Madison Community Hospital
Madison Community Hospital in Madison, SD publishes cash prices for 394 common procedures listed here, from its own machine-readable price file updated Oct 12, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the South Dakota median for 232 of 384 procedures and below it for 139. By typical cash price it ranks #17 of 24 South Dakota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
323 SW 10th St., Madison, SD 57042 Collected Nov 5, 2026 Source price file Check a bill from this hospital (605) 256-6551
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 431300 · CMS hospital register NPI 1588644058
The price file shows no self-pay discount
For 1334 of the 1334 prices listed here, the cash price in Madison Community Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Madison Community 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.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/O & W/Dye - CT Abdomen W WO Contrast | $3,198.00 | $3,198.00 | $260.15–$3,198.00 | at median | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen W/O & W/Dye - CT Abdomen W WO Contrast | $3,198.00 | $3,198.00 | $260.15–$3,198.00 | — | — |
| Abdominal X-ray, 2 views CPT 74019 HC Radiologic Exam Abdomen 2 Views - Xr Abdomen 2 Vw | $404.00 | $404.00 | $36.25–$404.00 | 10% below | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC Radiologic Exam Abdomen 2 Views - Xr Abdomen 2 Vw | $404.00 | $404.00 | $36.25–$404.00 | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right | $294.00 | $294.00 | $37.26–$294.00 | at median | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Left | $294.00 | $294.00 | $37.26–$294.00 | at median | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right | $294.00 | $294.00 | $37.26–$294.00 | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Left | $294.00 | $294.00 | $37.26–$294.00 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Upr/L Xtremity Art 2 Levels - Cv US Ankle Brachial Indices Extrm Cmp | $734.00 | $734.00 | $83.58–$734.00 | 43% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Upr/L Xtremity Art 2 Levels - Cv US Ankle Brachial Indices Extrm Cmp | $734.00 | $734.00 | $83.58–$734.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Upper Ext Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Humerus Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Elbow Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Shoulder Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Shoulder Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Radius Ulna Left WO IV Cont | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Wrist Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Wrist Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Hand Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Elbow Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Upper Ext Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | 54% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Radius Ulna Left WO IV Cont | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Humerus Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Elbow Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Upper Ext Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Upper Ext Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Elbow Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Hand Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Wrist Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Wrist Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Shoulder Right WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Scan Upper Extremity W/O Dye - CT Shoulder Left WO IV Contrast | $3,178.00 | $3,178.00 | $161.46–$3,178.00 | — | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram - Fl Esophagus Barium Swallow | $716.00 | $716.00 | $94.66–$716.00 | 14% below | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esophagram - Fl Esophagus Barium Swallow | $716.00 | $716.00 | $94.66–$716.00 | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Imaging, Whole Body - NM Bone Whole Body | $1,594.00 | $1,594.00 | $260.48–$1,594.00 | 19% below | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone Imaging, Whole Body - NM Bone Whole Body | $1,594.00 | $1,594.00 | $260.48–$1,594.00 | — | — |
| Breast ultrasound, complete, one breast one side CPT 76641 HC Ultrasound Breast Complete - US Breast Right Complete | $865.00 | $865.00 | $100.70–$865.00 | 54% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 HC Ultrasound Breast Complete - US Breast Left Complete | $865.00 | $865.00 | $100.70–$865.00 | 54% above | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC Ultrasound Breast Complete - US Breast Left Complete | $865.00 | $865.00 | $100.70–$865.00 | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC Ultrasound Breast Complete - US Breast Right Complete | $865.00 | $865.00 | $100.70–$865.00 | — | — |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC Ultrasound Breast Limited - US Breast Bilateral Limited | $821.00 | $821.00 | $83.92–$821.00 | — | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Ultrasound Breast Limited - US Breast Right Limited | $821.00 | $821.00 | $83.92–$821.00 | 46% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Ultrasound Breast Limited - US Breast Left Limited | $821.00 | $821.00 | $83.92–$821.00 | 46% above | — |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC Ultrasound Breast Limited - US Breast Bilateral Limited | $821.00 | $821.00 | $83.92–$821.00 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Ultrasound Breast Limited - US Breast Left Limited | $821.00 | $821.00 | $83.92–$821.00 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Ultrasound Breast Limited - US Breast Right Limited | $821.00 | $821.00 | $83.92–$821.00 | — | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye - CT Angiogram Abdomen Pelvis W Contrast | $4,892.00 | $4,892.00 | $380.32–$4,892.00 | 21% above | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye - CT Angiogram Abdomen Pelvis W Contrast | $4,892.00 | $4,892.00 | $380.32–$4,892.00 | — | — |
| CT angiography (CTA) of the head CPT 70496 HC CT Angio,Head Combo - CT Head Neck Angio W and WO IV Contrast | $3,261.00 | $3,261.00 | $275.25–$3,261.00 | 11% above | — |
| CT angiography (CTA) of the head CPT 70496 HC CT Angio,Head Combo - CT Head Angio W and WO IV Contrast | $3,357.00 | $3,357.00 | $275.25–$3,357.00 | 14% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angio,Head Combo - CT Head Neck Angio W and WO IV Contrast | $3,261.00 | $3,261.00 | $275.25–$3,261.00 | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angio,Head Combo - CT Head Angio W and WO IV Contrast | $3,357.00 | $3,357.00 | $275.25–$3,357.00 | — | — |
| CT angiography (CTA) of the neck CPT 70498 HC CT Angio,Neck Combo - CT Neck Angio W and WO IV Contrast | $3,261.00 | $3,261.00 | $275.25–$3,261.00 | 11% above | — |
| CT angiography (CTA) of the neck CPT 70498 HC CT Angio,Neck Combo - CT Head Neck Angio W and WO IV Contrast | $3,357.00 | $3,357.00 | $275.25–$3,357.00 | 14% above | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angio,Neck Combo - CT Neck Angio W and WO IV Contrast | $3,261.00 | $3,261.00 | $275.25–$3,261.00 | — | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angio,Neck Combo - CT Head Neck Angio W and WO IV Contrast | $3,357.00 | $3,357.00 | $275.25–$3,357.00 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio, Chest, Combo, Incl Image - CT Chest Angio W and WO IV Cont | $3,937.00 | $3,937.00 | $281.97–$3,937.00 | 37% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio, Chest, Combo, Incl Image - CT Chest Angio W and WO IV Cont | $3,937.00 | $3,937.00 | $281.97–$3,937.00 | — | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test - CT Heart Calcium Scoring WO Contrast | $76.00 | $76.00 | $69.16–$100.03 | 71% below | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Hrt W/O Dye W/Ca Test - CT Heart Calcium Scoring WO Contrast | $76.00 | $76.00 | $69.16–$100.03 | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd & Pelvis W/O Contrast - CT Abdomen Pelvis WO Contrast | $4,449.00 | $4,449.00 | $183.95–$4,449.00 | 17% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abd & Pelvis W/O Contrast - CT Abdomen Pelvis WO Contrast | $4,449.00 | $4,449.00 | $183.95–$4,449.00 | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast | $4,872.00 | $4,872.00 | $301.77–$4,872.00 | 4% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd & Pelv W/Contrast - CT Abdomen Pelvis W Contrast | $4,872.00 | $4,872.00 | $301.77–$4,872.00 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd & Pelv 1/> Regns - CT Abdomen Pelvis W WO Contrast | $5,557.00 | $5,557.00 | $339.70–$5,557.00 | 11% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abd & Pelv 1/> Regns - CT Abdomen Pelvis W WO Contrast | $5,557.00 | $5,557.00 | $339.70–$5,557.00 | — | — |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Dye - CT Abdomen W Contrast | $2,589.00 | $2,589.00 | $231.28–$2,589.00 | 11% below | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/Dye - CT Abdomen W Contrast | $2,589.00 | $2,589.00 | $231.28–$2,589.00 | — | — |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O Dye - CT Abdomen WO Contrast | $2,285.00 | $2,285.00 | $136.96–$2,285.00 | 16% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen W/O Dye - CT Abdomen WO Contrast | $2,285.00 | $2,285.00 | $136.96–$2,285.00 | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Scan,Maxillofacial W/O Contrast - CT Sinus WO Contrast | $2,360.00 | $2,360.00 | $128.90–$2,360.00 | 21% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Scan,Maxillofacial W/O Contrast - CT Sinus Facial Bones WO Cont | $2,409.00 | $2,409.00 | $128.90–$2,409.00 | 23% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Scan,Maxillofacial W/O Contrast - CT Sinus WO Contrast | $2,360.00 | $2,360.00 | $128.90–$2,360.00 | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Scan,Maxillofacial W/O Contrast - CT Sinus Facial Bones WO Cont | $2,409.00 | $2,409.00 | $128.90–$2,409.00 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast | $2,437.00 | $2,437.00 | $107.08–$2,437.00 | 23% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Scan,Head/Brain,W/O Contrast Matl - CT Head WO Contrast | $2,437.00 | $2,437.00 | $107.08–$2,437.00 | — | — |
| CT scan of the head without and with contrast CPT 70470 HC CT Scan Head Combo - CT Head W WO Contrast | $2,897.00 | $2,897.00 | $173.88–$2,897.00 | 3% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Scan Head Combo - CT Head W WO Contrast | $2,897.00 | $2,897.00 | $173.88–$2,897.00 | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Scan,Lumbar Spine,W/O Contrast - CT Lumbar Spine WO Contrast | $3,042.00 | $3,042.00 | $130.58–$3,042.00 | 28% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Scan,Lumbar Spine,W/O Contrast - CT Lumbar Spine WO Contrast | $3,042.00 | $3,042.00 | $130.58–$3,042.00 | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Scan,Cervical Spine,W/O Contrast - CT Cervical Spine WO Contrast | $3,066.00 | $3,066.00 | $131.25–$3,066.00 | 36% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Scan,Cervical Spine,W/O Contrast - CT Cervical Spine WO Contrast | $3,066.00 | $3,066.00 | $131.25–$3,066.00 | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Scan of Pelvis Contrast - CT Pelvis W Contrast | $2,897.00 | $2,897.00 | $226.92–$2,897.00 | 29% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Scan of Pelvis Contrast - CT Pelvis W Contrast | $2,897.00 | $2,897.00 | $226.92–$2,897.00 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Duplex Scan Extracranial,Bilat - Carotid Duplex | $1,356.00 | $1,356.00 | $189.99–$1,356.00 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Duplex Scan Extracranial,Bilat - Carotid Duplex | $1,356.00 | $1,356.00 | $189.99–$1,356.00 | — | — |
| Chest X-ray, 2 views CPT 71046 HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views | $321.00 | $321.00 | $33.23–$321.00 | 13% below | — |
| Chest X-ray, 2 views inpatient CPT 71046 HC Radiologic Exam Chest 2 Views - Xr Chest 2 Views | $321.00 | $321.00 | $33.23–$321.00 | — | — |
| Chest X-ray, single view CPT 71045 HC Radiologic Exam Chest Single View - Xr Chest 1 View | $219.00 | $219.00 | $25.51–$219.00 | 26% below | — |
| Chest X-ray, single view inpatient CPT 71045 HC Radiologic Exam Chest Single View - Xr Chest 1 View | $219.00 | $219.00 | $25.51–$219.00 | — | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-Ray Clavicle - Xr Clavicle Left | $256.00 | $256.00 | $33.57–$256.00 | 2% above | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC X-Ray Clavicle - Xr Clavicle Right | $256.00 | $256.00 | $33.57–$256.00 | 2% above | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-Ray Clavicle - Xr Clavicle Left | $256.00 | $256.00 | $33.57–$256.00 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC X-Ray Clavicle - Xr Clavicle Right | $256.00 | $256.00 | $33.57–$256.00 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,Retroperit, B-Scan/Real Time,Complete - US Renal Complete | $783.00 | $783.00 | $106.74–$783.00 | 11% below | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,Retroperit, B-Scan/Real Time,Complete - US Renal Complete | $783.00 | $783.00 | $106.74–$783.00 | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA Bone Density Axial - Dexa Bone Density | $657.00 | $657.00 | $39.61–$657.00 | 12% above | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA Bone Density Axial - Dexa Bone Density | $657.00 | $657.00 | $39.61–$657.00 | — | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US Detailed Sngl Fetus - US OB Detail Fetal Anat Sing or 1st Gest | $865.00 | $865.00 | $182.94–$865.00 | 26% above | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB US Detailed Sngl Fetus - US OB Detail Fetal Anat Sing or 1st Gest | $865.00 | $865.00 | $182.94–$865.00 | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Scan,Thorax,W/O Contrast - CT Chest WO Contrast | $3,040.00 | $3,040.00 | $133.26–$3,040.00 | 45% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest W/O Hi Res | $3,112.00 | $3,112.00 | $133.26–$3,112.00 | 49% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Scan,Thorax,W/O Contrast - CT Chest WO Contrast | $3,040.00 | $3,040.00 | $133.26–$3,040.00 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Chest W/O Hi Res | $3,112.00 | $3,112.00 | $133.26–$3,112.00 | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC Cat Scan of Chest Contrast - CT Chest Pulmonary Embolism W IV Cont | $3,198.00 | $3,198.00 | $167.50–$3,198.00 | 20% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC Cat Scan of Chest Contrast - CT Chest W Contrast | $3,198.00 | $3,198.00 | $167.50–$3,198.00 | 20% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC Cat Scan of Chest Contrast - CT Chest W Contrast | $3,198.00 | $3,198.00 | $167.50–$3,198.00 | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC Cat Scan of Chest Contrast - CT Chest Pulmonary Embolism W IV Cont | $3,198.00 | $3,198.00 | $167.50–$3,198.00 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi | $763.00 | $763.00 | $157.77–$763.00 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Dx Mammo Incl Cad Bi - Mg Breast Bilateral Post Biopsy Clip | $763.00 | $763.00 | $157.77–$763.00 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Dx Mammo Incl Cad Bi - Mg Breast Bilateral Post Biopsy Clip | $763.00 | $763.00 | $157.77–$763.00 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Computer-Aided Detcj Bi | $763.00 | $763.00 | $157.77–$763.00 | — | — |
| Diagnostic mammogram, one breast one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Additional Views Left | $629.00 | $629.00 | $124.54–$629.00 | 48% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic Right | $629.00 | $629.00 | $124.54–$629.00 | 48% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic Left | $629.00 | $629.00 | $124.54–$629.00 | 48% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Additional Views Right | $629.00 | $629.00 | $124.54–$629.00 | 48% above | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Additional Views Right | $629.00 | $629.00 | $124.54–$629.00 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic Right | $629.00 | $629.00 | $124.54–$629.00 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic Left | $629.00 | $629.00 | $124.54–$629.00 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Dx Mammo Incl Cad Uni - Mammo Additional Views Left | $629.00 | $629.00 | $124.54–$629.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Lo Extrem Art Bilat - Cv US Doppler Arterial Legs Bilateral | $1,731.00 | $1,731.00 | $238.66–$1,731.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Lo Extrem Art Bilat - US Lower Extremity Arteries Bilateral | $1,765.00 | $1,765.00 | $238.66–$1,765.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Duplex Lo Extrem Art Bilat - Cv US Doppler Arterial Legs Bilateral | $1,731.00 | $1,731.00 | $238.66–$1,731.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Duplex Lo Extrem Art Bilat - US Lower Extremity Arteries Bilateral | $1,765.00 | $1,765.00 | $238.66–$1,765.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Upper Extremity Dvt | $1,428.00 | $1,428.00 | $184.96–$1,428.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Extremity Study - US Upper Extremity Veins Bilateral | $1,442.00 | $1,442.00 | $184.96–$1,442.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Lower Extremity Dvt | $1,485.00 | $1,485.00 | $184.96–$1,485.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Extremity Study - US Lower Extremity Veins Bilateral | $1,514.00 | $1,514.00 | $184.96–$1,514.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US Vasc Vein Mapping Bilateral | $1,704.00 | $1,704.00 | $184.96–$1,704.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Venous Reflux Duplex | $1,790.00 | $1,790.00 | $184.96–$1,790.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Vascular Doppler & Reflux Bilateral | $1,790.00 | $1,790.00 | $184.96–$1,790.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Upper Extremity Dvt | $1,428.00 | $1,428.00 | $184.96–$1,428.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Extremity Study - US Upper Extremity Veins Bilateral | $1,442.00 | $1,442.00 | $184.96–$1,442.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Lower Extremity Dvt | $1,485.00 | $1,485.00 | $184.96–$1,485.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Extremity Study - US Lower Extremity Veins Bilateral | $1,514.00 | $1,514.00 | $184.96–$1,514.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC US Vasc Vein Mapping Bilateral | $1,704.00 | $1,704.00 | $184.96–$1,704.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Vascular Doppler & Reflux Bilateral | $1,790.00 | $1,790.00 | $184.96–$1,790.00 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Extrem Venous,Bilat - Venous Reflux Duplex | $1,790.00 | $1,790.00 | $184.96–$1,790.00 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tte W/Doppler Complete - Tte Complete | $1,825.00 | $1,825.00 | $197.71–$1,825.00 | 24% below | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Tte W/Doppler Complete - Tte Complete | $1,825.00 | $1,825.00 | $197.71–$1,825.00 | — | — |
| Elbow X-ray, 2 views one side CPT 73070 HC X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Left | $289.00 | $289.00 | $29.54–$289.00 | 7% above | — |
| Elbow X-ray, 2 views one side CPT 73070 HC X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right | $289.00 | $289.00 | $29.54–$289.00 | 7% above | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right | $289.00 | $289.00 | $29.54–$289.00 | — | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HC X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Left | $289.00 | $289.00 | $29.54–$289.00 | — | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Left | $301.00 | $301.00 | $33.23–$301.00 | 11% below | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right | $301.00 | $301.00 | $33.23–$301.00 | 11% below | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Left | $301.00 | $301.00 | $33.23–$301.00 | — | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right | $301.00 | $301.00 | $33.23–$301.00 | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Scan,Orbit/Sella/Post Fossa/Ear,W/O - CT Orbits/Sella WO IV Cont | $2,437.00 | $2,437.00 | $159.11–$2,437.00 | 16% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Scan,Orbit/Sella/Post Fossa/Ear,W/O - CT Auditory Canals WO Cont | $3,377.00 | $3,377.00 | $159.11–$3,377.00 | 61% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Scan,Orbit/Sella/Post Fossa/Ear,W/O - CT Orbits/Sella WO IV Cont | $2,437.00 | $2,437.00 | $159.11–$2,437.00 | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Scan,Orbit/Sella/Post Fossa/Ear,W/O - CT Auditory Canals WO Cont | $3,377.00 | $3,377.00 | $159.11–$3,377.00 | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views | $371.00 | $371.00 | $46.99–$371.00 | 2% above | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views | $371.00 | $371.00 | $46.99–$371.00 | — | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-Ray Forearm 2 Vw - Xr Forearm 2 Views Right | $302.00 | $302.00 | $29.20–$302.00 | 2% below | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC X-Ray Forearm 2 Vw - Xr Forearm 2 Views Left | $302.00 | $302.00 | $29.20–$302.00 | 2% below | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-Ray Forearm 2 Vw - Xr Forearm 2 Views Left | $302.00 | $302.00 | $29.20–$302.00 | — | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC X-Ray Forearm 2 Vw - Xr Forearm 2 Views Right | $302.00 | $302.00 | $29.20–$302.00 | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary Syst Imaging Including Gallbladder - NM Liver Function | $1,391.00 | $1,391.00 | $286.33–$1,391.00 | 28% below | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepatobiliary Syst Imaging Including Gallbladder - NM Liver Function | $1,391.00 | $1,391.00 | $286.33–$1,391.00 | — | — |
