Hospital Hilo-Kailua, HI

Kona Community Hospital

Kona Community Hospital in Kealakekua, HI publishes cash prices for 328 common procedures listed here, from its own machine-readable price file updated Jul 28, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Hawaii median for 157 of 323 procedures and below it for 125. By typical cash price it ranks #8 of 13 Hawaii hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

79-1019 Haukapila St Collected Nov 4, 2026 Source price file Check a bill from this hospital (808) 322-9311

Acute care hospital Government-owned hospital Emergency department CMS star rating 2 of 5 CCN 120019 · CMS hospital register

Financial assistance

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

Kona Community 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 Kona Community Hospital in Kealakekua, HI:

Jun 8, 2026 Warning notice
Jul 13, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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 CT scan without and with contrast CPT 74170 CT ABD W/WO CONTR	$1,025.05	$1,577.00	$230.00–$1,529.69	44% below	35%
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CONTR	$1,025.05	$1,577.00	—	44% below	35%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W/WO CONTR	$1,025.05	$1,577.00	—	—	35%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$328.25	$505.00	—	15% above	35%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$328.25	$505.00	$18.84–$489.85	15% above	35%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS PORT	$328.25	$505.00	—	15% above	35%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS PORT	$328.25	$505.00	$18.84–$489.85	15% above	35%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS PORT	$328.25	$505.00	—	—	35%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$328.25	$505.00	—	—	35%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS	$276.90	$426.00	—	15% above	35%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS	$276.90	$426.00	$17.34–$413.22	15% above	35%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE MIN 3 VIEWS	$276.90	$426.00	—	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 SEGMNT PRESSURE-SNGL LEV	$395.85	$609.00	$68.30–$590.73	40% above	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 SEGMNT PRESSURE-SNGL LEV	$395.85	$609.00	—	40% above	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 SEGMNT PRESSURE-SNGL LEV	$395.85	$609.00	—	—	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPP EXTREM W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT ARM LOWER W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT ARM LOWER W/O CONTRAST	$843.70	$1,298.00	—	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT ARM UPPER W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT ARM UPPER W/O CONTRAST	$843.70	$1,298.00	—	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPP EXTREM W/O CONTRAST	$843.70	$1,298.00	—	34% below	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT ARM UPPER W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPP EXTREM W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT ARM LOWER W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$500.50	$770.00	$39.30–$746.90	2% above	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$500.50	$770.00	—	2% above	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM	$500.50	$770.00	—	—	35%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE WHOLE BODY	$1,257.75	$1,935.00	—	16% above	35%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE WHOLE BODY	$1,257.75	$1,935.00	$140.75–$1,876.95	16% above	35%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE WHOLE BODY	$1,257.75	$1,935.00	—	—	35%
Breast ultrasound, complete, one breast CPT 76641 US BREAST W/IMAGE COMP	$307.45	$473.00	$34.94–$458.81	21% below	35%
Breast ultrasound, complete, one breast CPT 76641 US BREAST W/IMAGE COMP	$307.45	$473.00	—	21% below	35%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST W/IMAGE COMP	$307.45	$473.00	—	—	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST W/IMAGE LTD	$302.90	$466.00	—	30% below	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST W/IMAGE LTD	$302.90	$466.00	$34.94–$452.02	30% below	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST W/IMAGE LTD	$302.90	$466.00	—	—	35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PELVIS, W/CONT, INCL NON CONTR IMG IF PERF IMG PROCESS	$1,865.50	$2,870.00	$316.18–$2,783.90	39% below	35%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PELVIS, W/CONT, INCL NON CONTR IMG IF PERF IMG PROCESS	$1,865.50	$2,870.00	—	39% below	35%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD&PELVIS, W/CONT, INCL NON CONTR IMG IF PERF IMG PROCESS	$1,865.50	$2,870.00	—	—	35%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CONTR	$1,207.70	$1,858.00	—	31% below	35%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CONTR	$1,207.70	$1,858.00	$230.00–$1,802.26	31% below	35%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/ BRAIN PERFUSION	$1,207.70	$1,858.00	$230.00–$1,802.26	31% below	35%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/ BRAIN PERFUSION	$1,207.70	$1,858.00	—	31% below	35%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/ BRAIN PERFUSION	$1,207.70	$1,858.00	—	—	35%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CONTR	$1,207.70	$1,858.00	—	—	35%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CONTR	$1,207.70	$1,858.00	$230.00–$1,802.26	30% below	35%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CONTR	$1,207.70	$1,858.00	—	30% below	35%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CONTR	$1,207.70	$1,858.00	—	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CONTR	$1,207.70	$1,858.00	$230.00–$1,802.26	31% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CONTR	$1,207.70	$1,858.00	—	31% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CONTR	$1,207.70	$1,858.00	—	—	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HCHG CT ANGIO HRT W/3D IMAGE	$783.90	$1,206.00	$187.39–$1,169.82	60% below	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HCHG CT ANGIO HRT W/3D IMAGE	$783.90	$1,206.00	—	60% below	35%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HCHG CT ANGIO HRT W/3D IMAGE	$783.90	$1,206.00	—	—	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O DYE; EVAL CORONARY CALCIUM	$207.35	$319.00	$31.36–$309.43	65% above	35%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O DYE; EVAL CORONARY CALCIUM	$207.35	$319.00	—	65% above	35%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O DYE; EVAL CORONARY CALCIUM	$207.35	$319.00	—	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT, ABDOMEN & PELVIS, WO CONTRAST MATERIAL	$1,478.10	$2,274.00	—	29% below	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT, ABDOMEN & PELVIS, WO CONTRAST MATERIAL	$1,478.10	$2,274.00	$94.66–$2,205.78	29% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT, ABDOMEN & PELVIS, WO CONTRAST MATERIAL	$1,478.10	$2,274.00	—	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT, ABDOMEN & PELVIS, W CONTRAST MATERIAL	$1,855.75	$2,855.00	$180.62–$2,769.35	20% below	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT, ABDOMEN & PELVIS, W CONTRAST MATERIAL	$1,855.75	$2,855.00	—	20% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT, ABDOMEN & PELVIS, W CONTRAST MATERIAL	$1,855.75	$2,855.00	—	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT, ABDOMEN & PELVIS, WO FOLLOWED BY W CONTRAST MATERIAL	$2,078.70	$3,198.00	—	36% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT, ABDOMEN & PELVIS, WO FOLLOWED BY W CONTRAST MATERIAL	$2,078.70	$3,198.00	$238.75–$3,102.06	36% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT, ABDOMEN & PELVIS, WO FOLLOWED BY W CONTRAST MATERIAL	$2,078.70	$3,198.00	—	—	35%
CT scan of the abdomen with contrast CPT 74160 CT ABD EXT W CONTR	$954.85	$1,469.00	$225.48–$1,424.93	47% below	35%
CT scan of the abdomen with contrast CPT 74160 CT ABD EXT W CONTR	$954.85	$1,469.00	—	47% below	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD EXT W CONTR	$954.85	$1,469.00	—	—	35%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTR	$766.35	$1,179.00	$137.62–$1,143.63	45% below	35%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTR	$766.35	$1,179.00	—	45% below	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTR	$766.35	$1,179.00	—	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE W/O	$764.40	$1,176.00	$137.62–$1,140.72	36% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O	$764.40	$1,176.00	—	36% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE W/O	$764.40	$1,176.00	$137.62–$1,140.72	36% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE W/O	$764.40	$1,176.00	—	36% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O	$764.40	$1,176.00	$137.62–$1,140.72	36% below	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACE W/O	$764.40	$1,176.00	—	36% below	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O	$764.40	$1,176.00	—	—	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MANDIBLE W/O	$764.40	$1,176.00	—	—	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACE W/O	$764.40	$1,176.00	—	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTR	$859.30	$1,322.00	$137.62–$1,282.34	33% below	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTR	$859.30	$1,322.00	—	33% below	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTR	$859.30	$1,322.00	—	—	35%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTR	$1,059.50	$1,630.00	$186.48–$1,581.10	37% below	35%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTR	$1,059.50	$1,630.00	—	37% below	35%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTR	$1,059.50	$1,630.00	—	—	35%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTR	$1,179.75	$1,815.00	$230.00–$1,760.55	35% below	35%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTR	$1,179.75	$1,815.00	—	35% below	35%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTR	$1,179.75	$1,815.00	—	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LMBSC SPINE EXT, WO CONTR	$750.10	$1,154.00	$137.62–$1,119.38	45% below	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LMBSC SPINE EXT, WO CONTR	$750.10	$1,154.00	—	45% below	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LMBSC SPINE EXT, WO CONTR	$750.10	$1,154.00	—	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE EXT, WO CONTR	$750.10	$1,154.00	—	45% below	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE EXT, WO CONTR	$750.10	$1,154.00	$137.62–$1,119.38	45% below	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE EXT, WO CONTR	$750.10	$1,154.00	—	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTR	$1,059.50	$1,630.00	$225.48–$1,581.10	26% below	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTR	$1,059.50	$1,630.00	—	26% below	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTR	$1,059.50	$1,630.00	—	—	35%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DPLX SCAN, BILAT STUDY	$749.45	$1,153.00	—	—	35%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DPLX SCAN, BILAT STUDY	$749.45	$1,153.00	$142.03–$1,118.41	—	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DPLX SCAN, BILAT STUDY	$749.45	$1,153.00	—	—	35%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTR	$1,145.95	$1,763.00	$230.00–$1,710.11	39% below	35%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTR	$1,145.95	$1,763.00	—	39% below	35%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTR	$1,145.95	$1,763.00	—	—	35%
Chest X-ray, 2 views CPT 71046 CHEST PA LAT 2 VIEWS	$296.40	$456.00	—	15% above	35%
Chest X-ray, 2 views CPT 71046 CHEST PA LAT 2 VIEWS	$296.40	$456.00	$20.37–$442.32	15% above	35%
Chest X-ray, 2 views CPT 71046 CHEST INSP/EXP 2 VIEWS	$301.60	$464.00	—	17% above	35%
Chest X-ray, 2 views CPT 71046 CHEST INSP/EXP 2 VIEWS	$301.60	$464.00	$20.37–$450.08	17% above	35%
Chest X-ray, 2 views inpatient CPT 71046 CHEST PA LAT 2 VIEWS	$296.40	$456.00	—	—	35%
Chest X-ray, 2 views inpatient CPT 71046 CHEST INSP/EXP 2 VIEWS	$301.60	$464.00	—	—	35%
Chest X-ray, single view CPT 71045 CHEST AP 1 VIEW	$247.00	$380.00	—	13% above	35%
Chest X-ray, single view CPT 71045 CHEST AP ONLY PORT 1 VIEW	$247.00	$380.00	$13.07–$368.60	13% above	35%
Chest X-ray, single view CPT 71045 CHEST AP 1 VIEW	$247.00	$380.00	$13.07–$368.60	13% above	35%
Chest X-ray, single view CPT 71045 CHEST AP ONLY PORT 1 VIEW	$247.00	$380.00	—	13% above	35%
Chest X-ray, single view CPT 71045 CHEST SPEC 1 VIEW	$252.20	$388.00	$13.07–$376.36	16% above	35%
Chest X-ray, single view CPT 71045 CHEST PA ONLY 1 VIEW	$252.20	$388.00	—	16% above	35%
Chest X-ray, single view CPT 71045 CHEST PA ONLY 1 VIEW	$252.20	$388.00	$13.07–$376.36	16% above	35%
Chest X-ray, single view CPT 71045 CHEST SPEC 1 VIEW	$252.20	$388.00	—	16% above	35%
Chest X-ray, single view inpatient CPT 71045 CHEST AP 1 VIEW	$247.00	$380.00	—	—	35%
Chest X-ray, single view inpatient CPT 71045 CHEST AP ONLY PORT 1 VIEW	$247.00	$380.00	—	—	35%
Chest X-ray, single view inpatient CPT 71045 CHEST SPEC 1 VIEW	$252.20	$388.00	—	—	35%
Chest X-ray, single view inpatient CPT 71045 CHEST PA ONLY 1 VIEW	$252.20	$388.00	—	—	35%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$296.40	$456.00	—	24% above	35%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE PORT COMPLETE	$296.40	$456.00	$17.04–$442.32	24% above	35%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE PORT COMPLETE	$296.40	$456.00	—	24% above	35%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE	$296.40	$456.00	$17.04–$442.32	24% above	35%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE PORT COMPLETE	$296.40	$456.00	—	—	35%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CLAVICLE COMPLETE	$296.40	$456.00	—	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 U/S RENAL, COMPLETE	$469.30	$722.00	—	27% below	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 U/S RENAL, COMPLETE	$469.30	$722.00	$64.94–$700.34	27% below	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 U/S RENAL, COMPLETE	$469.30	$722.00	—	—	35%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 U/S OB W DETAIL SINGLE	$267.15	$411.00	—	58% below	35%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 U/S OB W DETAIL SINGLE	$267.15	$411.00	$112.44–$398.67	58% below	35%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 U/S OB W DETAIL SINGLE	$267.15	$411.00	—	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTR	$859.30	$1,322.00	—	36% below	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTR	$859.30	$1,322.00	$137.62–$1,282.34	36% below	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTR	$859.30	$1,322.00	—	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTR	$1,145.95	$1,763.00	$230.00–$1,710.11	23% below	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTR	$1,145.95	$1,763.00	—	23% below	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTR	$1,145.95	$1,763.00	—	—	35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DPLX IMAG PERIP-LOW EXTREM, BILAT STUDY	$694.20	$1,068.00	—	—	35%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DPLX IMAG PERIP-LOW EXTREM, BILAT STUDY	$694.20	$1,068.00	$173.10–$1,035.96	—	35%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ART DPLX IMAG PERIP-LOW EXTREM, BILAT STUDY	$694.20	$1,068.00	—	—	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DPLX IMAGING PERIP	$945.10	$1,454.00	$139.85–$1,410.38	35% above	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 DPLX SCAN-EXTREM VEINS CMPL	$945.10	$1,454.00	—	35% above	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 DPLX SCAN-EXTREM VEINS CMPL	$945.10	$1,454.00	$139.85–$1,410.38	35% above	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DPLX IMAGING PERIP	$945.10	$1,454.00	—	35% above	35%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DPLX IMAGING PERIP	$945.10	$1,454.00	—	—	35%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DPLX SCAN-EXTREM VEINS CMPL	$945.10	$1,454.00	—	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER, COMPLETE	$1,881.75	$2,895.00	—	56% above	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER, COMPLETE	$1,881.75	$2,895.00	$132.88–$2,808.15	56% above	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER, COMPLETE	$1,881.75	$2,895.00	—	—	35%
