Highlands Hospital
Highlands Hospital in Connellsville, PA publishes cash prices for 350 common procedures listed here, from its own machine-readable price file updated Feb 2, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Pennsylvania median for 260 of 348 procedures and below it for 84. By typical cash price it ranks #66 of 108 Pennsylvania hospitals and #17 of 26 hospitals in the Pittsburgh, PA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
401 E Murphy Ave. Connellsville, PA 15425 Collected Sep 22, 2026 Source price file Check a bill from this hospital (724) 628-1500
Acute care hospital Nonprofit hospital Emergency department CCN 390184 · CMS hospital register NPI 1144215039
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Highlands Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Highlands Hospital in Connellsville, PA:
- Jul 8, 2026 Met requirements
Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 31% below | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO | $1,293.00 | $2,155.00 | — | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 136% above | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE MIN 3 V | $639.60 | $1,066.00 | $359.24–$831.48 | 76% above | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 V-RT COMP | $639.60 | $1,066.00 | $359.24–$831.48 | 76% above | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 V-LT COMP | $639.60 | $1,066.00 | $359.24–$831.48 | 76% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE MIN 3 V | $639.60 | $1,066.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 V-LT COMP | $639.60 | $1,066.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 V-RT COMP | $639.60 | $1,066.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 SONO/ARTERIAL/PHYSIOLOGICAL UNILAT LE | $936.60 | $1,561.00 | $526.06–$1,217.58 | 109% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 SONO/ARTERIAL/PHYSIOLOGICAL UNILAT UE | $936.60 | $1,561.00 | $526.06–$1,217.58 | 109% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 SONO/ARTERIAL/PHYSIOLOGICAL UNILAT UE | $936.60 | $1,561.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 SONO/ARTERIAL/PHYSIOLOGICAL UNILAT LE | $936.60 | $1,561.00 | — | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O-RT CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 35% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O-LT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 35% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O-LT | $772.20 | $1,287.00 | — | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O-RT CONT | $772.20 | $1,287.00 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 181% above | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS | $1,293.00 | $2,155.00 | — | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY | $2,919.00 | $4,865.00 | $1,639.50–$3,794.70 | 138% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE IMAGING WHOLE BODY | $2,919.00 | $4,865.00 | — | — | 40% |
| Breast ultrasound, complete, one breast CPT 76641 SONO/BREAST | $772.20 | $1,287.00 | $433.72–$1,003.86 | 41% above | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 SONO/BREAST-RT COMPLETE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 41% above | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 SONO/BREAST-LT COMPLETE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 41% above | 40% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 SONO/BREAST | $772.20 | $1,287.00 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 SONO/BREAST-RT COMPLETE | $772.20 | $1,287.00 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 SONO/BREAST-LT COMPLETE | $772.20 | $1,287.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 SONO/BREAST-LT LIMITED | $639.60 | $1,066.00 | $359.24–$831.48 | 39% above | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 SONO/BREAST-RT LIMITED | $639.60 | $1,066.00 | $359.24–$831.48 | 39% above | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 SONO/BREAST-LT LIMITED | $639.60 | $1,066.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 SONO/BREAST-RT LIMITED | $639.60 | $1,066.00 | — | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ABD/PELVIS ANGIOGRAM | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 13% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ABD/PELVIS ANGIOGRAM | $2,594.40 | $4,324.00 | — | — | 40% |
| CT angiography (CTA) of the head CPT 70496 ()CTA HEAD W CONTR/NON CONTR | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 24% below | 40% |
| CT angiography (CTA) of the head CPT 70496 (STROKE) CTA HEAD W/WO CONTRAST | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 24% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 ()CTA HEAD W CONTR/NON CONTR | $1,293.00 | $2,155.00 | — | — | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 (STROKE) CTA HEAD W/WO CONTRAST | $1,293.00 | $2,155.00 | — | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 ()CTA NECK W CONTR/NON CONTR | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 23% below | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 ()CTA NECK W CONTR/NON CONTR | $1,293.00 | $2,155.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST ANGIOGRAM | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 33% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST FOR PE | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 33% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST ANGIOGRAM | $1,293.00 | $2,155.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST FOR PE | $1,293.00 | $2,155.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PEL KIDNEY STONE | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 16% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PEL W/O | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 16% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PEL W/O | $1,755.60 | $2,926.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PEL KIDNEY STONE | $1,755.60 | $2,926.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PEL W | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 13% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PEL W | $2,594.40 | $4,324.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 13% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/WO | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 13% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W/WO | $2,594.40 | $4,324.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM | $2,594.40 | $4,324.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 22% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONT | $1,293.00 | $2,155.00 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 32% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 31% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 .CT HEAD FACIAL BONES WO | $772.20 | $1,287.00 | $433.72–$1,003.86 | 31% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 .CT HEAD FACIAL BONES WO | $772.20 | $1,287.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD STROKE WO CONTRAST | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD STROKE WO CONTRAST | $772.20 | $1,287.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 CT HEAD W/CONT | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 4% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONT | $1,293.00 | $2,155.00 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 23% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO | $1,293.00 | $2,155.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONT | $991.20 | $1,652.00 | $556.72–$1,288.56 | 14% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE W/O CONT | $991.20 | $1,652.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONT | $972.60 | $1,621.00 | $546.28–$1,264.38 | 18% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O CONT | $972.60 | $1,621.00 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONT | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 24% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONT | $1,293.00 | $2,155.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 SONO/CAROTID DOPPLER COMPLETE | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 117% above | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID DOPPLER | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 117% above | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID DOPPLER | $1,755.60 | $2,926.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 SONO/CAROTID DOPPLER COMPLETE | $1,755.60 | $2,926.00 | — | — | 40% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 20% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO | $1,293.00 | $2,155.00 | — | — | 40% |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 98% above | 40% |
| Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 98% above | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW | $639.60 | $1,066.00 | $359.24–$831.48 | 239% above | 40% |
| Chest X-ray, single view CPT 71045 CHEST PORTABLE SINGLE VIEW FRONTAL | $639.60 | $1,066.00 | $359.24–$831.48 | 239% above | 40% |
| Chest X-ray, single view inpatient CPT 71045 CHEST PORTABLE SINGLE VIEW FRONTAL | $639.60 | $1,066.00 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW | $639.60 | $1,066.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE | $639.60 | $1,066.00 | $359.24–$831.48 | 123% above | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 123% above | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 123% above | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE | $639.60 | $1,066.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE-LT | $639.60 | $1,066.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE-RT | $639.60 | $1,066.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 SONO/RENAL - BLADDER | $772.20 | $1,287.00 | $433.72–$1,003.86 | 6% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 SONO/RENAL/AORTA COMPLETE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 6% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 SONO/RENAL - BLADDER | $772.20 | $1,287.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 SONO/RENAL/AORTA COMPLETE | $772.20 | $1,287.00 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY - DEXA SCAN AXIAL | $202.80 | $338.00 | $113.91–$263.64 | 25% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY - DEXA SCAN AXIAL | $202.80 | $338.00 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 SONO/OB DETAIL ANAT 2-3TRI SIN | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 40% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 SONO/OB DETAIL ANAT 2-3TRI SIN | $1,755.60 | $2,926.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONT | $799.20 | $1,332.00 | $448.88–$1,038.96 | 27% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONT | $799.20 | $1,332.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONT | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 9% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONT | $1,293.00 | $2,155.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO 3D DIAGNOSTIC DIGITAL BILAT | $278.40 | $464.00 | $156.37–$361.92 | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO 2D DIAGNOSTIC DIGITAL BILAT | $278.40 | $464.00 | $156.37–$361.92 | — | 40% |
| Diagnostic mammogram, both breasts CPT 77066 MM DIAG CAD ADD ON | $278.40 | $464.00 | $156.37–$361.92 | 14% below | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO 3D DIAGNOSTIC DIGITAL BILAT | $278.40 | $464.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO 2D DIAGNOSTIC DIGITAL BILAT | $278.40 | $464.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MM DIAG CAD ADD ON | $278.40 | $464.00 | — | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO 3D UNI DIAG-RT | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM DIAG LT CAD ADD ON | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO 2D UNI DIAG-LT | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO 2D UNI DIAG-RT | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM DIAG RT CAD ADD ON | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO 3D UNI DIAG-LT | $217.80 | $363.00 | $122.33–$283.14 | 31% below | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO 3D UNI DIAG-LT | $217.80 | $363.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAG RT CAD ADD ON | $217.80 | $363.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO 2D UNI DIAG-RT | $217.80 | $363.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO 3D UNI DIAG-RT | $217.80 | $363.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAG LT CAD ADD ON | $217.80 | $363.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO 2D UNI DIAG-LT | $217.80 | $363.00 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ARTERIAL LOWER IMAG BILAT | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ARTERIAL LOWER IMAG BILAT | $1,755.60 | $2,926.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VENOUS IMAGING EXT BILATERAL | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VENOUS IMAGING EXT BILATERAL | $1,755.60 | $2,926.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 . ECHO COMPLETE WITH CONTAST | $3,982.80 | $6,638.00 | $2,237.01–$5,177.64 | 112% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE TC | $3,982.80 | $6,638.00 | $2,237.01–$5,177.64 | 112% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 .ECHO COMPLETE | $3,982.80 | $6,638.00 | $2,237.01–$5,177.64 | 112% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 .ECHO COMPLETE | $3,982.80 | $6,638.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE TC | $3,982.80 | $6,638.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 . ECHO COMPLETE WITH CONTAST | $3,982.80 | $6,638.00 | — | — | 40% |
| Elbow X-ray, 2 views one side CPT 73070 ELBOW AP AND LATERAL-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 110% above | 40% |
| Elbow X-ray, 2 views one side CPT 73070 ELBOW AP AND LATERAL-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 110% above | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP AND LATERAL-LT | $639.60 | $1,066.00 | — | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP AND LATERAL-RT | $639.60 | $1,066.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMP 3 VIEWS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 85% above | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW COMP 3 VIEWS-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 85% above | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMP 3 VIEWS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 85% above | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMP 3 VIEWS-LT | $639.60 | $1,066.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW COMP 3 VIEWS-RT | $639.60 | $1,066.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW COMP 3 VIEWS-LT | $639.60 | $1,066.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 .CT MANDIBLE CHOMIAK | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT FACIAL W/O | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 .CT MAXILLA CHOMIAK | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT FACIAL W/O | $772.20 | $1,287.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 .CT MANDIBLE CHOMIAK | $772.20 | $1,287.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 .CT MAXILLA CHOMIAK | $772.20 | $1,287.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMP | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 ZYGOMA/ZYGOMATIC ARCHES | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES <3 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES <3 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMP | $772.20 | $1,287.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP | $772.20 | $1,287.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 ZYGOMA/ZYGOMATIC ARCHES | $772.20 | $1,287.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM AP AND LAT-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM AP AND LAT-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM AP AND LAT-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM AP AND LAT-LT | $639.60 | $1,066.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM AP AND LAT-RT | $639.60 | $1,066.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM AP AND LAT-LT | $639.60 | $1,066.00 | — | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY | $2,919.00 | $4,865.00 | $1,639.50–$3,794.70 | 138% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY | $2,919.00 | $4,865.00 | — | — | 40% |
| Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW-RT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 176% above | 40% |
| Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEW-LT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 176% above | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW-LT | $772.20 | $1,287.00 | — | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEW-RT | $772.20 | $1,287.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL MIN 2 VW | $639.60 | $1,066.00 | $359.24–$831.48 | 142% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL RT MIN 2 VW | $639.60 | $1,066.00 | $359.24–$831.48 | 142% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL LT MIN 2 VW | $639.60 | $1,066.00 | $359.24–$831.48 | 142% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL MIN 2 VW | $639.60 | $1,066.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL RT MIN 2 VW | $639.60 | $1,066.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL LT MIN 2 VW | $639.60 | $1,066.00 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY TYPE III PORTABLE MON | $524.40 | $874.00 | $294.54–$681.72 | 14% below | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP STUDY TYPE III PORTABLE MON | $524.40 | $874.00 | — | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP | $1,582.80 | $2,638.00 | $889.01–$2,057.64 | 50% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP | $1,582.80 | $2,638.00 | — | — | 40% |