| Hand X-ray, 2 views one side CPT 73120 HC X-Ray Hand 2 Vw - Xr Hand 1-2 Views Left | $285.00 | $285.00 | $31.55–$285.00 | 7% above | — |
| Hand X-ray, 2 views one side CPT 73120 HC X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right | $285.00 | $285.00 | $31.55–$285.00 | 7% above | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right | $285.00 | $285.00 | $31.55–$285.00 | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC X-Ray Hand 2 Vw - Xr Hand 1-2 Views Left | $285.00 | $285.00 | $31.55–$285.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 1 View Left | $246.00 | $246.00 | $28.53–$246.00 | 17% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 2 Views Left | $246.00 | $246.00 | $28.53–$246.00 | 17% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 1 View Right | $246.00 | $246.00 | $28.53–$246.00 | 17% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 2 Views Right | $246.00 | $246.00 | $28.53–$246.00 | 17% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 1 View Right | $246.00 | $246.00 | $28.53–$246.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 1 View Left | $246.00 | $246.00 | $28.53–$246.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 2 Views Right | $246.00 | $246.00 | $28.53–$246.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC X-Ray Heel - Xr Calcaneus 2 Views Left | $246.00 | $246.00 | $28.53–$246.00 | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Std Airflow Hrt Rate&O2 Sat Effort Unatt | $1,182.00 | $1,182.00 | $103.72–$1,182.00 | 41% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Sleep Std Airflow Hrt Rate&O2 Sat Effort Unatt | $1,182.00 | $1,182.00 | $103.72–$1,182.00 | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd | $6,184.00 | $6,184.00 | $711.30–$6,184.00 | 35% above | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography =>6yrs =>4 Param W Cpap or Bilevel Red Svc | $6,478.00 | $6,478.00 | $711.30–$6,478.00 | 41% above | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd | $6,184.00 | $6,184.00 | $711.30–$6,184.00 | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Polysomnography =>6yrs =>4 Param W Cpap or Bilevel Red Svc | $6,478.00 | $6,478.00 | $711.30–$6,478.00 | — | — |
| Knee X-ray, 3 views one side CPT 73562 HC X-Ray Knee 3 View - Xr Knee 3 Views Left | $306.00 | $306.00 | $42.63–$306.00 | 8% below | — |
| Knee X-ray, 3 views one side CPT 73562 HC X-Ray Knee 3 View - Xr Knee 3 Views Right | $306.00 | $306.00 | $42.63–$306.00 | 8% below | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-Ray Knee 3 View - Xr Knee 3 Views Right | $306.00 | $306.00 | $42.63–$306.00 | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-Ray Knee 3 View - Xr Knee 3 Views Left | $306.00 | $306.00 | $42.63–$306.00 | — | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-Ray Knee 4+ View - Xr Knee 4+ Views Right | $314.00 | $314.00 | $49.68–$314.00 | 11% below | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC X-Ray Knee 4+ View - Xr Knee 4+ Views Left | $314.00 | $314.00 | $49.68–$314.00 | 11% below | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-Ray Knee 4+ View - Xr Knee 4+ Views Left | $314.00 | $314.00 | $49.68–$314.00 | — | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC X-Ray Knee 4+ View - Xr Knee 4+ Views Right | $314.00 | $314.00 | $49.68–$314.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Knee Right WO IV Contrast | $2,972.00 | $2,972.00 | $130.91–$2,972.00 | 46% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Ankle Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Knee Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Hip Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Foot Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Hip Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Foot Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Ankle Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | 51% above | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Knee Right WO IV Contrast | $2,972.00 | $2,972.00 | $130.91–$2,972.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Knee Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Hip Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Hip Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Foot Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Foot Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Ankle Left WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Scan,Lower Extremity,W/O Contrast - CT Ankle Right WO IV Contrast | $3,059.00 | $3,059.00 | $130.91–$3,059.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Follow-Up Non OB | $416.00 | $416.00 | $86.60–$416.00 | 50% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited - US Abdomen Limited Liver | $823.00 | $823.00 | $86.60–$823.00 | at median | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited - US Gallbladder | $823.00 | $823.00 | $86.60–$823.00 | at median | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited - US Abdomen Limited | $823.00 | $823.00 | $86.60–$823.00 | at median | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited - US Lower Back | $823.00 | $823.00 | $86.60–$823.00 | at median | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, Abdomen Limited - US Pelvis Appendix | $881.00 | $881.00 | $86.60–$881.00 | 7% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Ruq | $881.00 | $881.00 | $86.60–$881.00 | 7% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Follow-Up Non OB | $416.00 | $416.00 | $86.60–$416.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, Abdomen Limited - US Abdomen Limited Liver | $823.00 | $823.00 | $86.60–$823.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, Abdomen Limited - US Gallbladder | $823.00 | $823.00 | $86.60–$823.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, Abdomen Limited - US Abdomen Limited | $823.00 | $823.00 | $86.60–$823.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, Abdomen Limited - US Lower Back | $823.00 | $823.00 | $86.60–$823.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Ruq | $881.00 | $881.00 | $86.60–$881.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, Abdomen Limited - US Pelvis Appendix | $881.00 | $881.00 | $86.60–$881.00 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Axilla | $835.00 | $835.00 | $64.45–$835.00 | 39% above | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Ext Non-Vasc Limited, Realtime W/ Img | $860.00 | $860.00 | $64.45–$860.00 | 43% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Lmtd Jt/Nonvasc Xtr Strux - US Knee Right Limited | $836.00 | $836.00 | $64.45–$836.00 | 39% above | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US Axilla | $835.00 | $835.00 | $64.45–$835.00 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US Ext Non-Vasc Limited, Realtime W/ Img | $860.00 | $860.00 | $64.45–$860.00 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US Lmtd Jt/Nonvasc Xtr Strux - US Knee Right Limited | $836.00 | $836.00 | $64.45–$836.00 | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Chest Low Dose Lung Cancer Screening | $3,587.00 | $3,587.00 | $136.96–$3,587.00 | 308% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC Ldct for Lung Ca Screen - Ldct Lung Screening | $3,587.00 | $3,587.00 | $136.96–$3,587.00 | 308% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC Ldct for Lung Ca Screen - Ldct Lung Screening | $3,587.00 | $3,587.00 | $136.96–$3,587.00 | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Chest Low Dose Lung Cancer Screening | $3,587.00 | $3,587.00 | $136.96–$3,587.00 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-Ray Tib + Fib, 2vw - Xr Tibia Fibula 2 Views Right | $294.00 | $294.00 | $31.55–$294.00 | 12% below | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC X-Ray Tib + Fib, 2vw - Xr Tibia Fibula 2 Views Left | $294.00 | $294.00 | $31.55–$294.00 | 12% below | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-Ray Tib + Fib, 2vw - Xr Tibia Fibula 2 Views Left | $294.00 | $294.00 | $31.55–$294.00 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC X-Ray Tib + Fib, 2vw - Xr Tibia Fibula 2 Views Right | $294.00 | $294.00 | $31.55–$294.00 | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MR Angio, Head - MR Head Angio WO IV Contrast | $3,822.00 | $3,822.00 | $215.84–$3,822.00 | 30% above | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MR Angio, Head - MR Head Angio WO IV Contrast | $3,822.00 | $3,822.00 | $215.84–$3,822.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MR Lower Ext Joint Lt WO IV Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Hip Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Knee Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Ankle Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Ankle Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Hip Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Knee Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | 10% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MR Lower Ext Joint Rt WO IV Cont | $3,601.00 | $3,601.00 | $205.43–$3,601.00 | 14% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Ankle Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Ankle Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Hip Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Hip Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Knee Lt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MRI Knee Rt WO Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MR Lower Ext Joint Lt WO IV Cont | $3,498.00 | $3,498.00 | $205.43–$3,498.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye - MR Lower Ext Joint Rt WO IV Cont | $3,601.00 | $3,601.00 | $205.43–$3,601.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Hip Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Knee Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Ankle Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Ankle Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Hip Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Knee Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | 9% below | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Hip Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Knee Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Ankle Left W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Ankle Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Hip Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, Joint of Leg. Combo - MR Knee Right W and WO IV Contrast | $3,812.00 | $3,812.00 | $383.34–$3,812.00 | — | — |
| MRI of the abdomen without contrast CPT 74181 HC MRI, Abdomen (MRI) - MRI Abdomen WO Contrast Mrcp | $4,145.00 | $4,145.00 | $194.69–$4,145.00 | 27% above | — |
| MRI of the abdomen without contrast CPT 74181 HC MRI, Abdomen (MRI) - MRI Abdomen WO Contrast | $4,145.00 | $4,145.00 | $194.69–$4,145.00 | 27% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, Abdomen (MRI) - MRI Abdomen WO Contrast | $4,145.00 | $4,145.00 | $194.69–$4,145.00 | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, Abdomen (MRI) - MRI Abdomen WO Contrast Mrcp | $4,145.00 | $4,145.00 | $194.69–$4,145.00 | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen W WO Contrast Mrcp | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | 10% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen W WO Contrast | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | 10% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen Renal W WO Contrast | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | 10% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen Renal W WO Contrast | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen W WO Contrast | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | — | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, Abdomen, Combo - MRI Abdomen W WO Contrast Mrcp | $4,807.00 | $4,807.00 | $337.69–$4,807.00 | — | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain - MRI Brain WO Contrast | $3,822.00 | $3,822.00 | $196.37–$3,822.00 | 22% above | — |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain - MR Pituitary WO IV Contrast | $3,822.00 | $3,822.00 | $196.37–$3,822.00 | 22% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain - MR Pituitary WO IV Contrast | $3,822.00 | $3,822.00 | $196.37–$3,822.00 | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain - MRI Brain WO Contrast | $3,822.00 | $3,822.00 | $196.37–$3,822.00 | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Combo - MRI Brain W WO Contrast | $4,954.00 | $4,954.00 | $318.56–$4,954.00 | 15% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Combo - MR Pituitary W/WO IV Contrast | $4,954.00 | $4,954.00 | $318.56–$4,954.00 | 15% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain Combo - MRI Brain W WO Contrast | $4,954.00 | $4,954.00 | $318.56–$4,954.00 | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain Combo - MR Pituitary W/WO IV Contrast | $4,954.00 | $4,954.00 | $318.56–$4,954.00 | — | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast | $4,163.00 | $4,163.00 | $192.68–$4,163.00 | 27% above | — |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, Lumbar Spine - MRI Complete Spine WO Contrast | $4,163.00 | $4,163.00 | $192.68–$4,163.00 | 27% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, Lumbar Spine - MRI Complete Spine WO Contrast | $4,163.00 | $4,163.00 | $192.68–$4,163.00 | — | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, Lumbar Spine - MRI Lumbar Spine WO Contrast | $4,163.00 | $4,163.00 | $192.68–$4,163.00 | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, Lumbar Spine Combo - MRI Lumbar Spine W WO Contrast | $4,722.00 | $4,722.00 | $319.90–$4,722.00 | 7% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, Lumbar Spine Combo - MRI Lumbar Spine W WO Contrast | $4,722.00 | $4,722.00 | $319.90–$4,722.00 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, Dorsal Spine - MRI Thoracic Spine WO Contrast | $3,874.00 | $3,874.00 | $191.33–$3,874.00 | 18% above | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, Dorsal Spine - MRI Complete Spine WO Contrast | $3,874.00 | $3,874.00 | $191.33–$3,874.00 | 18% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, Dorsal Spine - MRI Complete Spine WO Contrast | $3,874.00 | $3,874.00 | $191.33–$3,874.00 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, Dorsal Spine - MRI Thoracic Spine WO Contrast | $3,874.00 | $3,874.00 | $191.33–$3,874.00 | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, Cerv Spine Combo - MRI Cervical Spine W WO Contrast | $4,768.00 | $4,768.00 | $319.56–$4,768.00 | 11% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI, Cerv Spine Combo - MRI Cervical Spine W WO Contrast | $4,768.00 | $4,768.00 | $319.56–$4,768.00 | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, Cerv Spine - MRI Cervical Spine WO Contrast | $3,753.00 | $3,753.00 | $191.67–$3,753.00 | 15% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, Cerv Spine - MRI Cervical Spine WO Contrast | $3,753.00 | $3,753.00 | $191.67–$3,753.00 | — | — |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI, Pelvis, Combo - MRI Pelvis W WO Contrast | $4,683.00 | $4,683.00 | $336.01–$4,683.00 | 9% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI, Pelvis, Combo - MRI Pelvis W WO Contrast | $4,683.00 | $4,683.00 | $336.01–$4,683.00 | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI, Pelvis, W/O Contrast - MRI Pelvis WO Contrast | $3,789.00 | $3,789.00 | $228.59–$3,789.00 | 5% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI, Pelvis, W/O Contrast - MRI Pelvis WO Contrast | $3,789.00 | $3,789.00 | $228.59–$3,789.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Wrist Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Shoulder Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Shoulder Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Elbow Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Elbow Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, Joint Upper Extrem - MR Wrist Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | 11% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Shoulder Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Elbow Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Elbow Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Wrist Left WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Wrist Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, Joint Upper Extrem - MR Shoulder Right WO IV Contrast | $3,629.00 | $3,629.00 | $206.10–$3,629.00 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Radex Spine Cervical 4 or 5 Views - Xr Cervical Spine Comp 4-5 Views | $491.00 | $491.00 | $55.39–$491.00 | 8% below | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Radex Spine Cervical 4 or 5 Views - Xr Cervical Spine Comp 4-5 Views | $491.00 | $491.00 | $55.39–$491.00 | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck Tissue Contrast - CT Soft Tissue Neck W Contrast | $3,808.00 | $3,808.00 | $184.29–$3,808.00 | 51% above | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck Tissue Contrast - CT Soft Tissue Neck W Contrast | $3,808.00 | $3,808.00 | $184.29–$3,808.00 | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Scan,Soft Tissue Neck,W/O Contrast - CT Soft Tissue Neck WO Cont | $3,959.00 | $3,959.00 | $150.38–$3,959.00 | 94% above | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Scan,Soft Tissue Neck,W/O Contrast - CT Soft Tissue Neck WO Cont | $3,959.00 | $3,959.00 | $150.38–$3,959.00 | — | — |
| Neck soft tissue X-ray CPT 70360 HC X-Ray Neck Soft Tissue - Xr Neck Soft Tissue | $295.00 | $295.00 | $31.22–$295.00 | 7% below | — |
| Neck soft tissue X-ray inpatient CPT 70360 HC X-Ray Neck Soft Tissue - Xr Neck Soft Tissue | $295.00 | $295.00 | $31.22–$295.00 | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Ht Muscle Image Spect Mult - NM Heart Perfusion Spect Stress & Rest | $3,776.00 | $3,776.00 | $430.00–$3,776.00 | 7% below | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Ht Muscle Image Spect Mult - NM Heart Perfusion Spect Stress & Rest | $3,776.00 | $3,776.00 | $430.00–$3,776.00 | — | — |
| Pelvic CT scan without contrast CPT 72192 HC CT Scan,Pelvis,W/O Contrast - CT Pelvis WO Contrast | $2,897.00 | $2,897.00 | $133.26–$2,897.00 | 50% above | — |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT Scan,Pelvis,W/O Contrast - CT Pelvis WO Contrast | $2,897.00 | $2,897.00 | $133.26–$2,897.00 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC Sono Pelvis Limited - US Pelvis Limited Bladder | $412.00 | $412.00 | $51.36–$412.00 | 10% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC Sono Pelvis Limited - US Pelvis Limited | $512.00 | $512.00 | $51.36–$512.00 | 12% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC Sono Pelvis Limited - US Pelvis Limited Bladder | $412.00 | $412.00 | $51.36–$412.00 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC Sono Pelvis Limited - US Pelvis Limited | $512.00 | $512.00 | $51.36–$512.00 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC Echo,Pelvic (Nonobstetric) - US Pelvis | $764.00 | $764.00 | $105.74–$764.00 | 23% below | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC Echo,Pelvic (Nonobstetric) - US Pelvis | $764.00 | $764.00 | $105.74–$764.00 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 Wks Sngl Fetus - US OB 14+ Weeks Single or First Gest | $865.00 | $865.00 | $136.62–$865.00 | 9% above | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 Wks Sngl Fetus - US OB 14+ Weeks Single or First Gest | $865.00 | $865.00 | $136.62–$865.00 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 Wks Single Fetus - US OB < 14 Weeks Single or First Gest | $512.00 | $512.00 | $117.49–$512.00 | 19% below | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 Wks Single Fetus - US OB < 14 Weeks Single or First Gest | $512.00 | $512.00 | $117.49–$512.00 | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US Limited Fetus(S) - US OB Limited 1+ Fetuses | $427.00 | $427.00 | $81.90–$427.00 | 14% below | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US Limited Fetus(S) - US OB Limited 1+ Fetuses | $427.00 | $427.00 | $81.90–$427.00 | — | — |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right | $334.00 | $334.00 | $36.25–$334.00 | at median | — |
