Hospital Macomb, IL

MC Donough District Hospital

Listed in its price file as “McDonough County Hospital District”.

MC Donough District Hospital in Macomb, IL publishes cash prices for 268 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 211 of 267 procedures and above it for 52. By typical cash price it ranks #36 of 117 Illinois hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

525 E Grant Street Macomb IL 61455 Collected Nov 8, 2026 Source price file Check a bill from this hospital (309) 833-4101

Acute care hospital Government-owned hospital Emergency department CMS star rating 3 of 5 CCN 140089 · CMS hospital register NPI 1669420766

Financial assistance

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

MC Donough District Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

State law

This state limits hospital bills for lower-income patients

Illinois law (Hospital Uninsured Patient Discount Act, 210 ILCS 89): an uninsured Illinois resident with family income up to 600% of the federal poverty level (300% at rural and critical access hospitals) can apply for a discount that brings the bill down to about 135% of the hospital's cost; up to 200% (125% at rural hospitals) medically necessary care is free. A hospital may collect no more than 25% of family income in 12 months. Ask the billing office for the application. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	33% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views	$445.80	$743.00	$178.32–$743.00	34% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views	$445.80	$743.00	$609.26–$743.00	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Left	$317.40	$529.00	$126.96–$529.00	6% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Right	$317.40	$529.00	$126.96–$529.00	6% below	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle 3 Views Right	$317.40	$529.00	$433.78–$529.00	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle 3 Views Left	$317.40	$529.00	$433.78–$529.00	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Arterial Study ABI	$528.60	$881.00	$211.44–$881.00	27% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 ARTERIAL STUDY SINGLE Charge	$528.60	$881.00	$211.44–$881.00	27% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 ARTERIAL STUDY- UPPER Charge	$528.60	$881.00	$211.44–$881.00	27% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Arterial Study ABI	$528.60	$881.00	$722.42–$881.00	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 ARTERIAL STUDY- UPPER Charge	$528.60	$881.00	$722.42–$881.00	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 ARTERIAL STUDY SINGLE Charge	$528.60	$881.00	$722.42–$881.00	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$724.80	$1,208.00	$289.92–$1,208.00	19% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$724.80	$1,208.00	$990.56–$1,208.00	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body	$1,171.80	$1,953.00	$468.72–$1,953.00	26% below	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body	$1,171.80	$1,953.00	$1,601.46–$1,953.00	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Bill Only US Breast Limited Left.	$489.60	$816.00	$195.84–$816.00	12% above	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Comp Right.	$489.60	$816.00	$195.84–$816.00	12% above	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Bill Only US Breast Limited Left.	$489.60	$816.00	$669.12–$816.00	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Comp Right.	$489.60	$816.00	$669.12–$816.00	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen/Pelvis	$3,435.00	$5,725.00	$1,374.00–$5,725.00	7% below	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd/Pelvis	$3,435.00	$5,725.00	$1,374.00–$5,725.00	7% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen/Pelvis	$3,435.00	$5,725.00	$4,694.50–$5,725.00	—	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd/Pelvis	$3,435.00	$5,725.00	$4,694.50–$5,725.00	—	40%
CT angiography (CTA) of the head CPT 70496 CT Angio Head	$2,017.80	$3,363.00	$807.12–$3,363.00	20% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Head	$2,017.80	$3,363.00	$2,757.66–$3,363.00	—	40%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck	$1,394.40	$2,324.00	$557.76–$2,324.00	46% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck	$1,394.40	$2,324.00	$1,905.68–$2,324.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/ + w/o Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE Protocol	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE Chest and Abd/Pelv w/ +w/o Cont	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE Chest and Abdomen/Pelvis w/ Cont	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen/Pelvis	$1,639.20	$2,732.00	$655.68–$2,732.00	44% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE Protocol	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE Chest and Abdomen/Pelvis w/ Cont	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE Chest and Abd/Pelv w/ +w/o Cont	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen/Pelvis	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/ + w/o Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Cont	$2,410.20	$4,017.00	$964.08–$4,017.00	31% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	31% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Renal Stone Protocol	$2,410.20	$4,017.00	$964.08–$4,017.00	31% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis w/o Cont	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Renal Stone Protocol	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/ Contrast	$3,949.80	$6,583.00	$1,579.92–$6,583.00	11% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/ Cont	$3,949.80	$6,583.00	$1,579.92–$6,583.00	11% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w/ Contrast	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w/ Cont	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w/ + w/o Cont	$3,949.80	$6,583.00	$1,579.92–$6,583.00	20% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w/ + w/o Contrast	$3,949.80	$6,583.00	$1,579.92–$6,583.00	20% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis w/ + w/o Cont	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis w/ + w/o Contrast	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	28% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$1,159.20	$1,932.00	$463.68–$1,932.00	37% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$1,159.20	$1,932.00	$1,584.24–$1,932.00	