| Knee X-ray, 3 views CPT 73562 XR KNEE MIN 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 60% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 KNEE LT MIN 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 60% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 KNEE RT MIN 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 60% above | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE MIN 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LT MIN 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RT MIN 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VIEWS-RT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 77% above | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VIEWS-LT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 77% above | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VIEWS-RT | $772.20 | $1,287.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VIEWS-LT | $772.20 | $1,287.00 | — | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT LT W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT RT W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT LT W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT RT W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 .SONO/PANCREAS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO/R U Q | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO/APPENDIX | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO/ABD AREA LIMITED | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 .SONO/LIVER BILE DUCTS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO/SPLEEN | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 .SONO/GALLBLADDER | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 .SONO/LIVER HEPATIC | $772.20 | $1,287.00 | $433.72–$1,003.86 | 27% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 .SONO/LIVER BILE DUCTS | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO/R U Q | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO/APPENDIX | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 .SONO/LIVER HEPATIC | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 .SONO/GALLBLADDER | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 .SONO/PANCREAS | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO/ABD AREA LIMITED | $772.20 | $1,287.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO/SPLEEN | $772.20 | $1,287.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 SONO/US EXTREMITY LIMITED | $772.20 | $1,287.00 | $433.72–$1,003.86 | 96% above | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 SONO/US EXTREMITY LIMITED | $772.20 | $1,287.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE LUNG CANCER SCREEN | $799.20 | $1,332.00 | $448.88–$1,038.96 | 102% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LOW DOSE LUNG CANCER SCREEN | $799.20 | $1,332.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIB/FIB AP AND LAT | $639.60 | $1,066.00 | $359.24–$831.48 | 92% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB AP AND LAT-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 92% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB AP AND LAT-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 92% above | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIB/FIB AP AND LAT | $639.60 | $1,066.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB AP AND LAT-LT | $639.60 | $1,066.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB AP AND LAT-RT | $639.60 | $1,066.00 | — | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 2% below | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTREMITY JOINT WITHOUT CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RT W/O CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT LOWER EXTREMITY JOINT WO/CONTR | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LEFT LOWER EXTREMITY JOINT W/O CONTR | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 14% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXTREMITY JOINT WITHOUT CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RT W/O CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LEFT LOWER EXTREMITY JOINT W/O CONTR | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RIGHT LOWER EXTREMITY JOINT WO/CONTR | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTREMITY JOINT W/WO | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT LOWER EXTREMITY JOINT W/WO CON | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LEFT LOWER EXTREMITY JOINT W/WO CONT | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXTREMITY JOINT W/WO | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RIGHT LOWER EXTREMITY JOINT W/WO CON | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LEFT LOWER EXTREMITY JOINT W/WO CONT | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRCP | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 11% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABD WITHOUT CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 11% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP ABDOMEN W/O CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 11% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W O CONTRAST MTL | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 11% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP ABDOMEN W/O CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W O CONTRAST MTL | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRCP | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD WITHOUT CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD WITH/WITHOUT CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD WITH/WITHOUT CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO | $646.80 | $1,078.00 | $363.29–$840.84 | 64% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 4% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO | $646.80 | $1,078.00 | — | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 11% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 11% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE W/O | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 2% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR WO/CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 2% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR WO/CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE W/O | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE W/WO | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 21% below | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W/WO CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 21% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE W/WO | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W/WO CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WITHOUT | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 15% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC WO/CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 15% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC WO/CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WITHOUT | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV W/WO CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 11% below | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WITH OR WITHOUT | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 11% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE WITH OR WITHOUT | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV W/WO CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERV SPINE WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | at median | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WITHOUT | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | at median | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERV SPINE WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE WITHOUT | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST | $2,594.40 | $4,324.00 | $1,457.19–$3,372.72 | 26% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 10% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 10% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI U E JOINT WITHOUT CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT UPPER EXTREMITY JOINT WO/CONTR | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LEFT UPPER EXTREMITY JOINT WO/CONTRA | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RT WO CONTRAST | $1,755.60 | $2,926.00 | $986.06–$2,282.28 | 17% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI U E JOINT WITHOUT CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI RIGHT UPPER EXTREMITY JOINT WO/CONTR | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI LEFT UPPER EXTREMITY JOINT WO/CONTRA | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LT WO CONTRAST | $1,755.60 | $2,926.00 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE 4 VIEW | $772.20 | $1,287.00 | $433.72–$1,003.86 | 75% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4 VIEW | $772.20 | $1,287.00 | $433.72–$1,003.86 | 75% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE 4 VIEW | $772.20 | $1,287.00 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR C-SPINE 4 VIEW | $772.20 | $1,287.00 | — | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TIS W/CONT | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 4% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TIS W/CONT | $1,293.00 | $2,155.00 | — | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TIS W/O | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TIS W/O | $772.20 | $1,287.00 | — | — | 40% |
| Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE | $639.60 | $1,066.00 | — | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE | $639.60 | $1,066.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 .NM-C MYOCARD IMAG MULT | $9,483.00 | $15,805.00 | $5,326.29–$12,327.90 | 142% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD IMAG MULT SPEC | $9,483.00 | $15,805.00 | $5,326.29–$12,327.90 | 142% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 .NM T MYOCARD IMAG MULT SPEC | $9,483.00 | $15,805.00 | $5,326.29–$12,327.90 | 142% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 .NM T MYOCARD IMAG MULT SPEC | $9,483.00 | $15,805.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 .NM-C MYOCARD IMAG MULT | $9,483.00 | $15,805.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD IMAG MULT SPEC | $9,483.00 | $15,805.00 | — | — | 40% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 29% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 SONO/PELVIC NON-OB LIMITED | $772.20 | $1,287.00 | $433.72–$1,003.86 | 73% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 SONO/PELVIC NON-OB LIMITED | $772.20 | $1,287.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 SONO/PELVIC NON-OB COMP | $772.20 | $1,287.00 | $433.72–$1,003.86 | 33% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 SONO/PELVIC NON-OB COMP | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 SONO/PREGNANCY COMPLETE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 26% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 SONO/PREGNANCY COMPLETE | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 SONO/OB 1ST TRI SINGLE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 38% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 SONO/OB 1ST TRI SINGLE | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO/PLACENTA LOCATION | $772.20 | $1,287.00 | $433.72–$1,003.86 | 45% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO/PLACENTA GRADE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 45% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO/PREGNANT LIMITED | $772.20 | $1,287.00 | $433.72–$1,003.86 | 45% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO/FETAL AGE DET | $772.20 | $1,287.00 | $433.72–$1,003.86 | 45% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO/FETAL POSITION | $772.20 | $1,287.00 | $433.72–$1,003.86 | 45% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO/PLACENTA GRADE | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO/FETAL AGE DET | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO/FETAL POSITION | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO/PREGNANT LIMITED | $772.20 | $1,287.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO/PLACENTA LOCATION | $772.20 | $1,287.00 | — | — | 40% |
| Rib X-ray, one side, 2 views CPT 71100 XR RIBS-UNI-2 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 90% above | 40% |
| Rib X-ray, one side, 2 views CPT 71100 RIBS-UNI-2 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 90% above | 40% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 RIBS-UNI-2 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 XR RIBS-UNI-2 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS-UNI-RT 3+ VIEWS PA CHEST | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS-UNI-LT 3+ VIEWS PA CHEST | $772.20 | $1,287.00 | $433.72–$1,003.86 | 88% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS-UNI-LT 3+ VIEWS PA CHEST | $772.20 | $1,287.00 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS-UNI-RT 3+ VIEWS PA CHEST | $772.20 | $1,287.00 | — | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MM MAMMO 3D SCREEN DIGITAL BILAT | $585.60 | $976.00 | $328.91–$761.28 | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MM MAMMO 2D SCREEN DIGITAL BILAT | $585.60 | $976.00 | $328.91–$761.28 | — | 40% |
| Screening mammogram, both breasts CPT 77067 MM MAMMO SCREEN BIL 2 VIEW WITH CAD | $585.60 | $976.00 | $328.91–$761.28 | 128% above | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MM MAMMO 3D SCREEN DIGITAL BILAT | $585.60 | $976.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MM MAMMO 2D SCREEN DIGITAL BILAT | $585.60 | $976.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MM MAMMO SCREEN BIL 2 VIEW WITH CAD | $585.60 | $976.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULDER | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER R-MIN 2 V | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER L MIN 2 V | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER | $639.60 | $1,066.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER R-MIN 2 V | $639.60 | $1,066.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER L MIN 2 V | $639.60 | $1,066.00 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES 3+ VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 51% above | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES | $639.60 | $1,066.00 | $359.24–$831.48 | 51% above | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES | $639.60 | $1,066.00 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES 3+ VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 116% above | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 OR MORE | $1,582.80 | $2,638.00 | $889.01–$2,057.64 | 54% below | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 OR MORE | $1,582.80 | $2,638.00 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW-COOKIES | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 119% above | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW-COOKIES | $1,293.00 | $2,155.00 | — | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T SPINE W/O CONT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 34% below | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T SPINE W/O CONT | $772.20 | $1,287.00 | — | — | 40% |
| Toe X-ray, 2 or more views CPT 73660 XR TOES ALL | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 TOES ALL-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 TOES ALL-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOES ALL | $639.60 | $1,066.00 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES ALL-LT | $639.60 | $1,066.00 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES ALL-RT | $639.60 | $1,066.00 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 SONO/TRANSVAGINAL | $772.20 | $1,287.00 | $433.72–$1,003.86 | 38% above | 40% |
| Transvaginal pelvic ultrasound CPT 76830 SONO/TRANS & PELVIC | $772.20 | $1,287.00 | $433.72–$1,003.86 | 38% above | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 SONO/TRANSVAGINAL | $772.20 | $1,287.00 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 SONO/TRANS & PELVIC | $772.20 | $1,287.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 SONO/OB TRANSVAG | $772.20 | $1,287.00 | $433.72–$1,003.86 | 40% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 SONO/OB TRANSVAG | $772.20 | $1,287.00 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 SONO/ABD COMPLETE | $772.20 | $1,287.00 | $433.72–$1,003.86 | 2% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 SONO/ABD COMPLETE | $772.20 | $1,287.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 SONO/TESTICULAR | $772.20 | $1,287.00 | $433.72–$1,003.86 | 25% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 SONO/TESTICULAR | $772.20 | $1,287.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SONO/HEAD/NECK/THYROID | $772.20 | $1,287.00 | $433.72–$1,003.86 | 35% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SONO/HEAD/NECK/THYROID | $772.20 | $1,287.00 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER G I | $1,293.00 | $2,155.00 | $726.24–$1,680.90 | 106% above | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER G I | $1,293.00 | $2,155.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS | $639.60 | $1,066.00 | $359.24–$831.48 | 131% above | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 131% above | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 131% above | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS | $639.60 | $1,066.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS-LT | $639.60 | $1,066.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS-RT | $639.60 | $1,066.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS IMAGING UNILATERAL (LT) | $171.60 | $286.00 | $96.38–$223.08 | 73% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS IMAGING UNILATERAL (RT) | $171.60 | $286.00 | $96.38–$223.08 | 73% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SONO/VENOUS DOPPLER RIGHT UPPER EXT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VENOUS IMAGING LTD OR UNILAT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 .SONO/VENOUS IMAGING LTD OR UNILAT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SONO/VENOUS DOPPLER LEFT LOWER EXT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SONO/VENOUS DOPPLER RIGHT LOWER EXT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 SONO/VENOUS DOPPLER LEFT UPPER EXT | $772.20 | $1,287.00 | $433.72–$1,003.86 | 21% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS IMAGING UNILATERAL (RT) | $171.60 | $286.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS IMAGING UNILATERAL (LT) | $171.60 | $286.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 .SONO/VENOUS IMAGING LTD OR UNILAT | $772.20 | $1,287.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 SONO/VENOUS DOPPLER LEFT LOWER EXT | $772.20 | $1,287.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 SONO/VENOUS DOPPLER RIGHT LOWER EXT | $772.20 | $1,287.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 SONO/VENOUS DOPPLER RIGHT UPPER EXT | $772.20 | $1,287.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 SONO/VENOUS DOPPLER LEFT UPPER EXT | $772.20 | $1,287.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VENOUS IMAGING LTD OR UNILAT | $772.20 | $1,287.00 | — | — | 40% |
| Wrist X-ray, 2 views one side CPT 73100 WRIST AP AND LATERAL-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 133% above | 40% |