| Rib X-ray, one side, 2 views one side CPT 71100 HC X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Left | $334.00 | $334.00 | $36.25–$334.00 | at median | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right | $334.00 | $334.00 | $36.25–$334.00 | — | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Left | $334.00 | $334.00 | $36.25–$334.00 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior | $463.00 | $463.00 | $41.96–$463.00 | 2% below | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Rt W/ Chest Anteroposterior | $463.00 | $463.00 | $41.96–$463.00 | 2% below | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior | $463.00 | $463.00 | $41.96–$463.00 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Rt W/ Chest Anteroposterior | $463.00 | $463.00 | $41.96–$463.00 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Left | $555.00 | $555.00 | $126.89–$555.00 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Right | $555.00 | $555.00 | $126.89–$555.00 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral | $626.00 | $626.00 | $126.89–$626.00 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Left | $555.00 | $555.00 | $126.89–$555.00 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Right | $555.00 | $555.00 | $126.89–$555.00 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral | $626.00 | $626.00 | $126.89–$626.00 | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right | $303.00 | $303.00 | $35.92–$303.00 | 12% below | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Left | $303.00 | $303.00 | $35.92–$303.00 | 12% below | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right | $303.00 | $303.00 | $35.92–$303.00 | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Left | $303.00 | $303.00 | $35.92–$303.00 | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views | $377.00 | $377.00 | $37.93–$377.00 | 7% below | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views | $377.00 | $377.00 | $37.93–$377.00 | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 HC X-Ray Skull <4 Vw - Xr Skull 1-3 Views | $377.00 | $377.00 | $35.92–$377.00 | 9% below | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC X-Ray Skull <4 Vw - Xr Skull 1-3 Views | $377.00 | $377.00 | $35.92–$377.00 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $6,184.00 | $6,184.00 | $677.06–$6,184.00 | 42% above | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysom 6/>Yrs Sleep 4/> Addl Param Attnd | $6,184.00 | $6,184.00 | $677.06–$6,184.00 | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech | $674.00 | $674.00 | $120.84–$674.00 | 5% below | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech | $674.00 | $674.00 | $120.84–$674.00 | — | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt | $334.00 | $334.00 | $35.92–$334.00 | 6% above | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Rt | $334.00 | $334.00 | $35.92–$334.00 | 6% above | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt | $334.00 | $334.00 | $35.92–$334.00 | — | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Rt | $334.00 | $334.00 | $35.92–$334.00 | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Scan,Thoracic Spine,W/O Contrast - CT Thoracic Spine WO Contrast | $3,274.00 | $3,274.00 | $130.91–$3,274.00 | 44% above | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Scan,Thoracic Spine,W/O Contrast - CT Thoracic Spine WO Contrast | $3,274.00 | $3,274.00 | $130.91–$3,274.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-Ray Toe(S) - Xr Toes 2+ Views Right | $246.00 | $246.00 | $28.87–$246.00 | 1% below | — |
| Toe X-ray, 2 or more views one side CPT 73660 HC X-Ray Toe(S) - Xr Toes 2+ Views Left | $246.00 | $246.00 | $28.87–$246.00 | 1% below | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-Ray Toe(S) - Xr Toes 2+ Views Right | $246.00 | $246.00 | $28.87–$246.00 | — | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC X-Ray Toe(S) - Xr Toes 2+ Views Left | $246.00 | $246.00 | $28.87–$246.00 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 HC Echography,Transvaginal - US Pelvis Transvaginal | $216.00 | $216.00 | $118.16–$216.00 | 63% below | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC Echography,Transvaginal - US Pelvis Transvaginal | $216.00 | $216.00 | $118.16–$216.00 | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US Obstetric - US OB Transvaginal | $609.00 | $609.00 | $93.32–$609.00 | at median | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC Transvaginal US Obstetric - US OB Transvaginal | $609.00 | $609.00 | $93.32–$609.00 | — | — |
| Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen Complete | $911.00 | $911.00 | $114.80–$911.00 | 18% below | — |
| Ultrasound of the abdomen, complete CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen | $911.00 | $911.00 | $114.80–$911.00 | 18% below | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen | $911.00 | $911.00 | $114.80–$911.00 | — | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, Abdom,B-Scan &/or Real Time,Complete - US Abdomen Complete | $911.00 | $911.00 | $114.80–$911.00 | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 HC Echo,Scrotum & Contents - US Scrotum | $1,005.00 | $1,005.00 | $99.02–$1,005.00 | 22% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC Echo,Scrotum & Contents - US Scrotum | $1,005.00 | $1,005.00 | $99.02–$1,005.00 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, Head/Neck Tissues,Real Time - US Thyroid | $696.00 | $696.00 | $109.09–$696.00 | 14% below | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, Head/Neck Tissues,Real Time - US Head Neck Soft Tissue | $899.00 | $899.00 | $109.09–$899.00 | 11% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, Head/Neck Tissues,Real Time - US Thyroid | $696.00 | $696.00 | $109.09–$696.00 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, Head/Neck Tissues,Real Time - US Head Neck Soft Tissue | $899.00 | $899.00 | $109.09–$899.00 | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-Ray Upper GI Delay W/O Kub - Fl Upper GI Without Kub | $980.00 | $980.00 | $122.52–$980.00 | at median | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-Ray Upper GI Delay W/O Kub - Fl Upper GI Without Kub | $980.00 | $980.00 | $122.52–$980.00 | — | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-Ray Humerus - Xr Humerus Left | $289.00 | $289.00 | $32.22–$289.00 | 2% below | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC X-Ray Humerus - Xr Humerus Right | $289.00 | $289.00 | $32.22–$289.00 | 2% below | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-Ray Humerus - Xr Humerus Right | $289.00 | $289.00 | $32.22–$289.00 | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC X-Ray Humerus - Xr Humerus Left | $289.00 | $289.00 | $32.22–$289.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Extrem Venous,Uni or Ltd - Upper Extrem Superficial Vein Map | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | 5% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Extrem Venous,Uni or Ltd - Lower Extrem Superficial Vein Map | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | 5% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Vasc Duplex Extrem Venous,Uni or Ltd | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | 5% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Pbb Duplex Extrem Venous,Uni or Ltd | $1,436.00 | $1,436.00 | $116.81–$1,436.00 | 47% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Extremity Study - Rt US Veins Unilateral | $1,032.00 | $1,032.00 | $116.81–$1,032.00 | 6% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vascular Doppler & Reflux Unilateral | $1,465.00 | $1,465.00 | $116.81–$1,465.00 | 50% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Vasc Duplex Extrem Venous,Uni or Ltd | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Duplex Extrem Venous,Uni or Ltd - Upper Extrem Superficial Vein Map | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Duplex Extrem Venous,Uni or Ltd - Lower Extrem Superficial Vein Map | $1,022.00 | $1,022.00 | $116.81–$1,022.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Pbb Duplex Extrem Venous,Uni or Ltd | $1,436.00 | $1,436.00 | $116.81–$1,436.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Extremity Study - Rt US Veins Unilateral | $1,032.00 | $1,032.00 | $116.81–$1,032.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vascular Doppler & Reflux Unilateral | $1,465.00 | $1,465.00 | $116.81–$1,465.00 | — | — |
| Wrist X-ray, 2 views one side CPT 73100 HC X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Left | $285.00 | $285.00 | $34.57–$285.00 | 19% above | — |
| Wrist X-ray, 2 views one side CPT 73100 HC X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right | $285.00 | $285.00 | $34.57–$285.00 | 19% above | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right | $285.00 | $285.00 | $34.57–$285.00 | — | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Left | $285.00 | $285.00 | $34.57–$285.00 | — | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right | $294.00 | $294.00 | $42.97–$294.00 | 1% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Left | $294.00 | $294.00 | $42.97–$294.00 | 1% below | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Left | $294.00 | $294.00 | $42.97–$294.00 | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right | $294.00 | $294.00 | $42.97–$294.00 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views - Xr Hip 2 or 3 Vw Right | $339.00 | $339.00 | $49.01–$339.00 | 10% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views - Xr Hip 2 or 3 Vw Left | $339.00 | $339.00 | $49.01–$339.00 | 10% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views - Xr Hip 2 or 3 Vw Left | $339.00 | $339.00 | $49.01–$339.00 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views - Xr Hip 2 or 3 Vw Right | $339.00 | $339.00 | $49.01–$339.00 | — | — |
| X-ray of the abdomen, 1 view CPT 74018 HC Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View | $265.00 | $265.00 | $29.88–$265.00 | 17% below | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View | $265.00 | $265.00 | $29.88–$265.00 | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-Ray Ankle 2 Vw - Xr Ankle 2 Views Left | $285.00 | $285.00 | $32.56–$285.00 | 2% above | — |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-Ray Ankle 2 Vw - Xr Ankle 2 Views Right | $285.00 | $285.00 | $32.56–$285.00 | 2% above | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-Ray Ankle 2 Vw - Xr Ankle 2 Views Right | $285.00 | $285.00 | $32.56–$285.00 | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-Ray Ankle 2 Vw - Xr Ankle 2 Views Left | $285.00 | $285.00 | $32.56–$285.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-Ray Exam of Finger(S) - Xr Fingers 2+ Views Left | $238.00 | $238.00 | $39.61–$238.00 | at median | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-Ray Exam of Finger(S) - Xr Fingers 2+ Views Right | $238.00 | $238.00 | $39.61–$238.00 | at median | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-Ray Exam of Finger(S) - Xr Fingers 2+ Views Left | $238.00 | $238.00 | $39.61–$238.00 | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-Ray Exam of Finger(S) - Xr Fingers 2+ Views Right | $238.00 | $238.00 | $39.61–$238.00 | — | — |
| X-ray of the foot, 2 views one side CPT 73620 HC X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right | $285.00 | $285.00 | $28.87–$285.00 | 2% above | — |
| X-ray of the foot, 2 views one side CPT 73620 HC X-Ray Foot 2 Vw - Xr Foot 1-2 Views Left | $285.00 | $285.00 | $28.87–$285.00 | 2% above | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-Ray Foot 2 Vw - Xr Foot 1-2 Views Left | $285.00 | $285.00 | $28.87–$285.00 | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right | $285.00 | $285.00 | $28.87–$285.00 | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right | $294.00 | $294.00 | $34.24–$294.00 | 2% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-Ray Foot 3+ Vw - Xr Foot 3+ Views Left | $294.00 | $294.00 | $34.24–$294.00 | 2% above | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-Ray Foot 3+ Vw - Xr Foot 3+ Views Left | $294.00 | $294.00 | $34.24–$294.00 | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right | $294.00 | $294.00 | $34.24–$294.00 | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-Ray Hand 3+ Vw - Xr Hand 3+ Views Left | $340.00 | $340.00 | $38.27–$340.00 | 13% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right | $340.00 | $340.00 | $38.27–$340.00 | 13% above | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-Ray Hand 3+ Vw - Xr Hand 3+ Views Left | $340.00 | $340.00 | $38.27–$340.00 | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right | $340.00 | $340.00 | $38.27–$340.00 | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views Right | $294.00 | $294.00 | $34.57–$294.00 | 6% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views Left | $294.00 | $294.00 | $34.57–$294.00 | 6% above | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views Right | $294.00 | $294.00 | $34.57–$294.00 | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views Left | $294.00 | $294.00 | $34.57–$294.00 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views | $392.00 | $392.00 | $40.62–$392.00 | 2% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views | $392.00 | $392.00 | $40.62–$392.00 | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbar W Obliques | $575.00 | $575.00 | $53.71–$575.00 | 1% below | — |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $582.00 | $582.00 | $53.71–$582.00 | at median | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine Lumbar W Obliques | $575.00 | $575.00 | $53.71–$575.00 | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $582.00 | $582.00 | $53.71–$582.00 | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views | $392.00 | $392.00 | $33.23–$392.00 | 6% above | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views | $392.00 | $392.00 | $33.23–$392.00 | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-Ray Nasal Bones - Xr Nasal Bones | $274.00 | $274.00 | $37.60–$274.00 | 13% below | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-Ray Nasal Bones - Xr Nasal Bones | $274.00 | $274.00 | $37.60–$274.00 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Radex Spine Cervical 2 or 3 Views - Xr Cervical Spine 1 View | $389.00 | $389.00 | $39.95–$389.00 | 5% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Radex Spine Cervical 2 or 3 Views - Xr Cervical Spine 2-3 Views | $389.00 | $389.00 | $39.95–$389.00 | 5% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Radex Spine Cervical 2 or 3 Views - Xr Cervical Spine 1 View | $389.00 | $389.00 | $39.95–$389.00 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Radex Spine Cervical 2 or 3 Views - Xr Cervical Spine 2-3 Views | $389.00 | $389.00 | $39.95–$389.00 | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-Ray Pelvis 1/2 Vw - Xr Pelvis 1-2 Views | $323.00 | $323.00 | $28.20–$323.00 | 2% above | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-Ray Pelvis 1/2 Vw - Xr Pelvis 1-2 Views | $323.00 | $323.00 | $28.20–$323.00 | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views | $388.00 | $388.00 | $32.22–$388.00 | 21% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views | $388.00 | $388.00 | $32.22–$388.00 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC Assay of Acth - Acth | $416.00 | $416.00 | $33.41–$416.00 | 138% above | — |
| ACTH blood test inpatient CPT 82024 HC Assay of Acth - Acth | $416.00 | $416.00 | $33.41–$416.00 | — | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Transferase Alanine Amino (Alt) (Sgpt) - Alt (Sgpt) | $39.00 | $39.00 | $4.58–$39.00 | 46% below | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Transferase Alanine Amino (Alt) (Sgpt) - Alt (Sgpt) | $39.00 | $39.00 | $4.58–$39.00 | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase Aspartate Amino (Ast) (Sgot) - Ast (Sgot) | $92.00 | $92.00 | $4.48–$92.00 | 23% above | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Transferase Aspartate Amino (Ast) (Sgot) - Ast (Sgot) | $92.00 | $92.00 | $4.48–$92.00 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Hepatitis Panel,Acute - Bundled Charge | $412.00 | $412.00 | $41.20–$412.00 | 55% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Hepatitis Panel,Acute - Bundled Charge | $412.00 | $412.00 | $41.20–$412.00 | — | — |
| Albumin blood test CPT 82040 HC Assay of Serum Albumin - Albumin | $82.00 | $82.00 | $4.28–$82.00 | 33% above | — |
| Albumin blood test inpatient CPT 82040 HC Assay of Serum Albumin - Albumin | $82.00 | $82.00 | $4.28–$82.00 | — | — |
| Aldosterone blood test CPT 82088 HC Assay of Aldosterone - Aldosterone | $193.00 | $193.00 | $35.25–$193.00 | 79% above | — |
| Aldosterone blood test inpatient CPT 82088 HC Assay of Aldosterone - Aldosterone | $193.00 | $193.00 | $35.25–$193.00 | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Assay Alkal Phosphatase - Alkaline Phosphatase | $82.00 | $82.00 | $4.48–$82.00 | 13% above | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Assay Alkal Phosphatase - Alkaline Phosphatase | $82.00 | $82.00 | $4.48–$82.00 | — | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige Crude Allergen Extract Each | $13.00 | $13.00 | $4.52–$13.00 | 62% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Sesame Seed Ige | $22.00 | $22.00 | $4.52–$22.00 | 36% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Wheat Ige | $23.00 | $23.00 | $4.52–$23.00 | 33% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Walnut Ige | $23.00 | $23.00 | $4.52–$23.00 | 33% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spec Ige Crude Allergen Extract Each - Food Panel | $29.00 | $29.00 | $4.52–$29.00 | 16% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Milk (Cows) Allergen Reflex to Components | $36.00 | $36.00 | $4.52–$36.00 | 5% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige | $39.00 | $39.00 | $4.52–$39.00 | 13% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Allspice Ige | $40.00 | $40.00 | $4.52–$40.00 | 16% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Goose Feathers | $48.00 | $48.00 | $4.52–$48.00 | 40% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Hazelnut/Filbert Ige | $49.00 | $49.00 | $4.52–$49.00 | 42% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Almonds Ige | $51.00 | $51.00 | $4.52–$51.00 | 48% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Coconut Ige | $54.00 | $54.00 | $4.52–$54.00 | 57% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Milk Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Oat Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Yeast, Baker's Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Tomato Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Scallop Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Onion Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Orange Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Barley Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Cashew Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Food: Cacao | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Chicken, Serum Proteins Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Peanut Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Potato Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Codfish Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Corn Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Egg Yolk Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Pork Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Shrimp Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Egg White Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Soybean Ige | $69.00 | $69.00 | $4.52–$69.00 | 101% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Dog Dander | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Aspergillus Fumagatus Ige | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen House Dust: Hollister Ige | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Cladosporium Herbarum Ige | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Microorganism: Alternaria Alternata | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Mite: Dermatophagoides Pteronyssinus | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Microorganism: Penicillium Chrysogenum | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Mite: Dermatophagoides Farinae | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Cat Hair/Dander,Stan | $75.00 | $75.00 | $4.52–$75.00 | 118% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec Ige - Allergen Honeybee Venom, Ige, Serum | $77.00 | $77.00 | $4.52–$77.00 | 124% above | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige Crude Allergen Extract Each | $13.00 | $13.00 | $4.52–$13.