Elbow X-ray, 2 views CPT 73070 ELBOW (2 VIEWS)	$247.65	$381.00	—	24% above	35%
Elbow X-ray, 2 views CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS	$247.65	$381.00	$17.04–$369.57	24% above	35%
Elbow X-ray, 2 views CPT 73070 ELBOW (2 VIEWS)	$247.65	$381.00	$17.04–$369.57	24% above	35%
Elbow X-ray, 2 views CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS	$247.65	$381.00	—	24% above	35%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW COMPLETE- PORT, 2 VIEWS	$247.65	$381.00	—	—	35%
Elbow X-ray, 2 views inpatient CPT 73070 ELBOW (2 VIEWS)	$247.65	$381.00	—	—	35%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS	$297.70	$458.00	—	18% above	35%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS	$297.70	$458.00	$18.84–$444.26	18% above	35%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 ELBOW MIN 3 VIEWS	$297.70	$458.00	—	—	35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONES, WO CONTR	$780.00	$1,200.00	$137.62–$1,164.00	43% below	35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS WO CONTR	$780.00	$1,200.00	$137.62–$1,164.00	43% below	35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONES, WO CONTR	$780.00	$1,200.00	—	43% below	35%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS WO CONTR	$780.00	$1,200.00	—	43% below	35%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS WO CONTR	$780.00	$1,200.00	—	—	35%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONES, WO CONTR	$780.00	$1,200.00	—	—	35%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS	$356.20	$548.00	—	at median	35%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS	$356.20	$548.00	$25.96–$531.56	at median	35%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN 3 VIEWS	$356.20	$548.00	—	—	35%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS	$247.65	$381.00	$17.04–$369.57	10% above	35%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS	$247.65	$381.00	—	10% above	35%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 FOREARM 2 VIEWS	$247.65	$381.00	—	—	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING, INCL GALLBLADDER WHEN PRESENT	$1,186.25	$1,825.00	$202.87–$1,770.25	49% above	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING, INCL GALLBLADDER WHEN PRESENT	$1,186.25	$1,825.00	—	49% above	35%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING, INCL GALLBLADDER WHEN PRESENT	$1,186.25	$1,825.00	—	—	35%
Hand X-ray, 2 views CPT 73120 HAND (2 VIEWS)	$247.65	$381.00	$17.55–$369.57	3% above	35%
Hand X-ray, 2 views CPT 73120 HAND (2 VIEWS)	$247.65	$381.00	—	3% above	35%
Hand X-ray, 2 views inpatient CPT 73120 HAND (2 VIEWS)	$247.65	$381.00	—	—	35%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL MIN 2 VIEWS	$247.00	$380.00	—	44% above	35%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HEEL MIN 2 VIEWS	$247.00	$380.00	$17.03–$368.60	44% above	35%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HEEL MIN 2 VIEWS	$247.00	$380.00	—	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY - UNATTENDED	$638.30	$982.00	$114.38–$952.54	56% below	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY - UNATTENDED	$638.30	$982.00	—	56% below	35%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY - UNATTENDED	$638.30	$982.00	—	—	35%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS	$297.70	$458.00	—	3% above	35%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS	$297.70	$458.00	$18.84–$444.26	3% above	35%
Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS	$297.70	$458.00	—	—	35%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE W OBLIQUES 4>VIEWS	$310.70	$478.00	—	at median	35%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE W OBLIQUES 4>VIEWS	$310.70	$478.00	$22.13–$463.66	at median	35%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 KNEE W OBLIQUES 4>VIEWS	$310.70	$478.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT HIP W/O CONTRAST	$843.70	$1,298.00	—	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT HIP W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LEG LOW W/O CONTRAST	$843.70	$1,298.00	—	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOW EXTREM W/O CONTRAST	$843.70	$1,298.00	—	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LEG UP W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT FOOT W/O CONTRAST	$843.70	$1,298.00	—	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT FOOT W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LEG UP W/O CONTRAST	$843.70	$1,298.00	—	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LEG LOW W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	29% below	35%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOW EXTREM W/O CONTRAST	$843.70	$1,298.00	$137.62–$1,259.06	29% below	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LEG LOW W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LEG UP W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOW EXTREM W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT FOOT W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT HIP W/O CONTRAST	$843.70	$1,298.00	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD APPENDIX	$463.45	$713.00	—	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD LTD	$463.45	$713.00	$46.98–$691.61	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD LTD	$463.45	$713.00	—	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD LIVER	$463.45	$713.00	—	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD APPENDIX	$463.45	$713.00	$46.98–$691.61	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD ABD	$463.45	$713.00	$46.98–$691.61	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD LIVER	$463.45	$713.00	$46.98–$691.61	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD ABD	$463.45	$713.00	—	17% below	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABD LTD	$463.45	$713.00	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD LIVER	$463.45	$713.00	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD APPENDIX	$463.45	$713.00	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABD B-SCAN W IMAG DOC LTD ABD	$463.45	$713.00	—	—	35%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US, EXTREMITY, NONVAS, RT W IMAGE DOC, LIM	$469.30	$722.00	$7.22–$700.34	34% above	35%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US, EXTREMITY, NONVAS, RT W IMAGE DOC, LIM	$469.30	$722.00	—	34% above	35%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US, EXTREMITY, NONVAS, RT W IMAGE DOC, LIM	$469.30	$722.00	—	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$523.25	$805.00	$92.52–$780.85	5% below	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$523.25	$805.00	—	5% below	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$523.25	$805.00	—	—	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB, 2 VIEWS	$244.40	$376.00	$18.46–$364.72	9% above	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB, 2 VIEWS	$244.40	$376.00	—	9% above	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB PORT, 2 VIEWS	$244.40	$376.00	$18.46–$364.72	9% above	35%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIB/FIB PORT, 2 VIEWS	$244.40	$376.00	—	9% above	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIB/FIB PORT, 2 VIEWS	$244.40	$376.00	—	—	35%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 TIB/FIB, 2 VIEWS	$244.40	$376.00	—	—	35%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTR	$1,138.15	$1,751.00	—	46% below	35%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTR	$1,138.15	$1,751.00	$306.74–$1,698.47	46% below	35%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTR	$1,138.15	$1,751.00	—	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,648.40	$2,536.00	$273.31–$2,459.92	—	35%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,648.40	$2,536.00	—	—	35%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST C-+ W/CAD BI	$1,648.40	$2,536.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREM JNT W/O CONTR	$1,142.05	$1,757.00	—	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREM HIP WO CONTR	$1,142.05	$1,757.00	—	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREM JNT W/O CONTR	$1,142.05	$1,757.00	$306.74–$1,704.29	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREM HIP WO CONTR	$1,142.05	$1,757.00	$306.74–$1,704.29	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT/LT W/O CONTRAST	$1,142.05	$1,757.00	$306.74–$1,704.29	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT/LT W/O CONTRAST	$1,142.05	$1,757.00	—	24% below	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXTREM HIP WO CONTR	$1,142.05	$1,757.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXTREM JNT W/O CONTR	$1,142.05	$1,757.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RT/LT W/O CONTRAST	$1,142.05	$1,757.00	—	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTREM JNT W/WO CONTR	$1,648.40	$2,536.00	$481.42–$2,459.92	31% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTREM JNT W/WO CONTR	$1,648.40	$2,536.00	—	31% below	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXTREM JNT W/WO CONTR	$1,648.40	$2,536.00	—	—	35%
MRI of the abdomen without contrast CPT 74181 ABDOMEN MRI WO CONTR	$1,062.75	$1,635.00	—	50% below	35%
MRI of the abdomen without contrast CPT 74181 ABDOMEN MRI WO CONTR	$1,062.75	$1,635.00	$306.74–$1,585.95	50% below	35%
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN MRI WO CONTR	$1,062.75	$1,635.00	—	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN MRI W/WO CONTR	$1,512.55	$2,327.00	—	43% below	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN MRI W/WO CONTR	$1,512.55	$2,327.00	$481.42–$2,257.19	43% below	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN MRI W/WO CONTR	$1,512.55	$2,327.00	—	—	35%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTR	$1,158.30	$1,782.00	—	18% below	35%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTR	$1,158.30	$1,782.00	$306.74–$1,728.54	18% below	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTR	$1,158.30	$1,782.00	—	—	35%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTR	$1,540.50	$2,370.00	—	21% below	35%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTR	$1,540.50	$2,370.00	$481.42–$2,298.90	21% below	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTR	$1,540.50	$2,370.00	—	—	35%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE MRI WO CONTR	$1,043.90	$1,606.00	—	32% below	35%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE MRI WO CONTR	$1,043.90	$1,606.00	$306.74–$1,557.82	32% below	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE MRI WO CONTR	$1,043.90	$1,606.00	—	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 LUMB SPINE MRI W/WO CONTR	$1,678.30	$2,582.00	—	32% below	35%
MRI of the lower back, without and then with contrast dye CPT 72158 LUMB SPINE MRI W/WO CONTR	$1,678.30	$2,582.00	$481.42–$2,504.54	32% below	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMB SPINE MRI W/WO CONTR	$1,678.30	$2,582.00	—	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 T-SPINE MRI WO CONTR	$1,043.90	$1,606.00	$306.74–$1,557.82	47% below	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 T-SPINE MRI WO CONTR	$1,043.90	$1,606.00	—	47% below	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 T-SPINE MRI WO CONTR	$1,043.90	$1,606.00	—	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 C-SPINE MRI W/WO CONTR	$1,648.40	$2,536.00	$481.42–$2,459.92	24% below	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 C-SPINE MRI W/WO CONTR	$1,648.40	$2,536.00	—	24% below	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 C-SPINE MRI W/WO CONTR	$1,648.40	$2,536.00	—	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 C- SPINE MRI WO CONTR	$1,062.75	$1,635.00	—	27% below	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 C- SPINE MRI WO CONTR	$1,062.75	$1,635.00	$306.74–$1,585.95	27% below	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 C- SPINE MRI WO CONTR	$1,062.75	$1,635.00	—	—	35%
MRI of the pelvis without and with contrast CPT 72197 PELVIS MRI W/WO CONTR	$1,512.55	$2,327.00	—	40% below	35%