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones w/o Contrast	$1,159.20	$1,932.00	$463.68–$1,932.00	32% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$1,512.60	$2,521.00	$605.04–$2,521.00	11% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bones w/o Contrast	$1,159.20	$1,932.00	$1,584.24–$1,932.00	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$1,512.60	$2,521.00	$2,067.22–$2,521.00	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain for Stroke	$1,008.00	$1,680.00	$403.20–$1,680.00	45% below	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	45% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain for Stroke	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	2% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$1,159.20	$1,932.00	$463.68–$1,932.00	47% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$1,159.20	$1,932.00	$1,584.24–$1,932.00	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	56% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	13% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 93880 CAROTID DUPLEX-COMPLETE BILATERAL Charge	$1,128.60	$1,881.00	$451.44–$1,881.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid Duplex	$1,128.60	$1,881.00	$451.44–$1,881.00	30% above	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid Duplex Complete	$1,128.60	$1,881.00	$451.44–$1,881.00	30% above	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Temporal Artery Duplex	$1,128.60	$1,881.00	$451.44–$1,881.00	30% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 93880 CAROTID DUPLEX-COMPLETE BILATERAL Charge	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Temporal Artery Duplex	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid Duplex	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid Duplex Complete	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Chest CT scan without and with contrast CPT 71270 CT Chest/Abdomen/Pelvis w/ + w/o Cont	$1,884.00	$3,140.00	$753.60–$3,140.00	33% below	40%
Chest CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	33% below	40%
Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	33% below	40%
Chest CT scan without and with contrast CPT 71270 CT Abdomen/Chest w/+w/o Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	33% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Abdomen/Chest w/+w/o Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest/Abdomen/Pelvis w/ + w/o Cont	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Chest X-ray, 2 views CPT 71046 XR Chest 2 views 3 and under	$279.60	$466.00	$111.84–$466.00	7% below	40%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$317.40	$529.00	$126.96–$529.00	5% above	40%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 views 3 and under	$279.60	$466.00	$382.12–$466.00	—	40%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$317.40	$529.00	$433.78–$529.00	—	40%
Chest X-ray, single view CPT 71045 XR Chest Special Views	$276.00	$460.00	$110.40–$460.00	6% above	40%
Chest X-ray, single view CPT 71045 XR Babygram Port	$276.00	$460.00	$110.40–$460.00	6% above	40%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$276.00	$460.00	$110.40–$460.00	6% above	40%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$276.00	$460.00	$377.20–$460.00	—	40%
Chest X-ray, single view inpatient CPT 71045 XR Chest Special Views	$276.00	$460.00	$377.20–$460.00	—	40%
Chest X-ray, single view inpatient CPT 71045 XR Babygram Port	$276.00	$460.00	$377.20–$460.00	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal	$588.60	$981.00	$235.44–$981.00	27% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal	$588.60	$981.00	$804.42–$981.00	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Procedure (DEXA)	$445.80	$743.00	$178.32–$743.00	5% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Procedure (DEXA)	$445.80	$743.00	$609.26–$743.00	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton	$234.60	$391.00	$93.84–$391.00	at median	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton	$234.60	$391.00	$320.62–$391.00	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB + Fetal Detail 1 Gest	$720.00	$1,200.00	$288.00–$1,200.00	27% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB + Fetal Detail 1 Gest	$720.00	$1,200.00	$984.00–$1,200.00	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Con and Abd/Pel w/+w/o Con	$1,008.00	$1,680.00	$403.20–$1,680.00	44% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	44% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	44% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Abdomen/Chest w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	44% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	44% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Con and Abd/Pel w/+w/o Con	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Abdomen/Chest w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Cont and Abd w/ + w/o Cont	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Cont and Abd/Pel w/+w/o Cont	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Abdomen/Chest w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast	$1,639.20	$2,732.00	$655.68–$2,732.00	32% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Cont and Abd w/ + w/o Cont	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Abdomen/Chest w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Cont and Abd/Pel w/+w/o Cont	$1,639.20	$2,732.00	$2,240.24–$2,732.00	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilat w/ Tomo.	$384.00	$640.00	$153.60–$640.00	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Digital Diagnostic Bilat.	$384.00	$640.00	$153.60–$640.00	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Digital Diagnostic Bilat.	$384.00	$640.00	$524.80–$640.00	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA Mammogram Diagnostic Bilat w/ Tomo.	$384.00	$640.00	$524.80–$640.00	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Arterial Duplex Lower Bilateral Extremities	$959.40	$1,599.00	$383.76–$1,599.00	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 ARTERIAL DUPLEX LOW Charge 93925	$959.40	$1,599.00	$383.76–$1,599.00	at median	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Arterial Duplex Lower Bilateral Extremities	$959.40	$1,599.00	$1,311.18–$1,599.00	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 ARTERIAL DUPLEX LOW Charge 93925	$959.40	$1,599.00	$1,311.18–$1,599.00	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 93970 VENOUS DUPLEX COMPLETE Charge	$1,128.60	$1,881.00	$451.44–$1,881.00	19% below	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Duplex Complete	$1,128.60	$1,881.00	$451.44–$1,881.00	19% below	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Venous Duplex Complete	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 93970 VENOUS DUPLEX COMPLETE Charge	$1,128.60	$1,881.00	$1,542.42–$1,881.