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Sesame Seed Ige | $22.00 | $22.00 | $4.52–$22.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Wheat Ige | $23.00 | $23.00 | $4.52–$23.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Walnut Ige | $23.00 | $23.00 | $4.52–$23.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Spec Ige Crude Allergen Extract Each - Food Panel | $29.00 | $29.00 | $4.52–$29.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Milk (Cows) Allergen Reflex to Components | $36.00 | $36.00 | $4.52–$36.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige | $39.00 | $39.00 | $4.52–$39.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Allspice Ige | $40.00 | $40.00 | $4.52–$40.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Goose Feathers | $48.00 | $48.00 | $4.52–$48.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Hazelnut/Filbert Ige | $49.00 | $49.00 | $4.52–$49.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Almonds Ige | $51.00 | $51.00 | $4.52–$51.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Coconut Ige | $54.00 | $54.00 | $4.52–$54.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Barley Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Soybean Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Shrimp Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Pork Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Orange Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Onion Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Scallop Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Yeast, Baker's Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Oat Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Tomato Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Peanut Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Potato Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Milk Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Egg White Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Egg Yolk Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Corn Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Codfish Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Chicken, Serum Proteins Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Food: Cacao | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Cashew Ige | $69.00 | $69.00 | $4.52–$69.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Aspergillus Fumagatus Ige | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Microorganism: Penicillium Chrysogenum | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Microorganism: Alternaria Alternata | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen House Dust: Hollister Ige | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Dog Dander | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Cat Hair/Dander,Stan | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Mite: Dermatophagoides Farinae | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Mite: Dermatophagoides Pteronyssinus | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Cladosporium Herbarum Ige | $75.00 | $75.00 | $4.52–$75.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec Ige - Allergen Honeybee Venom, Ige, Serum | $77.00 | $77.00 | $4.52–$77.00 | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker | $152.00 | $152.00 | $14.51–$152.00 | 14% above | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker | $152.00 | $152.00 | $14.51–$152.00 | — | — |
| Ammonia blood test CPT 82140 HC Assay of Ammonia - Ammonia | $200.00 | $200.00 | $12.60–$200.00 | 18% above | — |
| Ammonia blood test inpatient CPT 82140 HC Assay of Ammonia - Ammonia | $200.00 | $200.00 | $12.60–$200.00 | — | — |
| Amylase blood test CPT 82150 HC Assay of Amylase - Amylase Body Fluid | $174.00 | $174.00 | $5.61–$174.00 | 73% above | — |
| Amylase blood test CPT 82150 HC Assay of Amylase - Amylase Blood | $181.00 | $181.00 | $5.61–$181.00 | 80% above | — |
| Amylase blood test inpatient CPT 82150 HC Assay of Amylase - Amylase Body Fluid | $174.00 | $174.00 | $5.61–$174.00 | — | — |
| Amylase blood test inpatient CPT 82150 HC Assay of Amylase - Amylase Blood | $181.00 | $181.00 | $5.61–$181.00 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Cirullinated Peptide Antibody - Cyclic Citrul Peptide Antibdy | $184.00 | $184.00 | $11.20–$184.00 | 28% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Cirullinated Peptide Antibody - Cyclic Citrul Peptide Antibdy | $184.00 | $184.00 | $11.20–$184.00 | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies - Ana (Antinuclear Antibodies) | $43.00 | $43.00 | $10.46–$43.00 | 41% below | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Antinuclear Antibodies - Ana (Antinuclear Antibodies) | $43.00 | $43.00 | $10.46–$43.00 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide - B-Type Natriuretic Peptide (Bnp) | $332.00 | $332.00 | $33.96–$332.00 | 56% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriuretic Peptide - B-Type Natriuretic Peptide (Bnp) | $332.00 | $332.00 | $33.96–$332.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture, Wound Sputum, Ms | $36.00 | $36.00 | $7.46–$36.00 | 58% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture Bacteria Excpt Urine Blood/Stool Aerobic Isol | $52.00 | $52.00 | $7.46–$52.00 | 39% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture, Wound Sputum, Ms | $36.00 | $36.00 | $7.46–$36.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture Bacteria Excpt Urine Blood/Stool Aerobic Isol | $52.00 | $52.00 | $7.46–$52.00 | — | — |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel Calcium Total | $157.00 | $157.00 | $7.32–$157.00 | 10% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel Calcium Total | $157.00 | $157.00 | $7.32–$157.00 | — | — |
| Bilirubin blood test, total CPT 82247 HC Bilirubin Total - Bilirubin Total | $105.00 | $105.00 | $4.34–$105.00 | 26% above | — |
| Bilirubin blood test, total CPT 82247 HC Bilirubin Total - Bilirubin Neonatal | $176.00 | $176.00 | $4.34–$176.00 | 112% above | — |
| Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin Total - Bilirubin Total | $105.00 | $105.00 | $4.34–$105.00 | — | — |
| Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin Total - Bilirubin Neonatal | $176.00 | $176.00 | $4.34–$176.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path,Level IV - Lab Surg Path,Level IV | $399.00 | $399.00 | $70.49–$399.00 | 148% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path,Level IV - Lab Surg Path,Level IV | $399.00 | $399.00 | $70.49–$399.00 | — | — |
| Blood culture for bacteria CPT 87040 HC Blood Culture for Bacteria | $101.00 | $101.00 | $8.93–$101.00 | 38% below | — |
| Blood culture for bacteria inpatient CPT 87040 HC Blood Culture for Bacteria | $101.00 | $101.00 | $8.93–$101.00 | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Chg Collection Venous Blood,Venipuncture | $38.00 | $38.00 | $9.09–$38.00 | 37% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Chg Collection Venous Blood,Venipuncture | $38.00 | $38.00 | $9.09–$38.00 | — | — |
| Blood glucose (sugar) test CPT 82947 HC Assay Quantitative,Blood Glucose - Glucose Fasting | $94.00 | $94.00 | $3.40–$94.00 | 59% above | — |
| Blood glucose (sugar) test CPT 82947 HC Assay Quantitative,Blood Glucose - Gtt Fasting | $94.00 | $94.00 | $3.40–$94.00 | 59% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose Quantitative Blood Xcpt Reagent Strip | $94.00 | $94.00 | $3.40–$94.00 | 59% above | — |
| Blood glucose (sugar) test CPT 82947 HC Assay Quantitative,Blood Glucose - Glucose Random | $94.00 | $94.00 | $3.40–$94.00 | 59% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 HC Assay Quantitative,Blood Glucose - Glucose Fasting | $94.00 | $94.00 | $3.40–$94.00 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HC Assay Quantitative,Blood Glucose - Gtt Fasting | $94.00 | $94.00 | $3.40–$94.00 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Quantitative Blood Xcpt Reagent Strip | $94.00 | $94.00 | $3.40–$94.00 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 HC Assay Quantitative,Blood Glucose - Glucose Random | $94.00 | $94.00 | $3.40–$94.00 | — | — |
| Blood lead test CPT 83655 HC Assay of Lead - Lead Blood | $63.00 | $63.00 | $10.48–$63.00 | 13% above | — |
| Blood lead test CPT 83655 HC Assay of Lead - Lead, Capillary Blood | $63.00 | $63.00 | $10.48–$63.00 | 13% above | — |
| Blood lead test inpatient CPT 83655 HC Assay of Lead - Lead, Capillary Blood | $63.00 | $63.00 | $10.48–$63.00 | — | — |
| Blood lead test inpatient CPT 83655 HC Assay of Lead - Lead Blood | $63.00 | $63.00 | $10.48–$63.00 | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Chorionic Gonadotropin, Qual - Hcg Qualitative Urine | $152.00 | $152.00 | $6.50–$152.00 | 30% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic Gonadotropin, Qual - Hcg Qualitative Serum | $152.00 | $152.00 | $6.50–$152.00 | 30% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Chorionic Gonadotropin, Qual - Hcg Qualitative Urine | $152.00 | $152.00 | $6.50–$152.00 | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic Gonadotropin, Qual - Hcg Qualitative Serum | $152.00 | $152.00 | $6.50–$152.00 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Serologic Abo | $56.00 | $56.00 | $2.59–$56.00 | at median | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Serologic Abo - Abo/Rh Type | $92.00 | $92.00 | $2.59–$92.00 | 64% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Serologic Abo | $56.00 | $56.00 | $2.59–$56.00 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Serologic Abo - Abo/Rh Type | $92.00 | $92.00 | $2.59–$92.00 | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 HC Assay Urea Nitrogen, Quan - Blood Urea Nitrogen | $82.00 | $82.00 | $3.42–$82.00 | 31% above | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Assay Urea Nitrogen, Quan - Blood Urea Nitrogen | $82.00 | $82.00 | $3.42–$82.00 | — | — |
| C-peptide blood test CPT 84681 HC Assay of C-Peptide - C-Peptide | $335.00 | $335.00 | $18.00–$335.00 | 125% above | — |
| C-peptide blood test inpatient CPT 84681 HC Assay of C-Peptide - C-Peptide | $335.00 | $335.00 | $18.00–$335.00 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein - C-Reactive Protein | $95.00 | $95.00 | $4.48–$95.00 | 14% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein - C-Reactive Protein | $95.00 | $95.00 | $4.48–$95.00 | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Amplified Probe | $101.00 | $101.00 | $32.24–$101.00 | 51% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Amplified Probe - Toxin a & B Gene | $131.00 | $131.00 | $32.24–$131.00 | 37% below | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C Diff Amplified Probe | $101.00 | $101.00 | $32.24–$101.00 | — | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C Diff Amplified Probe - Toxin a & B Gene | $131.00 | $131.00 | $32.24–$131.00 | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9 | $259.00 | $259.00 | $18.00–$259.00 | 124% above | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Immunoassay, Tumor Antigen, Ca 19-9 - Cancer Antigen 19-9 | $259.00 | $259.00 | $18.00–$259.00 | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay, Tumor Antigen, Ca 125 - Ca 125 | $260.00 | $260.00 | $18.00–$260.00 | 39% above | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Immunoassay, Tumor Antigen, Ca 125 - Ca 125 | $260.00 | $260.00 | $18.00–$260.00 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq - Sars-Cov-2 Rt Pcr | $345.00 | $345.00 | $44.38–$345.00 | 176% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq - Sars-Cov-2 Rt Pcr | $345.00 | $345.00 | $44.38–$345.00 | — | — |
| Calcium blood test, total CPT 82310 HC Assay of Calcium, Total - Calcium | $84.00 | $84.00 | $4.46–$84.00 | 11% above | — |
| Calcium blood test, total CPT 82310 HC Assay of Calcium, Total - Pth, Intact and Calcium | $84.00 | $84.00 | $4.46–$84.00 | 11% above | — |
| Calcium blood test, total inpatient CPT 82310 HC Assay of Calcium, Total - Pth, Intact and Calcium | $84.00 | $84.00 | $4.46–$84.00 | — | — |
| Calcium blood test, total inpatient CPT 82310 HC Assay of Calcium, Total - Calcium | $84.00 | $84.00 | $4.46–$84.00 | — | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen) | $169.00 | $169.00 | $16.40–$169.00 | 1% above | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen) | $169.00 | $169.00 | $16.40–$169.00 | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella-Zoster - Varicella Zoster Igm | $160.00 | $160.00 | $11.14–$160.00 | 194% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella-Zoster - Varicella Zoster Igg | $166.00 | $166.00 | $11.14–$166.00 | 205% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella-Zoster - Varicella Zoster Igm | $160.00 | $160.00 | $11.14–$160.00 | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella-Zoster - Varicella Zoster Igg | $166.00 | $166.00 | $11.14–$166.00 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr | $212.00 | $212.00 | $30.35–$212.00 | 85% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr | $212.00 | $212.00 | $30.35–$212.00 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel - Bundled Charge | $209.00 | $209.00 | $11.58–$209.00 | 94% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel - Bundled Charge | $209.00 | $209.00 | $11.58–$209.00 | — | — |
| Complete blood count (CBC) with differential CPT 85025 HC Complete Cbc & Auto Diff Wbc | $159.00 | $159.00 | $6.72–$159.00 | 48% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Complete Cbc & Auto Diff Wbc | $159.00 | $159.00 | $6.72–$159.00 | — | — |
| Complete blood count (CBC), no differential CPT 85027 HC Complete Cbc - Cbc | $106.00 | $106.00 | $5.60–$106.00 | 24% above | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Complete Cbc - Cbc | $106.00 | $106.00 | $5.60–$106.00 | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Metabolic Panel,Comprehensive | $194.00 | $194.00 | $9.13–$194.00 | 19% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Metabolic Panel,Comprehensive | $194.00 | $194.00 | $9.13–$194.00 | — | — |
| Cortisol blood test, total CPT 82533 HC Total Cortisol - Acth Stimulation 30 Minutes | $45.00 | $45.00 | $14.10–$45.00 | 51% below | — |
| Cortisol blood test, total CPT 82533 HC Total Cortisol - Acth Stimulation 1 Hour | $65.00 | $65.00 | $14.10–$65.00 | 29% below | — |
| Cortisol blood test, total CPT 82533 HC Total Cortisol - Cortisol | $110.00 | $110.00 | $14.10–$110.00 | 20% above | — |
| Cortisol blood test, total CPT 82533 Total Cortisol - Cortisol Am | $110.00 | $110.00 | $14.10–$110.00 | 20% above | — |
| Cortisol blood test, total CPT 82533 HC Total Cortisol - Cortisol Saliva | $308.00 | $308.00 | $14.10–$308.00 | 235% above | — |
| Cortisol blood test, total inpatient CPT 82533 HC Total Cortisol - Acth Stimulation 30 Minutes | $45.00 | $45.00 | $14.10–$45.00 | — | — |
| Cortisol blood test, total inpatient CPT 82533 HC Total Cortisol - Acth Stimulation 1 Hour | $65.00 | $65.00 | $14.10–$65.00 | — | — |
| Cortisol blood test, total inpatient CPT 82533 HC Total Cortisol - Cortisol | $110.00 | $110.00 | $14.10–$110.00 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Total Cortisol - Cortisol Am | $110.00 | $110.00 | $14.10–$110.00 | — | — |
| Cortisol blood test, total inpatient CPT 82533 HC Total Cortisol - Cortisol Saliva | $308.00 | $308.00 | $14.10–$308.00 | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 HC Assay of CK (Cpk) - CK | $93.00 | $93.00 | $5.63–$93.00 | 22% above | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Assay of CK (Cpk) - CK | $93.00 | $93.00 | $5.63–$93.00 | — | — |
| Creatinine blood test CPT 82565 HC Assay of Creatinine - Creatinine Serum | $87.00 | $87.00 | $4.43–$87.00 | 29% above | — |
| Creatinine blood test inpatient CPT 82565 HC Assay of Creatinine - Creatinine Serum | $87.00 | $87.00 | $4.43–$87.00 | — | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Antibody - Cytomegalovirus Igg | $71.00 | $71.00 | $12.45–$71.00 | 1% above | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Antibody - Cytomegalovirus Igg | $71.00 | $71.00 | $12.45–$71.00 | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dehydroepiandrosterone-Sulfate - Dhea-Sulfate | $304.00 | $304.00 | $19.23–$304.00 | 93% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dehydroepiandrosterone-Sulfate - Dhea-Sulfate | $304.00 | $304.00 | $19.23–$304.00 | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Analysis Profile, Comprehensive, Urine | $109.19 | $109.19 | $53.75–$109.19 | 27% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Meconium Drug Screen | $223.00 | $223.00 | $53.75–$223.00 | 48% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen | $245.00 | $245.00 | $53.75–$245.00 | 63% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Analysis Profile, Comprehensive, Urine | $109.19 | $109.19 | $53.75–$109.19 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Meconium Drug Screen | $223.00 | $223.00 | $53.75–$223.00 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen | $245.00 | $245.00 | $53.75–$245.00 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel | $161.00 | $161.00 | $6.06–$161.00 | 52% above | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel | $161.00 | $161.00 | $6.06–$161.00 | — | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg | $131.00 | $131.00 | $15.69–$131.00 | 90% above | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igm | $131.00 | $131.00 | $15.69–$131.00 | 90% above | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igm | $131.00 | $131.00 | $15.69–$131.00 | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr Capsid Vca - Epstein-Barr Virus Vca, Igg | $131.00 | $131.00 | $15.69–$131.00 | — | — |
| Estradiol blood test CPT 82670 HC Assay of Estradiol - Estradiol | $136.00 | $136.00 | $24.17–$136.00 | 7% below | — |
| Estradiol blood test CPT 82670 HC Assay of Estradiol - Estradiol High Sensitive | $171.00 | $171.00 | $24.17–$171.00 | 16% above | — |
| Estradiol blood test inpatient CPT 82670 HC Assay of Estradiol - Estradiol | $136.00 | $136.00 | $24.17–$136.00 | — | — |
| Estradiol blood test inpatient CPT 82670 HC Assay of Estradiol - Estradiol High Sensitive | $171.00 | $171.00 | $24.17–$171.00 | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Gonadotropin (Fsh) - Fsh | $149.00 | $149.00 | $16.07–$149.00 | 37% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Gonadotropin (Fsh) - Fsh | $149.00 | $149.00 | $16.07–$149.00 | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC Assay of Calprotectin Fecal | $233.00 | $233.00 | $16.98–$233.00 | 2% below | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Assay of Calprotectin Fecal | $233.00 | $233.00 | $16.98–$233.00 | — | — |
| Ferritin blood test (iron stores) CPT 82728 HC Assay of Ferritin - Ferritin | $199.00 | $199.00 | $11.79–$199.00 | 63% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Assay of Ferritin - Ferritin | $199.00 | $199.00 | $11.79–$199.00 | — | — |
| Fibrinogen blood test CPT 85384 HC Fibrinogen, Activity - Fibrinogen,Quantitative | $120.00 | $120.00 | $8.41–$120.00 | 5% above | — |
| Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen, Activity - Fibrinogen,Quantitative | $120.00 | $120.00 | $8.41–$120.00 | — | — |
| Folate (folic acid) blood test CPT 82746 HC Blood Folic Acid Serum - Folate | $160.00 | $160.00 | $12.72–$160.00 | 43% above | — |
| Folate (folic acid) blood test inpatient CPT 82746 HC Blood Folic Acid Serum - Folate | $160.00 | $160.00 | $12.72–$160.00 | — | — |
| Free T3 thyroid hormone test CPT 84481 HC Triiodothyronine Free Assay (Ft-3) - T3 Free | $180.00 | $180.00 | $14.65–$180.00 | 9% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 HC Triiodothyronine Free Assay (Ft-3) - T3 Free | $180.00 | $180.00 | $14.65–$180.00 | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Assay of Free Thyroxine - T4 Free | $66.00 | $66.00 | $7.80–$66.00 | 31% below | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC Assay of Free Thyroxine - T4 Free | $66.00 | $66.00 | $7.80–$66.00 | — | — |
| Free testosterone test CPT 84402 HC Assay of Testosterone - Testosterone Total Free | $122.00 | $122.00 | $22.03–$122.00 | 103% above | — |