MRI of the pelvis without and with contrast CPT 72197 PELVIS MRI W/WO CONTR	$1,512.55	$2,327.00	$481.42–$2,257.19	40% below	35%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE	$2,016.30	$3,102.00	$481.42–$3,008.94	20% below	35%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE	$2,016.30	$3,102.00	—	20% below	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS MRI W/WO CONTR	$1,512.55	$2,327.00	—	—	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE	$2,016.30	$3,102.00	—	—	35%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS MRI WO CONTR	$1,043.90	$1,606.00	$306.74–$1,557.82	49% below	35%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS MRI WO CONTR	$1,043.90	$1,606.00	—	49% below	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS MRI WO CONTR	$1,043.90	$1,606.00	—	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UPP EXTREM JNT WO CONTR	$1,142.05	$1,757.00	$306.74–$1,704.29	50% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UPP EXTREM JNT WO CONTR	$1,142.05	$1,757.00	—	50% below	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UPP EXTREM JNT WO CONTR	$1,142.05	$1,757.00	—	—	35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE 4 OR 5 VIEWS	$383.50	$590.00	$29.64–$572.30	20% above	35%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE 4 OR 5 VIEWS	$383.50	$590.00	—	20% above	35%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE 4 OR 5 VIEWS	$383.50	$590.00	—	—	35%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W CONTR	$1,105.00	$1,700.00	—	15% below	35%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W CONTR	$1,105.00	$1,700.00	$186.48–$1,649.00	15% below	35%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W CONTR	$1,105.00	$1,700.00	—	—	35%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK WO CONTR	$780.00	$1,200.00	$137.62–$1,164.00	45% below	35%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK WO CONTR	$780.00	$1,200.00	—	45% below	35%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK WO CONTR	$780.00	$1,200.00	—	—	35%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$247.65	$381.00	—	14% below	35%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$247.65	$381.00	$15.15–$369.57	14% below	35%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE PORT	$247.65	$381.00	$15.15–$369.57	14% below	35%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE PORT	$247.65	$381.00	—	14% below	35%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE PORT	$247.65	$381.00	—	—	35%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$247.65	$381.00	—	—	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$3,511.95	$5,403.00	—	36% above	35%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$3,511.95	$5,403.00	$164.65–$5,240.91	36% above	35%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$3,511.95	$5,403.00	—	—	35%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTR	$750.10	$1,154.00	—	42% below	35%
Pelvic CT scan without contrast CPT 72192 CT ACETABULUM, WO CONTR	$750.10	$1,154.00	—	42% below	35%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTR	$750.10	$1,154.00	$137.62–$1,119.38	42% below	35%
Pelvic CT scan without contrast CPT 72192 CT ACETABULUM, WO CONTR	$750.10	$1,154.00	$137.62–$1,119.38	42% below	35%
Pelvic CT scan without contrast inpatient CPT 72192 CT ACETABULUM, WO CONTR	$750.10	$1,154.00	—	—	35%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTR	$750.10	$1,154.00	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S PELVIC NON-OB LTD	$406.25	$625.00	$44.29–$606.25	3% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S BLADDER	$406.25	$625.00	—	3% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S PELVIC NON-OB LTD	$406.25	$625.00	—	3% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S BLADDER	$406.25	$625.00	$44.29–$606.25	3% below	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S BLADDER	$406.25	$625.00	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S PELVIC NON-OB LTD	$406.25	$625.00	—	—	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 PELVIC SCAN CMPLT	$469.30	$722.00	—	4% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIC SCAN CMPLT	$469.30	$722.00	$50.35–$700.34	4% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S PELVIS COMP PORT	$469.30	$722.00	$50.35–$700.34	4% below	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIS COMP PORT	$469.30	$722.00	—	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S PELVIC SCAN CMPLT	$469.30	$722.00	—	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S OB>14WK 1 GEST	$469.30	$722.00	$61.23–$700.34	15% below	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S OB>14WK 1 GEST	$469.30	$722.00	—	15% below	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U/S OB>14WK 1 GEST	$469.30	$722.00	—	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S OB<14 WK 1ST GEST	$469.30	$722.00	$55.49–$700.34	5% above	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S OB<14 WK 1ST GEST	$469.30	$722.00	—	5% above	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S OB<14 WK 1ST GEST	$469.30	$722.00	—	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S OB AMNIO FLUID	$406.25	$625.00	—	at median	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S OB AMNIO FLUID	$406.25	$625.00	$46.98–$606.25	at median	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S OB POSITION	$406.25	$625.00	—	at median	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S OB POSITION	$406.25	$625.00	$46.98–$606.25	at median	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S OB AMNIO FLUID	$406.25	$625.00	—	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S OB POSITION	$406.25	$625.00	—	—	35%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VIEWS	$285.35	$439.00	—	20% above	35%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VIEWS	$285.35	$439.00	$18.84–$425.83	20% above	35%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2 VIEWS	$285.35	$439.00	—	—	35%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W CHEST MIN 3 VIEWS	$297.70	$458.00	$21.96–$444.26	12% above	35%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS UNI W CHEST MIN 3 VIEWS	$297.70	$458.00	—	12% 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	$297.70	$458.00	—	—	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS PORT	$297.70	$458.00	$18.84–$444.26	34% above	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS PORT	$297.70	$458.00	—	34% above	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS	$302.25	$465.00	—	37% above	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS	$302.25	$465.00	$18.84–$451.05	37% above	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS PORT	$297.70	$458.00	—	—	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER MIN 2 VIEWS	$302.25	$465.00	—	—	35%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$296.40	$456.00	—	1% below	35%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$296.40	$456.00	$25.96–$442.32	1% below	35%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VIEWS	$296.40	$456.00	—	—	35%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS PORT	$296.40	$456.00	—	at median	35%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS	$296.40	$456.00	—	at median	35%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS PORT	$296.40	$456.00	$20.40–$442.32	at median	35%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEWS	$296.40	$456.00	$20.40–$442.32	at median	35%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 1-3 VIEWS	$296.40	$456.00	—	—	35%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 1-3 VIEWS PORT	$296.40	$456.00	—	—	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ESPHOGRAM VIDEO	$445.25	$685.00	—	3% above	35%
Swallow study (modified barium swallow, video X-ray) CPT 74230 ESPHOGRAM VIDEO	$445.25	$685.00	$42.98–$664.45	3% above	35%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 ESPHOGRAM VIDEO	$445.25	$685.00	—	—	35%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$247.00	$380.00	$15.87–$368.60	12% below	35%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$247.00	$380.00	—	12% below	35%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$247.00	$380.00	—	—	35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE EXT, WO CONTR	$750.10	$1,154.00	$137.62–$1,119.38	39% below	35%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE EXT, WO CONTR	$750.10	$1,154.00	—	39% below	35%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-SPINE EXT, WO CONTR	$750.10	$1,154.00	—	—	35%
Toe X-ray, 2 or more views CPT 73660 TOES MIN 2 VIEWS	$221.65	$341.00	$13.91–$330.77	42% above	35%
Toe X-ray, 2 or more views CPT 73660 TOES MIN 2 VIEWS	$221.65	$341.00	—	42% above	35%
Toe X-ray, 2 or more views inpatient CPT 73660 TOES MIN 2 VIEWS	$221.65	$341.00	—	—	35%
Transvaginal pelvic ultrasound CPT 76830 U/S NON OB TRANSVAG	$469.30	$722.00	—	3% above	35%
Transvaginal pelvic ultrasound CPT 76830 U/S NON OB TRANSVAG	$469.30	$722.00	$50.35–$700.34	3% above	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 U/S NON OB TRANSVAG	$469.30	$722.00	—	—	35%
Transvaginal ultrasound during pregnancy CPT 76817 U/S OB TRANSVAG	$469.30	$722.00	—	16% above	35%
Transvaginal ultrasound during pregnancy CPT 76817 U/S OB TRANSVAG	$469.30	$722.00	$46.06–$700.34	16% above	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 U/S OB TRANSVAG	$469.30	$722.00	—	—	35%
Ultrasound of the abdomen, complete CPT 76700 U/S ABD COMP	$469.30	$722.00	—	16% below	35%
Ultrasound of the abdomen, complete CPT 76700 U/S ABD COMP	$469.30	$722.00	$64.94–$700.34	16% below	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 U/S ABD COMP	$469.30	$722.00	—	—	35%
Ultrasound of the scrotum and testicles CPT 76870 U/S SCROTUM	$469.30	$722.00	$50.35–$700.34	3% above	35%
Ultrasound of the scrotum and testicles CPT 76870 U/S SCROTUM	$469.30	$722.00	—	3% above	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S SCROTUM	$469.30	$722.00	—	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S SOFT TISS HEAD/NECK/THYRD	$432.25	$665.00	—	20% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S SOFT TISS NECK	$432.25	$665.00	—	20% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S SOFT TISS HEAD/NECK/THYRD	$432.25	$665.00	$46.98–$645.05	20% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S SOFT TISS NECK	$432.25	$665.00	$46.98–$645.05	20% below	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S SOFT TISS HEAD/NECK/THYRD	$432.25	$665.00	—	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S SOFT TISS NECK	$432.25	$665.00	—	—	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI TRACT SINGLE CONTRAST	$500.50	$770.00	$48.23–$746.90	6% above	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI TRACT SINGLE CONTRAST	$500.50	$770.00	—	6% above	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI TRACT SINGLE CONTRAST	$500.50	$770.00	—	—	35%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS, MIN 2 VIEWS	$247.65	$381.00	—	39% above	35%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS, MIN 2 VIEWS	$247.65	$381.00	$18.84–$369.57	39% above	35%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HUMERUS, MIN 2 VIEWS	$247.65	$381.00	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VEIN MAP IMAGING PERIPH LTD	$469.30	$722.00	$93.10–$700.34	6% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DPLX IMAGING PERIP F/U	$469.30	$722.00	—	6% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VEIN MAP IMAGING PERIPH LTD	$469.30	$722.00	—	6% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS DPLX IMAGING PERIP F/U	$469.30	$722.00	$93.10–$700.34	6% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$313.30	$482.00	$93.10–$467.54	29% 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	$313.30	$482.00	—	29% below	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS DPLX IMAGING PERIP F/U	$469.30	$722.00	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VEIN MAP IMAGING PERIPH LTD	$469.30	$722.00	—	—	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	$313.30	$482.00	—	—	35%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS PORT	$247.65	$381.00	$16.41–$369.57	9% above	35%
Wrist X-ray, 2 views CPT 73100 WRIST (2 VIEWS)	$247.65	$381.00	—	9% above	35%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS PORT	$247.65	$381.00	—	9% above	35%
Wrist X-ray, 2 views CPT 73100 WRIST (2 VIEWS)	$247.65	$381.00	$16.41–$369.57	9% above	35%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST (2 VIEWS)	$247.65	$381.00	—	—	35%
Wrist X-ray, 2 views inpatient CPT 73100 WRIST 2 VIEWS PORT	$247.65	$381.00	—	—	35%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS	$297.70	$458.00	—	13% above	35%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS	$297.70	$458.00	$17.34–$444.26	13% above	35%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS	$302.25	$465.00	—	15% above	35%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST MIN 3 VIEWS	$302.25	$465.00	$17.34–$451.05	15% above	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST W NAVICULAR, MIN 3 VIEWS	$297.70	$458.00	—	—	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST MIN 3 VIEWS	$302.25	$465.00	—	—	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	$229.45	$353.00	—	21% 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	$229.45	$353.00	$20.87–$342.41	21% 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	$229.45	$353.00	—	—	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW	$177.45	$273.00	—	19% below	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW	$177.45	$273.00	$18.26–$264.81	19% below	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN AP 1 VIEW	$221.65	$341.00	—	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW	$221.65	$341.00	—	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 KUB PORT AP 1 VW	$221.65	$341.00	—	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 KUB AP 1 VW	$221.65	$341.00	$18.26–$330.77	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW	$221.65	$341.00	$18.26–$330.77	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 KUB AP 1 VW	$221.65	$341.00	—	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 KUB PORT AP 1 VW	$221.65	$341.00	$18.26–$330.77	1% above	35%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN AP 1 VIEW	$221.65	$341.00	$18.26–$330.77	1% above	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN DECUBITUS AP 1 VIEW	$177.45	$273.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 KUB AP 1 VW	$221.65	$341.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 KUB PORT AP 1 VW	$221.65	$341.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN-CROSS TABLE LAT-PORT AP 1 VW	$221.65	$341.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN AP 1 VIEW	$221.65	$341.00	—	—	35%
X-ray of the ankle, 2 views CPT 73600 ANKLE (2 VIEWS)	$247.65	$381.00	$16.41–$369.57	32% above	35%
X-ray of the ankle, 2 views CPT 73600 ANKLE (2 VIEWS)	$247.65	$381.00	—	32% above	35%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE (2 VIEWS)	$247.65	$381.00	—	—	35%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VWS	$265.85	$409.00	$14.98–$396.73	60% above	35%
X-ray of the finger(s), 2 or more views CPT 73140 FINGERS MIN 2 VWS	$265.85	$409.00	—	60% above	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGERS MIN 2 VWS	$265.85	$409.00	—	—	35%
X-ray of the foot, 2 views CPT 73620 FOOT PORT, 2 VIEWS	$247.65	$381.00	$16.41–$369.57	26% above	35%
X-ray of the foot, 2 views CPT 73620 FOOT PORT, 2 VIEWS	$247.65	$381.00	—	26% above	35%
X-ray of the foot, 2 views CPT 73620 FOOT (2 VIEWS)	$247.65	$381.00	$16.41–$369.57	26% above	35%
X-ray of the foot, 2 views CPT 73620 FOOT (2 VIEWS)	$247.65	$381.00	—	26% above	35%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT (2 VIEWS)	$247.65	$381.00	—	—	35%
X-ray of the foot, 2 views inpatient CPT 73620 FOOT PORT, 2 VIEWS	$247.65	$381.00	—	—	35%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS	$247.65	$381.00	—	5% above	35%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS	$247.65	$381.00	$19.08–$369.57	5% above	35%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS	$247.65	$381.00	—	—	35%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS	$297.70	$458.00	$19.08–$444.26	8% above	35%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS	$297.70	$458.00	—	8% above	35%