| Wrist X-ray, 2 views one side CPT 73100 WRIST AP AND LATERAL-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 133% above | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP AND LATERAL-LT | $639.60 | $1,066.00 | — | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP AND LATERAL-RT | $639.60 | $1,066.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MIN 3 VIEWS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 99% above | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MIN 3 VIEWS-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 99% above | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST MIN 3 VIEWS-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 99% above | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MIN 3 VIEWS-LT | $639.60 | $1,066.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST MIN 3 VIEWS-RT | $639.60 | $1,066.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MIN 3 VIEWS-RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP - RT - W/WO PELVIS 2 - 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 80% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP - LT - W/WO PELVIS 2 - 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 80% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP - LT - W/WO PELVIS 2 - 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP - RT - W/WO PELVIS 2 - 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW KUB | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW KUB | $639.60 | $1,066.00 | $359.24–$831.48 | 128% above | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW KUB | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW KUB | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE RT- AP AND LATERAL | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE AP AND LATERAL-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE LT- AP AND LATERAL | $639.60 | $1,066.00 | $359.24–$831.48 | 89% above | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE AP AND LATERAL-RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RT- AP AND LATERAL | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LT- AP AND LATERAL | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) 2 VWS RT | $639.60 | $1,066.00 | $359.24–$831.48 | 165% above | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 VWS RT | $639.60 | $1,066.00 | $359.24–$831.48 | 165% above | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) 2 VWS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 165% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) 2 VWS RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) 2 VWS-LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) 2 VWS RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS RT | $639.60 | $1,066.00 | $359.24–$831.48 | 97% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 .FOOT 2 VIEWS LT | $639.60 | $1,066.00 | $359.24–$831.48 | 97% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS LT | $639.60 | $1,066.00 | $359.24–$831.48 | 97% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT | $639.60 | $1,066.00 | $359.24–$831.48 | 97% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 .FOOT 2 VIEWS RT | $639.60 | $1,066.00 | $359.24–$831.48 | 97% above | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 .FOOT 2 VIEWS RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 .FOOT 2 VIEWS LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT 3 VIEWS | $639.60 | $1,066.00 | $359.24–$831.48 | 75% above | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 75% above | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 75% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT 3 VIEWS | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT 3 VIEWS-RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT 3 VIEWS-LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEW-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 115% above | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEW-RT | $639.60 | $1,066.00 | $359.24–$831.48 | 115% above | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEW-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 115% above | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEW-RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MIN 3 VIEW-RT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEW-LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RT AP AND LATERAL | $639.60 | $1,066.00 | $359.24–$831.48 | 127% above | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LT AP AND LATERAL | $639.60 | $1,066.00 | $359.24–$831.48 | 127% above | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE AP AND LATERAL-LT | $639.60 | $1,066.00 | $359.24–$831.48 | 127% above | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RT AP AND LATERAL | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE AP AND LATERAL-LT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LT AP AND LATERAL | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 L-SPINE 2 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 112% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 112% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 L-SPINE 2 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBOSACRAL SPINE COMP | $772.20 | $1,287.00 | $433.72–$1,003.86 | 70% above | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR LUMBOSACRAL SPINE COMP | $772.20 | $1,287.00 | $433.72–$1,003.86 | 70% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSACRAL SPINE COMP | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBOSACRAL SPINE COMP | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 111% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 111% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T-SPINE 2 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2 VIEWS | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL | $639.60 | $1,066.00 | $359.24–$831.48 | 136% above | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES | $639.60 | $1,066.00 | $359.24–$831.48 | 136% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE AP AND LAT | $639.60 | $1,066.00 | $359.24–$831.48 | 92% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE AP AND LAT | $639.60 | $1,066.00 | $359.24–$831.48 | 92% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE AP AND LAT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE AP AND LAT | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS A AND P VIEW ONLY | $772.20 | $1,287.00 | $433.72–$1,003.86 | 164% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS A/P AND FROG LEGS | $772.20 | $1,287.00 | $433.72–$1,003.86 | 164% above | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP VIEW ONLY | $772.20 | $1,287.00 | $433.72–$1,003.86 | 164% above | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS A/P AND FROG LEGS | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS A AND P VIEW ONLY | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP VIEW ONLY | $772.20 | $1,287.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX | $639.60 | $1,066.00 | $359.24–$831.48 | 91% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX | $639.60 | $1,066.00 | $359.24–$831.48 | 91% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX | $639.60 | $1,066.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX | $639.60 | $1,066.00 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH PLASMA LEVEL | $272.40 | $454.00 | $153.00–$354.12 | 23% above | 40% |
| ACTH blood test inpatient CPT 82024 ACTH PLASMA LEVEL | $272.40 | $454.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 .DO NOT ORDER LX SGPT/ALT | $37.20 | $62.00 | $20.89–$48.36 | 2% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $37.20 | $62.00 | $20.89–$48.36 | 2% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 .DO NOT ORDER LX SGPT/ALT | $37.20 | $62.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT | $37.20 | $62.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 .DO NOT ORDER LX SGOT/AST | $36.60 | $61.00 | $20.56–$47.58 | 1% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $36.60 | $61.00 | $20.56–$47.58 | 1% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $36.60 | $61.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 .DO NOT ORDER LX SGOT/AST | $36.60 | $61.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP PANEL ACUTE | $336.00 | $560.00 | $188.72–$436.80 | 8% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP PANEL ACUTE | $336.00 | $560.00 | — | — | 40% |
| Albumin blood test CPT 82040 .ALBUMIN | $34.80 | $58.00 | $19.55–$45.24 | 9% above | 40% |
| Albumin blood test CPT 82040 ALBUMIN | $34.80 | $58.00 | $19.55–$45.24 | 9% above | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $34.80 | $58.00 | — | — | 40% |
| Albumin blood test inpatient CPT 82040 .ALBUMIN | $34.80 | $58.00 | — | — | 40% |
| Aldosterone blood test CPT 82088 .ALDOSTERONE SERUM QUANUM | $287.40 | $479.00 | $161.42–$373.62 | 38% above | 40% |
| Aldosterone blood test CPT 82088 ALDOSTERONE URINE 24 HOUR | $287.40 | $479.00 | $161.42–$373.62 | 38% above | 40% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE 24 HOUR | $287.40 | $479.00 | — | — | 40% |
| Aldosterone blood test inpatient CPT 82088 .ALDOSTERONE SERUM QUANUM | $287.40 | $479.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE TOTAL | $36.60 | $61.00 | $20.56–$47.58 | 1% above | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 .DO NOT ORDER LX ALP | $36.60 | $61.00 | $20.56–$47.58 | 1% above | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE TOTAL | $36.60 | $61.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 .DO NOT ORDER LX ALP | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED (w1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH (i6) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH (t3) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS (g2) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS (M3) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY TREE (t70) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL (w18) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .DOG DANDER IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .D PTERONYS IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .D FARINAE IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .COCKROACH IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM (m2) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER (e1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE (m6) | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP (p338) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT (F256) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM (f207) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP (f24) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN (f14) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT (f13) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED (f10) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN (f8) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT (f4) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH (f3) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK (f2) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE (f1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TEST RIA | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS (g8) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS (g3) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PERENNIAL RYE GRASS (g5) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RED TOP GRASS (g9) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL GRASS (g1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR (w13) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY WHITE IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WILLOW TREE (t12) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAT EPITHELIA (e73) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITHELIA (e71) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT (f18) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHESTNUT (rf299) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT (f253) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO (f203) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE PINE TREE (t16) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGEN INDIVIDUAL IgE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHILDHOOD ALLERGEN INDIVIDUAL CHARGE IgE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 .SULFAMETHOXAZOL IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN (f79) IGE ALLERGY TESTING | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMOXICILLIN IGE (c6) | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST TEST ADDITIONAL | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YEAST (f45) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON (f41) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEADOW FESCUE (g4) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA (m13) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHIZOPUS (m11) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM (m9) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER (f290) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (f17) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT (f36) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE (f20) | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT (f201) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT (f202) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUE MUSSEL (F37) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN (f78) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TREE OF HEAVEN IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGY (g14) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK (f75) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN (w9) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTERS (w10) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS (e85) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS (e70) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHERS (e86) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM (m14) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA (m16) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHOSPORIUM (m8) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS (g10) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA (f40) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER (f80) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB (f23) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALBICANS (m5) IGE ALLERGY TEST | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR (m4) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH PIGWEED (w14) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE (t1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK (t7) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH TREE (t15) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE (t10) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS (g6) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE (t11)IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM (m1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT (w6) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR (t6) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM (t8) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER (e5) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. PTERONYSSINUS (d1) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. FARINAE (d2) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD (t14) IGE | $36.60 | $61.00 | $20.56–$47.58 | 13% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TEST RIA | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TEST ADDITIONAL | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST (f45) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON (f41) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MEADOW FESCUE (g4) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA (m13) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHIZOPUS (m11) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM (m9) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER (f290) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (f17) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT (f36) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND IGE (f20) | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT (f201) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT (f202) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUE MUSSEL (F37) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN (f78) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE OF HEAVEN IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT ALLERGY (g14) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK (f75) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTERS (w10) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN (w9) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS (e85) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS (e70) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHERS (e86) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM (m14) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CURVULARIA (m16) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHOSPORIUM (m8) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS (g10) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA (f40) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER (f80) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB (f23) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANDIDA ALBICANS (m5) IGE ALLERGY TEST | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR (m4) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH PIGWEED (w14) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE (t1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK (t7) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH TREE (t15) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE (t10) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS (g6) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE (t11)IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM NOTATUM (m1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT (w6) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR (t6) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM (t8) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER (e5) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. PTERONYSSINUS (d1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. FARINAE (d2) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD (t14) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED (w1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH (i6) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH (t3) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS (g2) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS (M3) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE MULBERRY TREE (t70) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL (w18) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .DOG DANDER IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .D PTERONYS IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .D FARINAE IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .COCKROACH IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM (m2) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER (e1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE (m6) | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP (p338) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT (F256) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM (f207) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP (f24) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN (f14) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT (f13) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED (f10) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN (f8) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT (f4) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH (f3) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK (f2) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE (f1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS (g8) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS (g3) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PERENNIAL RYE GRASS (g5) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED TOP GRASS (g9) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL GRASS (g1) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR (w13) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY WHITE IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WILLOW TREE (t12) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAT EPITHELIA (e73) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITHELIA (e71) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT (f18) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHESTNUT (rf299) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT (f253) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO (f203) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE PINE TREE (t16) IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESPIRATORY ALLERGEN INDIVIDUAL IgE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILDHOOD ALLERGEN INDIVIDUAL CHARGE IgE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .SULFAMETHOXAZOL IGE | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN (f79) IGE ALLERGY TESTING | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMOXICILLIN IGE (c6) | $36.60 | $61.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IGE | $36.60 | $61.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 .AFP | $118.20 | $197.00 | $66.39–$153.66 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER | $118.20 | $197.00 | $66.39–$153.66 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL SERUM | $118.20 | $197.00 | $66.39–$153.66 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TUMOR MARKER | $118.20 | $197.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP MATERNAL SERUM | $118.20 | $197.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 .AFP | $118.20 | $197.00 | — | — | 40% |