| Free testosterone test inpatient CPT 84402 HC Assay of Testosterone - Testosterone Total Free | $122.00 | $122.00 | $22.03–$122.00 | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Assay of Ggt - Gamma Gt | $84.00 | $84.00 | $6.23–$84.00 | 21% above | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Assay of Ggt - Gamma Gt | $84.00 | $84.00 | $6.23–$84.00 | — | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC Hf General Health Panel - Bundled Charge | $533.00 | $533.00 | $55.12–$533.00 | 107% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel - Bundled Charge | $544.00 | $544.00 | $55.12–$544.00 | 111% above | — |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC Hf General Health Panel - Bundled Charge | $533.00 | $533.00 | $55.12–$533.00 | — | — |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC General Health Panel - Bundled Charge | $544.00 | $544.00 | $55.12–$544.00 | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Test - Gtt 1 Hour | $96.00 | $96.00 | $4.11–$96.00 | 18% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Test - Gtt 1 Hour | $96.00 | $96.00 | $4.11–$96.00 | — | — |
| Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance Test (Gtt) - Gtt 2 Hour | $96.00 | $96.00 | $11.13–$96.00 | 34% below | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tolerance Test (Gtt) - Gtt 2 Hour | $96.00 | $96.00 | $11.13–$96.00 | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.Gonorrhoeae, Dna, Amp Prob - Gc Dna Pcr | $237.00 | $237.00 | $30.35–$237.00 | 174% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.Gonorrhoeae, Dna, Amp Prob - Gc Dna Pcr | $237.00 | $237.00 | $30.35–$237.00 | — | — |
| H. pylori stool antigen test CPT 87338 HC Iaad Ia Hpylori Stool - H Pylori Antigen Stool | $240.00 | $240.00 | $12.44–$240.00 | 27% above | — |
| H. pylori stool antigen test inpatient CPT 87338 HC Iaad Ia Hpylori Stool - H Pylori Antigen Stool | $240.00 | $240.00 | $12.44–$240.00 | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv-1 Quant&Revrse Trnscrpj - Hiv Rna, Quantitative, Pcr | $513.00 | $513.00 | $73.61–$513.00 | 24% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv-1 Quant&Revrse Trnscrpj - Hiv Rna, Quantitative, Pcr | $513.00 | $513.00 | $73.61–$513.00 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv-1 Antigens W/Hiv 1 & 2 Antibody | $110.00 | $110.00 | $20.83–$110.00 | 3% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv-1 Antigens W/Hiv 1 & 2 Antibody | $110.00 | $110.00 | $20.83–$110.00 | — | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp | $128.00 | $128.00 | $30.35–$128.00 | 6% below | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp/Direct/Pcr | $128.00 | $128.00 | $30.35–$128.00 | 6% below | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp | $128.00 | $128.00 | $30.35–$128.00 | — | — |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Iadna Human Papillomavirus High-Risk Types - Hpv Dna Probe, Amp/Direct/Pcr | $128.00 | $128.00 | $30.35–$128.00 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycosylated Hemoglobin Test - POCT Glycated Hemoglobin, Total | $103.00 | $103.00 | $8.40–$103.00 | 27% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycosylated Hemoglobin Test - Hemoglobin A1c | $116.00 | $116.00 | $8.40–$116.00 | 43% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycosylated Hemoglobin Test - POCT Glycated Hemoglobin, Total | $103.00 | $103.00 | $8.40–$103.00 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycosylated Hemoglobin Test - Hemoglobin A1c | $116.00 | $116.00 | $8.40–$116.00 | — | — |
| Hemoglobin blood test CPT 85018 HC Hemoglobin - Hemoglobin | $51.00 | $51.00 | $2.05–$51.00 | 9% above | — |
| Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin - Hemoglobin | $51.00 | $51.00 | $2.05–$51.00 | — | — |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total | $90.00 | $90.00 | $10.42–$90.00 | at median | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Core Ab Test, Total - Hepatitis B Core Antibody, Total | $90.00 | $90.00 | $10.42–$90.00 | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surface Ab Test - Hepatitis B Surface Antibody | $141.00 | $141.00 | $9.29–$141.00 | 29% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hepatitis B Surface Ab Test - Hepatitis B Surface Antibody | $141.00 | $141.00 | $9.29–$141.00 | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Iaad Ia Hepatitis B Surface Antigen - Hepatitis B Surface Antigen | $141.00 | $141.00 | $8.94–$141.00 | 68% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Iaad Ia Hepatitis B Surface Antigen - Hepatitis B Surface Antigen | $141.00 | $141.00 | $8.94–$141.00 | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Ab Test - Hepatitis C Antibody | $112.00 | $112.00 | $12.34–$112.00 | 10% below | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hepatitis C Ab Test - Hepatitis C Antibody | $112.00 | $112.00 | $12.34–$112.00 | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription - Hepatitis C Bdna | $579.00 | $579.00 | $37.06–$579.00 | 127% above | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr | $603.00 | $603.00 | $37.06–$603.00 | 137% above | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription - Hepatitis C Bdna | $579.00 | $579.00 | $37.06–$579.00 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr | $603.00 | $603.00 | $37.06–$603.00 | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex Test, Type 1 - Hsv 1 Igg Antibody | $91.00 | $91.00 | $11.41–$91.00 | 3% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Herpes Simplex Test, Type 1 - Hsv 1 Igg Antibody | $91.00 | $91.00 | $11.41–$91.00 | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex Test, Type 2 - Hsv 2 Igg Antibody | $103.00 | $103.00 | $16.74–$103.00 | 9% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex Test, Type 2 - Hsv 2 Igg Antibody | $103.00 | $103.00 | $16.74–$103.00 | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein,High Sensitivity - High Sensitivity Crp | $61.00 | $61.00 | $11.20–$61.00 | 40% below | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-Reactive Protein,High Sensitivity - High Sensitivity Crp | $61.00 | $61.00 | $11.20–$61.00 | — | — |
| Homocysteine blood test CPT 83090 HC Assay of Homocystine - Homocysteine | $277.00 | $277.00 | $15.50–$277.00 | 189% above | — |
| Homocysteine blood test inpatient CPT 83090 HC Assay of Homocystine - Homocysteine | $277.00 | $277.00 | $15.50–$277.00 | — | — |
| Insulin blood test CPT 83525 HC Assay of Insulin,Total - Insulin, Fasting | $128.00 | $128.00 | $9.89–$128.00 | 21% above | — |
| Insulin blood test CPT 83525 HC Assay of Insulin,Total - Insulin, Total | $134.00 | $134.00 | $9.89–$134.00 | 26% above | — |
| Insulin blood test inpatient CPT 83525 HC Assay of Insulin,Total - Insulin, Fasting | $128.00 | $128.00 | $9.89–$128.00 | — | — |
| Insulin blood test inpatient CPT 83525 HC Assay of Insulin,Total - Insulin, Total | $134.00 | $134.00 | $9.89–$134.00 | — | — |
| Iron blood test (serum iron) CPT 83540 HC Assay of Iron - Iron | $140.00 | $140.00 | $5.60–$140.00 | 92% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 HC Assay of Iron - Iron | $140.00 | $140.00 | $5.60–$140.00 | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Test - Iron + Transferrin + Tibc | $110.00 | $110.00 | $7.56–$110.00 | 28% above | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Test - Iron + Transferrin + Tibc | $110.00 | $110.00 | $7.56–$110.00 | — | — |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel - Bundled Charge | $170.00 | $170.00 | $7.51–$170.00 | 22% above | — |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel - Bundled Charge | $170.00 | $170.00 | $7.51–$170.00 | — | — |
| LH (luteinizing hormone) test CPT 83002 HC Gonadotropin (Lh) - Luteinizing Hormone | $143.00 | $143.00 | $16.02–$143.00 | 18% below | — |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Gonadotropin (Lh) - Luteinizing Hormone | $143.00 | $143.00 | $16.02–$143.00 | — | — |
| Lactate (lactic acid) blood test CPT 83605 HC Assay of Lactic Acid - Lactate | $183.00 | $183.00 | $10.01–$183.00 | 76% above | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC Assay of Lactic Acid - Lactate | $183.00 | $183.00 | $10.01–$183.00 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase | $78.00 | $78.00 | $5.22–$78.00 | 7% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Blood | $82.00 | $82.00 | $5.22–$82.00 | 13% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Fl | $82.00 | $82.00 | $5.22–$82.00 | 13% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase | $78.00 | $78.00 | $5.22–$78.00 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Fl | $82.00 | $82.00 | $5.22–$82.00 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate (Ld) (Ldh) Enzyme - Lactate Dehydrogenase Blood | $82.00 | $82.00 | $5.22–$82.00 | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Assay of Lipase - Lipase | $196.00 | $196.00 | $5.96–$196.00 | 63% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Assay of Lipase - Lipase | $196.00 | $196.00 | $5.96–$196.00 | — | — |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $158.00 | $158.00 | $7.07–$158.00 | 14% above | — |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $158.00 | $158.00 | $7.07–$158.00 | — | — |
| Lyme disease antibody test CPT 86618 HC Lyme Disease Antibody - POCT Lyme Disease Antibodies (Borrelia Burg) | $165.00 | $165.00 | $14.73–$165.00 | 47% above | — |
| Lyme disease antibody test CPT 86618 HC Lyme Disease Antibody - Lyme Disease (Borrelia Burgdorferi), Quant | $171.00 | $171.00 | $14.73–$171.00 | 53% above | — |
| Lyme disease antibody test inpatient CPT 86618 HC Lyme Disease Antibody - POCT Lyme Disease Antibodies (Borrelia Burg) | $165.00 | $165.00 | $14.73–$165.00 | — | — |
| Lyme disease antibody test inpatient CPT 86618 HC Lyme Disease Antibody - Lyme Disease (Borrelia Burgdorferi), Quant | $171.00 | $171.00 | $14.73–$171.00 | — | — |
| Magnesium blood test CPT 83735 HC Assay of Magnesium - Magnesium Urine | $46.00 | $46.00 | $5.80–$46.00 | 33% below | — |
| Magnesium blood test CPT 83735 HC Assay of Magnesium - Magnesium RBC | $80.00 | $80.00 | $5.80–$80.00 | 16% above | — |
| Magnesium blood test CPT 83735 HC Assay of Magnesium - Magnesium 24hr Urine | $116.00 | $116.00 | $5.80–$116.00 | 69% above | — |
| Magnesium blood test CPT 83735 HC Assay of Magnesium - Magnesium | $116.00 | $116.00 | $5.80–$116.00 | 69% above | — |
| Magnesium blood test inpatient CPT 83735 HC Assay of Magnesium - Magnesium Urine | $46.00 | $46.00 | $5.80–$46.00 | — | — |
| Magnesium blood test inpatient CPT 83735 HC Assay of Magnesium - Magnesium RBC | $80.00 | $80.00 | $5.80–$80.00 | — | — |
| Magnesium blood test inpatient CPT 83735 HC Assay of Magnesium - Magnesium 24hr Urine | $116.00 | $116.00 | $5.80–$116.00 | — | — |
| Magnesium blood test inpatient CPT 83735 HC Assay of Magnesium - Magnesium | $116.00 | $116.00 | $5.80–$116.00 | — | — |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola - Rubeola Antibody Igg | $47.00 | $47.00 | $11.14–$47.00 | 41% below | — |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola - Rubeola Antibody, Igm | $53.00 | $53.00 | $11.14–$53.00 | 33% below | — |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola - Rubeola Antibody Igg | $47.00 | $47.00 | $11.14–$47.00 | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola - Rubeola Antibody, Igm | $53.00 | $53.00 | $11.14–$53.00 | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Heterophile Antibodies,Screen - Mononucleosis Screen | $82.00 | $82.00 | $4.48–$82.00 | 19% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Heterophile Antibodies,Screen - Mononucleosis Screen | $82.00 | $82.00 | $4.48–$82.00 | — | — |
| Mumps immunity blood test CPT 86735 HC Mumps - Mumps Igg Antibody | $133.00 | $133.00 | $11.29–$133.00 | 7% above | — |
| Mumps immunity blood test inpatient CPT 86735 HC Mumps - Mumps Igg Antibody | $133.00 | $133.00 | $11.29–$133.00 | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa Free | $94.00 | $94.00 | $15.91–$94.00 | 20% below | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa Free | $94.00 | $94.00 | $15.91–$94.00 | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa | $96.00 | $96.00 | $15.91–$96.00 | 28% below | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa Total and Free | $190.00 | $190.00 | $15.91–$190.00 | 43% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen,Total - Psa, Ultrasensitive | $190.00 | $190.00 | $15.91–$190.00 | 43% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen,Total - Psa | $96.00 | $96.00 | $15.91–$96.00 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen,Total - Psa, Ultrasensitive | $190.00 | $190.00 | $15.91–$190.00 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen,Total - Psa Total and Free | $190.00 | $190.00 | $15.91–$190.00 | — | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC Cytopath C/V Auto Fluid Redo - Lab Cytopat,Cer/Vag,Thin Layer,Inter | $94.00 | $94.00 | $23.02–$94.00 | 9% below | — |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Cytopath C/V Auto Fluid Redo - Lab Cytopat,Cer/Vag,Thin Layer,Inter | $94.00 | $94.00 | $23.02–$94.00 | — | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer | $65.00 | $65.00 | $17.52–$65.00 | 7% below | — |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer | $65.00 | $65.00 | $17.52–$65.00 | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Assay of Parathormone - Pth Intact | $203.00 | $203.00 | $35.71–$203.00 | 7% below | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Assay of Parathormone - Pth Intact | $203.00 | $203.00 | $35.71–$203.00 | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial (Aptt) - Plasma/Whole Blood | $114.00 | $114.00 | $5.20–$114.00 | 27% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplas Time Partial - Ptt Crrt System | $120.00 | $120.00 | $5.20–$120.00 | 34% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplas Time Partial (Aptt) - Plasma/Whole Blood | $114.00 | $114.00 | $5.20–$114.00 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplas Time Partial - Ptt Crrt System | $120.00 | $120.00 | $5.20–$120.00 | — | — |
| Phosphorus (phosphate) blood test CPT 84100 HC Assay of Inorganic Phosphorus - Phosphorus | $82.00 | $82.00 | $4.10–$82.00 | 40% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC Assay of Inorganic Phosphorus - Phosphorus | $82.00 | $82.00 | $4.10–$82.00 | — | — |
| Potassium blood test CPT 84132 HC Assay of Serum Potassium - Potassium | $82.00 | $82.00 | $4.12–$82.00 | 41% above | — |
| Potassium blood test inpatient CPT 84132 HC Assay of Serum Potassium - Potassium | $82.00 | $82.00 | $4.12–$82.00 | — | — |
| Progesterone blood test CPT 84144 HC Assay of Progesterone - Progesterone | $139.00 | $139.00 | $18.04–$139.00 | 3% below | — |
| Progesterone blood test inpatient CPT 84144 HC Assay of Progesterone - Progesterone | $139.00 | $139.00 | $18.04–$139.00 | — | — |
| Prolactin blood test CPT 84146 HC Assay of Prolactin - Prolactin | $138.00 | $138.00 | $16.76–$138.00 | at median | — |
| Prolactin blood test inpatient CPT 84146 HC Assay of Prolactin - Prolactin | $138.00 | $138.00 | $16.76–$138.00 | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Protime-Inr | $96.00 | $96.00 | $3.71–$96.00 | 158% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time - Protime-Inr, Fingerstick | $96.00 | $96.00 | $3.71–$96.00 | 158% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time - Protime-Inr | $96.00 | $96.00 | $3.71–$96.00 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time - Protime-Inr, Fingerstick | $96.00 | $96.00 | $3.71–$96.00 | — | — |
| Renin blood test CPT 84244 HC Assay of Renin - Renin Direct Assay | $193.00 | $193.00 | $19.02–$193.00 | 127% above | — |
| Renin blood test inpatient CPT 84244 HC Assay of Renin - Renin Direct Assay | $193.00 | $193.00 | $19.02–$193.00 | — | — |
| Rh blood typing CPT 86901 HC Blood Typing Serologic Rh (D) | $56.00 | $56.00 | $2.59–$56.00 | 32% above | — |
| Rh blood typing inpatient CPT 86901 HC Blood Typing Serologic Rh (D) | $56.00 | $56.00 | $2.59–$56.00 | — | — |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor, Quant - Rheumatoid Factor, Body Fluid | $45.00 | $45.00 | $4.90–$45.00 | 45% below | — |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor, Quant - Rheumatoid Factor | $68.00 | $68.00 | $4.90–$68.00 | 17% below | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor, Quant - Rheumatoid Factor, Body Fluid | $45.00 | $45.00 | $4.90–$45.00 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor, Quant - Rheumatoid Factor | $68.00 | $68.00 | $4.90–$68.00 | — | — |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella - Rubella Antibody, Igg | $47.00 | $47.00 | $12.45–$47.00 | 33% below | — |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella - Rubella Antibody, Igm | $48.00 | $48.00 | $12.45–$48.00 | 32% below | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella - Rubella Antibody, Igg | $47.00 | $47.00 | $12.45–$47.00 | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella - Rubella Antibody, Igm | $48.00 | $48.00 | $12.45–$48.00 | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC Sed Rate, Auto - Sedimentation Rate, Automated | $120.00 | $120.00 | $2.34–$120.00 | 72% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC Sed Rate, Auto - Sedimentation Rate, Automated | $120.00 | $120.00 | $2.34–$120.00 | — | — |
| Sodium blood test CPT 84295 HC Assay of Serum Sodium - Sodium | $82.00 | $82.00 | $4.16–$82.00 | 40% above | — |
| Sodium blood test inpatient CPT 84295 HC Assay of Serum Sodium - Sodium | $82.00 | $82.00 | $4.16–$82.00 | — | — |
| Stool ova and parasites exam CPT 87177 HC Ova and Parasites Smears - Ova and Parasite Examination | $53.00 | $53.00 | $7.70–$53.00 | 39% below | — |
| Stool ova and parasites exam inpatient CPT 87177 HC Ova and Parasites Smears - Ova and Parasite Examination | $53.00 | $53.00 | $7.70–$53.00 | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Occult Bld | $69.00 | $69.00 | $3.79–$69.00 | 35% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Occult Bld | $69.00 | $69.00 | $3.79–$69.00 | — | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Blood Occult Fecal Immunoassay | $89.00 | $89.00 | $13.77–$89.00 | 55% above | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Blood Occult Fecal Immunoassay | $89.00 | $89.00 | $13.77–$89.00 | — | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Antibody Treponema Pallidum - T. Pallidum Confirmatory | $96.00 | $96.00 | $11.45–$96.00 | 40% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Antibody Treponema Pallidum - Fta Antibodies, Igg and Igm | $109.00 | $109.00 | $11.45–$109.00 | 58% above | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Antibody Treponema Pallidum - T. Pallidum Confirmatory | $96.00 | $96.00 | $11.45–$96.00 | — | — |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Antibody Treponema Pallidum - Fta Antibodies, Igg and Igm | $109.00 | $109.00 | $11.45–$109.00 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Vdrl CSF | $60.00 | $60.00 | $3.69–$60.00 | at median | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Rapid Plasma Reagin-Syp | $60.00 | $60.00 | $3.69–$60.00 | at median | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Vdrl | $62.00 | $62.00 | $3.69–$62.00 | 3% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Rapid Plasma Reagin-Syp | $60.00 | $60.00 | $3.69–$60.00 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Vdrl CSF | $60.00 | $60.00 | $3.69–$60.00 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non Treponemal Antibody Qual - Vdrl | $62.00 | $62.00 | $3.69–$62.00 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Test, Cell Mediated Antigen Response,Gamma Interfron - TB Test | $328.00 | $328.00 | $53.61–$328.00 | 18% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB Test, Cell Mediated Antigen Response,Gamma Interfron - TB Test | $328.00 | $328.00 | $53.61–$328.00 | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Assay of Testosterone Total | $134.00 | $134.00 | $22.33–$134.00 | 2% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Assay of Total Testosterone - Testosterone | $134.00 | $134.00 | $22.33–$134.00 | 2% above | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Assay of Testosterone Total | $134.00 | $134.00 | $22.33–$134.00 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Assay of Total Testosterone - Testosterone | $134.00 | $134.00 | $22.33–$134.00 | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody - Liver-Kidney Microsome Igg | $132.00 | $132.00 | $12.59–$132.00 | 2% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody - Anti-Microsomal Ab | $135.00 | $135.00 | $12.59–$135.00 | 5% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody - Thyroid Peroxidase Antibody | $162.00 | $162.00 | $12.59–$162.00 | 26% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibody - Liver-Kidney Microsome Igg | $132.00 | $132.00 | $12.59–$132.00 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibody - Anti-Microsomal Ab | $135.00 | $135.00 | $12.59–$135.00 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibody - Thyroid Peroxidase Antibody | $162.00 | $162.00 | $12.59–$162.00 | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $202.00 | $202.00 | $14.53–$202.00 | 85% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $202.00 | $202.00 | $14.53–$202.00 | — | — |