X-ray of the hand, 3 or more views inpatient CPT 73130 HAND MIN 3 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2 VIEWS PORT	$247.65	$381.00	—	15% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE (1-2) VIEWS	$247.65	$381.00	$17.04–$369.57	15% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE (1-2) VIEWS	$247.65	$381.00	—	15% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2 VIEWS PORT	$247.65	$381.00	$17.04–$369.57	15% above	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 2 VIEWS PORT	$247.65	$381.00	—	—	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE (1-2) VIEWS	$247.65	$381.00	—	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS PORT	$297.70	$458.00	—	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS	$297.70	$458.00	$21.96–$444.26	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS	$297.70	$458.00	—	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS	$297.70	$458.00	$21.96–$444.26	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS	$297.70	$458.00	—	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2 VIEWS PORT	$297.70	$458.00	$21.96–$444.26	6% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2 VIEWS PORT	$297.70	$458.00	—	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 L-SPINE FLEX EXT ONLY, 2-3 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the lower back, 4 or more views CPT 72110 LS SPINE MIN 4 VIEWS	$421.85	$649.00	$32.35–$629.53	4% below	35%
X-ray of the lower back, 4 or more views CPT 72110 LS SPINE MIN 4 VIEWS	$421.85	$649.00	—	4% below	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LS SPINE MIN 4 VIEWS	$421.85	$649.00	—	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS	$297.70	$458.00	—	23% above	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS	$297.70	$458.00	$21.34–$444.26	23% above	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS PORT	$297.70	$458.00	—	23% above	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS PORT	$297.70	$458.00	$21.34–$444.26	23% above	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VIEWS PORT	$297.70	$458.00	—	—	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS	$391.95	$603.00	—	55% above	35%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS	$391.95	$603.00	$17.04–$584.91	55% above	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VIEWS	$391.95	$603.00	—	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C- SPINE AP & LAT ONLY	$297.70	$458.00	$19.78–$444.26	7% above	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2-3 VIEWS	$297.70	$458.00	—	7% above	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C- SPINE AP & LAT ONLY	$297.70	$458.00	—	7% above	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2-3 VIEWS	$297.70	$458.00	$19.78–$444.26	7% above	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C- SPINE AP & LAT ONLY	$297.70	$458.00	—	—	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE 2-3 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS PORT 1-2 VIEWS	$235.95	$363.00	$18.74–$352.11	19% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS PORT 1-2 VIEWS	$235.95	$363.00	—	19% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS 1-2 VIEWS	$235.95	$363.00	$18.74–$352.11	19% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 AP PELVIS 1-2 VIEWS	$235.95	$363.00	—	19% above	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 AP PELVIS 1-2 VIEWS	$235.95	$363.00	—	—	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 AP PELVIS PORT 1-2 VIEWS	$235.95	$363.00	—	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACROCOC SPINE, MIN 2 VIEWS	$297.70	$458.00	—	29% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS	$297.70	$458.00	—	29% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACROCOC SPINE, MIN 2 VIEWS	$297.70	$458.00	$18.84–$444.26	29% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS	$297.70	$458.00	$18.84–$444.26	29% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACROCOC SPINE, MIN 2 VIEWS	$297.70	$458.00	—	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX, MIN 2 VIEWS	$297.70	$458.00	—	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Hawaii	Off list
ACTH blood test CPT 82024 ACTH LEVEL RIA 90	$293.80	$452.00	—	39% above	35%
ACTH blood test CPT 82024 ACTH LEVEL RIA 90	$293.80	$452.00	$39.91–$438.44	39% above	35%
ACTH blood test inpatient CPT 82024 ACTH LEVEL RIA 90	$293.80	$452.00	—	—	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$50.05	$77.00	$5.48–$74.69	5% above	35%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$50.05	$77.00	—	5% above	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$50.05	$77.00	—	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$50.05	$77.00	—	at median	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$50.05	$77.00	$5.35–$74.69	at median	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$50.05	$77.00	—	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$497.90	$766.00	—	at median	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$497.90	$766.00	$49.22–$743.02	at median	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$497.90	$766.00	—	—	35%
Albumin blood test CPT 82040 ALBUMIN SERUM/PLASMA/WHOLE BLOOD	$37.70	$58.00	$5.12–$56.26	10% above	35%
Albumin blood test CPT 82040 ALBUMIN SERUM/PLASMA/WHOLE BLOOD	$37.70	$58.00	—	10% above	35%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM/PLASMA/WHOLE BLOOD	$37.70	$58.00	—	—	35%
Aldosterone blood test CPT 82088 ALDOSTERONE-SERUM 90	$310.70	$478.00	$42.11–$463.66	19% above	35%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR URINE	$310.70	$478.00	—	19% above	35%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR URINE	$310.70	$478.00	$42.11–$463.66	19% above	35%
Aldosterone blood test CPT 82088 ALDOSTERONE-SERUM 90	$310.70	$478.00	—	19% above	35%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE-SERUM 90	$310.70	$478.00	—	—	35%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24 HR URINE	$310.70	$478.00	—	—	35%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHTASE	$50.05	$77.00	$5.35–$74.69	at median	35%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHTASE	$50.05	$77.00	—	at median	35%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHTASE	$50.05	$77.00	—	—	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM	$128.05	$197.00	—	at median	35%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN SERUM	$128.05	$197.00	$17.33–$191.09	at median	35%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN SERUM	$128.05	$197.00	—	—	35%
Ammonia blood test CPT 82140 AMMONIA	$136.50	$210.00	$15.06–$203.70	at median	35%
Ammonia blood test CPT 82140 AMMONIA	$136.50	$210.00	—	at median	35%
Ammonia blood test inpatient CPT 82140 AMMONIA	$136.50	$210.00	—	—	35%
Amylase blood test CPT 82150 AMYLASE	$68.25	$105.00	—	at median	35%
Amylase blood test CPT 82150 AMYLASE BODY FLD	$68.25	$105.00	$6.70–$101.85	at median	35%
Amylase blood test CPT 82150 AMYLASE BODY FLD	$68.25	$105.00	—	at median	35%
Amylase blood test CPT 82150 AMYLASE	$68.25	$105.00	$6.70–$101.85	at median	35%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLD	$68.25	$105.00	—	—	35%
Amylase blood test inpatient CPT 82150 AMYLASE	$68.25	$105.00	—	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 C-CITRULLINATED PEPTIDE 90	$98.80	$152.00	—	3% below	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 C-CITRULLINATED PEPTIDE 90	$98.80	$152.00	$12.66–$147.44	3% below	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 C-CITRULLINATED PEPTIDE 90	$98.80	$152.00	—	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM	$127.40	$196.00	$12.49–$190.12	at median	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM	$127.40	$196.00	—	at median	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HCHG ANTI-NUCLEAR AB, IFA, SERUM	$127.40	$196.00	—	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP	$284.05	$437.00	$28.46–$423.89	12% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP	$284.05	$437.00	—	12% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PROBNP	$284.05	$437.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CSF	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CSF	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT MISC	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT MISC	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT SPUTUM	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT SPUTUM	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL	$90.35	$139.00	—	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP	$90.35	$139.00	$8.91–$134.83	at median	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NASAL	$120.25	$185.00	$8.91–$179.45	33% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NASAL	$120.25	$185.00	—	33% above	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT CSF	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT SPUTUM	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BRONCHIAL	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT MISC	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT THROAT	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT BODY FLUID	$90.35	$139.00	—	—	35%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NASAL	$120.25	$185.00	—	—	35%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE	$83.85	$129.00	$8.74–$125.13	at median	35%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE	$83.85	$129.00	—	at median	35%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE	$83.85	$129.00	—	—	35%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT	$42.25	$65.00	$5.19–$63.05	10% below	35%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT	$42.25	$65.00	—	10% below	35%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOT	$42.25	$65.00	—	—	35%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV GROSS MICRO EXAM	$254.80	$392.00	$40.64–$380.24	at median	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) inpatient CPT 88305 LEVEL IV GROSS MICRO EXAM	$254.80	$392.00	—	—	35%
Blood culture for bacteria CPT 87040 CULT BLOOD	$92.30	$142.00	—	8% below	35%
Blood culture for bacteria CPT 87040 CULT BLOOD	$92.30	$142.00	$10.66–$137.74	8% below	35%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD	$92.30	$142.00	—	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLD, VENIPUNCTURE	$35.10	$54.00	—	164% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLD, VENIPUNCTURE	$35.10	$54.00	$3.00–$52.38	164% above	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLD, VENIPUNCTURE	$35.10	$54.00	—	—	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$33.80	$52.00	—	8% below	35%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$33.80	$52.00	$4.06–$50.44	8% below	35%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$33.80	$52.00	—	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL URINE	$79.30	$122.00	$7.77–$118.34	at median	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM	$79.30	$122.00	$7.77–$118.34	at median	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL URINE	$79.30	$122.00	—	at median	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM	$79.30	$122.00	—	at median	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL URINE	$79.30	$122.00	—	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUAL, SERUM	$79.30	$122.00	—	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$130.00	$200.00	—	21% above	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$130.00	$200.00	$4.12–$194.00	21% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$130.00	$200.00	—	—	35%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN	$37.70	$58.00	$4.08–$56.26	at median	35%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN	$37.70	$58.00	—	at median	35%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN	$37.70	$58.00	—	—	35%
C-peptide blood test CPT 84681 C-PEPTIDE 90	$158.60	$244.00	—	1% below	35%
C-peptide blood test CPT 84681 C-PEPTIDE 90	$158.60	$244.00	$21.50–$236.68	1% below	35%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE 90	$158.60	$244.00	—	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP)	$49.40	$76.00	—	57% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP)	$49.40	$76.00	$5.35–$73.72	57% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (CRP)	$49.40	$76.00	—	—	35%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY	$299.65	$461.00	—	at median	35%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY	$299.65	$461.00	$38.51–$447.17	at median	35%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE NUCLEIC ACID AMPLIFY	$299.65	$461.00	—	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 90	$174.85	$269.00	—	17% above	35%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 90	$174.85	$269.00	$21.50–$260.93	17% above	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 90	$174.85	$269.00	—	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$158.60	$244.00	—	9% above	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$158.60	$244.00	$21.50–$236.68	9% above	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$158.60	$244.00	—	—	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	—	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	$51.31–$308.46	176% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 AMP PRO/CEPHIED	$206.70	$318.00	$51.31–$308.46	176% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 AMP PRO/CEPHIED	$206.70	$318.00	—	176% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 AMP PR ABBOTT	$206.70	$318.00	$51.31–$308.46	176% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 AMP PR ABBOTT	$206.70	$318.00	—	176% above	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 AMP PR ABBOTT	$206.70	$318.00	—	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 AMP PRO/CEPHIED	$206.70	$318.00	—	—	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%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$54.60	$84.00	$5.33–$81.48	9% above	35%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$54.60	$84.00	—	9% above	35%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$54.60	$84.00	—	—	35%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA LEVEL RIA	$118.95	$183.00	$19.59–$177.51	10% below	35%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA LEVEL RIA	$118.95	$183.00	—	10% below	35%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LEVEL RIA	$118.95	$183.00	—	—	35%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB IGG	$98.15	$151.00	—	at median	35%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB IGG	$98.15	$151.00	$13.31–$146.47	at median	35%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB IGG	$98.15	$151.00	—	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA	$367.25	$565.00	$36.26–$548.05	232% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA	$367.25	$565.00	—	232% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 MOLEC INFECT AGENT DETECTION BY NUC ACID CHLAMYDIA	$367.25	$565.00	—	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC RISK/LIPID PROFILE	$112.45	$173.00	—	4% below	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CARDIAC RISK/LIPID PROFILE	$112.45	$173.00	$13.84–$167.81	4% below	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CARDIAC RISK/LIPID PROFILE	$112.45	$173.00	—	—	35%