| Ammonia blood test CPT 82140 AMMONIA LEVEL | $102.60 | $171.00 | $57.63–$133.38 | 13% above | 40% |
| Ammonia blood test CPT 82140 .AMMONIUM ST RSK | $102.60 | $171.00 | $57.63–$133.38 | 13% above | 40% |
| Ammonia blood test CPT 82140 . DO NOT ORDER LX AMMONIA | $102.60 | $171.00 | $57.63–$133.38 | 13% above | 40% |
| Ammonia blood test inpatient CPT 82140 .AMMONIUM ST RSK | $102.60 | $171.00 | — | — | 40% |
| Ammonia blood test inpatient CPT 82140 . DO NOT ORDER LX AMMONIA | $102.60 | $171.00 | — | — | 40% |
| Ammonia blood test inpatient CPT 82140 AMMONIA LEVEL | $102.60 | $171.00 | — | — | 40% |
| Amylase blood test CPT 82150 AMYLASE | $45.60 | $76.00 | $25.61–$59.28 | 4% above | 40% |
| Amylase blood test CPT 82150 AMYLASE, RANDOM URINE W/O CREATININE | $45.60 | $76.00 | $25.61–$59.28 | 4% above | 40% |
| Amylase blood test CPT 82150 . DO NOT ORDER LX AMYLASE | $45.60 | $76.00 | $25.61–$59.28 | 4% above | 40% |
| Amylase blood test CPT 82150 AMYLASE BODY FLUID | $45.60 | $76.00 | $25.61–$59.28 | 4% above | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID | $45.60 | $76.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE, RANDOM URINE W/O CREATININE | $45.60 | $76.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 . DO NOT ORDER LX AMYLASE | $45.60 | $76.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $45.60 | $76.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 .CYCLIC CITRUL PEPTIDE ANTIBODY QUANUM | $91.20 | $152.00 | $51.22–$118.56 | 7% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 .CYCLIC CITRUL PEPTIDE ANTIBODY QUANUM | $91.20 | $152.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 .ANA AB | $85.20 | $142.00 | $47.85–$110.76 | 15% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (ANTI-NUCLEAR AB SCREEN) W/REFLEX | $85.20 | $142.00 | $47.85–$110.76 | 15% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 .ANA AB | $85.20 | $142.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA (ANTI-NUCLEAR AB SCREEN) W/REFLEX | $85.20 | $142.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 .BNP WESTMORELAND | $276.60 | $461.00 | $155.36–$359.58 | 39% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP SENDOUT | $276.60 | $461.00 | $155.36–$359.58 | 39% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP | $276.60 | $461.00 | $155.36–$359.58 | 39% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP TRIAGE | $276.60 | $461.00 | $155.36–$359.58 | 39% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 .BNP WESTMORELAND | $276.60 | $461.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP | $276.60 | $461.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO-BNP SENDOUT | $276.60 | $461.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP TRIAGE | $276.60 | $461.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE UTERINE | $24.00 | $40.00 | $13.48–$31.20 | 54% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .CULTURE NOSE | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .CULTURE NASAL | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE VAGINAL | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL WASH | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .CULTURE PENIS | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .CULT BACT AER EXCEPT UR | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .CULTURE GENITAL DRAIN | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CERVIX | $50.40 | $84.00 | $28.31–$65.52 | 3% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE UTERINE | $24.00 | $40.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .CULTURE NASAL | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .CULTURE NOSE | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE VAGINAL | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BRONCHIAL WASH | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .CULTURE PENIS | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .CULT BACT AER EXCEPT UR | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .CULTURE GENITAL DRAIN | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TISSUE | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CERVIX | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT | $50.40 | $84.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID | $50.40 | $84.00 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 . DO NOT ORDER AM BMP | $59.40 | $99.00 | $33.36–$77.22 | 23% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC META PANEL | $59.40 | $99.00 | $33.36–$77.22 | 23% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 .BASIC METABOLIC PANEL | $59.40 | $99.00 | $33.36–$77.22 | 23% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 .DO NOT ORDER LX BMP | $59.40 | $99.00 | $33.36–$77.22 | 23% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 . DO NOT ORDER AM BMP | $59.40 | $99.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 .BASIC METABOLIC PANEL | $59.40 | $99.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC META PANEL | $59.40 | $99.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 .DO NOT ORDER LX BMP | $59.40 | $99.00 | — | — | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $35.40 | $59.00 | $19.88–$46.02 | 11% above | 40% |
| Bilirubin blood test, total CPT 82247 .DO NOT ORDER LX BILIRUBIN TOTAL | $35.40 | $59.00 | $19.88–$46.02 | 11% above | 40% |
| Bilirubin blood test, total inpatient CPT 82247 .DO NOT ORDER LX BILIRUBIN TOTAL | $35.40 | $59.00 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $35.40 | $59.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW BIOPSY | $388.20 | $647.00 | $218.04–$504.66 | 119% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW BIOPSY | $388.20 | $647.00 | — | — | 40% |
| Blood culture for bacteria CPT 87040 .OLD CULTURE BLOOD #3 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 CULT BLOOD SET #1 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 CULT BLOOD SET #2 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 .CULT BLOOD SET #3 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 .CULT BLOOD SET #4 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 .OLD CULTURE BLOOD #1 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 .OLD CULTURE BLOOD #2 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria CPT 87040 .OLD CULTURE BLOOD #4 | $72.60 | $121.00 | $40.78–$94.38 | 14% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD SET #2 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .CULT BLOOD SET #4 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .CULT BLOOD SET #3 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD SET #1 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .OLD CULTURE BLOOD #4 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .OLD CULTURE BLOOD #3 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .OLD CULTURE BLOOD #2 | $72.60 | $121.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 .OLD CULTURE BLOOD #1 | $72.60 | $121.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE | $15.60 | $26.00 | $8.76–$20.28 | 4% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE | $15.60 | $26.00 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 .DO NOT ORDER LX GLUCOSE TOTAL | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test CPT 82947 .GLUCOSE PRE HOSPITAL | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test CPT 82947 .DO NOT ORDER LX GLUCOSE CSF | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE TOTAL | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test CPT 82947 .GLUCOSE | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR PP | $27.60 | $46.00 | $15.50–$35.88 | 7% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 .DO NOT ORDER LX GLUCOSE TOTAL | $27.60 | $46.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOTAL | $27.60 | $46.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 .GLUCOSE PRE HOSPITAL | $27.60 | $46.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 .DO NOT ORDER LX GLUCOSE CSF | $27.60 | $46.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR PP | $27.60 | $46.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 .GLUCOSE | $27.60 | $46.00 | — | — | 40% |
| Blood lead test CPT 83655 .ORGANIC AUD QUALITATIVE EACH | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test CPT 83655 .LEAD BLD | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test CPT 83655 .LEAD URINE | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test CPT 83655 LEAD BLOOD | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test CPT 83655 .PROBE ARRAY 251 THROUGHT 500 | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test CPT 83655 LEAD 24HR URINE | $85.20 | $142.00 | $47.85–$110.76 | 9% above | 40% |
| Blood lead test inpatient CPT 83655 .ORGANIC AUD QUALITATIVE EACH | $85.20 | $142.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 .LEAD URINE | $85.20 | $142.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD 24HR URINE | $85.20 | $142.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 .LEAD BLD | $85.20 | $142.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD BLOOD | $85.20 | $142.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 .PROBE ARRAY 251 THROUGHT 500 | $85.20 | $142.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY, URINE | $58.80 | $98.00 | $33.03–$76.44 | 17% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY, SERUM | $58.80 | $98.00 | $33.03–$76.44 | 17% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY, SERUM | $58.80 | $98.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY, URINE | $58.80 | $98.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO TYPE | $936.60 | $1,561.00 | $526.06–$1,217.58 | 604% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO TYPE | $936.60 | $1,561.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 .DO NOT ORDER LX BUN | $27.60 | $46.00 | $15.50–$35.88 | 2% above | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN (BLOOD UREA NITROGEN) | $27.60 | $46.00 | $15.50–$35.88 | 2% above | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 .BUN | $27.60 | $46.00 | $15.50–$35.88 | 2% above | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 .DO NOT ORDER LX BUN | $27.60 | $46.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 .BUN | $27.60 | $46.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (BLOOD UREA NITROGEN) | $27.60 | $46.00 | — | — | 40% |
| C-peptide blood test CPT 84681 C-PEPTIDE (C-TERMINAL INSULIN) | $147.00 | $245.00 | $82.57–$191.10 | 35% above | 40% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE (C-TERMINAL INSULIN) | $147.00 | $245.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 .CRP bad cpt code | $11.40 | $19.00 | $6.40–$14.82 | 68% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (MON VALLEY) | $36.60 | $61.00 | $20.56–$47.58 | 2% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 .CRP bad cpt code | $11.40 | $19.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (MON VALLEY) | $36.60 | $61.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN B, PCR, QUALITATIVE | $262.80 | $438.00 | $147.61–$341.64 | 27% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN B, PCR, QUALITATIVE | $262.80 | $438.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $147.00 | $245.00 | $82.57–$191.10 | 11% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $147.00 | $245.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $147.00 | $245.00 | $82.57–$191.10 | 12% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $147.00 | $245.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 DO NOT ORDER-TEST DEACTIVATED | $361.80 | $603.00 | $203.21–$470.34 | 297% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 PCR-QUEST QUANUM | $361.80 | $603.00 | $203.21–$470.34 | 297% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 PCR | $361.80 | $603.00 | $203.21–$470.34 | 297% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID ADD-ON CHARGE | $361.80 | $603.00 | $203.21–$470.34 | 297% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 PCR - EMPLOYEE HEALTH | $361.80 | $603.00 | $203.21–$470.34 | 297% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 DO NOT ORDER-TEST DEACTIVATED | $361.80 | $603.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 PCR-QUEST QUANUM | $361.80 | $603.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 PCR - EMPLOYEE HEALTH | $361.80 | $603.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 PCR | $361.80 | $603.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID ADD-ON CHARGE | $361.80 | $603.00 | — | — | 40% |
| Calcium blood test, total CPT 82310 CALCIUM TOTAL | $36.60 | $61.00 | $20.56–$47.58 | 9% above | 40% |
| Calcium blood test, total CPT 82310 .CALCIUM RAND UR | $36.60 | $61.00 | $20.56–$47.58 | 9% above | 40% |
| Calcium blood test, total CPT 82310 .CA TOTAL | $36.60 | $61.00 | $20.56–$47.58 | 9% above | 40% |
| Calcium blood test, total CPT 82310 .DO NOT ORDER LX CALCIUM | $36.60 | $61.00 | $20.56–$47.58 | 9% above | 40% |
| Calcium blood test, total inpatient CPT 82310 .DO NOT ORDER LX CALCIUM | $36.60 | $61.00 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 .CA TOTAL | $36.60 | $61.00 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 .CALCIUM RAND UR | $36.60 | $61.00 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL | $36.60 | $61.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $133.80 | $223.00 | $75.15–$173.94 | 13% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 .CEA QUEST | $133.80 | $223.00 | $75.15–$173.94 | 13% above | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA | $133.80 | $223.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 .CEA QUEST | $133.80 | $223.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM AB | $90.60 | $151.00 | $50.89–$117.78 | 7% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG AB | $90.60 | $151.00 | $50.89–$117.78 | 7% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 .VARICELLA ZOSTER IGG AB CSF | $90.60 | $151.00 | $50.89–$117.78 | 7% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 .VARICELLA ZOSTER IGM AB CSF | $90.60 | $151.00 | $50.89–$117.78 | 7% above | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM AB | $90.60 | $151.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 .VARICELLA ZOSTER IGG AB CSF | $90.60 | $151.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 .VARICELLA ZOSTER IGM AB CSF | $90.60 | $151.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG AB | $90.60 | $151.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PROBE | $247.20 | $412.00 | $138.84–$321.36 | 26% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .C.TRACH AMP PROBE TECH | $247.20 | $412.00 | $138.84–$321.36 | 26% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .C.TRACH AMP PROBE TECH | $247.20 | $412.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PROBE | $247.20 | $412.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .LIPID PANEL | $94.20 | $157.00 | $52.91–$122.46 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .DO NOT ORDER LX LIPID PROFILE | $94.20 | $157.00 | $52.91–$122.46 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $94.20 | $157.00 | $52.91–$122.46 | 5% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE | $94.20 | $157.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .DO NOT ORDER LX LIPID PROFILE | $94.20 | $157.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .LIPID PANEL | $94.20 | $157.00 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 .DIFFERENTIAL AUTOMATED | $54.60 | $91.00 | $30.67–$70.98 | 7% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 .DIFFERENTIAL AUTOMATED | $54.60 | $91.00 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC W/DIFF & ANC | $45.60 | $76.00 | $25.61–$59.28 | 6% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC | $45.60 | $76.00 | $25.61–$59.28 | 6% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 .MANUAL DIFF HEMAGRAM | $45.60 | $76.00 | $25.61–$59.28 | 6% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 . DO NOT ORDER AM CBC | $45.60 | $76.00 | $25.61–$59.28 | 6% above | 40% |
