415.20 | 3% below | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL | $224.90 | $346.00 | — | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 OCCULT BLOOD | $224.90 | $346.00 | — | — | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90 | $352.30 | $542.00 | $53.19–$650.40 | 9% above | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90 | $352.30 | $542.00 | — | 9% above | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90 | $352.30 | $542.00 | — | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM | $137.80 | $212.00 | — | 238% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM | $137.80 | $212.00 | $20.80–$254.40 | 238% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM | $137.80 | $212.00 | — | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST BIFULAR FX | $756.60 | $1,164.00 | $582.00–$1,396.80 | 8% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST BIFULAR FX | $756.60 | $1,164.00 | — | 8% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIST BIFULAR FX | $756.60 | $1,164.00 | — | — | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $1,719.25 | $2,645.00 | $1,322.50–$3,174.00 | 46% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $1,719.25 | $2,645.00 | — | 46% above | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $1,719.25 | $2,645.00 | — | — | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISTAL RADIAL FX | $756.60 | $1,164.00 | $582.00–$1,396.80 | 16% below | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISTAL RADIAL FX | $756.60 | $1,164.00 | — | 16% below | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISTAL RADIAL FX | $756.60 | $1,164.00 | — | — | 35% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY - DIAGNOSTIC | $1,412.45 | $2,173.00 | — | 5% below | 35% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY - DIAGNOSTIC | $1,412.45 | $2,173.00 | $1,086.50–$2,607.60 | 5% below | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY - DIAGNOSTIC | $1,412.45 | $2,173.00 | — | — | 35% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $224.25 | $345.00 | $172.50–$414.00 | 2% above | 35% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $224.25 | $345.00 | — | 2% above | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $224.25 | $345.00 | — | — | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $224.25 | $345.00 | — | 11% above | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $224.25 | $345.00 | $172.50–$414.00 | 11% above | 35% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $224.25 | $345.00 | — | — | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD | $116.35 | $179.00 | $89.50–$214.80 | 29% below | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD | $116.35 | $179.00 | — | 29% below | 35% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD | $116.35 | $179.00 | — | — | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SIMP/SINGL | $659.75 | $1,015.00 | — | 93% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SIMP/SINGL | $659.75 | $1,015.00 | $507.50–$1,218.00 | 93% above | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC SIMP/SINGL | $659.75 | $1,015.00 | — | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JNT | $926.90 | $1,426.00 | $713.00–$1,711.20 | 55% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JNT | $926.90 | $1,426.00 | — | 55% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JNT | $926.90 | $1,426.00 | — | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERM JNT | $926.90 | $1,426.00 | — | 35% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERM JNT | $926.90 | $1,426.00 | $713.00–$1,711.20 | 35% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERM JNT | $926.90 | $1,426.00 | — | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JNT | $926.90 | $1,426.00 | — | 32% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JNT | $926.90 | $1,426.00 | $713.00–$1,711.20 | 32% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JNT | $926.90 | $1,426.00 | — | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SUTURE INTER-SCALP+-2.5 OR LES | $1,272.70 | $1,958.00 | — | 45% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 SUTURE INTER-SCALP+-2.5 OR LES | $1,272.70 | $1,958.00 | $979.00–$2,349.60 | 45% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 SUTURE INTER-SCALP+-2.5 OR LES | $1,272.70 | $1,958.00 | — | — | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< | $1,897.35 | $2,919.00 | $1,459.50–$3,502.80 | 49% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< | $1,897.35 | $2,919.00 | — | 49% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/< | $1,897.35 | $2,919.00 | — | — | 35% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGL | $659.75 | $1,015.00 | — | 9% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGL | $659.75 | $1,015.00 | $507.50–$1,218.00 | 9% above | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGL | $659.75 | $1,015.00 | — | — | 35% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W/IMG GUID | $2,413.45 | $3,713.00 | $1,856.50–$4,455.60 | 94% above | 35% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W/IMG GUID | $2,413.45 | $3,713.00 | — | 94% above | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DX/THER W/IMG GUID | $2,413.45 | $3,713.00 | — | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE NAIL & MATRIX PERM | $1,272.70 | $1,958.00 | $979.00–$2,349.60 | 33% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE NAIL & MATRIX PERM | $1,272.70 | $1,958.00 | — | 33% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVE NAIL & MATRIX PERM | $1,272.70 | $1,958.00 | — | — | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R FB SIMP | $1,272.70 | $1,958.00 | $979.00–$2,349.60 | 43% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 I&R FB SIMP | $1,272.70 | $1,958.00 | — | 43% above | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FB SIMP | $1,272.70 | $1,958.00 | — | — | 35% |