| Total IgE blood test CPT 82785 HC Assay of Gammaglobulin Ige - Immunoglobulin Ige | $47.00 | $47.00 | $14.24–$47.00 | 45% below | — |
| Total IgE blood test inpatient CPT 82785 HC Assay of Gammaglobulin Ige - Immunoglobulin Ige | $47.00 | $47.00 | $14.24–$47.00 | — | — |
| Total cholesterol blood test CPT 82465 HC Assay, Bld/Serum Cholesterol - Cholesterol Total | $80.00 | $80.00 | $3.76–$80.00 | 53% above | — |
| Total cholesterol blood test inpatient CPT 82465 HC Assay, Bld/Serum Cholesterol - Cholesterol Total | $80.00 | $80.00 | $3.76–$80.00 | — | — |
| Total thyroxine (T4) blood test CPT 84436 HC Assay of Total Thyroxine - T4 (Thyroid Hormone) | $79.00 | $79.00 | $5.94–$79.00 | 35% above | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC Assay of Total Thyroxine - T4 (Thyroid Hormone) | $79.00 | $79.00 | $5.94–$79.00 | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 HC Triiodothyronine Total Assay, Tt-3 - T3 (Thyroid Hormone) | $127.00 | $127.00 | $12.27–$127.00 | 2% above | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC Triiodothyronine Total Assay, Tt-3 - T3 (Thyroid Hormone) | $127.00 | $127.00 | $12.27–$127.00 | — | — |
| Transferrin blood test CPT 84466 HC Assay of Transferrin - Transferrin | $113.00 | $113.00 | $11.04–$113.00 | 2% above | — |
| Transferrin blood test inpatient CPT 84466 HC Assay of Transferrin - Transferrin | $113.00 | $113.00 | $11.04–$113.00 | — | — |
| Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Dna Amp Prob | $88.00 | $88.00 | $30.35–$88.00 | 19% below | — |
| Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas Vaginalis Dna Amp Prob | $88.00 | $88.00 | $30.35–$88.00 | — | — |
| Triglycerides blood test CPT 84478 HC Assay of Triglycerides - Triglycerides | $123.00 | $123.00 | $4.97–$123.00 | 77% above | — |
| Triglycerides blood test inpatient CPT 84478 HC Assay of Triglycerides - Triglycerides | $123.00 | $123.00 | $4.97–$123.00 | — | — |
| Troponin test, quantitative CPT 84484 HC Assay of Troponin, Quant - Troponin T | $85.00 | $85.00 | $10.79–$85.00 | 43% below | — |
| Troponin test, quantitative CPT 84484 HC Assay of Troponin, Quant - Troponin I | $89.00 | $89.00 | $10.79–$89.00 | 40% below | — |
| Troponin test, quantitative inpatient CPT 84484 HC Assay of Troponin, Quant - Troponin T | $85.00 | $85.00 | $10.79–$85.00 | — | — |
| Troponin test, quantitative inpatient CPT 84484 HC Assay of Troponin, Quant - Troponin I | $89.00 | $89.00 | $10.79–$89.00 | — | — |
| Uric acid blood test CPT 84550 HC Assay of Uric Acid, Blood - POCT Uric Acid | $58.00 | $58.00 | $3.91–$58.00 | 1% below | — |
| Uric acid blood test CPT 84550 HC Assay of Uric Acid, Blood - Uric Acid | $82.00 | $82.00 | $3.91–$82.00 | 40% above | — |
| Uric acid blood test inpatient CPT 84550 HC Assay of Uric Acid, Blood - POCT Uric Acid | $58.00 | $58.00 | $3.91–$58.00 | — | — |
| Uric acid blood test inpatient CPT 84550 HC Assay of Uric Acid, Blood - Uric Acid | $82.00 | $82.00 | $3.91–$82.00 | — | — |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $90.00 | $90.00 | $2.74–$90.00 | 56% above | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $90.00 | $90.00 | $2.74–$90.00 | — | — |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis, Auto, W/O Scope - Urinalysis Chem Only | $47.00 | $47.00 | $1.95–$47.00 | 19% above | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis, Auto, W/O Scope - Urinalysis Chem Only | $47.00 | $47.00 | $1.95–$47.00 | — | — |
| Urine culture for bacteria, with colony count CPT 87086 Culture Bacterial Quantitative Colony Count Urine | $43.00 | $43.00 | $6.98–$43.00 | 47% below | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Bacterial Quantitative Colony Count Urine | $43.00 | $43.00 | $6.98–$43.00 | — | — |
| Urine microalbumin (albumin) test CPT 82043 HC Microalbumin, Quantitative - Microalbumin 24hr Urine | $152.00 | $152.00 | $5.00–$152.00 | 38% above | — |
| Urine microalbumin (albumin) test CPT 82043 HC Microalbumin, Quantitative - Microalbumin / Creatinine Urine Ratio | $271.00 | $271.00 | $5.00–$271.00 | 147% above | — |
| Urine microalbumin (albumin) test CPT 82043 HC Microalbumin, Quantitative - Microalbumin Random Urine | $282.00 | $282.00 | $5.00–$282.00 | 157% above | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin, Quantitative - Microalbumin 24hr Urine | $152.00 | $152.00 | $5.00–$152.00 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin, Quantitative - Microalbumin / Creatinine Urine Ratio | $271.00 | $271.00 | $5.00–$271.00 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin, Quantitative - Microalbumin Random Urine | $282.00 | $282.00 | $5.00–$282.00 | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B-12 - Vitamin B12 | $188.00 | $188.00 | $13.04–$188.00 | 62% above | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B-12 - Vitamin B12 | $188.00 | $188.00 | $13.04–$188.00 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D Total | $287.00 | $287.00 | $25.60–$287.00 | 86% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Assay of Vit D,Calcifediol W Fractions, if Performed - Vitamin D 25 | $342.00 | $342.00 | $25.60–$342.00 | 122% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vitamin D Total | $287.00 | $287.00 | $25.60–$287.00 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Assay of Vit D,Calcifediol W Fractions, if Performed - Vitamin D 25 | $342.00 | $342.00 | $25.60–$342.00 | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Assay, Dihydroxyvitamin D W/Fractions, if Performed - Vitamin D 1 | $154.00 | $154.00 | $33.30–$154.00 | 16% above | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Assay, Dihydroxyvitamin D W/Fractions, if Performed - Vitamin D 1 | $154.00 | $154.00 | $33.30–$154.00 | — | — |
| Zinc blood test CPT 84630 HC Assay of Zinc - Zinc Urine | $133.00 | $133.00 | $9.85–$133.00 | 220% above | — |
| Zinc blood test CPT 84630 HC Assay of Zinc - Zinc | $136.00 | $136.00 | $9.85–$136.00 | 228% above | — |
| Zinc blood test inpatient CPT 84630 HC Assay of Zinc - Zinc Urine | $133.00 | $133.00 | $9.85–$133.00 | — | — |
| Zinc blood test inpatient CPT 84630 HC Assay of Zinc - Zinc | $136.00 | $136.00 | $9.85–$136.00 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Chorionic Gonadotropin, Quant - Hcg Quantitative Blood | $238.00 | $238.00 | $13.02–$238.00 | 76% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Chorionic Gonadotropin, Quant - Hcg Quantitative Blood | $238.00 | $238.00 | $13.02–$238.00 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Appendectomy, open surgery CPT 44950 HC Appendectomy | $7,059.00 | $7,059.00 | $576.80–$7,059.00 | — | — |
| Appendectomy, open surgery inpatient CPT 44950 HC Appendectomy | $7,059.00 | $7,059.00 | $576.80–$7,059.00 | — | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion, Elective;Extern | $2,483.00 | $2,483.00 | $95.33–$2,483.00 | 69% above | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Electric Ext - Cardioversion External | $2,532.00 | $2,532.00 | $95.33–$2,532.00 | 73% above | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion, Elective;Extern | $2,483.00 | $2,483.00 | $95.33–$2,483.00 | — | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion Electric Ext - Cardioversion External | $2,532.00 | $2,532.00 | $95.33–$2,532.00 | — | — |
| Carpal tunnel release, open surgery CPT 64721 HC Neuroplasty &/Transpos Median Nrv Carpal Tunnel | $5,173.00 | $5,173.00 | $416.56–$5,173.00 | 10% above | — |
| Carpal tunnel release, open surgery inpatient CPT 64721 HC Neuroplasty &/Transpos Median Nrv Carpal Tunnel | $5,173.00 | $5,173.00 | $416.56–$5,173.00 | — | — |
| Cataract surgery with lens implant CPT 66984 HC Cataract Phaco (1st) | $4,893.00 | $4,893.00 | $464.91–$4,893.00 | 11% above | — |
| Cataract surgery with lens implant inpatient CPT 66984 HC Cataract Phaco (1st) | $4,893.00 | $4,893.00 | $464.91–$4,893.00 | — | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision W/Clamp/Oth Dev W/Block | $986.00 | $986.00 | $84.59–$986.00 | 44% below | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC Circumcision W/Clamp/Oth Dev W/Block | $986.00 | $986.00 | $84.59–$986.00 | — | — |
| Circumcision, surgical, older than a newborn CPT 54160 HC Circumcision Neonate | $730.00 | $730.00 | $132.93–$730.00 | 6% above | — |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 HC Circumcision Neonate | $730.00 | $730.00 | $132.93–$730.00 | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Closed Tx Dist Rad/Ulna Fx | $403.00 | $403.00 | $323.35–$403.00 | 33% below | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Closed Tx Dist Rad/Ulna Fx | $403.00 | $403.00 | $323.35–$403.00 | — | — |
| Colonoscopy with polyp removal CPT 45385 HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq - Colonoscopy | $3,300.00 | $3,300.00 | $224.57–$3,300.00 | 14% above | — |
| Colonoscopy with polyp removal inpatient CPT 45385 HC Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq - Colonoscopy | $3,300.00 | $3,300.00 | $224.57–$3,300.00 | — | — |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy Single/Multiple - Colonoscopy | $3,300.00 | $3,300.00 | $178.58–$3,300.00 | 87% above | — |
| Colonoscopy with tissue sample inpatient CPT 45380 HC Colonoscopy W/Biopsy Single/Multiple - Colonoscopy | $3,300.00 | $3,300.00 | $178.58–$3,300.00 | — | — |
| Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $3,300.00 | $3,300.00 | $165.49–$3,300.00 | 54% above | — |
| Colonoscopy, diagnostic inpatient CPT 45378 HC Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $3,300.00 | $3,300.00 | $165.49–$3,300.00 | — | — |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy | $1,475.00 | $1,475.00 | $71.50–$1,475.00 | 5% below | — |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystourethroscopy | $1,475.00 | $1,475.00 | $71.50–$1,475.00 | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destruc Benign/Premal,First Lesion | $60.00 | $60.00 | $48.00–$60.00 | 75% below | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC Destruc Benign/Premal,First Lesion | $60.00 | $60.00 | $48.00–$60.00 | — | — |
| Ear tube placement (tympanostomy) under general anesthesia, one ear both sides CPT 69436 HC Tympanostomy Bilateral | $6,491.00 | $6,491.00 | $145.35–$6,491.00 | — | — |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient both sides CPT 69436 HC Tympanostomy Bilateral | $6,491.00 | $6,491.00 | $145.35–$6,491.00 | — | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Remv Impacted Cerumen Irrigation/Lvg Unilat | $78.00 | $78.00 | $15.00–$78.00 | 52% below | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC Remv Impacted Cerumen Irrigation/Lvg Unilat | $78.00 | $78.00 | $15.00–$78.00 | — | — |
| Earwax removal with instruments, one ear both sides CPT 69210 HC Fac Removal Impacted Cerumen Instrumentation Unilat/Bilat | $34.00 | $34.00 | $27.19–$34.00 | — | — |
| Earwax removal with instruments, one ear both sides CPT 69210 HC Remv Impacted Cerumen Instrumentation Unilat/Bilat | $986.00 | $986.00 | $27.19–$986.00 | — | — |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC Fac Removal Impacted Cerumen Instrumentation Unilat/Bilat | $34.00 | $34.00 | $27.19–$34.00 | — | — |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC Remv Impacted Cerumen Instrumentation Unilat/Bilat | $986.00 | $986.00 | $27.19–$986.00 | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Endometrial Bx W/WO Endocervix Bx W/O Dilat Spx | $92.00 | $92.00 | $55.39–$92.00 | 78% below | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 3615810001 | $1,043.00 | $1,043.00 | $55.39–$1,043.00 | 145% above | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Endometrial Bx W/WO Endocervix Bx W/O Dilat Spx | $92.00 | $92.00 | $55.39–$92.00 | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 3615810001 | $1,043.00 | $1,043.00 | $55.39–$1,043.00 | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $395.00 | $395.00 | $96.00–$395.00 | 79% below | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $395.00 | $395.00 | $96.00–$395.00 | — | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1st Level | $342.00 | $342.00 | $81.90–$342.00 | 83% below | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Lumbar/Sac, 1st Level | $342.00 | $342.00 | $81.90–$342.00 | — | — |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC Rpr Aa Hernia 1st < 3 Cm Reducible | $7,757.00 | $7,757.00 | $304.10–$7,757.00 | at median | — |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC Rpr Aa Hernia 1st < 3 Cm Reducible | $7,757.00 | $7,757.00 | $304.10–$7,757.00 | — | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Sigmoidoscopy, Flex, Dx W/Collect Specim | $2,185.00 | $2,185.00 | $52.71–$2,185.00 | 91% above | — |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC Sigmoidoscopy, Flex, Dx W/Collect Specim | $2,185.00 | $2,185.00 | $52.71–$2,185.00 | — | — |
| Gallbladder removal, laparoscopic CPT 47562 HC Laparoscopic Cholecystectomy | $16,262.00 | $16,262.00 | $596.50–$16,262.00 | 176% above | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC Laparoscopic Cholecystectomy | $16,262.00 | $16,262.00 | $596.50–$16,262.00 | — | — |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC Laps Surg Cholecystectomy W/Cholangiography | $14,272.00 | $14,272.00 | $647.71–$14,272.00 | 68% above | — |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC Laps Surg Cholecystectomy W/Cholangiography | $14,272.00 | $14,272.00 | $647.71–$14,272.00 | — | — |
| Hammertoe correction surgery CPT 28285 HC Repair of Hammertoe | $7,641.00 | $7,641.00 | $372.29–$7,641.00 | 79% above | — |
| Hammertoe correction surgery inpatient CPT 28285 HC Repair of Hammertoe | $7,641.00 | $7,641.00 | $372.29–$7,641.00 | — | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy Internal Rubber Band Ligations | $205.00 | $205.00 | $183.32–$205.00 | 83% below | — |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Hemorrhoidectomy Internal Rubber Band Ligations | $1,406.00 | $1,406.00 | $183.32–$1,406.00 | 19% above | — |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hemorrhoidectomy Internal Rubber Band Ligations | $205.00 | $205.00 | $183.32–$205.00 | — | — |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Hemorrhoidectomy Internal Rubber Band Ligations | $1,406.00 | $1,406.00 | $183.32–$1,406.00 | — | — |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysteroscopy, Biopsy | $7,365.00 | $7,365.00 | $205.43–$7,365.00 | 101% above | — |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC Hysteroscopy, Biopsy | $7,365.00 | $7,365.00 | $205.43–$7,365.00 | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Incision Drain Skin Abscess Simple | $403.00 | $403.00 | $101.04–$403.00 | 12% below | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Incision Drain Skin Abscess Simple | $403.00 | $403.00 | $101.04–$403.00 | — | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC Repair Ing Hernia,5+Y/O,Reducibl | $9,911.00 | $9,911.00 | $475.82–$9,911.00 | 214% above | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC Repair Ing Hernia,5+Y/O,Reducibl | $9,911.00 | $9,911.00 | $475.82–$9,911.00 | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inject Tendon Sheath/Ligament | $57.00 | $57.00 | $33.57–$57.00 | 88% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inject Tendon Sheath/Ligament | $1,075.00 | $1,075.00 | $33.57–$1,075.00 | 118% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inject Tendon Sheath/Ligament | $57.00 | $57.00 | $33.57–$57.00 | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inject Tendon Sheath/Ligament | $1,075.00 | $1,075.00 | $33.57–$1,075.00 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir Inj Major Jt/Bursa W/O US | $65.00 | $65.00 | $39.95–$65.00 | 91% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US | $536.00 | $536.00 | $39.95–$536.00 | 22% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Aspir Inj Major Jt/Bursa W/O US | $65.00 | $65.00 | $39.95–$65.00 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US | $536.00 | $536.00 | $39.95–$536.00 | — | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Implant Devic | $276.00 | $276.00 | $55.05–$276.00 | 10% below | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC Insert Drug Implant Devic | $276.00 | $276.00 | $55.05–$276.00 | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir Inj Interm Jt/Burs W/O US | $58.00 | $58.00 | $32.22–$58.00 | 88% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentesis Aspir Inj Interm Jt/Burs W/O US | $58.00 | $58.00 | $32.22–$58.00 | — | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $58.00 | $58.00 | $31.55–$58.00 | 88% below | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $58.00 | $58.00 | $31.55–$58.00 | — | — |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HC Arthroscopy With Meniscus Repair | $7,210.00 | $7,210.00 | $644.48–$7,210.00 | 46% above | — |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 HC Arthroscopy With Meniscus Repair | $7,210.00 | $7,210.00 | $644.48–$7,210.00 | — | — |
| Knee arthroscopy with meniscus trim CPT 29881 HC Knee Arthroscopy Meniscectomy W Shaving | $9,325.00 | $9,325.00 | $510.46–$9,325.00 | 50% above | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 HC Knee Arthroscopy Meniscectomy W Shaving | $9,325.00 | $9,325.00 | $510.46–$9,325.00 | — | — |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC Knee Menisecectomy and Chondroplasty | $10,337.00 | $10,337.00 | $528.91–$10,337.00 | 66% above | — |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HC Knee Menisecectomy and Chondroplasty | $10,337.00 | $10,337.00 | $528.91–$10,337.00 | — | — |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC Laparoscopic Appendectomy | $12,559.00 | $12,559.00 | $545.44–$12,559.00 | 1% below | — |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 HC Laparoscopic Appendectomy | $12,559.00 | $12,559.00 | $545.44–$12,559.00 | — | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Post-Cataract Laser Surgery | $1,524.00 | $1,524.00 | $276.60–$1,524.00 | 25% above | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Post-Cataract Laser Surgery | $1,524.00 | $1,524.00 | $276.60–$1,524.00 | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Layr Clos Wnd Trunk,Arm,Leg <2.5 Cm | $149.00 | $149.00 | $133.93–$149.00 | 79% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Layr Clos Wnd Trunk,Arm,Leg <2.5 Cm | $149.00 | $149.00 | $133.93–$149.00 | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $453.00 | $453.00 | $89.63–$453.00 | 74% below | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $453.00 | $453.00 | $89.63–$453.00 | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level | $350.00 | $350.00 | $100.03–$350.00 | 81% below | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level | $350.00 | $350.00 | $100.03–$350.00 | — | — |
| Lumbar spinal fusion (posterior), one level CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar | $1,372.00 | $1,372.00 | $1,248.52–$1,474.96 | — | — |
| Lumbar spinal fusion (posterior), one level CPT 22612 HC Lumbar Fusion - Minuteman | $1,372.00 | $1,372.00 | $1,248.52–$1,474.96 | — | — |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 HC Lumbar Fusion - Minuteman | $1,372.00 | $1,372.00 | $1,248.52–$1,474.96 | — | — |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar | $1,372.00 | $1,372.00 | $1,248.52–$1,474.96 | — | — |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC D & C / 1st Trimester | $5,714.00 | $5,714.00 | $353.13–$5,714.00 | 56% above | — |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC D & C / 1st Trimester | $5,714.00 | $5,714.00 | $353.13–$5,714.00 | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Skin Benig <0.5 Cm Trunk,Arm,Leg | $90.00 | $90.00 | $76.87–$90.00 | 87% below | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Benign Lesion <0.5cm Trunk/Arm/Leg | $986.00 | $986.00 | $76.87–$986.00 | 46% above | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Skin Benig <0.5 Cm Trunk,Arm,Leg | $90.00 | $90.00 | $76.87–$90.00 | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Benign Lesion <0.5cm Trunk/Arm/Leg | $986.00 | $986.00 | $76.87–$986.00 | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Exc Skin Benig <0.5 Cm Face,Facial | $99.00 | $99.00 | $90.09–$103.05 | 88% below | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC Exc Skin Benig <0.5 Cm Face,Facial | $99.00 | $99.00 | $90.09–$103.05 | — | — |