| Complete blood count (CBC), no differential CPT 85027 .CBC-ACT | $45.60 | $76.00 | $25.61–$59.28 | 6% above | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 . DO NOT ORDER AM CBC | $45.60 | $76.00 | — | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/DIFF & ANC | $45.60 | $76.00 | — | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 .CBC-ACT | $45.60 | $76.00 | — | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $45.60 | $76.00 | — | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 .MANUAL DIFF HEMAGRAM | $45.60 | $76.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE META PANEL | $74.40 | $124.00 | $41.79–$96.72 | 16% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 . DO NOT ORDER AM AMP | $74.40 | $124.00 | $41.79–$96.72 | 16% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 .DO NOT ORDER LX CMP | $74.40 | $124.00 | $41.79–$96.72 | 16% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 .COMP PANEL W/ GFR | $74.40 | $124.00 | $41.79–$96.72 | 16% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE META PANEL | $74.40 | $124.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 . DO NOT ORDER AM AMP | $74.40 | $124.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 .DO NOT ORDER LX CMP | $74.40 | $124.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 .COMP PANEL W/ GFR | $74.40 | $124.00 | — | — | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $115.20 | $192.00 | $64.70–$149.76 | 12% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL PM | $115.20 | $192.00 | $64.70–$149.76 | 12% above | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL AM | $115.20 | $192.00 | $64.70–$149.76 | 12% above | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL | $115.20 | $192.00 | — | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL PM | $115.20 | $192.00 | — | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL AM | $115.20 | $192.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 .CK TOTAL | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 .CPK BODY FLUID | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 .DO NOT ORDER LX CPK | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 .CPK CSF | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK BODY FLUID | $45.60 | $76.00 | $25.61–$59.28 | 1% above | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 .DO NOT ORDER LX CPK | $45.60 | $76.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 .CK TOTAL | $45.60 | $76.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL | $45.60 | $76.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 .CPK BODY FLUID | $45.60 | $76.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK BODY FLUID | $45.60 | $76.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 .CPK CSF | $45.60 | $76.00 | — | — | 40% |
| Creatinine blood test CPT 82565 CREATININE SERUM | $36.00 | $60.00 | $20.22–$46.80 | 7% above | 40% |
| Creatinine blood test CPT 82565 .CREATININE W/ GFR | $36.00 | $60.00 | $20.22–$46.80 | 7% above | 40% |
| Creatinine blood test CPT 82565 .DO NOT ORDER LX CREATININE | $36.00 | $60.00 | $20.22–$46.80 | 7% above | 40% |
| Creatinine blood test inpatient CPT 82565 CREATININE SERUM | $36.00 | $60.00 | — | — | 40% |
| Creatinine blood test inpatient CPT 82565 .DO NOT ORDER LX CREATININE | $36.00 | $60.00 | — | — | 40% |
| Creatinine blood test inpatient CPT 82565 .CREATININE W/ GFR | $36.00 | $60.00 | — | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS IGG ANTIBODY | $101.40 | $169.00 | $56.95–$131.82 | 17% above | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS IGG ANTIBODY | $101.40 | $169.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 .D-DIMER DO NOT ORDER | $72.00 | $120.00 | $40.44–$93.60 | 5% above | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER | $72.00 | $120.00 | $40.44–$93.60 | 5% above | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 .D-DIMER DO NOT ORDER | $72.00 | $120.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER | $72.00 | $120.00 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 .DHEA SULFATE QUANUM | $61.80 | $103.00 | $34.71–$80.34 | 54% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 .DHEA SULFATE QUANUM | $61.80 | $103.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TOX SCREEN ORAL SWAB | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE SCREEN URINE QUALITATIVE | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 .OXYCODONE SCREEN | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 .COCAINE SCREEN URINE | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN MEDTOX | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 .DRUG SCREEN DEFINITIVE ANALYZER | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 .UDS WITH REFLEX | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TOXICOLOGY MONITORING SCREEN | $438.00 | $730.00 | $246.01–$569.40 | 141% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOX SCREEN ORAL SWAB | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE SCREEN URINE QUALITATIVE | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .OXYCODONE SCREEN | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .COCAINE SCREEN URINE | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .DRUG SCREEN DEFINITIVE ANALYZER | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TOXICOLOGY MONITORING SCREEN | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .UDS WITH REFLEX | $438.00 | $730.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN MEDTOX | $438.00 | $730.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $55.80 | $93.00 | $31.34–$72.54 | 6% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 .DO NOT ORDER LX ELECTROLYTE PANEL | $55.80 | $93.00 | $31.34–$72.54 | 6% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 .ELECTROLYTE PANEL | $55.80 | $93.00 | $31.34–$72.54 | 6% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ANION GAP WITH ELECTROLYTES | $55.80 | $93.00 | $31.34–$72.54 | 6% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 .ELECTROLYTE PANEL | $55.80 | $93.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $55.80 | $93.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 .DO NOT ORDER LX ELECTROLYTE PANEL | $55.80 | $93.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ANION GAP WITH ELECTROLYTES | $55.80 | $93.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR CAPSID (VCA) IGG | $127.80 | $213.00 | $71.78–$166.14 | 11% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR CAPSID (VCA) IGM | $127.80 | $213.00 | $71.78–$166.14 | 11% above | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR CAPSID (VCA) IGG | $127.80 | $213.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR CAPSID (VCA) IGM | $127.80 | $213.00 | — | — | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL | $196.80 | $328.00 | $110.54–$255.84 | 18% above | 40% |
| Estradiol blood test CPT 82670 ESTRADIOL - QUEST | $196.80 | $328.00 | $110.54–$255.84 | 18% above | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL - QUEST | $196.80 | $328.00 | — | — | 40% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $196.80 | $328.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $130.80 | $218.00 | $73.47–$170.04 | 10% above | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 .DO NOT ORDER | $130.80 | $218.00 | $73.47–$170.04 | 10% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 .DO NOT ORDER | $130.80 | $218.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $130.80 | $218.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL | $138.60 | $231.00 | $77.85–$180.18 | 7% above | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL | $138.60 | $231.00 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 .FERRITIN (QUEST SENDOUT) | $96.00 | $160.00 | $53.92–$124.80 | 11% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 .FERRITIN QUEST | $96.00 | $160.00 | $53.92–$124.80 | 11% above | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $96.00 | $160.00 | $53.92–$124.80 | 11% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 .FERRITIN QUEST | $96.00 | $160.00 | — | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $96.00 | $160.00 | — | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 .FERRITIN (QUEST SENDOUT) | $96.00 | $160.00 | — | — | 40% |
| Fibrinogen blood test CPT 85384 .FIBRINOGEN | $68.40 | $114.00 | $38.42–$88.92 | 3% above | 40% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $68.40 | $114.00 | $38.42–$88.92 | 3% above | 40% |
| Fibrinogen blood test inpatient CPT 85384 .FIBRINOGEN | $68.40 | $114.00 | — | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $68.40 | $114.00 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 . FOLATE SERUM E411 | $58.20 | $97.00 | $32.69–$75.66 | 33% below | 40% |
| Folate (folic acid) blood test CPT 82746 .FOLATE QUEST | $58.20 | $97.00 | $32.69–$75.66 | 33% below | 40% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM | $58.20 | $97.00 | $32.69–$75.66 | 33% below | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 . FOLATE SERUM E411 | $58.20 | $97.00 | — | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM | $58.20 | $97.00 | — | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 .FOLATE QUEST | $58.20 | $97.00 | — | — | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $119.40 | $199.00 | $67.06–$155.22 | 12% above | 40% |
| Free T3 thyroid hormone test CPT 84481 .T3 FREE(QUEST SENDOUT) | $119.40 | $199.00 | $67.06–$155.22 | 12% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 .T3 FREE(QUEST SENDOUT) | $119.40 | $199.00 | — | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE | $119.40 | $199.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $85.80 | $143.00 | $48.19–$111.54 | 43% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 .DO NOT ORDER T4 FREE E411 | $85.80 | $143.00 | $48.19–$111.54 | 43% above | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 .T4 FREE DIRECT DIALYSIS QUANUM | $85.80 | $143.00 | $48.19–$111.54 | 43% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .T4 FREE DIRECT DIALYSIS QUANUM | $85.80 | $143.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $85.80 | $143.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .DO NOT ORDER T4 FREE E411 | $85.80 | $143.00 | — | — | 40% |
| Free testosterone test CPT 84402 .TRS | $179.40 | $299.00 | $100.76–$233.22 | 12% above | 40% |
| Free testosterone test inpatient CPT 84402 .TRS | $179.40 | $299.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 .DO NOT ORDER LX GGT | $51.00 | $85.00 | $28.65–$66.30 | 7% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $51.00 | $85.00 | $28.65–$66.30 | 7% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 .DO NOT ORDER LX GGT | $51.00 | $85.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $51.00 | $85.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR TOLERANCE | $33.60 | $56.00 | $18.87–$43.68 | 10% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR GESTATION | $33.60 | $56.00 | $18.87–$43.68 | 10% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR GESTATION | $33.60 | $56.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR TOLERANCE | $33.60 | $56.00 | — | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 2HR TOLERANCE | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 3HR TOLERANCE PREGNANT | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 5HR TOLERANCE | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 4HR TOLERANCE | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 3HR TOLERANCE/NON-PREGNANT | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 2HR TOLERANCE | $90.60 | $151.00 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 3HR TOLERANCE PREGNANT | $90.60 | $151.00 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 3HR TOLERANCE/NON-PREGNANT | $90.60 | $151.00 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 4HR TOLERANCE | $90.60 | $151.00 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 5HR TOLERANCE | $90.60 | $151.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE DNA PROBE | $247.20 | $412.00 | $138.84–$321.36 | 34% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 .N GON AMP PROBE TECH | $247.20 | $412.00 | $138.84–$321.36 | 34% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 .N GON AMP PROBE TECH | $247.20 | $412.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE DNA PROBE | $247.20 | $412.00 | — | — | 40% |
| H. pylori antibody blood test CPT 86677 . HELICOBACTER PYLORI IGA | $118.80 | $198.00 | $66.73–$154.44 | 3% above | 40% |
| H. pylori antibody blood test CPT 86677 . HELICOBACTER PYLORI IGM | $118.80 | $198.00 | $66.73–$154.44 | 3% above | 40% |
| H. pylori antibody blood test CPT 86677 . HELICOBACTER PYLORI IGG | $118.80 | $198.00 | $66.73–$154.44 | 3% above | 40% |
| H. pylori antibody blood test inpatient CPT 86677 . HELICOBACTER PYLORI IGA | $118.80 | $198.00 | — | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 . HELICOBACTER PYLORI IGG | $118.80 | $198.00 | — | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 . HELICOBACTER PYLORI IGM | $118.80 | $198.00 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 H.PYLORI ANTIGEN, EIA, STOOL | $101.40 | $169.00 | $56.95–$131.82 | 5% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 H.PYLORI ANTIGEN, EIA, STOOL | $101.40 | $169.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, QUANTITATIVE PCR | $600.00 | $1,000.00 | $337.00–$780.00 | 21% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA, QUANTITATIVE PCR | $600.00 | $1,000.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANITBODY SCREEN (SOURCE PATIENT) | $169.80 | $283.00 | $95.37–$220.74 | 20% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY SCREEN (EMPLOYEE EXPOSURE) | $169.80 | $283.00 | $95.37–$220.74 | 20% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/2 ANTIBODY SCREEN WITH REFLEX | $169.80 | $283.00 | $95.37–$220.74 | 20% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANTIBODY SCREEN (EMPLOYEE EXPOSURE) | $169.80 | $283.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/2 ANTIBODY SCREEN WITH REFLEX | $169.80 | $283.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANITBODY SCREEN (SOURCE PATIENT) | $169.80 | $283.00 | — | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI RISK TYPES, POOLED RSLT | $247.20 | $412.00 | $138.84–$321.36 | 19% above | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HI RISK TYPES, POOLED RSLT | $247.20 | $412.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $9.60 | $16.00 | $5.39–$12.48 | 81% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 .DO NOT ORDER LX HGB A1C | $9.60 | $16.00 | $5.39–$12.48 | 81% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $9.60 | $16.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 .DO NOT ORDER LX HGB A1C | $9.60 | $16.00 | — | — | 40% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $16.80 | $28.00 | $9.44–$21.84 | 2% below | 40% |
| Hemoglobin blood test CPT 85018 .HEMOGLOB | $16.80 | $28.00 | $9.44–$21.84 | 2% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $16.80 | $28.00 | — | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 .HEMOGLOB | $16.80 | $28.00 | — | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 .HEP B CORE ANTIBODY TOTAL | $85.20 | $142.00 | $47.85–$110.76 | 1% above | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (TOTAL) | $85.20 | $142.00 | $47.85–$110.76 | 1% above | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY (TOTAL) | $85.20 | $142.00 | — | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 .HEP B CORE ANTIBODY TOTAL | $85.20 | $142.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY QUAL | $75.60 | $126.00 | $42.46–$98.28 | 3% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY QUAL | $75.60 | $126.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN (SOURCE) | $72.60 | $121.00 | $40.78–$94.38 | 4% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 .HEP B SURFACE ANTIGEN | $72.60 | $121.00 | $40.78–$94.38 | 4% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN | $72.60 | $121.00 | $40.78–$94.38 | 4% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN | $72.60 | $121.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN (SOURCE) | $72.60 | $121.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 .HEP B SURFACE ANTIGEN | $72.60 | $121.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 .HEP C ANTIBODY | $100.80 | $168.00 | $56.62–$131.04 | 1% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY (SOURCE PATIENT) | $100.80 | $168.00 | $56.62–$131.04 | 1% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY (EMPLOYEE EXPOSURE) | $100.80 | $168.00 | $56.62–$131.04 | 1% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY WITH REFLEX | $100.80 | $168.00 | $56.62–$131.04 | 1% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 .HEP C ANTIBODY | $100.80 | $168.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY WITH REFLEX | $100.80 | $168.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY (SOURCE PATIENT) | $100.80 | $168.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY (EMPLOYEE EXPOSURE) | $100.80 | $168.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 REFLEX HCV RNA QUANT PCR | $301.80 | $503.00 | $169.51–$392.34 | 6% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA - QUANAT PCR | $301.80 | $503.00 | $169.51–$392.34 | 6% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 .HEPATITIS C PCR QUANT WITH REFLEX GENO | $301.80 | $503.00 | $169.51–$392.34 | 6% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA QUANTITATIVE | $301.80 | $503.00 | $169.51–$392.34 | 6% above | 40% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEPATITIS C QUANTITATIVE RT-PCR | $301.80 | $503.00 | $169.51–$392.34 | 6% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA - QUANAT PCR | $301.80 | $503.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 REFLEX HCV RNA QUANT PCR | $301.80 | $503.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV RNA QUANTITATIVE | $301.80 | $503.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HEPATITIS C PCR QUANT WITH REFLEX GENO | $301.80 | $503.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HEPATITIS C QUANTITATIVE RT-PCR | $301.80 | $503.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 REFLEX HERPES IgM TITER | $93.00 | $155.00 | $52.24–$120.90 | 16% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 .HERPES 1 IgM | $93.00 | $155.00 | $52.24–$120.90 | 16% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 REFLEX HERPES IgM TITER | $93.00 | $155.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 .HERPES 1 IgM | $93.00 | $155.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 .HERPES 2 IgG | $136.20 | $227.00 | $76.50–$177.06 | 27% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 REFLEX HERPES IgG TITER | $136.20 | $227.00 | $76.50–$177.06 | 27% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 REFLEX HERPES IgG TITER | $136.20 | $227.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HERPES 2 IgG | $136.20 | $227.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP - HIGH SENSITIVITY | $91.20 | $152.00 | $51.22–$118.56 | 16% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP - HIGH SENSITIVITY | $91.20 | $152.00 | — | — | 40% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE SERUM CVD | $126.60 | $211.00 | $71.11–$164.58 | 6% above | 40% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE SERUM CVD | $126.60 | $211.00 | — | — | 40% |