Complete blood count (CBC) with differential CPT 85025 CBC W DIFF	$81.90	$126.00	$8.03–$122.22	33% above	35%
Complete blood count (CBC) with differential CPT 85025 CBC W DIFF	$81.90	$126.00	—	33% above	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W DIFF	$81.90	$126.00	—	—	35%
Complete blood count (CBC), no differential CPT 85027 CBC WO DIFF	$62.40	$96.00	$6.69–$93.12	31% above	35%
Complete blood count (CBC), no differential CPT 85027 CBC WO DIFF	$62.40	$96.00	—	31% above	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WO DIFF	$62.40	$96.00	—	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROF	$104.65	$161.00	$10.91–$156.17	8% above	35%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PROF	$104.65	$161.00	—	8% above	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PROF	$104.65	$161.00	—	—	35%
Cortisol blood test, total CPT 82533 CORTISOL SERUM/PLASMA RIA	$136.50	$210.00	—	at median	35%
Cortisol blood test, total CPT 82533 CORTISOL SERUM/PLASMA RIA	$136.50	$210.00	$16.84–$203.70	at median	35%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM/PLASMA RIA	$136.50	$210.00	—	—	35%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$68.25	$105.00	—	at median	35%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$68.25	$105.00	$6.73–$101.85	at median	35%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$68.25	$105.00	—	—	35%
Creatinine blood test CPT 82565 CREATININE BLOOD	$42.90	$66.00	—	23% above	35%
Creatinine blood test CPT 82565 CREATININE BLOOD	$42.90	$66.00	$5.29–$64.02	23% above	35%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$42.90	$66.00	—	—	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$110.50	$170.00	—	11% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$110.50	$170.00	$14.87–$164.90	11% below	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB SCRN 1 UNIT 90	$146.90	$226.00	—	18% above	35%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB SCRN 1 UNIT 90	$146.90	$226.00	$14.87–$219.22	18% above	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$110.50	$170.00	—	—	35%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB SCRN 1 UNIT 90	$146.90	$226.00	—	—	35%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$106.60	$164.00	—	at median	35%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$106.60	$164.00	$10.52–$159.08	at median	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$106.60	$164.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATES BLOOD	$123.50	$190.00	—	30% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATES BLOOD	$123.50	$190.00	$47.89–$184.30	30% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE SCREEN U CORD SO	$154.05	$237.00	—	62% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE SCREEN U CORD SO	$154.05	$237.00	$47.89–$229.89	62% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL BLOOD	$154.70	$238.00	—	62% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL BLOOD	$154.70	$238.00	$47.89–$230.86	62% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90	$192.40	$296.00	—	102% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90	$192.40	$296.00	$47.89–$287.12	102% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN TYLENOL	$243.10	$374.00	$47.89–$362.78	155% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN TYLENOL	$243.10	$374.00	—	155% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ROHYPNOL SCREEN SO	$243.10	$374.00	—	155% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ROHYPNOL SCREEN SO	$243.10	$374.00	$47.89–$362.78	155% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN MECONIUM 14 SO	$319.15	$491.00	—	235% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN MECONIUM 14 SO	$319.15	$491.00	$47.89–$476.27	235% 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 SCRN FENTANYL SO	$371.80	$572.00	$47.89–$554.84	291% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN U CORD 15 SO	$371.80	$572.00	$47.89–$554.84	291% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN U CORD 15 SO	$371.80	$572.00	—	291% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN U CORD 17 SO	$405.60	$624.00	$47.89–$605.28	326% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN U CORD 17 SO	$405.60	$624.00	—	326% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB UR SCRN/CONF SO	$410.15	$631.00	$47.89–$612.07	331% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN U CORD 14 SO	$410.15	$631.00	—	331% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN U CORD 14 SO	$410.15	$631.00	$47.89–$612.07	331% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB UR SCRN/CONF SO	$410.15	$631.00	—	331% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN PAIN MANAGE	$425.75	$655.00	$47.89–$635.35	347% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN PAIN MANAGE	$425.75	$655.00	—	347% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN ALCOHOL MET SO	$474.50	$730.00	$47.89–$708.10	398% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN ALCOHOL MET SO	$474.50	$730.00	—	398% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN U CORD 15 ETG SO	$540.80	$832.00	—	468% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN UCRD 17 ETG SO	$540.80	$832.00	$47.89–$807.04	468% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN UCRD 17 ETG SO	$540.80	$832.00	—	468% above	35%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN U CORD 15 ETG SO	$540.80	$832.00	$47.89–$807.04	468% above	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATES BLOOD	$123.50	$190.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COTININE SCREEN U CORD SO	$154.05	$237.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL BLOOD	$154.70	$238.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST(S) PRESUMPTIVE BY INSTRUMENT - 90	$192.40	$296.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN TYLENOL	$243.10	$374.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ROHYPNOL SCREEN SO	$243.10	$374.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN MECONIUM 14 SO	$319.15	$491.00	—	—	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 U CORD 15 SO	$371.80	$572.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN U CORD 17 SO	$405.60	$624.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GHB UR SCRN/CONF SO	$410.15	$631.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN U CORD 14 SO	$410.15	$631.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN PAIN MANAGE	$425.75	$655.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN ALCOHOL MET SO	$474.50	$730.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN U CORD 15 ETG SO	$540.80	$832.00	—	—	35%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN UCRD 17 ETG SO	$540.80	$832.00	—	—	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$53.30	$82.00	$7.24–$79.54	16% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$53.30	$82.00	—	16% below	35%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$53.30	$82.00	—	—	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGM 90	$137.80	$212.00	$18.74–$205.64	1% below	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGM 90	$137.80	$212.00	—	1% below	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGG 90	$137.80	$212.00	$18.74–$205.64	1% below	35%
Epstein-Barr virus (EBV) antibody test CPT 86665 E-B VIRUS AB IGG 90	$137.80	$212.00	—	1% below	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 E-B VIRUS AB IGG 90	$137.80	$212.00	—	—	35%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 E-B VIRUS AB IGM 90	$137.80	$212.00	—	—	35%
Estradiol blood test CPT 82670 ESTRADIOL SERUM	$213.20	$328.00	—	at median	35%
Estradiol blood test CPT 82670 ESTRADIOL SERUM	$213.20	$328.00	$28.87–$318.16	at median	35%
Estradiol blood test inpatient CPT 82670 ESTRADIOL SERUM	$213.20	$328.00	—	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH LEVEL	$141.70	$218.00	$19.20–$211.46	10% above	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH LEVEL	$141.70	$218.00	—	10% above	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH LEVEL	$141.70	$218.00	—	—	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL RIA	$120.25	$185.00	$14.08–$179.45	at median	35%
Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL RIA	$120.25	$185.00	—	at median	35%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN LEVEL RIA	$120.25	$185.00	—	—	35%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$89.70	$138.00	$10.04–$133.86	12% above	35%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$89.70	$138.00	—	12% above	35%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$89.70	$138.00	—	—	35%
Folate (folic acid) blood test CPT 82746 FOLIC ACID-SERUM	$122.85	$189.00	$15.19–$183.33	8% below	35%
Folate (folic acid) blood test CPT 82746 FOLIC ACID-SERUM	$122.85	$189.00	—	8% below	35%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID-SERUM	$122.85	$189.00	—	—	35%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$129.35	$199.00	—	12% below	35%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$129.35	$199.00	$17.50–$193.03	12% below	35%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$129.35	$199.00	—	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4	$85.15	$131.00	$9.32–$127.07	8% above	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4	$85.15	$131.00	—	8% above	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE T4	$85.15	$131.00	—	—	35%
Free testosterone test CPT 84402 TESTOSTERONE FREE 90	$193.70	$298.00	$26.32–$289.06	at median	35%
Free testosterone test CPT 84402 TESTOSTERONE FREE 90	$193.70	$298.00	—	at median	35%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 90	$193.70	$298.00	—	—	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$59.80	$92.00	$7.44–$89.24	6% below	35%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$59.80	$92.00	—	6% below	35%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT	$59.80	$92.00	—	—	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$278.20	$428.00	$41.19–$415.16	34% above	35%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$278.20	$428.00	—	34% above	35%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$278.20	$428.00	—	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POST GLUCOLA	$33.80	$52.00	$4.91–$50.44	at median	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POST GLUCOLA	$33.80	$52.00	—	at median	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR POST GLUCOLA	$36.40	$56.00	$4.91–$54.32	8% above	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR POST GLUCOLA	$36.40	$56.00	—	8% above	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POST GLUCOLA	$33.80	$52.00	—	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HR POST GLUCOLA	$36.40	$56.00	—	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA	$367.25	$565.00	—	232% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA	$367.25	$565.00	$36.26–$548.05	232% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 MOLEC INFECT AGENT DETECTION BY NUC ACID GONORRHEA	$367.25	$565.00	—	—	35%
H. pylori antibody blood test CPT 86677 HELIOCOBACTER PYLORI AB IGG	$122.20	$188.00	—	15% below	35%
H. pylori antibody blood test CPT 86677 HELIOCOBACTER PYLORI AB IGG	$122.20	$188.00	$17.41–$182.36	15% below	35%
H. pylori antibody blood test inpatient CPT 86677 HELIOCOBACTER PYLORI AB IGG	$122.20	$188.00	—	—	35%
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL	$100.75	$155.00	$14.86–$150.35	at median	35%
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL	$100.75	$155.00	—	at median	35%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG EIA STOOL	$100.75	$155.00	—	—	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT BY PCR 90	$679.90	$1,046.00	—	9% above	35%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT BY PCR 90	$679.90	$1,046.00	$87.94–$1,014.62	9% above	35%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT BY PCR 90	$679.90	$1,046.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 AG W HIV 1/2 ABS	$211.90	$326.00	$24.88–$316.22	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 PRENATAL HIV 1/2 COMBO	$211.90	$326.00	$24.88–$316.22	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 PRENATAL HIV 1/2 COMBO	$211.90	$326.00	—	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/ HIV-1 & HIV-2 AB WITH REFLEX	$211.90	$326.00	$24.88–$316.22	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/ HIV-1 & HIV-2 AB WITH REFLEX	$211.90	$326.00	—	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 AG W HIV 1/2 ABS	$211.90	$326.00	—	8% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 AG W HIV 1/2 ABS	$211.90	$326.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 PRENATAL HIV 1/2 COMBO	$211.90	$326.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/ HIV-1 & HIV-2 AB WITH REFLEX	$211.90	$326.00	—	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C HPLC	$91.00	$140.00	$10.03–$135.80	at median	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C HPLC	$91.00	$140.00	—	at median	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C HPLC	$91.00	$140.00	—	—	35%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$25.35	$39.00	$2.45–$37.83	2% below	35%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$25.35	$39.00	—	2% below	35%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$25.35	$39.00	—	—	35%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOT	$100.75	$155.00	$12.45–$150.35	6% below	35%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOT	$100.75	$155.00	—	6% below	35%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOT	$100.75	$155.00	—	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B AB QUANT SURFACE	$90.35	$139.00	—	9% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B AB QUANT SURFACE	$90.35	$139.00	$11.10–$134.83	9% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$90.35	$139.00	—	9% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$90.35	$139.00	$11.10–$134.83	9% below	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB	$90.35	$139.00	—	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B AB QUANT SURFACE	$90.35	$139.00	—	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG	$108.55	$167.00	—	6% above	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG	$108.55	$167.00	$10.67–$161.99	6% above	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG	$108.55	$167.00	—	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$119.60	$184.00	$14.75–$178.48	8% below	35%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$119.60	$184.00	—	8% below	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$119.60	$184.00	—	—	35%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR QUANT PCR	$325.65	$501.00	$44.27–$485.97	3% below	35%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR QUANT PCR	$325.65	$501.00	—	3% below	35%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR QUANT PCR	$325.65	$501.00	—	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB, IGG	$100.75	$155.00	$13.63–$150.35	6% above	35%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB, IGG	$100.75	$155.00	—	6% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 AB, IGG	$100.75	$155.00	—	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 AB, IGG	$147.55	$227.00	$20.00–$220.19	20% above	35%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 AB, IGG	$147.55	$227.00	—	20% above	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 AB, IGG	$147.55	$227.00	—	—	35%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOT	$128.70	$198.00	$18.52–$192.06	17% below	35%