| Short arm cast (elbow to hand) CPT 29075 APPLIC SHORT ARM CAST | $570.05 | $877.00 | — | at median | 35% |
| Short arm cast (elbow to hand) CPT 29075 APPLIC SHORT ARM CAST | $570.05 | $877.00 | $438.50–$1,052.40 | at median | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLIC SHORT ARM CAST | $570.05 | $877.00 | — | — | 35% |
| Short arm splint (forearm and hand) CPT 29125 APPLIC SPLINT SHORT ARM | $424.45 | $653.00 | — | 102% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 APPLIC SPLINT SHORT ARM | $424.45 | $653.00 | $326.50–$783.60 | 102% above | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLIC SPLINT SHORT ARM | $424.45 | $653.00 | — | — | 35% |
| Short leg cast (below the knee) CPT 29405 APPLIC SHORT LEG CAST | $570.05 | $877.00 | — | 27% below | 35% |
| Short leg cast (below the knee) CPT 29405 APPLIC SHORT LEG CAST | $570.05 | $877.00 | $438.50–$1,052.40 | 27% below | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLIC SHORT LEG CAST | $570.05 | $877.00 | — | — | 35% |
| Short leg splint (calf to foot) CPT 29515 APPLIC SPLINT SHORT LEG | $533.00 | $820.00 | — | 4% above | 35% |
| Short leg splint (calf to foot) CPT 29515 APPLIC SPLINT SHORT LEG | $533.00 | $820.00 | $410.00–$984.00 | 4% above | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLIC SPLINT SHORT LEG | $533.00 | $820.00 | — | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SUTURE SIMP-SCALP+-2.5 OR LESS | $659.75 | $1,015.00 | — | 81% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SUTURE SIMP-SCALP+-2.5 OR LESS | $659.75 | $1,015.00 | $507.50–$1,218.00 | 81% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SUTURE SIMP-SCALP+-2.5 OR LESS | $659.75 | $1,015.00 | — | — | 35% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 | $751.40 | $1,156.00 | — | 105% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 | $751.40 | $1,156.00 | $578.00–$1,387.20 | 105% above | 35% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 | $751.40 | $1,156.00 | — | — | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC LUMBAR DX | $1,884.35 | $2,899.00 | — | 47% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC LUMBAR DX | $1,884.35 | $2,899.00 | $1,449.50–$3,478.80 | 47% above | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNC LUMBAR DX | $1,884.35 | $2,899.00 | — | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SUTURE SIMP-SCALP+-2.6-7.5 | $659.75 | $1,015.00 | — | 80% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SUTURE SIMP-SCALP+-2.6-7.5 | $659.75 | $1,015.00 | $507.50–$1,218.00 | 80% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SUTURE SIMP-SCALP+-2.6-7.5 | $659.75 | $1,015.00 | — | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SUTURE SIMP-FACE+-2.5 OR LESS | $659.75 | $1,015.00 | $507.50–$1,218.00 | 84% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SUTURE SIMP-FACE+-2.5 OR LESS | $659.75 | $1,015.00 | — | 84% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SUTURE SIMP-FACE+-2.5 OR LESS | $659.75 | $1,015.00 | — | — | 35% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,691.95 | $2,603.00 | — | 18% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,691.95 | $2,603.00 | $1,301.50–$3,123.60 | 18% above | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,691.95 | $2,603.00 | — | — | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SNGL/MULT TRIGGER PTS 1-2 MUSC | $926.90 | $1,426.00 | — | at median | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ SNGL/MULT TRIGGER PTS 1-2 MUSC | $926.90 | $1,426.00 | $713.00–$1,711.20 | at median | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SNGL/MULT TRIGGER PTS 1-2 MUSC | $926.90 | $1,426.00 | — | — | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W BIOPSY | $2,413.45 | $3,713.00 | — | 29% above | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W BIOPSY | $2,413.45 | $3,713.00 | $1,856.50–$4,455.60 | 29% above | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY W BIOPSY | $2,413.45 | $3,713.00 | — | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN & SUBQ TISSUE | $1,272.70 | $1,958.00 | $979.00–$2,349.60 | 64% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN & SUBQ TISSUE | $1,272.70 | $1,958.00 | — | 64% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN & SUBQ TISSUE | $1,272.70 | $1,958.00 | — | — | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPON | $993.85 | $1,529.00 | $33.38–$1,834.80 | 6% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPON | $993.85 | $1,529.00 | — | 6% above | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPON | $993.85 | $1,529.00 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PAP SYSTEM, DAILY | $661.05 | $1,017.00 | $13.32–$1,220.40 | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 META NEB COMBO TX, DAILY | $661.05 | $1,017.00 | $13.32–$1,220.40 | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN W PEAK FLOW, DAILY | $661.05 | $1,017.00 | — | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN W PEAK FLOW, DAILY | $661.05 | $1,017.00 | $13.32–$1,220.40 | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN TX, DAILY | $661.05 | $1,017.00 | $13.32–$1,220.40 | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 META NEB COMBO TX, DAILY | $661.05 | $1,017.00 | — | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PAP SYSTEM, DAILY | $661.05 | $1,017.00 | — | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERONEB TX, DAILY | $661.05 | $1,017.00 | $13.32–$1,220.40 | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERONEB TX, DAILY | $661.05 | $1,017.00 | — | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN TX, DAILY | $661.05 | $1,017.00 | — | 264% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN TX, DAILY | $661.05 | $1,017.00 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 META NEB COMBO TX, DAILY | $661.05 | $1,017.00 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERONEB TX, DAILY | $661.05 | $1,017.00 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PAP SYSTEM, DAILY | $661.05 | $1,017.00 | — | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN W PEAK FLOW, DAILY | $661.05 | $1,017.00 | — | — | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY FEE 6 CRITICAL CARE | $4,425.85 | $6,809.00 | $390.00–$8,170.80 | at median | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY FEE 6 CRITICAL CARE | $4,425.85 | $6,809.00 | — | at median | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY FEE 6 CRITICAL CARE | $4,425.85 | $6,809.00 | — | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING ONLY | $217.10 | $334.00 | $15.16–$400.80 | 13% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING ONLY | $217.10 | $334.00 | — | 13% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACING ONLY | $217.10 | $334.00 | — | — | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY FEE 1 NON-URGENT | $470.60 | $724.00 | $362.00–$1,400.00 | 26% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY FEE 1 NON-URGENT | $470.60 | $724.00 | — | 26% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY FEE 1 NON-URGENT | $470.60 | $724.00 | — | — | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY FEE 2 URGENT I | $837.20 | $1,288.00 | — | 27% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY FEE 2 URGENT I | $837.20 | $1,288.00 | $390.00–$1,545.60 | 27% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY FEE 2 URGENT I | $837.20 | $1,288.00 | — | — | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY FEE 3 URGENT II | $1,199.25 | $1,845.00 | $390.00–$2,214.00 | 9% below | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY FEE 3 URGENT II | $1,199.25 | $1,845.00 | — | 9% below | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY FEE 3 URGENT II | $1,199.25 | $1,845.00 | — | — | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY FEE 4 EMERGENT I | $2,079.35 | $3,199.00 | $390.00–$3,838.80 | 1% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY FEE 4 EMERGENT I | $2,079.35 | $3,199.00 | — | 1% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY FEE 4 EMERGENT I | $2,079.35 | $3,199.00 | — | — | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY FEE 5 EMERGENT II | $3,256.50 | $5,010.00 | $390.00–$6,012.00 | 20% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY FEE 5 EMERGENT II | $3,256.50 | $5,010.00 | — | 20% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY FEE 5 EMERGENT II | $3,256.50 | $5,010.00 | — | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR | $650.65 | $1,001.00 | $38.10–$1,201.20 | 41% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR | $650.65 | $1,001.00 | — | 41% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 1ST HR | $650.65 | $1,001.00 | — | — | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX UP TO 1 HR | $131.95 | $203.00 | — | 71% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX UP TO 1 HR | $131.95 | $203.00 | $46.51–$243.60 | 71% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY UP TO 1 HR | $217.75 | $335.00 | — | 53% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY UP TO 1 HR | $217.75 | $335.00 | $46.51–$402.00 | 53% below | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX UP TO 1 HR | $131.95 | $203.00 | — | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY UP TO 1 HR | $217.75 | $335.00 | — | — | 35% |
| IV push of a medicine, first drug CPT 96374 IV INJ/PUSH INITIAL | $259.35 | $399.00 | $199.50–$478.80 | 31% below | 35% |
| IV push of a medicine, first drug CPT 96374 IV INFUSION INITIAL PUSH | $259.35 | $399.00 | $36.88–$478.80 | 31% below | 35% |
| IV push of a medicine, first drug CPT 96374 IV INJ/PUSH INITIAL | $259.35 | $399.00 | — | 31% below | 35% |
| IV push of a medicine, first drug CPT 96374 IV INFUSION INITIAL PUSH | $259.35 | $399.00 | — | 31% below | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 IV INFUSION INITIAL PUSH | $259.35 | $399.00 | — | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 IV INJ/PUSH INITIAL | $259.35 | $399.00 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPEUTIC SUBQ/IM | $135.85 | $209.00 | $104.50–$250.80 | 10% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ | $135.85 | $209.00 | — | 10% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ | $135.85 | $209.00 | $13.87–$250.80 | 10% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPEUTIC SUBQ/IM | $135.85 | $209.00 | — | 10% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SUBQ | $135.85 | $209.00 | — | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THERAPEUTIC SUBQ/IM | $135.85 | $209.00 | — | — | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN | $146.90 | $226.00 | $18.58–$271.20 | 49% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED 15 MIN | $146.90 | $226.00 | $18.58–$271.20 | 49% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN | $146.90 | $226.00 | — | 49% above | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED 15 MIN | $146.90 | $226.00 | — | 49% above | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED 15 MIN | $146.90 | $226.00 | — | — | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN | $146.90 | $226.00 | — | — | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 OT MED-SURG EVAL LOW | $383.50 | $590.00 | $49.83–$708.00 | 119% above | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 OT MED-SURG EVAL LOW | $383.50 | $590.00 | — | 119% above | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT MED-SURG EVAL LOW | $383.50 | $590.00 | — | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT INIT EVAL HIGH | $383.50 | $590.00 | — | 9% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT INIT EVAL HIGH | $383.50 | $590.00 | $51.57–$708.00 | 9% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT INIT EVAL HIGH | $383.50 | $590.00 | — | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT INIT EVAL LOW | $383.50 | $590.00 | $51.57–$708.00 | 87% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT INIT EVAL LOW | $383.50 | $590.00 | — | 87% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT INIT EVAL LOW | $383.50 | $590.00 | — | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT INIT EVAL MOD | $383.50 | $590.00 | $51.57–$708.00 | 9% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT INIT EVAL MOD | $383.50 | $590.00 | — | 9% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT INIT EVAL MOD | $383.50 | $590.00 | — | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN | $122.20 | $188.00 | $20.55–$225.60 | 22% below | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN | $122.20 | $188.00 | — | 22% below | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN | $122.20 | $188.00 | $20.55–$225.60 | 22% below | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN | $122.20 | $188.00 | — | 22% below | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 15 MIN | $122.20 | $188.00 | — | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN | $122.20 | $188.00 | — | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE 15 MIN | $131.30 | $202.00 | — | 30% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE 15 MIN | $131.30 | $202.00 | $17.65–$242.40 | 30% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN | $131.30 | $202.00 | — | 30% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN | $131.30 | $202.00 | $17.65–$242.40 | 30% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE 15 MIN | $131.30 | $202.00 | — | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN | $131.30 | $202.00 | — | — | 35% |
| Speech and language evaluation CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL | $688.35 | $1,059.00 | $123.10–$1,270.80 | 120% above | 35% |
| Speech and language evaluation CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL | $688.35 | $1,059.00 | — | 120% above | 35% |
| Speech and language evaluation inpatient CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL | $688.35 | $1,059.00 | — | — | 35% |
| Speech therapy session, individual CPT 92507 SP SPEECH-LANG-VOICE TREAT | $299.00 | $460.00 | — | 65% above | 35% |
| Speech therapy session, individual CPT 92507 SP SPEECH-LANG-VOICE TREAT | $299.00 | $460.00 | $21.05–$552.00 | 65% above | 35% |
| Speech therapy session, individual inpatient CPT 92507 SP SPEECH-LANG-VOICE TREAT | $299.00 | $460.00 | — | — | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIV 15 MIN | $146.90 | $226.00 | — | 49% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN | $146.90 | $226.00 | — | 49% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN | $146.90 | $226.00 | $18.32–$271.20 | 49% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIV 15 MIN | $146.90 | $226.00 | $18.32–$271.20 | 49% above | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIV 15 MIN | $146.90 | $226.00 | — | — | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN | $146.90 | $226.00 | — | — | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Hawaii | Off list |
|---|---|---|---|---|---|
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP | $70.44 | $108.37 | $54.19–$130.04 | 46% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP | $70.44 | $108.37 | — | 46% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP | $70.44 | $108.37 | — | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYR | $423.29 | $651.21 | $325.61–$781.45 | 40% below | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYR | $423.29 | $651.21 | — | 40% below | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYR | $423.29 | $651.21 | — | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYR | $261.66 | $402.56 | $201.28–$483.07 | 33% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYR | $261.66 | $402.56 | — | 33% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJ SYR | $261.66 | $402.56 | — | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYR | $111.97 | $172.26 | $86.13–$206.71 | 19% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYR | $111.97 | $172.26 | — | 19% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYR | $111.97 | $172.26 | — | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION, ONE VACCINE | $139.75 | $215.00 | — | 17% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION, ONE VACCINE | $139.75 | $215.00 | $4.00–$258.00 | 17% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION, ONE VACCINE | $139.75 | $215.00 | — | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL | $83.85 | $129.00 | $4.00–$154.80 | 38% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL | $83.85 | $129.00 | — | 38% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL | $83.85 | $129.00 | — | — | 35% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.hhsc.org/standardcharge/kohala/99-0262197_Kohala-Hospital_standardcharges.csv