| Insulin blood test CPT 83525 INSULIN, TOTAL | $80.40 | $134.00 | $45.16–$104.52 | 11% above | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN, TOTAL | $80.40 | $134.00 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 IRON TOTAL | $45.60 | $76.00 | $25.61–$59.28 | at median | 40% |
| Iron blood test (serum iron) CPT 83540 .IRON TOTAL QUEST SENDOUT | $45.60 | $76.00 | $25.61–$59.28 | at median | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL | $45.60 | $76.00 | — | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 .IRON TOTAL QUEST SENDOUT | $45.60 | $76.00 | — | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 .IRON TOTAL & TIBC QUEST SEND OUT | $61.80 | $103.00 | $34.71–$80.34 | 3% above | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON TOTAL AND TIBC | $61.80 | $103.00 | $34.71–$80.34 | 3% above | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 .IRON TOTAL & TIBC QUEST SEND OUT | $61.80 | $103.00 | — | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON TOTAL AND TIBC | $61.80 | $103.00 | — | — | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $61.20 | $102.00 | $34.37–$79.56 | 11% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $61.20 | $102.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 LH | $130.80 | $218.00 | $73.47–$170.04 | 10% above | 40% |
| LH (luteinizing hormone) test CPT 83002 .DO NOT ORDER | $130.80 | $218.00 | $73.47–$170.04 | 10% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH | $130.80 | $218.00 | — | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 .DO NOT ORDER | $130.80 | $218.00 | — | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 .DO NOT ORDER | $81.60 | $136.00 | $45.83–$106.08 | 6% above | 40% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $81.60 | $136.00 | $45.83–$106.08 | 6% above | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID | $81.60 | $136.00 | — | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 .DO NOT ORDER | $81.60 | $136.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH CSF | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PERICARDIAL FLUID | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH TOTAL | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 .DO NOT ORDER LX LDH | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PERITONEAL FLUID | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PLEURAL FLUID | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SYNOVIAL FLUID | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 .LDH | $25.80 | $43.00 | $14.49–$33.54 | 30% below | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PERICARDIAL FLUID | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH SYNOVIAL FLUID | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 .DO NOT ORDER LX LDH | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH CSF | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PLEURAL FLUID | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PERITONEAL FLUID | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH TOTAL | $25.80 | $43.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 .LDH | $25.80 | $43.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PERITONEAL FLUID | $33.00 | $55.00 | $18.54–$42.90 | 30% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PANCREATIC FLUID | $33.00 | $55.00 | $18.54–$42.90 | 30% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 .DO NOT ORDER LX LIPASE | $33.00 | $55.00 | $18.54–$42.90 | 30% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PLEURAL FLUID | $33.00 | $55.00 | $18.54–$42.90 | 30% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $33.00 | $55.00 | $18.54–$42.90 | 30% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $33.00 | $55.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 .DO NOT ORDER LX LIPASE | $33.00 | $55.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PERITONEAL FLUID | $33.00 | $55.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PLEURAL FLUID | $33.00 | $55.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PANCREATIC FLUID | $33.00 | $55.00 | — | — | 40% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $57.60 | $96.00 | $32.35–$74.88 | 26% below | 40% |
| Liver function blood test panel CPT 80076 .DO NOT ORDER LX LFP | $57.60 | $96.00 | $32.35–$74.88 | 26% below | 40% |
| Liver function blood test panel inpatient CPT 80076 .DO NOT ORDER LX LFP | $57.60 | $96.00 | — | — | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE | $57.60 | $96.00 | — | — | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease AB Screen w/Reflex | $120.00 | $200.00 | $67.40–$156.00 | 27% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease AB Screen w/Reflex | $120.00 | $200.00 | — | — | 40% |
| Magnesium blood test CPT 83735 RBC MAGNESIUM | $47.40 | $79.00 | $26.62–$61.62 | 14% above | 40% |
| Magnesium blood test CPT 83735 .DO NOT ORDER LX MAGNESIUM | $47.40 | $79.00 | $26.62–$61.62 | 14% above | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $47.40 | $79.00 | $26.62–$61.62 | 14% above | 40% |
| Magnesium blood test CPT 83735 .MAG 24 HR URINE | $47.40 | $79.00 | $26.62–$61.62 | 14% above | 40% |
| Magnesium blood test CPT 83735 .MAGNESIUM ST RSK | $47.40 | $79.00 | $26.62–$61.62 | 14% above | 40% |
| Magnesium blood test inpatient CPT 83735 .MAG 24 HR URINE | $47.40 | $79.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 RBC MAGNESIUM | $47.40 | $79.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 .DO NOT ORDER LX MAGNESIUM | $47.40 | $79.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $47.40 | $79.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 .MAGNESIUM ST RSK | $47.40 | $79.00 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 .RUBEOLA VIRUS AB IGG | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG ONLY | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Measles (rubeola) antibody test CPT 86765 .RUBEOLA VIRUS AB IGM | $90.60 | $151.00 | $50.89–$117.78 | 12% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 .RUBEOLA VIRUS AB IGM | $90.60 | $151.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 .RUBEOLA VIRUS AB IGG | $90.60 | $151.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG ONLY | $90.60 | $151.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $37.20 | $62.00 | $20.89–$48.36 | at median | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN | $37.20 | $62.00 | — | — | 40% |
| Mumps immunity blood test CPT 86735 MUMPS IGM AB | $91.80 | $153.00 | $51.56–$119.34 | 13% above | 40% |
| Mumps immunity blood test CPT 86735 MUMPS IGG AB | $91.80 | $153.00 | $51.56–$119.34 | 13% above | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGG AB | $91.80 | $153.00 | — | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS IGM AB | $91.80 | $153.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 .PSA FREE | $129.60 | $216.00 | $72.79–$168.48 | 14% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 .PSA FREE | $129.60 | $216.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA | $129.60 | $216.00 | $72.79–$168.48 | 18% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 .DO NOT ORDER OLD PSA | $129.60 | $216.00 | $72.79–$168.48 | 18% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $129.60 | $216.00 | $72.79–$168.48 | 18% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 .PSA ASSOC CHRG | $129.60 | $216.00 | $72.79–$168.48 | 18% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $129.60 | $216.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 .PSA ASSOC CHRG | $129.60 | $216.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 .DO NOT ORDER OLD PSA | $129.60 | $216.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA | $129.60 | $216.00 | — | — | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 IMAGED LIQUID BASED PAP (SCREEN) | $186.60 | $311.00 | $104.81–$242.58 | 128% above | 40% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 IMAGED LIQUID BASED PAP (SCREEN) | $186.60 | $311.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $291.00 | $485.00 | $163.45–$378.30 | 33% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 .PTH INTACT ONLY | $291.00 | $485.00 | $163.45–$378.30 | 33% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 .PTH INTACT ONLY | $291.00 | $485.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $291.00 | $485.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $29.40 | $49.00 | $16.51–$38.22 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 .PTT-LA | $29.40 | $49.00 | $16.51–$38.22 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT BFT | $29.40 | $49.00 | $16.51–$38.22 | 29% below | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT BFT | $29.40 | $49.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 .PTT-LA | $29.40 | $49.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $29.40 | $49.00 | — | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 .DO NOT ORDER LX PHOSPHORUS | $30.60 | $51.00 | $17.19–$39.78 | 6% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $30.60 | $51.00 | $17.19–$39.78 | 6% below | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $30.60 | $51.00 | — | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 .DO NOT ORDER LX PHOSPHORUS | $30.60 | $51.00 | — | — | 40% |
| Potassium blood test CPT 84132 .DO NOT ORDER LX POTASSIUM SERUM | $33.60 | $56.00 | $18.87–$43.68 | 5% above | 40% |
| Potassium blood test CPT 84132 RBC POTASSIUM | $33.60 | $56.00 | $18.87–$43.68 | 5% above | 40% |
| Potassium blood test CPT 84132 POTASSIUM BODY FLUID | $33.60 | $56.00 | $18.87–$43.68 | 5% above | 40% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $33.60 | $56.00 | $18.87–$43.68 | 5% above | 40% |
| Potassium blood test inpatient CPT 84132 RBC POTASSIUM | $33.60 | $56.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $33.60 | $56.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 .DO NOT ORDER LX POTASSIUM SERUM | $33.60 | $56.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM BODY FLUID | $33.60 | $56.00 | — | — | 40% |
| Progesterone blood test CPT 84144 PROGESTERONE | $147.00 | $245.00 | $82.57–$191.10 | 7% above | 40% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $147.00 | $245.00 | — | — | 40% |
| Prolactin blood test CPT 84146 .PROLACTIN | $136.80 | $228.00 | $76.84–$177.84 | 10% above | 40% |
| Prolactin blood test CPT 84146 PROLACTIN | $136.80 | $228.00 | $76.84–$177.84 | 10% above | 40% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $136.80 | $228.00 | — | — | 40% |
| Prolactin blood test inpatient CPT 84146 .PROLACTIN | $136.80 | $228.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .PT | $30.00 | $50.00 | $16.85–$39.00 | 5% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT BFT | $30.00 | $50.00 | $16.85–$39.00 | 5% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 A.M. LABS - PT/INR | $30.00 | $50.00 | $16.85–$39.00 | 5% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR | $30.00 | $50.00 | $16.85–$39.00 | 5% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR | $30.00 | $50.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .PT | $30.00 | $50.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 A.M. LABS - PT/INR | $30.00 | $50.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT BFT | $30.00 | $50.00 | — | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 .DRUG SCREEN DIRECT OBS | $12.30 | $20.50 | $6.91–$15.99 | 78% below | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 FENTANYL | $12.30 | $20.50 | $6.91–$15.99 | 78% below | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 FENTANYL | $12.30 | $20.50 | — | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 .DRUG SCREEN DIRECT OBS | $12.30 | $20.50 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 .INFLUENZA A ANTIGEN | $32.40 | $54.00 | $18.20–$42.12 | 41% below | 40% |
| Rapid flu test (influenza antigen) CPT 87804 .INFLUENZA B ANTIGEN | $116.40 | $194.00 | $65.38–$151.32 | 112% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 .INFLUENZA A ANTIGEN | $32.40 | $54.00 | — | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 .INFLUENZA B ANTIGEN | $116.40 | $194.00 | — | — | 40% |
| Renin blood test CPT 84244 .RENIN,PLASMA | $154.80 | $258.00 | $86.95–$201.24 | 7% above | 40% |
| Renin blood test inpatient CPT 84244 .RENIN,PLASMA | $154.80 | $258.00 | — | — | 40% |
| Rh blood typing CPT 86901 BB RH TYPE | $285.00 | $475.00 | $160.08–$370.50 | 400% above | 40% |
| Rh blood typing inpatient CPT 86901 BB RH TYPE | $285.00 | $475.00 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 .RF | $40.20 | $67.00 | $22.58–$52.26 | 3% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 .RHEUMATOID FACTOR (QUANTITATIVE) | $40.20 | $67.00 | $22.58–$52.26 | 3% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 .RHEUMATOID FACTOR (QUANTITATIVE) | $40.20 | $67.00 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 .RF | $40.20 | $67.00 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG ONLY | $101.40 | $169.00 | $56.95–$131.82 | 20% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGM ONLY | $101.40 | $169.00 | $56.95–$131.82 | 20% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG ONLY | $101.40 | $169.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGM ONLY | $101.40 | $169.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 .SED RATE (POLYMED CO) | $32.40 | $54.00 | $18.20–$42.12 | 50% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE (MINIISED) | $32.40 | $54.00 | $18.20–$42.12 | 50% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 .SED RATE (POLYMED CO) | $32.40 | $54.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE (MINIISED) | $32.40 | $54.00 | — | — | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 .SEMEN ANALYSIS | $57.00 | $95.00 | $32.02–$74.10 | 36% below | 40% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 .SEMEN ANALYSIS | $57.00 | $95.00 | — | — | 40% |
| Sodium blood test CPT 84295 .DO NOT ORDER LX SODIUM SERUM | $34.20 | $57.00 | $19.21–$44.46 | 6% above | 40% |
| Sodium blood test CPT 84295 SODIUM SERUM | $34.20 | $57.00 | $19.21–$44.46 | 6% above | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM | $34.20 | $57.00 | — | — | 40% |
| Sodium blood test inpatient CPT 84295 .DO NOT ORDER LX SODIUM SERUM | $34.20 | $57.00 | — | — | 40% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES | $63.00 | $105.00 | $35.39–$81.90 | 7% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES | $63.00 | $105.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 .OCCULT BLOOD STOOL #2 | $30.60 | $51.00 | $17.19–$39.78 | 50% above | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 .OCCULT BLOOD STOOL #3 | $30.60 | $51.00 | $17.19–$39.78 | 50% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 .OCCULT BLOOD STOOL #2 | $30.60 | $51.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 .OCCULT BLOOD STOOL #3 | $30.60 | $51.00 | — | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL GLOBULIN IMMUNOASSAY | $112.20 | $187.00 | $63.02–$145.86 | 212% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL GLOBULIN IMMUNOASSAY | $112.20 | $187.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABS | $93.60 | $156.00 | $52.57–$121.68 | 25% above | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA ABS | $93.60 | $156.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF VDRL | $30.00 | $50.00 | $16.85–$39.00 | 7% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY QUALITATIVE | $30.00 | $50.00 | $16.85–$39.00 | 7% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SEROLOGY QUALITATIVE | $30.00 | $50.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF VDRL | $30.00 | $50.00 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD | $436.80 | $728.00 | $245.34–$567.84 | 41% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD | $436.80 | $728.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 .TESTOSTERONE TOTAL LC MS | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 .TESTOSTERONE TOTAL | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL LC MS | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 .TESTOSTERONE TOTAL MALES | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 .TESTOSTERONE TOTAL QUEST | $181.80 | $303.00 | $102.11–$236.34 | 12% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .TESTOSTERONE TOTAL QUEST | $181.80 | $303.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .TESTOSTERONE TOTAL MALES | $181.80 | $303.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL LC MS | $181.80 | $303.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .TESTOSTERONE TOTAL LC MS | $181.80 | $303.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .TESTOSTERONE TOTAL | $181.80 | $303.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $181.80 | $303.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICORSOMAL IGG | $102.60 | $171.00 | $57.63–$133.38 | 36% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODIES (TPO) | $102.60 | $171.00 | $57.63–$133.38 | 36% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 .ANTI-THYROID PEROXIDASE AB | $102.60 | $171.00 | $57.63–$133.38 | 36% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICORSOMAL IGG | $102.60 | $171.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 .ANTI-THYROID PEROXIDASE AB | $102.60 | $171.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODIES (TPO) | $102.60 | $171.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $118.20 | $197.00 | $66.39–$153.66 | 18% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 .E41TSH | $118.20 | $197.00 | $66.39–$153.66 | 18% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 .E41TSH | $118.20 | $197.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $118.20 | $197.00 | — | — | 40% |
| Total IgE blood test CPT 82785 .IGE IMMUNOGLOBULIN | $115.80 | $193.00 | $65.04–$150.54 | 12% above | 40% |
| Total IgE blood test CPT 82785 IGE ASSAY | $115.80 | $193.00 | $65.04–$150.54 | 12% above | 40% |
| Total IgE blood test inpatient CPT 82785 IGE ASSAY | $115.80 | $193.00 | — | — | 40% |
| Total IgE blood test inpatient CPT 82785 .IGE IMMUNOGLOBULIN | $115.80 | $193.00 | — | — | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL | $30.60 | $51.00 | $17.19–$39.78 | 1% above | 40% |
| Total cholesterol blood test CPT 82465 .CHOLESTEROL | $30.60 | $51.00 | $17.19–$39.78 | 1% above | 40% |
| Total cholesterol blood test CPT 82465 .DO NOT ORDER LX CHOL | $30.60 | $51.00 | $17.19–$39.78 | 1% above | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL | $30.60 | $51.00 | — | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 .DO NOT ORDER LX CHOL | $30.60 | $51.00 | — | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 .CHOLESTEROL | $30.60 | $51.00 | — | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $48.60 | $81.00 | $27.30–$63.18 | 8% above | 40% |