Homocysteine blood test CPT 83090 HOMOCYSTEINE TOT	$128.70	$198.00	—	17% below	35%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE TOT	$128.70	$198.00	—	—	35%
Insulin blood test CPT 83525 INSULIN TOTAL 90	$87.10	$134.00	—	at median	35%
Insulin blood test CPT 83525 INSULIN TOTAL 90	$87.10	$134.00	$11.81–$129.98	at median	35%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL 90	$87.10	$134.00	—	—	35%
Iron blood test (serum iron) CPT 83540 IRON TOT	$61.10	$94.00	—	56% above	35%
Iron blood test (serum iron) CPT 83540 IRON TOT	$61.10	$94.00	$6.69–$91.18	56% above	35%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOT	$61.10	$94.00	—	—	35%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING	$91.00	$140.00	$9.03–$135.80	at median	35%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING	$91.00	$140.00	—	at median	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING	$91.00	$140.00	—	—	35%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$81.25	$125.00	—	17% above	35%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$81.25	$125.00	$8.97–$121.25	17% above	35%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$81.25	$125.00	—	—	35%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$141.05	$217.00	$19.14–$210.49	at median	35%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$141.05	$217.00	—	at median	35%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$141.05	$217.00	—	—	35%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$89.70	$138.00	$11.96–$133.86	9% below	35%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$89.70	$138.00	—	9% below	35%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$89.70	$138.00	—	—	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$63.70	$98.00	$6.24–$95.06	10% above	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$63.70	$98.00	—	10% above	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$63.70	$98.00	$6.24–$95.06	10% above	35%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$63.70	$98.00	—	10% above	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$63.70	$98.00	—	—	35%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID	$63.70	$98.00	—	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$72.80	$112.00	—	at median	35%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$72.80	$112.00	$7.12–$108.64	at median	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$72.80	$112.00	—	—	35%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$87.10	$134.00	$8.44–$129.98	30% above	35%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$87.10	$134.00	—	30% above	35%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION	$87.10	$134.00	—	—	35%
Lyme disease antibody test CPT 86618 LYME DISEASE ABS, REFLX TO BLOT	$162.50	$250.00	—	16% above	35%
Lyme disease antibody test CPT 86618 LYME DISEASE ABS, REFLX TO BLOT	$162.50	$250.00	$17.60–$242.50	16% above	35%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ABS, REFLX TO BLOT	$162.50	$250.00	—	—	35%
Magnesium blood test CPT 83735 MAGNESIUM FECES	$71.50	$110.00	$6.92–$106.70	15% above	35%
Magnesium blood test CPT 83735 MAGNESIUM FECES	$71.50	$110.00	—	15% above	35%
Magnesium blood test CPT 83735 MAGNESIUM	$71.50	$110.00	$6.92–$106.70	15% above	35%
Magnesium blood test CPT 83735 MAGNESIUM	$71.50	$110.00	—	15% above	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM FECES	$71.50	$110.00	—	—	35%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$71.50	$110.00	—	—	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$103.35	$159.00	$13.31–$154.23	28% above	35%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$103.35	$159.00	—	28% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG	$103.35	$159.00	—	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCRN SPECIFIC	$55.25	$85.00	—	at median	35%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCRN SPECIFIC	$55.25	$85.00	$5.35–$82.45	at median	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCRN SPECIFIC	$55.25	$85.00	—	—	35%
Mumps immunity blood test CPT 86735 MUMPS AB IGM 90	$99.45	$153.00	$13.49–$148.41	30% above	35%
Mumps immunity blood test CPT 86735 MUMPS AB IGG 90	$99.45	$153.00	—	30% above	35%
Mumps immunity blood test CPT 86735 MUMPS AB IGG 90	$99.45	$153.00	$13.49–$148.41	30% above	35%
Mumps immunity blood test CPT 86735 MUMPS AB IGM 90	$99.45	$153.00	—	30% above	35%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGM 90	$99.45	$153.00	—	—	35%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGG 90	$99.45	$153.00	—	—	35%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$155.35	$239.00	$21.14–$231.83	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, free CPT 84154 PROSTATIC SPECIFIC AG FREE	$140.40	$216.00	—	10% above	35%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATIC SPECIFIC AG FREE	$140.40	$216.00	$19.00–$209.52	10% above	35%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATIC SPECIFIC AG FREE	$140.40	$216.00	—	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL	$154.70	$238.00	—	36% above	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL	$154.70	$238.00	$19.00–$230.86	36% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC AG SCRN TOTAL	$154.70	$238.00	—	—	35%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN)	$221.65	$341.00	$27.50–$330.77	13% above	35%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN)	$221.65	$341.00	—	13% above	35%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IN FLD(NEOPATH/MAN RESCRN)	$221.65	$341.00	—	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$313.95	$483.00	—	17% below	35%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$313.95	$483.00	$42.66–$468.51	17% below	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$313.95	$483.00	—	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PART THRMPLSTN PTT	$50.70	$78.00	—	7% above	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PART THRMPLSTN PTT	$50.70	$78.00	$6.21–$75.66	7% above	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PART THRMPLSTN PTT	$50.70	$78.00	—	—	35%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$40.30	$62.00	$4.90–$60.14	9% below	35%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$40.30	$62.00	—	9% below	35%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$40.30	$62.00	—	—	35%
Potassium blood test CPT 84132 POTASSIUM SERUM/PLASMA/WHOLE BLOOD	$48.10	$74.00	$4.92–$71.78	1% above	35%
Potassium blood test CPT 84132 POTASSIUM SERUM/PLASMA/WHOLE BLOOD	$48.10	$74.00	—	1% above	35%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM/PLASMA/WHOLE BLOOD	$48.10	$74.00	—	—	35%
Progesterone blood test CPT 84144 PROGESTERONE	$159.25	$245.00	$21.56–$237.65	at median	35%
Progesterone blood test CPT 84144 PROGESTERONE	$159.25	$245.00	—	at median	35%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$159.25	$245.00	—	—	35%
Prolactin blood test CPT 84146 PROLACTIN	$202.80	$312.00	$20.03–$302.64	12% above	35%
Prolactin blood test CPT 84146 PROLACTIN	$202.80	$312.00	—	12% above	35%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$202.80	$312.00	—	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$33.80	$52.00	—	8% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$33.80	$52.00	$4.43–$50.44	8% below	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$33.80	$52.00	—	—	35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES	$73.45	$113.00	—	18% below	35%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES	$73.45	$113.00	$8.98–$109.61	18% below	35%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN ANY NUMBER OF CLASSES	$73.45	$113.00	—	—	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AG	$100.75	$155.00	—	8% above	35%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AG	$100.75	$155.00	$16.58–$150.35	8% above	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA AG	$100.75	$155.00	—	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID DIR GRP-A STREP SCREEN	$112.45	$173.00	—	103% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID DIR GRP-A STREP SCREEN	$112.45	$173.00	$16.58–$167.81	103% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$150.15	$231.00	$16.58–$224.07	171% above	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$150.15	$231.00	—	171% above	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID DIR GRP-A STREP SCREEN	$112.45	$173.00	—	—	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$150.15	$231.00	—	—	35%
Renin blood test CPT 84244 RENIN ACTIVITY PLASMA	$167.05	$257.00	$22.72–$249.29	18% above	35%
Renin blood test CPT 84244 RENIN ACTIVITY PLASMA	$167.05	$257.00	—	18% above	35%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY PLASMA	$167.05	$257.00	—	—	35%
Rh blood typing CPT 86901 BLOOD TYPING RH	$75.40	$116.00	$7.33–$112.52	54% above	35%
Rh blood typing CPT 86901 BLOOD TYPING RH	$75.40	$116.00	—	54% above	35%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH	$75.40	$116.00	—	—	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$60.45	$93.00	$5.86–$90.21	at median	35%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$60.45	$93.00	—	at median	35%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$60.45	$93.00	—	—	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$152.10	$234.00	—	98% above	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$152.10	$234.00	$14.87–$226.98	98% above	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$152.10	$234.00	—	98% above	35%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$152.10	$234.00	$14.87–$226.98	98% above	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$152.10	$234.00	—	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$152.10	$234.00	—	—	35%
Sodium blood test CPT 84295 SODIUM SERUM/PLASMA/WHOLE BLOOD	$40.30	$62.00	$4.97–$60.14	11% below	35%
Sodium blood test CPT 84295 SODIUM SERUM/PLASMA/WHOLE BLOOD	$40.30	$62.00	—	11% below	35%
Sodium blood test inpatient CPT 84295 SODIUM SERUM/PLASMA/WHOLE BLOOD	$40.30	$62.00	—	—	35%
Stool ova and parasites exam CPT 87177 OVA & PARASITES CONC & ID	$92.95	$143.00	—	1% above	35%
Stool ova and parasites exam CPT 87177 OVA & PARASITES CONC & ID	$92.95	$143.00	$9.20–$138.71	1% above	35%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES CONC & ID	$92.95	$143.00	—	—	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$37.05	$57.00	—	19% above	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$37.05	$57.00	$4.49–$55.29	19% above	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$37.05	$57.00	—	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD	$127.40	$196.00	$13.33–$190.12	34% above	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD	$127.40	$196.00	—	34% above	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD	$127.40	$196.00	—	—	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABSORPTION 90	$106.60	$164.00	$13.68–$159.08	at median	35%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABSORPTION 90	$106.60	$164.00	—	at median	35%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ABSORPTION 90	$106.60	$164.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP RPR, REFLEX TO TITER, QUAL	$36.40	$56.00	—	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL QUAL SERUM SO	$36.40	$56.00	$4.41–$54.32	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL QUAL SERUM SO	$36.40	$56.00	—	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP RPR, REFLEX TO TITER, QUAL	$36.40	$56.00	$4.41–$54.32	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF	$36.40	$56.00	$4.41–$54.32	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF	$36.40	$56.00	—	2% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF	$36.40	$56.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP RPR, REFLEX TO TITER, QUAL	$36.40	$56.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL QUAL SERUM SO	$36.40	$56.00	—	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD	$341.25	$525.00	$51.95–$509.25	23% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD	$341.25	$525.00	—	23% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD	$341.25	$525.00	—	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE SERUM TOTAL	$196.30	$302.00	$26.67–$292.94	at median	35%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE SERUM TOTAL	$196.30	$302.00	—	at median	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE SERUM TOTAL	$196.30	$302.00	—	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO MICROSOMAL	$111.15	$171.00	$15.04–$165.87	at median	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO MICROSOMAL	$111.15	$171.00	—	at median	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$111.15	$171.00	$15.04–$165.87	at median	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$111.15	$171.00	—	at median	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-TPO MICROSOMAL	$111.15	$171.00	—	—	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$111.15	$171.00	—	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$175.50	$270.00	—	38% above	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$175.50	$270.00	$17.36–$261.90	38% above	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$175.50	$270.00	—	—	35%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$35.10	$54.00	—	7% below	35%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$35.10	$54.00	$4.50–$52.38	7% below	35%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$35.10	$54.00	—	—	35%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$72.80	$112.00	—	21% above	35%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL	$72.80	$112.00	$7.10–$108.64	21% above	35%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL	$72.80	$112.00	—	—	35%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOT	$135.20	$208.00	—	2% above	35%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOT	$135.20	$208.00	$14.65–$201.76	2% above	35%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOT	$135.20	$208.00	—	—	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–$225.04	at median	35%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAG, AMP PROBE	$150.80	$232.00	—	—	35%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$48.10	$74.00	$5.93–$71.78	1% above	35%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$48.10	$74.00	—	1% above	35%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$48.10	$74.00	—	—	35%