| Nail removal (partial or complete), one nail CPT 11730 HC Avulsion Nail Plate Partial/Complete Simple | $73.00 | $73.00 | $49.01–$73.00 | 76% below | — |
| Nail removal (partial or complete), one nail CPT 11730 HC Removal of Nail Plate | $371.00 | $371.00 | $49.01–$371.00 | 21% above | — |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/Complete Simple 1 | $929.00 | $929.00 | $49.01–$929.00 | 204% above | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC Avulsion Nail Plate Partial/Complete Simple | $73.00 | $73.00 | $49.01–$73.00 | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC Removal of Nail Plate | $371.00 | $371.00 | $49.01–$371.00 | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Partial/Complete Simple 1 | $929.00 | $929.00 | $49.01–$929.00 | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inject Nerv Blck,Great Occiptl | $277.00 | $277.00 | $46.32–$277.00 | 64% below | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Inject Nerv Blck,Great Occiptl | $277.00 | $277.00 | $46.32–$277.00 | — | — |
| Paracentesis with imaging guidance CPT 49083 HC Abdom Paracentesis Dx/Ther W Imaging Guidance | $1,211.00 | $1,211.00 | $93.32–$1,211.00 | 38% below | — |
| Paracentesis with imaging guidance inpatient CPT 49083 HC Abdom Paracentesis Dx/Ther W Imaging Guidance | $1,211.00 | $1,211.00 | $93.32–$1,211.00 | — | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excision Nail Matrix Prt/Cmpl Permanent Removal | $633.00 | $633.00 | $94.66–$633.00 | 25% below | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Excision Nail Matrix Prt/Cmpl Permanent Removal | $633.00 | $633.00 | $94.66–$633.00 | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral | $584.00 | $584.00 | $173.88–$584.00 | 85% below | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of Lower or Sacral Spinal Facet Joint Nerves Using Imaging Guidance | $584.00 | $584.00 | $173.88–$584.00 | 85% below | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destruction of Lower or Sacral Spinal Facet Joint Nerves Using Imaging Guidance | $584.00 | $584.00 | $173.88–$584.00 | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral | $584.00 | $584.00 | $173.88–$584.00 | — | — |
| Removal of a foreign object under the skin, simple CPT 10120 HC Remove Foreign Body Simple | $105.00 | $105.00 | $95.55–$105.00 | 84% below | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove Foreign Body Simple | $105.00 | $105.00 | $95.55–$105.00 | — | — |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC Colon Ca Scrn Low Rsk Ind | $3,184.00 | $3,184.00 | $165.82–$3,184.00 | 109% above | — |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC Colon Ca Scrn Low Rsk Ind | $3,184.00 | $3,184.00 | $165.82–$3,184.00 | — | — |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC Colorectal Scrn; Hi Risk Ind | $3,184.00 | $3,184.00 | $165.49–$3,184.00 | 65% above | — |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC Colorectal Scrn; Hi Risk Ind | $3,184.00 | $3,184.00 | $165.49–$3,184.00 | — | — |
| Short arm cast (elbow to hand) CPT 29075 HC Apply Forearm Cast | $66.00 | $66.00 | $59.08–$66.00 | 78% below | — |
| Short arm cast (elbow to hand) CPT 29075 Application Cast Elbow Finger Short Arm | $376.00 | $376.00 | $59.08–$376.00 | 23% above | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC Apply Forearm Cast | $66.00 | $66.00 | $59.08–$66.00 | — | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application Cast Elbow Finger Short Arm | $376.00 | $376.00 | $59.08–$376.00 | — | — |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint,Static | $53.00 | $53.00 | $38.19–$53.00 | 79% below | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Apply Forearm Splint,Static | $53.00 | $53.00 | $38.19–$53.00 | — | — |
| Short leg splint (calf to foot) CPT 29515 HC Apply Lower Leg Splint | $53.00 | $53.00 | $46.77–$53.00 | 80% below | — |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Apply Lower Leg Splint | $53.00 | $53.00 | $46.77–$53.00 | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Repair Superfical Wnd Body <2.5cm | $557.00 | $557.00 | $40.14–$557.00 | 21% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Resuperf Wnd Body <2.5cm | $1,042.00 | $1,042.00 | $40.14–$1,042.00 | 126% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Repair Superfical Wnd Body <2.5cm | $557.00 | $557.00 | $40.14–$557.00 | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Resuperf Wnd Body <2.5cm | $1,042.00 | $1,042.00 | $40.14–$1,042.00 | — | — |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion | $202.00 | $202.00 | $38.27–$202.00 | 57% below | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy Skin Single Lesion | $202.00 | $202.00 | $38.27–$202.00 | — | — |
| Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags, Up to 15 | $1,106.00 | $1,106.00 | $69.48–$1,106.00 | 180% above | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Removal of Skin Tags, Up to 15 | $1,106.00 | $1,106.00 | $69.48–$1,106.00 | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture,Lumbar,Diagnostic | $817.00 | $817.00 | $56.83–$817.00 | 20% below | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Puncture,Lumbar,Diagnostic | $817.00 | $817.00 | $56.83–$817.00 | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Resup Npterf Wnd Body 2.6-7.5 Cm | $441.00 | $441.00 | $52.53–$441.00 | 11% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Repair Superfical Wnd Body 2.6-7.5 Cm | $613.00 | $613.00 | $52.53–$613.00 | 23% above | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Resup Npterf Wnd Body 2.6-7.5 Cm | $441.00 | $441.00 | $52.53–$441.00 | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Repair Superfical Wnd Body 2.6-7.5 Cm | $613.00 | $613.00 | $52.53–$613.00 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Repair Superficial Wnd Face <2.5cm | $105.00 | $105.00 | $49.82–$105.00 | 77% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Resuperf Wnd Face <2.5 Cm | $361.00 | $361.00 | $49.82–$361.00 | 21% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Repair Superficial Wnd Face <2.5cm | $105.00 | $105.00 | $49.82–$105.00 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Resuperf Wnd Face <2.5 Cm | $361.00 | $361.00 | $49.82–$361.00 | — | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion | $73.00 | $73.00 | $30.21–$73.00 | 82% below | — |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion | $73.00 | $73.00 | $30.21–$73.00 | — | — |
| Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis Needle/Cath Pleura W/Imaging | $1,404.00 | $1,404.00 | $94.32–$1,404.00 | 24% below | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis Needle/Cath Pleura W/Imaging | $1,404.00 | $1,404.00 | $94.32–$1,404.00 | — | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 HC Tonsillectomy & Adenoidectomy 11 Yrs | $6,089.00 | $6,089.00 | $262.16–$6,089.00 | 33% above | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 HC Tonsillectomy & Adenoidectomy 11 Yrs | $6,089.00 | $6,089.00 | $262.16–$6,089.00 | — | — |
| Total knee replacement CPT 27447 HC Total Knee Arthroplasty | $33,582.00 | $33,582.00 | $1,165.13–$33,582.00 | 103% above | — |
| Total knee replacement inpatient CPT 27447 HC Total Knee Arthroplasty | $33,582.00 | $33,582.00 | $1,165.13–$33,582.00 | — | — |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $3,161.00 | $3,161.00 | $282.36–$3,161.00 | 19% below | — |
| Trigger finger release surgery inpatient CPT 26055 HC Incise Finger Tendon Sheath | $3,161.00 | $3,161.00 | $282.36–$3,161.00 | — | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inject Trigger Point, 1 or 2 | $372.00 | $372.00 | $33.86–$372.00 | 26% below | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inject Trigger Point, 1 or 2 | $372.00 | $372.00 | $33.86–$372.00 | — | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Egd Balloon Dilation Esophagus <30 Mm Diam - Egd | $4,750.00 | $4,750.00 | $136.96–$4,750.00 | 87% above | — |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC Egd Balloon Dilation Esophagus <30 Mm Diam - Egd | $4,750.00 | $4,750.00 | $136.96–$4,750.00 | — | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Transoral Biopsy Single/Multiple - Egd | $2,635.00 | $2,635.00 | $124.20–$2,635.00 | 79% above | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd Transoral Biopsy Single/Multiple - Egd | $2,635.00 | $2,635.00 | $124.20–$2,635.00 | — | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Esophagogastroduodenoscopy Transoral Diagnostic | $2,439.00 | $2,439.00 | $111.11–$2,439.00 | 96% above | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Esophagogastroduodenoscopy Transoral Diagnostic | $2,439.00 | $2,439.00 | $111.11–$2,439.00 | — | — |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC Vasectomy Uni/Bi Spx W/Postop Semen Exams | $2,326.00 | $2,326.00 | $218.10–$2,326.00 | — | — |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC Vasectomy Uni/Bi Spx W/Postop Semen Exams | $2,326.00 | $2,326.00 | $218.10–$2,326.00 | — | — |
| Wart removal, up to 14 warts CPT 17110 HC Destruction Benign Lesions Up to 14 | $82.00 | $82.00 | $62.77–$82.00 | 65% below | — |
| Wart removal, up to 14 warts inpatient CPT 17110 HC Destruction Benign Lesions Up to 14 | $82.00 | $82.00 | $62.77–$82.00 | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm | $1,180.00 | $1,180.00 | $56.06–$1,180.00 | 12% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm | $1,180.00 | $1,180.00 | $56.06–$1,180.00 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion Service | $953.00 | $953.00 | $41.13–$953.00 | 1% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 2 Hrs | $1,244.00 | $1,244.00 | $41.13–$1,244.00 | 29% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion Service 2 Hrs | $1,266.00 | $1,266.00 | $41.13–$1,266.00 | 31% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 3 Hrs | $1,581.00 | $1,581.00 | $41.13–$1,581.00 | 64% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 4 Hrs | $1,691.00 | $1,691.00 | $41.13–$1,691.00 | 75% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 5 Hrs | $1,914.00 | $1,914.00 | $41.13–$1,914.00 | 98% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 6 Hrs | $2,011.00 | $2,011.00 | $41.13–$2,011.00 | 108% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 7 Hrs | $2,069.00 | $2,069.00 | $41.13–$2,069.00 | 114% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion Service | $953.00 | $953.00 | $41.13–$953.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 2 Hrs | $1,244.00 | $1,244.00 | $41.13–$1,244.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion Service 2 Hrs | $1,266.00 | $1,266.00 | $41.13–$1,266.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 3 Hrs | $1,581.00 | $1,581.00 | $41.13–$1,581.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 4 Hrs | $1,691.00 | $1,691.00 | $41.13–$1,691.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 5 Hrs | $1,914.00 | $1,914.00 | $41.13–$1,914.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 6 Hrs | $2,011.00 | $2,011.00 | $41.13–$2,011.00 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 7 Hrs | $2,069.00 | $2,069.00 | $41.13–$2,069.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment (Once) | $409.00 | $409.00 | $7.56–$409.00 | 88% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Pressurized/Nonpressurized Inhalation Treatment | $428.00 | $428.00 | $7.56–$428.00 | 97% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Inhaler Treatment(Once) | $428.00 | $428.00 | $7.56–$428.00 | 97% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhaler Treatment (Multi-Day) | $758.00 | $758.00 | $7.56–$758.00 | 248% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Rt Mdi/Dpi Subsequent | $758.00 | $758.00 | $7.56–$758.00 | 248% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment Subsequent (Ea) | $2,065.00 | $2,065.00 | $7.56–$2,065.00 | 849% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment (Multi-Neb) | $2,065.00 | $2,065.00 | $7.56–$2,065.00 | 849% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt Mdi/Dpi | $173.00 | $173.00 | $7.56–$173.00 | 20% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhalation Treatment (Once) | $409.00 | $409.00 | $7.56–$409.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Rt Inhaler Treatment(Once) | $428.00 | $428.00 | $7.56–$428.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Pressurized/Nonpressurized Inhalation Treatment | $428.00 | $428.00 | $7.56–$428.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Rt Mdi/Dpi Subsequent | $758.00 | $758.00 | $7.56–$758.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhaler Treatment (Multi-Day) | $758.00 | $758.00 | $7.56–$758.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhalation Treatment Subsequent (Ea) | $2,065.00 | $2,065.00 | $7.56–$2,065.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhalation Treatment (Multi-Neb) | $2,065.00 | $2,065.00 | $7.56–$2,065.00 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt Mdi/Dpi | $173.00 | $173.00 | $7.56–$173.00 | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemother, IV Infusion, 1 Hr | $860.00 | $860.00 | $118.16–$860.00 | 14% above | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemother, IV Infusion, 1 Hr | $860.00 | $860.00 | $118.16–$860.00 | — | — |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care First Patient Init 30-74 Min | $2,186.00 | $2,186.00 | $196.92–$2,186.00 | 11% below | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care First Patient Init 30-74 Min | $2,186.00 | $2,186.00 | $196.92–$2,186.00 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Electrocardiogram, Tracing | $182.00 | $182.00 | $5.95–$182.00 | 25% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Electrocardiogram, Tracing | $182.00 | $182.00 | $5.95–$182.00 | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Emergency Department Level 1 Visit Limited/Minor Prob | $292.00 | $292.00 | $10.40–$292.00 | 6% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC Emergency Department Level 1 Visit Limited/Minor Prob | $292.00 | $292.00 | $10.40–$292.00 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Emergency Department Level 2 Visit Low/Moder Severity | $427.00 | $427.00 | $38.43–$427.00 | 2% below | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC Emergency Department Level 2 Visit Low/Moder Severity | $427.00 | $427.00 | $38.43–$427.00 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Emergency Department Level 3 Visit Moderate Severity | $625.00 | $625.00 | $65.05–$625.00 | 11% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC Emergency Department Level 3 Visit Moderate Severity | $625.00 | $625.00 | $65.05–$625.00 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC Emergency Department Level 4 Visit High/Urgent Severity | $1,028.00 | $1,028.00 | $110.65–$1,028.00 | 6% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC Emergency Department Level 4 Visit High/Urgent Severity | $1,028.00 | $1,028.00 | $110.65–$1,028.00 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC Emergency Department Level 5 Visit High Severity&Threat Func | $2,200.00 | $2,200.00 | $160.25–$2,200.00 | 38% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC Emergency Department Level 5 Visit High Severity&Threat Func | $2,200.00 | $2,200.00 | $160.25–$2,200.00 | — | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiovascular Stress Test - Stress Test Only, Regadenoson | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | 9% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiac Stress Tst,Tracing Only | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | 9% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiac Stress Tst,Tracing Only - Stress Test Only, Exercise | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | 9% above | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiac Stress Tst,Tracing Only - Stress Test Only, Exercise | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiac Stress Tst,Tracing Only | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiovascular Stress Test - Stress Test Only, Regadenoson | $1,279.00 | $1,279.00 | $36.80–$1,279.00 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Infusion, Hydration, 31-60 Min | $424.00 | $424.00 | $29.88–$424.00 | 2% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Infusion, Hydration, 31-60 Min | $424.00 | $424.00 | $29.88–$424.00 | — | — |
| IV infusion of a medicine, first hour CPT 96365 HC IV Infusion, Therap/Proph/Diagnost,Initial,1st Hour | $424.00 | $424.00 | $57.10–$424.00 | 5% below | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infusion, Therap/Proph/Diagnost,Initial,1st Hour | $424.00 | $424.00 | $57.10–$424.00 | — | — |
| IV push of a medicine, first drug CPT 96374 HC Injection,Therap/Proph/Diagnost, IV Push, Initial Drug | $308.00 | $308.00 | $33.56–$308.00 | 12% below | — |
| IV push of a medicine, first drug inpatient CPT 96374 HC Injection,Therap/Proph/Diagnost, IV Push, Initial Drug | $308.00 | $308.00 | $33.56–$308.00 | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut | $89.00 | $89.00 | $13.71–$89.00 | at median | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Sq/Im | $215.00 | $215.00 | $13.71–$215.00 | 142% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut | $89.00 | $89.00 | $13.71–$89.00 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Sq/Im | $215.00 | $215.00 | $13.71–$215.00 | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Ot Neuromusc Reeducat,1+ Areas, Ea 15 Min | $106.00 | $106.00 | $31.82–$106.00 | 12% below | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min | $110.00 | $110.00 | $31.82–$110.00 | 8% below | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Ot Home Safety Assess Neuro Re/15 Mins | $135.00 | $135.00 | $31.82–$135.00 | 12% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Home Safety Assess Neuro Re/15 Mins | $139.00 | $139.00 | $31.82–$139.00 | 16% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Ot Neuromusc Reeducat,1+ Areas, Ea 15 Min | $106.00 | $106.00 | $31.82–$106.00 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min | $110.00 | $110.00 | $31.82–$110.00 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Ot Home Safety Assess Neuro Re/15 Mins | $135.00 | $135.00 | $31.82–$135.00 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Home Safety Assess Neuro Re/15 Mins | $139.00 | $139.00 | $31.82–$139.00 | — | — |
| New patient office visit, about 30 minutes CPT 99203 Office Outpatient New 30 Minutes | $59.00 | $59.00 | $53.69–$76.05 | 69% below | — |
| New patient office visit, about 30 minutes CPT 99203 HC Pbb Office Outpatient New 30 Minutes | $64.00 | $64.00 | $58.24–$76.05 | 67% below | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Outpatient New 30 Minutes | $59.00 | $59.00 | $53.69–$76.05 | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC Pbb Office Outpatient New 30 Minutes | $64.00 | $64.00 | $58.24–$76.05 | — | — |
| New patient office visit, about 45 minutes CPT 99204 HC Pbb Office Outpatient New 45-59 Minutes | $87.00 | $87.00 | $79.17–$124.26 | 66% below | — |
| New patient office visit, about 45 minutes CPT 99204 HC Pbb Office Outpatient New 45 Minutes | $96.00 | $96.00 | $87.36–$124.26 | 63% below | — |
| New patient office visit, about 45 minutes CPT 99204 Office Outpatient New 45-59 Minutes | $131.00 | $131.00 | $117.49–$131.00 | 49% below | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC Pbb Office Outpatient New 45-59 Minutes | $87.00 | $87.00 | $79.17–$124.26 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC Pbb Office Outpatient New 45 Minutes | $96.00 | $96.00 | $87.36–$124.26 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Outpatient New 45-59 Minutes | $131.00 | $131.00 | $117.49–$131.00 | — | — |