| Total thyroxine (T4) blood test CPT 84436 . T4 TOTAL E411 | $48.60 | $81.00 | $27.30–$63.18 | 8% above | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL | $48.60 | $81.00 | — | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 . T4 TOTAL E411 | $48.60 | $81.00 | — | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL (RIA) | $100.20 | $167.00 | $56.28–$130.26 | 3% above | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 .T3 TOTAL (RIA) | $100.20 | $167.00 | $56.28–$130.26 | 3% above | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 .T3 TOTAL (RIA) | $100.20 | $167.00 | — | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL (RIA) | $100.20 | $167.00 | — | — | 40% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $90.00 | $150.00 | $50.55–$117.00 | 5% above | 40% |
| Transferrin blood test CPT 84466 .TRANSFERRIN | $90.00 | $150.00 | $50.55–$117.00 | 5% above | 40% |
| Transferrin blood test inpatient CPT 84466 .TRANSFERRIN | $90.00 | $150.00 | — | — | 40% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $90.00 | $150.00 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS RNA,TMA PAP VIAL | $90.00 | $150.00 | $50.55–$117.00 | 51% below | 40% |
| Trichomonas test (NAAT) CPT 87661 .TRICH TMA | $294.00 | $490.00 | $165.13–$382.20 | 60% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS RNA,TMA PAP VIAL | $90.00 | $150.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 .TRICH TMA | $294.00 | $490.00 | — | — | 40% |
| Triglycerides blood test CPT 84478 .TRIG | $40.20 | $67.00 | $22.58–$52.26 | 1% above | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDE | $40.20 | $67.00 | $22.58–$52.26 | 1% above | 40% |
| Triglycerides blood test CPT 84478 .DO NOT ORDER LX TRIGLYCERIDE | $40.20 | $67.00 | $22.58–$52.26 | 1% above | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE | $40.20 | $67.00 | — | — | 40% |
| Triglycerides blood test inpatient CPT 84478 .DO NOT ORDER LX TRIGLYCERIDE | $40.20 | $67.00 | — | — | 40% |
| Triglycerides blood test inpatient CPT 84478 .TRIG | $40.20 | $67.00 | — | — | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $88.20 | $147.00 | $49.54–$114.66 | 7% above | 40% |
| Troponin test, quantitative CPT 84484 .TRIAGE TROPONIN | $88.20 | $147.00 | $49.54–$114.66 | 7% above | 40% |
| Troponin test, quantitative CPT 84484 . E411TROPONIN T | $88.20 | $147.00 | $49.54–$114.66 | 7% above | 40% |
| Troponin test, quantitative inpatient CPT 84484 .TRIAGE TROPONIN | $88.20 | $147.00 | — | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I | $88.20 | $147.00 | — | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 . E411TROPONIN T | $88.20 | $147.00 | — | — | 40% |
| Uric acid blood test CPT 84550 URIC ACID | $28.80 | $48.00 | $16.18–$37.44 | 9% below | 40% |
| Uric acid blood test CPT 84550 .DO NOT ORDER LX URIC ACID SERUM | $28.80 | $48.00 | $16.18–$37.44 | 9% below | 40% |
| Uric acid blood test inpatient CPT 84550 .DO NOT ORDER LX URIC ACID SERUM | $28.80 | $48.00 | — | — | 40% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $28.80 | $48.00 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 AM - URINALYSIS | $35.40 | $59.00 | $19.88–$46.02 | 7% above | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W MICROSCOPIC EXAM | $35.40 | $59.00 | $19.88–$46.02 | 7% above | 40% |
| Urinalysis with microscope exam, automated CPT 81001 .URINALYSIS COMPLETE CHARGE | $35.40 | $59.00 | $19.88–$46.02 | 7% above | 40% |
| Urinalysis with microscope exam, automated CPT 81001 .UA WITH REVIEW DON'T ORDER | $35.40 | $59.00 | $19.88–$46.02 | 7% above | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 .URINALYSIS COMPLETE CHARGE | $35.40 | $59.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W MICROSCOPIC EXAM | $35.40 | $59.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 AM - URINALYSIS | $35.40 | $59.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 .UA WITH REVIEW DON'T ORDER | $35.40 | $59.00 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 .BLOOD URINE | $29.40 | $49.00 | $16.51–$38.22 | 65% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 .URINALYSIS MACROSCOPIC CHARGE | $29.40 | $49.00 | $16.51–$38.22 | 65% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE | $29.40 | $49.00 | $16.51–$38.22 | 65% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .BLOOD URINE | $29.40 | $49.00 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE | $29.40 | $49.00 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .URINALYSIS MACROSCOPIC CHARGE | $29.40 | $49.00 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 .UA NONAUTO WO MICROSPY | $24.60 | $41.00 | $13.82–$31.98 | 17% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 .UA NONAUTO WO MICROSPY | $24.60 | $41.00 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE CLEAN CATCH | $57.00 | $95.00 | $32.02–$74.10 | 1% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE CYSTO | $57.00 | $95.00 | $32.02–$74.10 | 1% above | 40% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE CATH | $57.00 | $95.00 | $32.02–$74.10 | 1% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE CLEAN CATCH | $57.00 | $95.00 | — | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE CYSTO | $57.00 | $95.00 | — | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE CATH | $57.00 | $95.00 | — | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN | $48.60 | $81.00 | $27.30–$63.18 | 23% above | 40% |
| Urine microalbumin (albumin) test CPT 82043 .MICROALBUMIN UR QUANT QUEST | $48.60 | $81.00 | $27.30–$63.18 | 23% above | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 .MICROALBUMIN UR QUANT QUEST | $48.60 | $81.00 | — | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN | $48.60 | $81.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 . VITAMIN B12,SERUM E411 | $106.20 | $177.00 | $59.65–$138.06 | 13% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 SERUM | $106.20 | $177.00 | $59.65–$138.06 | 13% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 .VITAMIN B12 QUEST | $106.20 | $177.00 | $59.65–$138.06 | 13% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 . VITAMIN B12,SERUM E411 | $106.20 | $177.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 .VITAMIN B12 QUEST | $106.20 | $177.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 SERUM | $106.20 | $177.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D LEVEL | $208.80 | $348.00 | $117.28–$271.44 | 40% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25-HYDROXY TOTAL,D2&D3 | $208.80 | $348.00 | $117.28–$271.44 | 40% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D LEVEL | $208.80 | $348.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25-HYDROXY TOTAL,D2&D3 | $208.80 | $348.00 | — | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 .VITAMIN D QUEST | $271.20 | $452.00 | $152.32–$352.56 | 13% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 .VITAMIN D QUEST | $271.20 | $452.00 | — | — | 40% |
| Zinc blood test CPT 84630 ZINC LEVEL BLOOD | $80.40 | $134.00 | $45.16–$104.52 | 11% above | 40% |
| Zinc blood test CPT 84630 ZINC, 24 HR URINE | $80.40 | $134.00 | $45.16–$104.52 | 11% above | 40% |
| Zinc blood test inpatient CPT 84630 ZINC LEVEL BLOOD | $80.40 | $134.00 | — | — | 40% |
| Zinc blood test inpatient CPT 84630 ZINC, 24 HR URINE | $80.40 | $134.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .HCG QUANTITATIVE TUMOR MARKER | $106.20 | $177.00 | $59.65–$138.06 | 19% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREG HCG QUANTITATIVE SERUM | $106.20 | $177.00 | $59.65–$138.06 | 19% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .HCG ASSOC CHARGE | $106.20 | $177.00 | $59.65–$138.06 | 19% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREG HCG QUANTITATIVE SERUM | $106.20 | $177.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .HCG ASSOC CHARGE | $106.20 | $177.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .HCG QUANTITATIVE TUMOR MARKER | $106.20 | $177.00 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MM MAMMO BIOPSY BREAST FIRST LESION | $11,769.00 | $19,615.00 | $6,610.26–$15,299.70 | 201% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MM MAMMO BIOPSY BREAST FIRST LESION | $11,769.00 | $19,615.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIS FIBULA W/O MANIP | $1,742.40 | $2,904.00 | $978.65–$2,265.12 | 163% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIS FIBULA W/O MANIP | $1,742.40 | $2,904.00 | — | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLO METATARSAL FX W/O MANIP EA | $1,742.40 | $2,904.00 | $978.65–$2,265.12 | 235% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLO METATARSAL FX W/O MANIP EA | $1,742.40 | $2,904.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $4,753.20 | $7,922.00 | $2,669.71–$6,179.16 | 224% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $4,753.20 | $7,922.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD DISTAL RADIAL FX W/O MANIP | $1,742.40 | $2,904.00 | $978.65–$2,265.12 | 163% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD DISTAL RADIAL FX W/O MANIP | $1,742.40 | $2,904.00 | — | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C | $5,896.80 | $9,828.00 | $3,312.04–$7,665.84 | at median | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C | $5,896.80 | $9,828.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 CERUMEN REMOVAL UNILATERAL W/IRRIGATION | $431.40 | $719.00 | $242.30–$560.82 | 209% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 CERUMEN REMOVAL UNILATERAL W/IRRIGATION | $431.40 | $719.00 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 REM IMPACTED CERUMEN | $431.40 | $719.00 | $242.30–$560.82 | 222% above | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACTED CERUMEN | $431.40 | $719.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ FACET JOINT L/S SNGL LVL | $6,466.80 | $10,778.00 | $3,632.19–$8,406.84 | 349% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ FACET JOINT L/S SNGL LVL | $6,466.80 | $10,778.00 | — | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOIDS | $2,818.20 | $4,697.00 | $1,582.89–$3,663.66 | 57% above | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOIDS | $2,818.20 | $4,697.00 | — | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROSAL PINGO INJ | $296.40 | $494.00 | $166.48–$385.32 | 23% below | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROSAL PINGO INJ | $296.40 | $494.00 | — | — | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 ABLATION PROCEDURE Use instead of OR min | $9,154.80 | $15,258.00 | $5,141.95–$11,901.24 | 1% below | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 ABLATION PROCEDURE Use instead of OR min | $9,154.80 | $15,258.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMPLE | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 183% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SIMPLE | $1,443.60 | $2,406.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON, LIGAMENT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 276% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 SONO/INJ/TENDON SHEATH | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 276% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON, LIGAMENT | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 SONO/INJ/TENDON SHEATH | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCEN ASP OR INJ MAJOR JT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTEISIS MAJOR JOINT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE SHOULDER JT LEFT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE HIP JT LEFT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE HIP JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE KNEE JT LEFT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE KNEE JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT/ASPIRATE SHOULDER JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 358% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCEN ASP OR INJ MAJOR JT | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTEISIS MAJOR JOINT | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE SHOULDER JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE SHOULDER JT LEFT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE KNEE JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE KNEE JT LEFT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE HIP JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT/ASPIRATE HIP JT LEFT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMEDIATE JOINT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCEN ASP OR INJ INT JOINT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT/ASPIRATE WRIST JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT/ASPIRATE ELBOW JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT/ASPIRATE WRIST JT LEFT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT/ASPIRATE ELBOW JT LEFT/FLUORO | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 506% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCEN ASP OR INJ INT JOINT | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMEDIATE JOINT | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT/ASPIRATE ELBOW JT LEFT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT/ASPIRATE WRIST JT LEFT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT/ASPIRATE ELBOW JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT/ASPIRATE WRIST JT RIGHT/FLUORO | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 422% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTEST ASP OR INJ SM JT | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 422% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTEST ASP OR INJ SM JT | $2,144.40 | $3,574.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT | $2,144.40 | $3,574.00 | — | — | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG LASER | $3,985.20 | $6,642.00 | $2,238.35–$5,180.76 | 330% above | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG LASER | $3,985.20 | $6,642.00 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT LAC < 2.6 CM BODY SCALP | $2,902.20 | $4,837.00 | $1,630.07–$3,772.86 | 395% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT LAC < 2.6 CM BODY SCALP | $2,902.20 | $4,837.00 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECT LUMBAR SACRAL | $6,466.80 | $10,778.00 | $3,632.19–$8,406.84 | 237% above | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION LUMBAR OR SACRAL | $6,466.80 | $10,778.00 | $3,632.19–$8,406.84 | 237% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT LUMBAR SACRAL | $6,466.80 | $10,778.00 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION LUMBAR OR SACRAL | $6,466.80 | $10,778.00 | — | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ FORAMEN EPIDURAL I/S | $6,466.80 | $10,778.00 | $3,632.19–$8,406.84 | 237% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ FORAMEN EPIDURAL I/S | $6,466.80 | $10,778.00 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 206% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE | $1,443.60 | $2,406.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECT OCCIPITAL NERVE | $1,544.40 | $2,574.00 | $867.44–$2,007.72 | 174% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 HYSTEROSCOPE PRECEDURE KITPOLYPECTOMY | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 280% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECT OCCIPITAL NERVE | $1,544.40 | $2,574.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HYSTEROSCOPE PRECEDURE KITPOLYPECTOMY | $2,144.40 | $3,574.00 | — | — | 40% |
| Paracentesis with imaging guidance CPT 49083 SONO/PARACENTESIS PROC W/US | $6,810.00 | $11,350.00 | $3,824.95–$8,853.00 | 304% above | 40% |
| Paracentesis with imaging guidance CPT 49083 CT PARACENTESIS PROC | $6,810.00 | $11,350.00 | $3,824.95–$8,853.00 | 304% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 SONO/PARACENTESIS PROC W/US | $6,810.00 | $11,350.00 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 CT PARACENTESIS PROC | $6,810.00 | $11,350.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED-PERMANENT | $2,902.20 | $4,837.00 | $1,630.07–$3,772.86 | 248% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED-PERMANENT | $2,902.20 | $4,837.00 | — | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUC LUMBAR SACRAL SINGLE FACET JOINT | $14,184.60 | $23,641.00 | $7,967.02–$18,439.98 | 376% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUC LUMBAR SACRAL SINGLE FACET JOINT | $14,184.60 | $23,641.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 I & REM F B SIMPLE | $2,902.20 | $4,837.00 | $1,630.07–$3,772.86 | 434% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I & REM F B SIMPLE | $2,902.20 | $4,837.00 | — | — | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) one side CPT 50590 LITHOTRIPSY - UNILATERAL | $8,163.60 | $13,606.00 | $4,585.22–$10,612.68 | 23% above | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient one side CPT 50590 LITHOTRIPSY - UNILATERAL | $8,163.60 | $13,606.00 | — | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST | $1,929.00 | $3,215.00 | $1,083.46–$2,507.70 | 364% above | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST | $1,929.00 | $3,215.00 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT | $936.60 | $1,561.00 | $526.06–$1,217.58 | 197% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT | $936.60 | $1,561.00 | — | — | 40% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $1,929.00 | $3,215.00 | $1,083.46–$2,507.70 | 270% above | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST | $1,929.00 | $3,215.00 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLNT CALF FOOT | $1,146.00 | $1,910.00 | $643.67–$1,489.80 | 148% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLNT CALF FOOT | $1,146.00 | $1,910.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM LAC<2.6CM BODY SCLP HAN FT | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 181% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM LAC<2.6CM BODY SCLP HAN FT | $1,443.60 | $2,406.00 | — | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 139% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS | $1,443.60 | $2,406.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $5,030.40 | $8,384.00 | $2,825.41–$6,539.52 | 311% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $5,030.40 | $8,384.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM LAC 2.6 - 7.5 CM | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 173% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM LAC 2.6 - 7.5 CM | $1,443.60 | $2,406.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIM LAC<2.6 CM FACE CHIN EARS | $1,443.60 | $2,406.00 | $810.82–$1,876.68 | 183% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIM LAC<2.6 CM FACE CHIN EARS | $1,443.60 | $2,406.00 | — | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 SONO/THORACENTESIS | $1,425.60 | $2,376.00 | $800.71–$1,853.28 | 3% below | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 SONO/THORACENTESIS | $1,425.60 | $2,376.