Troponin test, quantitative CPT 84484 TROPONIN T	$83.20	$128.00	—	9% below	35%
Troponin test, quantitative CPT 84484 TROPONIN T	$83.20	$128.00	$12.89–$124.16	9% below	35%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$83.20	$128.00	—	—	35%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$47.45	$73.00	—	at median	35%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$47.45	$73.00	$4.67–$70.81	at median	35%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$47.45	$73.00	—	—	35%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED, W/ MICROSCOPY	$34.45	$53.00	—	at median	35%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED, W/ MICROSCOPY	$34.45	$53.00	$3.28–$51.41	at median	35%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE	$34.45	$53.00	—	at median	35%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE	$34.45	$53.00	$3.28–$51.41	at median	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTOMATED W/MICRO, REFLEX TO CULTURE	$34.45	$53.00	—	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTOMATED, W/ MICROSCOPY	$34.45	$53.00	—	—	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, REFLEX MICROSCOPIC	$24.05	$37.00	$2.33–$35.89	at median	35%
Urinalysis without microscope exam, automated CPT 81003 UA QUAL AUTO WO MICRO	$24.05	$37.00	—	at median	35%
Urinalysis without microscope exam, automated CPT 81003 UA QUAL AUTO WO MICRO	$24.05	$37.00	$2.33–$35.89	at median	35%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, REFLEX MICROSCOPIC	$24.05	$37.00	—	at median	35%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY UR AUTO	$31.85	$49.00	$2.33–$47.53	32% above	35%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY UR AUTO	$31.85	$49.00	—	32% above	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA QUAL AUTO WO MICRO	$24.05	$37.00	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, REFLEX MICROSCOPIC	$24.05	$37.00	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY UR AUTO	$31.85	$49.00	—	—	35%
Urinalysis without microscope exam, manual CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY	$15.60	$24.00	—	14% below	35%
Urinalysis without microscope exam, manual CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY	$15.60	$24.00	$3.54–$23.28	14% below	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 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$29.25	$45.00	$3.54–$43.65	61% above	35%
Urinalysis without microscope exam, manual CPT 81002 KETONES UR	$35.75	$55.00	$3.54–$53.35	96% above	35%
Urinalysis without microscope exam, manual CPT 81002 KETONES UR	$35.75	$55.00	—	96% above	35%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA (DIPSTICK), NON-AUTOMATED, W/O MICROSCOPY	$15.60	$24.00	—	—	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 KETONES UR	$35.75	$55.00	—	—	35%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE	$69.55	$107.00	$8.34–$103.79	6% below	35%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE	$69.55	$107.00	—	6% below	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE	$69.55	$107.00	—	—	35%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE	$44.20	$68.00	—	18% below	35%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE	$44.20	$68.00	$5.97–$65.96	18% below	35%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE	$44.20	$68.00	—	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$127.40	$196.00	$15.58–$190.12	8% below	35%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$127.40	$196.00	—	8% below	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$127.40	$196.00	—	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL	$206.05	$317.00	—	11% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL	$206.05	$317.00	$30.59–$307.49	11% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25- HYDROXY (D2 &D3)	$206.05	$317.00	—	11% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25- HYDROXY (D2 &D3)	$206.05	$317.00	$30.59–$307.49	11% below	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25- HYDROXY (D2 &D3)	$206.05	$317.00	—	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY, TOTAL	$206.05	$317.00	—	—	35%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90	$293.15	$451.00	$39.78–$437.47	9% below	35%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90	$293.15	$451.00	—	9% below	35%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D (1 25 DIHYDROXY) 90	$293.15	$451.00	—	—	35%
Zinc blood test CPT 84630 ZINC SO	$86.45	$133.00	—	at median	35%
Zinc blood test CPT 84630 ZINC SO	$86.45	$133.00	$11.77–$129.01	at median	35%
Zinc blood test inpatient CPT 84630 ZINC SO	$86.45	$133.00	—	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM	$126.10	$194.00	$15.55–$188.18	209% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM	$126.10	$194.00	—	209% above	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANT, SERUM	$126.10	$194.00	—	—	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	—	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	$295.21–$1,129.08	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 EXTERNAL	$1,358.50	$2,090.00	—	15% above	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$1,358.50	$2,090.00	$125.14–$2,027.30	15% above	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,719.25	$2,645.00	$814.71–$2,565.65	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 EXTERNAL	$1,358.50	$2,090.00	—	—	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,719.25	$2,645.00	—	—	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION (NURSERY)	$321.10	$494.00	—	91% below	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HCHG CIRCUMCISION W/REGIONL BLOCK	$321.10	$494.00	—	91% below	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION (NURSERY)	$321.10	$494.00	$84.95–$2,804.68	91% below	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HCHG CIRCUMCISION W/REGIONL BLOCK	$321.10	$494.00	$84.95–$2,804.68	91% below	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION (NURSERY)	$321.10	$494.00	—	—	35%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HCHG CIRCUMCISION W/REGIONL BLOCK	$321.10	$494.00	—	—	35%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISTAL RADIAL FX	$756.60	$1,164.00	$295.21–$1,129.08	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	$1,144.10–$2,107.81	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	—	2% above	35%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$224.25	$345.00	$76.57–$334.65	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	$76.57–$334.65	11% above	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 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	$112.77–$173.63	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 OF ABSCESS SIMPLE	$372.45	$573.00	—	9% above	35%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D OF ABSCESS SIMPLE	$372.45	$573.00	$52.42–$555.81	9% above	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	$250.61–$984.55	93% above	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D OF ABSCESS SIMPLE	$372.45	$573.00	—	—	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 into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH	$696.15	$1,071.00	—	7% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH	$696.15	$1,071.00	$39.27–$1,038.87	7% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH	$696.15	$1,071.00	—	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FLUORO ARTHROCENTESIS LARGE JOINT	$560.95	$863.00	$48.79–$837.11	6% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FLUORO ARTHROCENTESIS LARGE JOINT	$560.95	$863.00	—	6% below	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JNT	$926.90	$1,426.00	$370.77–$1,383.22	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 FLUORO ARTHROCENTESIS LARGE JOINT	$560.95	$863.00	—	—	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	$370.77–$1,383.22	35% above	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) 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	$370.77–$1,383.22	32% above	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) 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	$499.15–$1,899.26	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	—	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%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DIAG/THER SUB LUMB/SAC W/ IMG GDE	$1,479.40	$2,276.00	$63.61–$2,207.72	125% above	35%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DIAG/THER SUB LUMB/SAC W/ IMG GDE	$1,479.40	$2,276.00	—	125% above	35%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DIAG/THER SUB LUMB/SAC W/ IMG GDE	$1,479.40	$2,276.00	—	—	35%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ DIAG/THER SUB LUMB/SAC W/O IMG GDE	$1,479.40	$2,276.00	$52.93–$2,207.72	24% above	35%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ DIAG/THER SUB LUMB/SAC W/O IMG GDE	$1,479.40	$2,276.00	—	24% above	35%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ DIAG/THER SUB LUMB/SAC W/O IMG GDE	$1,479.40	$2,276.00	—	—	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	—	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	$880.74–$2,831.43	49% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR EXT B9+MARG 0.5 < CM	$2,158.65	$3,321.00	—	70% above	35%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR EXT B9+MARG 0.5 < CM	$2,158.65	$3,321.00	$42.74–$3,221.37	70% 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%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR EXT B9+MARG 0.5 < CM	$2,158.65	$3,321.00	—	—	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	$250.61–$984.55	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	$1,311.70	$2,018.00	—	6% above	35%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DX/THER W/IMG GUID	$1,311.70	$2,018.00	$66.52–$1,957.46	6% above	35%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DX/THER W/IMG GUID	$1,311.70	$2,018.00	—	—	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE NAIL & MATRIX PERM	$1,272.70	$1,958.00	$499.15–$1,899.26	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	$499.15–$1,899.26	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	$336.19–$850.69	at median	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) 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	$159.91–$633.41	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	$714.35	$1,099.00	$336.19–$1,066.03	8% below	35%
Short leg cast (below the knee) CPT 29405 APPLIC SHORT LEG CAST	$714.35	$1,099.00	—	8% below	35%
Short leg cast (below the knee) inpatient CPT 29405 APPLIC SHORT LEG CAST	$714.35	$1,099.00	—	—	35%
Short leg splint (calf to foot) CPT 29515 APPLIC SPLINT SHORT LEG	$533.00	$820.00	$197.25–$795.40	4% above	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) 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	$250.61–$984.55	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	—	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	$250.61–$1,121.32	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	—	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 LUMBAR PUNCTURE DIAG	$1,149.85	$1,769.00	$51.03–$1,715.93	10% below	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG	$1,149.85	$1,769.00	—	10% below	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNC LUMBAR DX	$1,884.35	$2,899.00	$865.69–$2,812.03	47% above	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 inpatient CPT 62270 LUMBAR PUNCTURE DIAG	$1,149.85	$1,769.00	—	—	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	$250.61–$984.55	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	—	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	—	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	$250.61–$984.55	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	$1,296.10	$1,994.00	$68.47–$1,934.18	10% below	35%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,296.10	$1,994.00	—	10% below	35%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,296.10	$1,994.00	—	—	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	$370.77–$1,383.22	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	$1,134.75–$3,601.61	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	$499.15–$1,899.26	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	$1,092.65	$1,681.00	—	16% above	35%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPON	$1,092.65	$1,681.00	$33.38–$1,630.57	16% above	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPON	$1,092.65	$1,681.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 META NEB COMBO TX, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PAP SYSTEM, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 META NEB COMBO TX, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PAP SYSTEM, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN TX, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN TX, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN W PEAK FLOW, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SVN W PEAK FLOW, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERONEB TX, DAILY	$842.40	$1,296.00	$13.32–$1,257.12	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERONEB TX, DAILY	$842.40	$1,296.00	—	364% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PAP SYSTEM, DAILY	$842.40	$1,296.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 META NEB COMBO TX, DAILY	$842.40	$1,296.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERONEB TX, DAILY	$842.40	$1,296.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT, DAILY	$842.40	$1,296.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN W PEAK FLOW, DAILY	$842.40	$1,296.00	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SVN TX, DAILY	$842.40	$1,296.00	—	—	35%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN BY INFUS UP TO 1 HR	$853.45	$1,313.00	$113.96–$1,273.61	13% above	35%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN BY INFUS UP TO 1 HR	$853.45	$1,313.00	—	13% above	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN BY INFUS UP TO 1 HR	$853.45	$1,313.00	—	—	35%
Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY FEE 6 CRITICAL CARE	$2,801.50	$4,310.00	—	36% below	35%
Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY FEE 6 CRITICAL CARE	$2,801.50	$4,310.00	$452.00–$4,180.70	36% below	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY FEE 6 CRITICAL CARE	$2,801.50	$4,310.00	—	—	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 LEAD EKG	$110.50	$170.00	$14.96–$164.90	—	35%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 LEAD EKG	$110.50	$170.00	—	—	35%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 12 LEAD EKG	$110.50	$170.00	—	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING ONLY	$183.95	$283.00	$15.16–$274.51	27% below	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING ONLY	$183.95	$283.00	—	27% below	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACING ONLY	$183.95	$283.00	—	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY FEE 1 NON-URGENT	$339.95	$523.00	$111.14–$1,400.00	9% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY FEE 1 NON-URGENT	$339.95	$523.00	—	9% below	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY FEE 1 NON-URGENT	$339.95	$523.00	—	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY FEE 2 URGENT I	$601.90	$926.00	—	9% below	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY FEE 2 URGENT I	$601.90	$926.00	$204.74–$1,400.00	9% below	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY FEE 2 URGENT I	$601.90	$926.00	—	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY FEE 3 URGENT II	$906.75	$1,395.00	—	31% below	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY FEE 3 URGENT II	$906.75	$1,395.00	$357.17–$1,400.00	31% below	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY FEE 3 URGENT II	$906.75	$1,395.00	—	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY FEE 4 EMERGENT I	$1,571.70	$2,418.00	—	23% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY FEE 4 EMERGENT I	$1,571.70	$2,418.00	$452.00–$2,345.46	23% below	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY FEE 4 EMERGENT I	$1,571.70	$2,418.00	—	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY FEE 5 EMERGENT II	$2,139.80	$3,292.00	$452.00–$3,193.24	21% below	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY FEE 5 EMERGENT II	$2,139.80	$3,292.00	—	21% below	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY FEE 5 EMERGENT II	$2,139.80	$3,292.00	—	—	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS EKG PHARMACOLOGIC	$811.85	$1,249.00	—	at median	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL EXAM	$811.85	$1,249.00	$55.90–$1,211.53	at median	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL EXAM	$811.85	$1,249.00	—	at median	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS EKG PHARMACOLOGIC	$811.85	$1,249.00	$55.90–$1,211.53	at median	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS EKG PHARMACOLOGIC	$811.85	$1,249.00	—	—	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL EXAM	$811.85	$1,249.00	—	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR	$551.20	$848.00	—	19% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION 1ST HR	$551.20	$848.00	$38.10–$822.56	19% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION 1ST HR	$551.20	$848.00	—	—	35%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY UP TO 1 HR	$551.20	$848.00	—	19% above	35%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX UP TO 1 HR	$551.20	$848.00	$46.51–$822.56	19% above	35%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY UP TO 1 HR	$551.20	$848.00	$46.51–$822.56	19% above	35%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX UP TO 1 HR	$551.20	$848.00	—	19% above	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY UP TO 1 HR	$551.20	$848.00	—	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX UP TO 1 HR	$551.20	$848.00	—	—	35%
IV push of a medicine, first drug CPT 96374 IV INJ/PUSH INITIAL	$219.70	$338.00	$212.94–$327.86	41% below	35%
IV push of a medicine, first drug CPT 96374 IV INFUSION INITIAL PUSH	$219.70	$338.00	—	41% below	35%
IV push of a medicine, first drug CPT 96374 IV INFUSION INITIAL PUSH	$219.70	$338.00	$36.88–$327.86	41% below	35%
IV push of a medicine, first drug CPT 96374 IV INJ/PUSH INITIAL	$219.70	$338.00	—	41% below	35%
IV push of a medicine, first drug inpatient CPT 96374 IV INJ/PUSH INITIAL	$219.70	$338.00	—	—	35%
IV push of a medicine, first drug inpatient CPT 96374 IV INFUSION INITIAL PUSH	$219.70	$338.00	—	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ	$114.40	$176.00	—	24% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPEUTIC SUBQ/IM	$114.40	$176.00	$88.18–$170.72	24% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPEUTIC SUBQ/IM	$114.40	$176.00	—	24% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ MOD XU	$114.40	$176.00	$13.87–$170.72	24% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ MOD XU	$114.40	$176.00	—	24% below	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SUBQ	$114.40	$176.00	$13.87–$170.72	24% below	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SUBQ	$114.40	$176.00	—	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THERAPEUTIC SUBQ/IM	$114.40	$176.00	—	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SUBQ MOD XU	$114.40	$176.00	—	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN	$133.90	$206.00	—	35% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED 15 MIN	$133.90	$206.00	$18.58–$199.82	35% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC RE-ED 15 MIN	$133.90	$206.00	—	35% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN	$133.90	$206.00	$18.58–$199.82	35% above	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC RE-ED 15 MIN	$133.90	$206.00	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUC 15 MIN	$133.90	$206.00	—	—	35%
Occupational therapy evaluation, low complexity CPT 97165 OT MED-SURG EVAL LOW	$373.75	$575.00	—	114% above	35%
Occupational therapy evaluation, low complexity CPT 97165 OT MED-SURG EVAL LOW	$373.75	$575.00	$49.83–$557.75	114% above	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT MED-SURG EVAL LOW	$373.75	$575.00	—	—	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–$572.30	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	$356.85	$549.00	—	74% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT INIT EVAL LOW	$356.85	$549.00	$51.57–$532.53	74% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT INIT EVAL LOW	$356.85	$549.00	—	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT INIT EVAL MOD	$383.50	$590.00	$51.57–$572.30	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 PT MANUAL THERAPY 15 MIN	$120.25	$185.00	—	24% below	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN	$120.25	$185.00	$20.55–$179.45	24% below	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY 15 MIN	$120.25	$185.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN	$129.35	$199.00	—	28% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE 15 MIN	$129.35	$199.00	$17.65–$193.03	28% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE 15 MIN	$129.35	$199.00	—	28% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN	$129.35	$199.00	$17.65–$193.03	28% above	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE 15 MIN	$129.35	$199.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE 15 MIN	$129.35	$199.00	—	—	35%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAVIOR CHANGE SMOKING 3 to 10 MINS	$97.50	$150.00	$9.63–$145.50	83% above	35%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAVIOR CHANGE SMOKING 3 to 10 MINS	$97.50	$150.00	—	83% above	35%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAVIOR CHANGE SMOKING 3 to 10 MINS	$97.50	$150.00	—	—	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M EST PT-(COMPLEX)	$486.20	$748.00	$83.57–$725.56	50% above	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M EST PT-(COMPLEX)	$486.20	$748.00	—	50% above	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E&M EST PT-(COMPLEX)	$486.20	$748.00	—	—	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M EST PT-(INTERMEDIATE)	$247.00	$380.00	—	2% below	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M EST PT-(INTERMEDIATE)	$247.00	$380.00	$36.31–$368.60	2% below	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E&M EST PT-(INTERMEDIATE)	$247.00	$380.00	—	—	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M EST PT-(EXTENDED)	$348.40	$536.00	$56.46–$519.92	39% above	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M EST PT-(EXTENDED)	$348.40	$536.00	—	39% above	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E&M EST PT-(EXTENDED)	$348.40	$536.00	—	—	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M EST PT-(LIMITED)	$143.00	$220.00	$24.13–$213.40	29% below	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M EST PT-(LIMITED)	$143.00	$220.00	—	29% below	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E&M EST PT-(LIMITED)	$143.00	$220.00	—	—	35%
Speech and language evaluation CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL	$630.50	$970.00	$123.10–$940.90	102% above	35%
Speech and language evaluation CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL	$630.50	$970.00	—	102% above	35%
Speech and language evaluation inpatient CPT 92523 SPEECH PRODUCTION W LANG COMPREHEN EVAL	$630.50	$970.00	—	—	35%
Speech therapy session, individual CPT 92507 SP SPEECH-LANG-VOICE TREAT	$296.40	$456.00	$21.05–$442.32	63% above	35%
Speech therapy session, individual CPT 92507 SP SPEECH-LANG-VOICE TREAT	$296.40	$456.00	—	63% above	35%
Speech therapy session, individual inpatient CPT 92507 SP SPEECH-LANG-VOICE TREAT	$296.40	$456.00	—	—	35%
Spirometry (breathing test) CPT 94010 SIMP SPIROMETRY	$312.65	$481.00	—	5% above	35%
Spirometry (breathing test) CPT 94010 SIMP SPIROMETRY	$312.65	$481.00	$16.03–$466.57	5% above	35%
Spirometry (breathing test) inpatient CPT 94010 SIMP SPIROMETRY	$312.65	$481.00	—	—	35%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM	$319.15	$491.00	—	12% below	35%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM	$319.15	$491.00	$31.20–$476.27	12% below	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM	$319.15	$491.00	—	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIV 15 MIN	$133.90	$206.00	—	35% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$133.90	$206.00	$18.32–$199.82	35% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACTIV 15 MIN	$133.90	$206.00	$18.32–$199.82	35% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$133.90	$206.00	—	35% above	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACTIV 15 MIN	$133.90	$206.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$133.90	$206.00	—	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$171.60	$264.00	$14.85–$256.08	52% below	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$171.60	$264.00	—	52% below	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$171.60	$264.00	—	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Hawaii	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$325.19	$500.29	—	12% above	35%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$325.19	$500.29	$255.15–$485.28	12% above	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR	$325.19	$500.29	—	—	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 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP	$70.44	$108.37	$55.27–$105.12	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%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYR	$182.64	$280.98	—	48% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYR	$182.64	$280.98	$143.30–$272.55	48% above	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYR	$182.64	$280.98	—	—	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP	$68.88	$105.97	—	50% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP	$68.88	$105.97	$54.04–$102.79	50% above	35%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP	$68.88	$105.97	—	—	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM RECON.SOLN.	$37.04	$56.99	$29.06–$55.28	26% above	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM RECON.SOLN.	$37.04	$56.99	—	26% above	35%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM RECON.SOLN.	$37.04	$56.99	—	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS RECON.SOLN.	$222.89	$342.91	$174.88–$332.62	23% above	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS RECON.SOLN.	$222.89	$342.91	—	23% above	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS RECON.SOLN.	$222.89	$342.91	—	—	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN	$316.93	$487.59	$248.67–$472.96	23% below	35%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN	$316.93	$487.59	—	23% below	35%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENING VAC A,C,Y,W135,TET (PF) 10 MCG/0.5 ML IM SOLN	$316.93	$487.59	—	—	35%
Meningococcal B vaccine (Trumenba) CPT 90621 N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYR	$343.11	$527.86	—	—	35%
Meningococcal B vaccine (Trumenba) CPT 90621 N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYR	$343.11	$527.86	$269.21–$512.02	—	35%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYR	$343.11	$527.86	—	—	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) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYR	$423.29	$651.21	$332.12–$631.67	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%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR	$688.53	$1,059.28	—	30% below	35%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR	$688.53	$1,059.28	$540.23–$1,027.50	30% below	35%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR	$688.53	$1,059.28	—	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYR	$89.59	$137.83	$70.29–$133.70	56% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYR	$89.59	$137.83	—	56% above	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYR	$89.59	$137.83	—	—	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 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	$87.85–$167.09	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	$106.60	$164.00	$4.00–$159.08	11% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION, ONE VACCINE	$106.60	$164.00	—	11% below	35%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION, ONE VACCINE	$106.60	$164.00	—	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL	$70.85	$109.00	$4.00–$105.73	17% above	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL	$70.85	$109.00	—	17% above	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL	$70.85	$109.00	—	—	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/kona/99-0262196_Kona-Hospital_standardcharges.csv