| New patient office visit, about 60 minutes CPT 99205 Office Outpatient New 60 Minutes | $101.00 | $101.00 | $91.91–$168.84 | 68% below | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Outpatient New 60 Minutes | $101.00 | $101.00 | $91.91–$168.84 | — | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Outpatient New 15-29 Minutes | $40.00 | $40.00 | $36.40–$43.89 | 73% below | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Pbb Office Outpatient New 20 Minutes | $44.00 | $44.00 | $40.04–$44.00 | 70% below | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Outpatient New 15-29 Minutes | $40.00 | $40.00 | $36.40–$43.89 | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Pbb Office Outpatient New 20 Minutes | $44.00 | $44.00 | $40.04–$44.00 | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Med Nutr Ther, 1st, Indiv, Ea 15 Min | $110.00 | $110.00 | $26.52–$110.00 | 102% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Med Nutr Ther, 1st, Indiv, Ea 15 Min | $110.00 | $110.00 | $26.52–$110.00 | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Occupational Therapy Eval Low Complex 30 Mins | $210.00 | $210.00 | $99.80–$210.00 | 20% below | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Occupational Therapy Eval Low Complex 30 Mins | $210.00 | $210.00 | $99.80–$210.00 | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Physical Therapy Evaluation High Complex 45 Mins | $321.00 | $321.00 | $97.21–$321.00 | 8% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Physical Therapy Evaluation High Complex 45 Mins | $321.00 | $321.00 | $97.21–$321.00 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Physical Therapy Evaluation Low Complex 20 Mins | $218.00 | $218.00 | $97.21–$218.00 | at median | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Physical Therapy Evaluation Low Complex 20 Mins | $218.00 | $218.00 | $97.21–$218.00 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Physical Therapy Evaluation Mod Complex 30 Mins | $276.00 | $276.00 | $97.21–$276.00 | 5% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Physical Therapy Evaluation Mod Complex 30 Mins | $276.00 | $276.00 | $97.21–$276.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Ther Tech,1+Regions,Ea 15 Min | $136.00 | $136.00 | $26.97–$136.00 | 16% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pt Manual Ther Tech,1+Regions,Ea 15 Min | $140.00 | $140.00 | $26.97–$140.00 | 19% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Ther Tech,1+Regions,Ea 15 Min | $136.00 | $136.00 | $26.97–$136.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pt Manual Ther Tech,1+Regions,Ea 15 Min | $140.00 | $140.00 | $26.97–$140.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Exercises | $106.00 | $106.00 | $28.59–$106.00 | 10% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercises | $110.00 | $110.00 | $28.59–$110.00 | 6% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Home Safety Assess Thera Exer/15 Mins | $135.00 | $135.00 | $28.59–$135.00 | 15% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Home Safety Assess Thera Exer/15 Mins | $139.00 | $139.00 | $28.59–$139.00 | 18% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Exercises | $106.00 | $106.00 | $28.59–$106.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercises | $110.00 | $110.00 | $28.59–$110.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Home Safety Assess Thera Exer/15 Mins | $135.00 | $135.00 | $28.59–$135.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Home Safety Assess Thera Exer/15 Mins | $139.00 | $139.00 | $28.59–$139.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office Outpatient Visit Est 40-54 Minutes | $72.00 | $72.00 | $65.52–$134.57 | 72% below | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Pbb Office Outpatient Visit 40 Minutes | $84.00 | $84.00 | $76.44–$134.57 | 67% below | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Outpatient Visit Est 40-54 Minutes | $72.00 | $72.00 | $65.52–$134.57 | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Pbb Office Outpatient Visit 40 Minutes | $84.00 | $84.00 | $76.44–$134.57 | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office Outpatient Visit Est 20-29 Minutes | $40.00 | $40.00 | $36.40–$61.72 | 71% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Office Outpatient Visit Est 20-29 Minutes | $65.00 | $65.00 | $57.74–$65.00 | 53% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Lactation Consultation - Moderate | $140.00 | $140.00 | $57.74–$140.00 | 1% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Treatment Room 1.5 Hrs | $638.00 | $638.00 | $57.74–$638.00 | 361% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Wound Care Level 3 | $690.00 | $690.00 | $57.74–$690.00 | 399% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Outpatient Visit Est 20-29 Minutes | $40.00 | $40.00 | $36.40–$61.72 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Office Outpatient Visit Est 20-29 Minutes | $65.00 | $65.00 | $57.74–$65.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Lactation Consultation - Moderate | $140.00 | $140.00 | $57.74–$140.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Treatment Room 1.5 Hrs | $638.00 | $638.00 | $57.74–$638.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Wound Care Level 3 | $690.00 | $690.00 | $57.74–$690.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office Outpatient Visit Est 30-39 Minutes | $54.00 | $54.00 | $49.14–$90.80 | 71% below | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Office Outpatient Visit Est 30-39 Minutes | $192.00 | $192.00 | $84.93–$192.00 | 4% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Outpatient Visit Est 30-39 Minutes | $54.00 | $54.00 | $49.14–$90.80 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Office Outpatient Visit Est 30-39 Minutes | $192.00 | $192.00 | $84.93–$192.00 | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office Outpatient Visit 10 Minutes | $23.00 | $23.00 | $20.93–$32.96 | 79% below | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Lactation Consultation - Low | $103.00 | $103.00 | $31.22–$103.00 | 7% below | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Treatment Room 1 Hr | $460.00 | $460.00 | $31.22–$460.00 | 317% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Wound Care Level 2 | $464.00 | $464.00 | $31.22–$464.00 | 320% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Outpatient Visit 10 Minutes | $23.00 | $23.00 | $20.93–$32.96 | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Lactation Consultation - Low | $103.00 | $103.00 | $31.22–$103.00 | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Treatment Room 1 Hr | $460.00 | $460.00 | $31.22–$460.00 | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Wound Care Level 2 | $464.00 | $464.00 | $31.22–$464.00 | — | — |
| Speech and language evaluation CPT 92523 HC Slp Eval Speech Sound Product Language Comprehension | $382.00 | $382.00 | $221.51–$382.00 | 10% below | — |
| Speech and language evaluation inpatient CPT 92523 HC Slp Eval Speech Sound Product Language Comprehension | $382.00 | $382.00 | $221.51–$382.00 | — | — |
| Speech therapy session, individual CPT 92507 HC Slp Speech/Hearing Therapy, Individual | $274.00 | $274.00 | $74.44–$274.00 | 2% below | — |
| Speech therapy session, individual inpatient CPT 92507 HC Slp Speech/Hearing Therapy, Individual | $274.00 | $274.00 | $74.44–$274.00 | — | — |
| Spirometry (breathing test) CPT 94010 HC Breathing Capacity Test - Office Spirometry | $108.00 | $108.00 | $29.88–$108.00 | 66% below | — |
| Spirometry (breathing test) CPT 94010 HC Breathing Capacity Test - Breathing Capacity Test | $350.00 | $350.00 | $29.88–$350.00 | 10% above | — |
| Spirometry (breathing test) CPT 94010 HC Breathing Capacity Test - Spirometry Without Bronchodilator | $350.00 | $350.00 | $29.88–$350.00 | 10% above | — |
| Spirometry (breathing test) inpatient CPT 94010 HC Breathing Capacity Test - Office Spirometry | $108.00 | $108.00 | $29.88–$108.00 | — | — |
| Spirometry (breathing test) inpatient CPT 94010 HC Breathing Capacity Test - Breathing Capacity Test | $350.00 | $350.00 | $29.88–$350.00 | — | — |
| Spirometry (breathing test) inpatient CPT 94010 HC Breathing Capacity Test - Spirometry Without Bronchodilator | $350.00 | $350.00 | $29.88–$350.00 | — | — |
| Spirometry before and after a bronchodilator CPT 94060 HC Eval of Bronchospasm - Spirometry With Bronchodilator | $484.00 | $484.00 | $43.64–$484.00 | 12% below | — |
| Spirometry before and after a bronchodilator CPT 94060 HC Breathing Capacity Test - Bp Pre & Post | $484.00 | $484.00 | $43.64–$484.00 | 12% below | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Breathing Capacity Test - Bp Pre & Post | $484.00 | $484.00 | $43.64–$484.00 | — | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Eval of Bronchospasm - Spirometry With Bronchodilator | $484.00 | $484.00 | $43.64–$484.00 | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Therapeut Actvity Direct Pt Contact Each 15 Min | $119.00 | $119.00 | $34.41–$119.00 | at median | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Therapeut Actvity Direct Pt Contact Each 15 Min | $124.00 | $124.00 | $34.41–$124.00 | 4% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Home Safety Assess Thera Act/15 Mins | $135.00 | $135.00 | $34.41–$135.00 | 13% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Home Safety Assess Thera Acti/15 Mins | $139.00 | $139.00 | $34.41–$139.00 | 17% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Therapeut Actvity Direct Pt Contact Each 15 Min | $119.00 | $119.00 | $34.41–$119.00 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Therapeut Actvity Direct Pt Contact Each 15 Min | $124.00 | $124.00 | $34.41–$124.00 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Home Safety Assess Thera Act/15 Mins | $135.00 | $135.00 | $34.41–$135.00 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Home Safety Assess Thera Acti/15 Mins | $139.00 | $139.00 | $34.41–$139.00 | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy Therapeutic | $291.00 | $291.00 | $86.21–$291.00 | 20% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Phlebotomy Therapeutic | $291.00 | $291.00 | $86.21–$291.00 | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs South Dakota | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Sarscov2 Vac 50 Mcg/0.5ml Im | $389.25 | $389.25 | $354.22–$389.25 | 89% above | — |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE | $425.40 | $425.40 | $387.11–$425.40 | 106% above | — |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Sarscov2 Vac 50 Mcg/0.5ml Im | $389.25 | $389.25 | $354.22–$389.25 | — | — |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE | $425.40 | $425.40 | $387.11–$425.40 | — | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Var Vaccine Live for Subcutaneous Use | $546.76 | $546.76 | $497.55–$546.76 | 137% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Var Vaccine Live for Subcutaneous Use | $546.76 | $546.76 | $497.55–$546.76 | — | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Dtap-Ipv Vaccine Child 4-6 Yrs for Im Use | $179.46 | $179.46 | $163.31–$179.46 | 94% above | — |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Dtap-Ipv Vaccine Child 4-6 Yrs for Im Use | $179.46 | $179.46 | $163.31–$179.46 | — | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Dtap Immunization, Im, <7 Yo | $82.02 | $82.02 | $74.64–$82.02 | 7% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Dtap Immunization, Im, <7 Yo | $82.02 | $82.02 | $74.64–$82.02 | — | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Dtap-Hepb-Ipv Vaccine Intramuscular | $299.61 | $299.61 | $272.65–$299.61 | 143% above | — |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Dtap-Hepb-Ipv Vaccine Intramuscular | $299.61 | $299.61 | $272.65–$299.61 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Iiv3 Vacc Preservative Free 3 Yrs & Older Im Use | $35.00 | $35.00 | $31.85–$35.00 | 13% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $59.22 | $59.22 | $53.89–$59.22 | 91% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Iiv3 Vacc Preservative Free 3 Yrs & Older Im Use | $35.00 | $35.00 | $31.85–$35.00 | — | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $59.22 | $59.22 | $53.89–$59.22 | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use | $920.58 | $920.58 | $837.73–$920.58 | 139% above | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use | $920.58 | $920.58 | $837.73–$920.58 | — | — |
| Hepatitis A vaccine, adult dose CPT 90632 Hepa Vaccine Adult Dose for Intramuscular Use | $166.89 | $166.89 | $151.87–$166.89 | 36% above | — |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $266.45 | $266.45 | $242.47–$266.45 | 118% above | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepa Vaccine Adult Dose for Intramuscular Use | $166.89 | $166.89 | $151.87–$166.89 | — | — |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $266.45 | $266.45 | $242.47–$266.45 | — | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepa Vaccine 2 Dose Schedule Ped/Adolesc Im Use | $76.92 | $76.92 | $70.00–$76.92 | 63% above | — |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepa Vaccine 2 Dose Schedule Ped/Adolesc Im Use | $76.92 | $76.92 | $70.00–$76.92 | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use | $145.08 | $145.08 | $132.02–$145.08 | 61% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use | $145.08 | $145.08 | $132.02–$145.08 | — | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE | $495.29 | $495.29 | $450.71–$495.29 | 113% above | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hepb Vaccine Adult 2/4 Dose Schedule for Im Use | $495.29 | $495.29 | $450.71–$495.29 | 113% above | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE | $495.29 | $495.29 | $450.71–$495.29 | — | — |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Hepb Vaccine Adult 2/4 Dose Schedule for Im Use | $495.29 | $495.29 | $450.71–$495.29 | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepb Vaccine Ped/Adolesc 3 Dose Schedule Im | $44.64 | $44.64 | $40.62–$44.64 | at median | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $88.07 | $88.07 | $80.14–$88.07 | 97% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepb Vaccine Ped/Adolesc 3 Dose Schedule Im | $44.64 | $44.64 | $40.62–$44.64 | — | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $88.07 | $88.07 | $80.14–$88.07 | — | — |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Hib Prp-Omp Vaccine 3 Dose Schedule Im Use | $89.48 | $89.48 | $81.43–$89.48 | 119% above | — |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Hib Prp-Omp Vaccine 3 Dose Schedule Im Use | $89.48 | $89.48 | $81.43–$89.48 | — | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib Prp-T Vaccine 4 Dose Schedule Im Use | $90.16 | $90.16 | $82.05–$90.16 | 130% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib Prp-T Vaccine 4 Dose Schedule Im Use | $90.16 | $90.16 | $82.05–$90.16 | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Iiv Vaccine Preserv Free Increased Ag Count Im | $80.00 | $80.00 | $72.80–$80.00 | 9% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $256.44 | $256.44 | $233.36–$256.44 | 250% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Iiv Vaccine Preserv Free Increased Ag Count Im | $80.00 | $80.00 | $72.80–$80.00 | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $256.44 | $256.44 | $233.36–$256.44 | — | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr Virus Immunization, Subcut | $278.85 | $278.85 | $253.75–$278.85 | 164% above | — |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr Virus Immunization, Subcut | $278.85 | $278.85 | $253.75–$278.85 | — | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Combined Vaccine,Mmr+Varicella,Sub-Q | $518.79 | $518.79 | $472.10–$518.79 | 14% above | — |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Combined Vaccine,Mmr+Varicella,Sub-Q | $518.79 | $518.79 | $472.10–$518.79 | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menacwy Conjugate Vaccine Groups Acyw-135 Im Use | $497.99 | $497.99 | $453.17–$497.99 | 162% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menacwy Conjugate Vaccine Groups Acyw-135 Im Use | $497.99 | $497.99 | $453.17–$497.99 | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im | $397.71 | $397.71 | $361.92–$397.71 | 49% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menb-4c Recombnt Prot & Outer Memb Vesic Vacc Im | $397.71 | $397.71 | $361.92–$397.71 | — | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 Menb-Fhbp Recombnt Lipoprotein Vacc 2/3 Dose Im | $528.00 | $528.00 | $480.48–$528.00 | 85% above | — |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Menb-Fhbp Recombnt Lipoprotein Vacc 2/3 Dose Im | $528.00 | $528.00 | $480.48–$528.00 | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 Vaccine for Intramuscular Use | $730.14 | $730.14 | $664.43–$730.14 | 130% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $949.23 | $949.23 | $863.80–$949.23 | 200% above | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20 Vaccine for Intramuscular Use | $730.14 | $730.14 | $664.43–$730.14 | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE | $949.23 | $949.23 | $863.80–$949.23 | — | — |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliomyelitis Immunizatn,Inactv,Sub-Q | $83.13 | $83.13 | $75.65–$83.13 | 89% above | — |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliomyelitis Immunizatn,Inactv,Sub-Q | $83.13 | $83.13 | $75.65–$83.13 | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Rsv Monoclonal Antb Seasonal Dose 1 Ml Im Use | $1,635.00 | $1,635.00 | $1,487.85–$1,635.00 | 113% above | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE | $1,785.19 | $1,785.19 | $1,624.52–$1,785.19 | 132% above | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Rsv Monoclonal Antb Seasonal Dose 1 Ml Im Use | $1,635.00 | $1,635.00 | $1,487.85–$1,635.00 | — | — |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE | $1,785.19 | $1,785.19 | $1,624.52–$1,785.19 | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Rsv Monoclonal Antb Seasonal Dose 0.5ml Im Use | $1,635.00 | $1,635.00 | $1,487.85–$1,635.00 | 113% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $1,785.18 | $1,785.18 | $1,624.51–$1,785.18 | 132% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Rsv Monoclonal Antb Seasonal Dose 0.5ml Im Use | $1,635.00 | $1,635.00 | $1,487.85–$1,635.00 | — | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $1,785.18 | $1,785.18 | $1,624.51–$1,785.18 | — | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Rsv Vaccine Pref Subunit Bivalent for Im Use | $882.78 | $882.78 | $803.33–$882.78 | 138% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Rsv Vaccine Pref Subunit Bivalent for Im Use | $882.78 | $882.78 | $803.33–$882.78 | — | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $1,355.97 | $1,355.97 | $1,233.93–$1,355.97 | 162% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP | $1,355.97 | $1,355.97 | $1,233.93–$1,355.97 | — | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rv5 Vaccine 3 Dose Schedule Live for Oral Use | $294.20 | $294.20 | $267.72–$294.20 | 181% above | — |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rv5 Vaccine 3 Dose Schedule Live for Oral Use | $294.20 | $294.20 | $267.72–$294.20 | — | — |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Hzv Zoster Vacc Recombinant Adjuvanted Im Use | $414.75 | $414.75 | $377.42–$414.75 | 14% above | — |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Hzv Zoster Vacc Recombinant Adjuvanted Im Use | $414.75 | $414.75 | $377.42–$414.75 | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Vaccine Prsrv Free 7 Yrs or Older for Im Use | $64.98 | $64.98 | $59.13–$64.98 | at median | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $133.24 | $133.24 | $121.25–$133.24 | 105% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Vaccine Prsrv Free 7 Yrs or Older for Im Use | $64.98 | $64.98 | $59.13–$64.98 | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $133.24 | $133.24 | $121.25–$133.24 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vaccine >7 Yo, Im | $105.93 | $105.93 | $96.40–$105.93 | 24% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $143.67 | $143.67 | $130.74–$143.67 | 68% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine >7 Yo, Im | $105.93 | $105.93 | $96.40–$105.93 | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $143.67 | $143.67 | $130.74–$143.67 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Flu Immuniz Admin,1 Single/Comb Vac/Toxoid | $29.00 | $29.00 | $19.85–$29.00 | 44% below | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immuniz Admin,1 Single/Comb Vac/Toxoid | $67.00 | $67.00 | $19.85–$67.00 | 29% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immuniz Admin,1 Single/Comb Vac/Toxoid Children | $67.00 | $67.00 | $19.85–$67.00 | 29% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Flu Immuniz Admin,1 Single/Comb Vac/Toxoid | $29.00 | $29.00 | $19.85–$29.00 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immuniz Admin,1 Single/Comb Vac/Toxoid Children | $67.00 | $67.00 | $19.85–$67.00 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immuniz Admin,1 Single/Comb Vac/Toxoid | $67.00 | $67.00 | $19.85–$67.00 | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immuniz,Admin,Each Addl | $36.00 | $36.00 | $14.03–$36.00 | 28% below | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immuniz,Admin,Each Addl | $36.00 | $36.00 | $14.03–$36.00 | — | — |
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://madisonregionalhealth.org/wp-content/uploads/460228038_madison-community-hospital_standardcharges.csv