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION 1 OR 2 MUSCLES | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 297% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECT SINGLE OR MULTIPLE TRIGGER PTS | $2,144.40 | $3,574.00 | $1,204.44–$2,787.72 | 297% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECTION 1 OR 2 MUSCLES | $2,144.40 | $3,574.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT SINGLE OR MULTIPLE TRIGGER PTS | $2,144.40 | $3,574.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 SONO/GUIDED BREAST BIOPSY | $11,769.00 | $19,615.00 | $6,610.26–$15,299.70 | 228% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 SONO/GUIDED BREAST BIOPSY | $11,769.00 | $19,615.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE | $2,902.20 | $4,837.00 | $1,630.07–$3,772.86 | 169% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE | $2,902.20 | $4,837.00 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE | $3,175.80 | $5,293.00 | $1,783.74–$4,128.54 | 237% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 .BB TRANSFUSION PER DAY | $3,175.80 | $5,293.00 | $1,783.74–$4,128.54 | 237% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 .BB TRANSFUSION PER DAY | $3,175.80 | $5,293.00 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE | $3,175.80 | $5,293.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 FAC - AEROSOL TREATMENT | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPONTANEOUS AEROSOL - MDI INITIAL | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 .SPONTANEOUS AEROSOL TEST | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 .IPPB | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPONTANEOUS AEROSOL - MDI SUBSEQUENT | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PULMICORT SPON AEROSAL | $1,477.20 | $2,462.00 | $829.69–$1,920.36 | 562% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPONTANEOUS AEROSOL - MDI INITIAL | $1,477.20 | $2,462.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 FAC - AEROSOL TREATMENT | $1,477.20 | $2,462.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 .SPONTANEOUS AEROSOL TEST | $1,477.20 | $2,462.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPONTANEOUS AEROSOL - MDI SUBSEQUENT | $1,477.20 | $2,462.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 .IPPB | $1,477.20 | $2,462.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PULMICORT SPON AEROSAL | $1,477.20 | $2,462.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION 1ST HOUR | $678.60 | $1,131.00 | $381.15–$882.18 | 6% below | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION 1ST HOUR | $678.60 | $1,131.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST HR | $6,120.60 | $10,201.00 | $3,437.74–$7,956.78 | 226% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST HR | $6,120.60 | $10,201.00 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG; AWAKE & DROWSY | $2,262.00 | $3,770.00 | $1,270.49–$2,940.60 | 197% above | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG; AWAKE & DROWSY | $2,262.00 | $3,770.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING ONLY | $123.00 | $205.00 | $69.09–$159.90 | 29% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 .EKG | $123.00 | $205.00 | $69.09–$159.90 | 29% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 .EKG | $123.00 | $205.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACING ONLY | $123.00 | $205.00 | — | — | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 ELECTRO-CONVULSIVE THPY-SINGLE | $3,854.40 | $6,424.00 | $2,164.89–$5,010.72 | 205% above | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ELECTRO-CONVULSIVE THPY-SINGLE | $3,854.40 | $6,424.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER BRIEF TREATMENT | $639.60 | $1,066.00 | $359.24–$831.48 | 110% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER BRIEF TREATMENT | $639.60 | $1,066.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LIMITED TREATMENT | $1,150.20 | $1,917.00 | $646.03–$1,495.26 | 140% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LIMITED TREATMENT | $1,150.20 | $1,917.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER INTERMEDIATE TREAT | $2,011.20 | $3,352.00 | $1,129.62–$2,614.56 | 170% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER INTERMEDIATE TREAT | $2,011.20 | $3,352.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER COMPLEX TREATMENT | $3,093.00 | $5,155.00 | $1,737.24–$4,020.90 | 153% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER COMPLEX TREATMENT | $3,093.00 | $5,155.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER EXTENSIVE TREATMENT | $4,453.20 | $7,422.00 | $2,501.21–$5,789.16 | 179% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER EXTENSIVE TREATMENT | $4,453.20 | $7,422.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/TREADMILL | $2,262.00 | $3,770.00 | $1,270.49–$2,940.60 | 139% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 .STRESS TEST ECHO | $2,262.00 | $3,770.00 | $1,270.49–$2,940.60 | 139% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/TREADMILL | $2,262.00 | $3,770.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 .STRESS TEST ECHO | $2,262.00 | $3,770.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION HYDRATION 1ST HOUR | $363.00 | $605.00 | $203.89–$471.90 | 17% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION, INITIAL 1ST HOUR | $363.00 | $605.00 | $203.89–$471.90 | 17% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION, INITIAL 1ST HOUR | $363.00 | $605.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION HYDRATION 1ST HOUR | $363.00 | $605.00 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 THERAP INFUSION 1ST HOUR | $1,530.60 | $2,551.00 | $859.69–$1,989.78 | 240% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV THERAPY (INFUSION) FIRST HOUR | $1,530.60 | $2,551.00 | $859.69–$1,989.78 | 240% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY (INFUSION) FIRST HOUR | $1,530.60 | $2,551.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 THERAP INFUSION 1ST HOUR | $1,530.60 | $2,551.00 | — | — | 40% |
| IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL | $363.00 | $605.00 | $203.89–$471.90 | 11% above | 40% |
| IV push of a medicine, first drug CPT 96374 605.IV PUSH INITIAL | $363.00 | $605.00 | $203.89–$471.90 | 11% above | 40% |
| IV push of a medicine, first drug CPT 96374 THERAP IVP, INITIAL | $363.00 | $605.00 | $203.89–$471.90 | 11% above | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 THERAP IVP, INITIAL | $363.00 | $605.00 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 605.IV PUSH INITIAL | $363.00 | $605.00 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL | $363.00 | $605.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM SQ EA | $517.20 | $862.00 | $290.49–$672.36 | 319% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ/IM | $517.20 | $862.00 | $290.49–$672.36 | 319% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM SQ EA | $517.20 | $862.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SQ/IM | $517.20 | $862.00 | — | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT INITIAL 30 MINS | $178.20 | $297.00 | $100.09–$231.66 | 26% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 297.FAC - INITIAL OFFICE VIST LVL 3 | $178.20 | $297.00 | $100.09–$231.66 | 26% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 FAC - INITIAL OFFICE VIST LVL 3 | $178.20 | $297.00 | $100.09–$231.66 | 26% below | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 297.FAC - INITIAL OFFICE VIST LVL 3 | $178.20 | $297.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT INITIAL 30 MINS | $178.20 | $297.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 FAC - INITIAL OFFICE VIST LVL 3 | $178.20 | $297.00 | — | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 FAC - INITIAL OFFICE VIST LVL 4 | $178.20 | $297.00 | $100.09–$231.66 | 41% below | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 FAC - INITIAL OFFICE VIST LVL 4 | $178.20 | $297.00 | — | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 FAC - INITIAL OFFICE VIST LVL 5 | $178.20 | $297.00 | $100.09–$231.66 | 66% below | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 FAC - INITIAL OFFICE VIST LVL 5 | $178.20 | $297.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 FAC - INITIAL OFFICE VIST LVL 2 | $178.20 | $297.00 | $100.09–$231.66 | 3% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 FAC - INITIAL OFFICE VIST LVL 2 | $178.20 | $297.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL ASSESSMENT INDIVIDUAL 15 MIN | $55.20 | $92.00 | $31.00–$71.76 | 10% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL ASSESSMENT INDIVIDUAL 15 MIN | $55.20 | $92.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 .ESTABLISHED PATIENT FOLLOW UP 15 MINS | $178.20 | $297.00 | $100.09–$231.66 | 4% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 .ESTABLISHED PATIENT FOLLOW UP 15 MINS | $178.20 | $297.00 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 PFT - SPIROMETRY | $455.40 | $759.00 | $255.78–$592.02 | 51% above | 40% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $455.40 | $759.00 | $255.78–$592.02 | 51% above | 40% |
| Spirometry (breathing test) CPT 94010 .PFT SPIROMETRY BEDSIDE | $455.40 | $759.00 | $255.78–$592.02 | 51% above | 40% |
| Spirometry (breathing test) CPT 94010 PFT SPIROMETRY | $455.40 | $759.00 | $255.78–$592.02 | 51% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $455.40 | $759.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 .PFT SPIROMETRY BEDSIDE | $455.40 | $759.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PFT SPIROMETRY | $455.40 | $759.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PFT - SPIROMETRY | $455.40 | $759.00 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PFT PRE/POST COMPLETE | $455.40 | $759.00 | $255.78–$592.02 | 30% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVALUATION | $455.40 | $759.00 | $255.78–$592.02 | 30% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE/POST COMPLETE | $455.40 | $759.00 | — | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVALUATION | $455.40 | $759.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THER PHLEBOTOMY W/WO NSS REPLACEMENT | $936.60 | $1,561.00 | $526.06–$1,217.58 | 305% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $936.60 | $1,561.00 | $526.06–$1,217.58 | 305% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC | $936.60 | $1,561.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THER PHLEBOTOMY W/WO NSS REPLACEMENT | $936.60 | $1,561.00 | — | — | 40% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 .STRESS TEST (TECHNICAL & PROFESSIONAL) | $669.60 | $1,116.00 | $376.09–$870.48 | 62% above | 40% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 .STRESS TEST (TECHNICAL & PROFESSIONAL) | $669.60 | $1,116.00 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Pennsylvania | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE INJ | $292.56 | $487.60 | $164.32–$380.33 | 42% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE INJ | $292.56 | $487.60 | — | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTaP-IPV VACC, INACTIVATED IM | $174.57 | $290.95 | $98.05–$226.94 | 110% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTaP-IPV VACC, INACTIVATED IM | $174.57 | $290.95 | — | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPHTHERIA, TETANUS, & PERTUSSIS FOR <7Y | $244.29 | $407.15 | $137.21–$317.58 | 614% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPHTHERIA, TETANUS, & PERTUSSIS FOR <7Y | $244.29 | $407.15 | — | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DtaP-HepB-IPV vacc, inactivated, im | $253.47 | $422.45 | $142.37–$329.51 | 205% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DtaP-HepB-IPV vacc, inactivated, im | $253.47 | $422.45 | — | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE VACCINE (2024-25) 0.5ML SYR | $49.63 | $82.72 | $27.88–$64.52 | 25% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE VACCINE (2024-25) 0.5ML SYR | $49.63 | $82.72 | — | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMA VIRUS VACC NONAVALEN INJ | $484.32 | $807.20 | $272.03–$629.62 | 91% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMA VIRUS VACC NONAVALEN INJ | $484.32 | $807.20 | — | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE, ADULT DOSAGE INJ | $225.66 | $376.10 | $126.75–$293.36 | 153% above | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE, ADULT DOSAGE INJ | $225.66 | $376.10 | — | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE PEDIATRIC/ADOLES INJ | $101.22 | $168.70 | $56.85–$131.59 | 36% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE PEDIATRIC/ADOLES INJ | $101.22 | $168.70 | — | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE, ADULT DOSAGE INJ | $234.66 | $391.10 | $131.80–$305.06 | 185% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE, ADULT DOSAGE INJ | $234.66 | $391.10 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B (ENGERIX-B) SDV 10MCG/0.5ML | $86.61 | $144.35 | $48.65–$112.59 | 83% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE, PEDIA/ADOL DOSE INJ | $101.49 | $169.15 | $57.00–$131.94 | 114% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B (ENGERIX-B) SDV 10MCG/0.5ML | $86.61 | $144.35 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE, PEDIA/ADOL DOSE INJ | $101.49 | $169.15 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS INFLUENZA B PRP-OMP INJ | $244.29 | $407.15 | $137.21–$317.58 | 194% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS INFLUENZA B PRP-OMP INJ | $244.29 | $407.15 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS INFLUENZA B PRP-T INJ | $108.66 | $181.10 | $61.03–$141.26 | 247% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS INFLUENZA B PRP-T INJ | $108.66 | $181.10 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE HIGH DOSE | $16.20 | $27.00 | $9.10–$21.06 | 81% below | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE (2024-25) 0.5ML SYR | $176.06 | $293.44 | $98.89–$228.88 | 102% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH DOSE | $197.13 | $328.55 | $110.72–$256.27 | 126% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VACCINE HIGH DOSE | $16.20 | $27.00 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE (2024-25) 0.5ML SYR | $176.06 | $293.44 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH DOSE | $197.13 | $328.55 | — | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VIRUS VACC INJ | $174.06 | $290.10 | $97.76–$226.28 | 166% above | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VIRUS VACC INJ | $174.06 | $290.10 | — | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV, LIVE, SC INJ | $497.58 | $829.30 | $279.47–$646.85 | 106% above | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMRV, LIVE, SC INJ | $497.58 | $829.30 | — | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE VACC TETRAVALENT | $281.88 | $469.80 | $158.32–$366.44 | 201% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE VACC TETRAVALENT | $281.88 | $469.80 | — | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL CONJUGATE VACCINE 13 VALENT | $555.84 | $926.40 | $312.20–$722.59 | 286% above | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL CONJUGATE VACCINE 13 VALENT | $555.84 | $926.40 | — | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE 20 VALENT | $627.74 | $1,046.24 | $352.58–$816.07 | 94% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE 20 VALENT | $627.74 | $1,046.24 | — | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSACC VACCINE 23 VALENT | $293.40 | $489.00 | $164.79–$381.42 | 129% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL POLYSACC VACCINE 23 VALENT | $293.40 | $489.00 | — | — | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INACTIVATE INJ | $108.48 | $180.80 | $60.93–$141.02 | 81% above | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INACTIVATE INJ | $108.48 | $180.80 | — | — | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) SDV 2.5IU | $967.59 | $1,612.65 | $543.46–$1,257.87 | 62% above | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) 2.5 UNITS/ML | $1,146.22 | $1,910.36 | $643.79–$1,490.08 | 91% above | 40% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE (IMOVAX) SDV 2.5 IU | $1,288.71 | $2,147.85 | $723.83–$1,675.32 | 115% above | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) SDV 2.5IU | $967.59 | $1,612.65 | — | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) 2.5 UNITS/ML | $1,146.22 | $1,910.36 | — | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (IMOVAX) SDV 2.5 IU | $1,288.71 | $2,147.85 | — | — | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus vacc (pentavalent) 3 dose live | $280.41 | $467.35 | $157.50–$364.53 | 238% above | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus vacc (pentavalent) 3 dose live | $280.41 | $467.35 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td (TETANUS/DIPHTHERIA TOXOIDS) | $105.54 | $175.90 | $59.28–$137.20 | 89% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tdap (TETANUS/DIPHTHERIA /PERTUSSIS) | $1,406.16 | $2,343.60 | $789.79–$1,828.01 | 2420% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td (TETANUS/DIPHTHERIA TOXOIDS) | $105.54 | $175.90 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tdap (TETANUS/DIPHTHERIA /PERTUSSIS) | $1,406.16 | $2,343.60 | — | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (DTAP) INJECTION | $163.83 | $273.05 | $92.02–$212.98 | 192% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (DTAP) INJECTION | $163.83 | $273.05 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION 1 VACCINE | $517.20 | $862.00 | $290.49–$672.36 | 712% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINIS 1 SINGLE/COMB | $517.20 | $862.00 | $290.49–$672.36 | 712% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $517.20 | $862.00 | $290.49–$672.36 | 712% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ONE VACCINE | $517.20 | $862.00 | $290.49–$672.36 | 712% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ONE VACCINE | $517.20 | $862.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN | $517.20 | $862.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINIS 1 SINGLE/COMB | $517.20 | $862.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION 1 VACCINE | $517.20 | $862.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION EA ADDITIONAL VACCINE | $53.40 | $89.00 | $29.99–$69.42 | 99% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINIS EA ADDL SINGLE/COMB | $53.40 | $89.00 | $29.99–$69.42 | 99% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION EA ADDITIONAL VACCINE | $53.40 | $89.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINIS EA ADDL SINGLE/COMB | $53.40 | $89.00 | — | — | 40% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.phhealthcare.org/download/?id=14597