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo with Contrast with Doppler	$1,999.20	$3,332.00	$799.68–$3,332.00	4% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W/O CONTRAST WITH DOPPLER Charge	$1,999.20	$3,332.00	$799.68–$3,332.00	4% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo without Contrast with Doppler	$1,999.20	$3,332.00	$799.68–$3,332.00	4% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Echocardiogram	$1,999.20	$3,332.00	$799.68–$3,332.00	4% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W/O CONTRAST WITH DOPPLER Charge	$1,999.20	$3,332.00	$2,732.24–$3,332.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo with Contrast with Doppler	$1,999.20	$3,332.00	$2,732.24–$3,332.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo without Contrast with Doppler	$1,999.20	$3,332.00	$2,732.24–$3,332.00	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Echocardiogram	$1,999.20	$3,332.00	$2,732.24–$3,332.00	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella etc. w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	40% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit Sella etc. w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views	$445.80	$743.00	$178.32–$743.00	8% above	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches	$445.80	$743.00	$178.32–$743.00	8% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches	$445.80	$743.00	$609.26–$743.00	—	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Minimum 3 Views	$445.80	$743.00	$609.26–$743.00	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Duct System Imaging	$1,171.80	$1,953.00	$468.72–$1,953.00	19% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepa Duct System Imaging w/o Pharm	$1,171.80	$1,953.00	$468.72–$1,953.00	19% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepa Duct System Imaging w/o Pharm	$1,171.80	$1,953.00	$1,601.46–$1,953.00	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Duct System Imaging	$1,171.80	$1,953.00	$1,601.46–$1,953.00	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 95806 Sleep study/unattended/simultaneous recording of heart rate/oxygen saturation/respiratory air	$346.80	$578.00	$138.72–$578.00	44% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 95806 Sleep study/unattended/simultaneous recording of heart rate/oxygen saturation/respiratory air	$346.80	$578.00	$473.96–$578.00	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPH W CPAP Charge	$3,615.60	$6,026.00	$1,446.24–$6,026.00	21% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study CPAP	$3,615.60	$6,026.00	$1,446.24–$6,026.00	21% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 Night Two	$3,615.60	$6,026.00	$1,446.24–$6,026.00	21% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 Polysomnography; age 6 years or older sleep staging with 4 or more additional parameters of s	$3,615.60	$6,026.00	$1,446.24–$6,026.00	21% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 Polysomnography; age 6 years or older sleep staging with 4 or more additional parameters of s	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPH W CPAP Charge	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 Night Two	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study CPAP	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 MDH US Abdominal Real Time w/ Image Limited	$178.20	$297.00	$71.28–$297.00	74% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue	$687.00	$1,145.00	$274.80–$1,145.00	1% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 MDH US Abdominal Real Time w/ Image Limited	$178.20	$297.00	$243.54–$297.00	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screen	$415.80	$693.00	$166.32–$693.00	26% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Screen	$415.80	$693.00	$568.26–$693.00	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRV Head w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	8% below	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	8% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	12% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$3,949.80	$6,583.00	$1,579.92–$6,583.00	6% above	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP	$3,949.80	$6,583.00	$1,579.92–$6,583.00	6% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	14% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary/IAC w/ and w/o Contrast	$3,949.80	$6,583.00	$1,579.92–$6,583.00	2% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$3,949.80	$6,583.00	$1,579.92–$6,583.00	2% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary/IAC w/ and w/o Contrast	$3,949.80	$6,583.00	$5,398.06–$6,583.00	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$2,346.00	$3,910.00	$938.40–$3,910.00	19% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$2,346.00	$3,910.00	$3,206.20–$3,910.00	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,844.80	$6,408.00	$1,537.92–$6,408.00	5% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,844.80	$6,408.00	$5,254.56–$6,408.00	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$2,346.00	$3,910.00	$938.40–$3,910.00	18% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$2,346.00	$3,910.00	$3,206.20–$3,910.00	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,844.80	$6,408.00	$1,537.92–$6,408.00	2% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,844.80	$6,408.00	$5,254.56–$6,408.00	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$2,346.00	$3,910.00	$938.40–$3,910.00	20% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$2,346.00	$3,910.00	$3,206.20–$3,910.00	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$3,499.80	$5,833.00	$1,399.92–$5,833.00	2% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$3,499.80	$5,833.00	$4,783.06–$5,833.00	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$2,410.20	$4,017.00	$964.08–$4,017.00	8% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$2,410.20	$4,017.00	$3,293.94–$4,017.00	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4-5 Views	$445.80	$743.00	$178.32–$743.00	18% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4-5 Views	$445.80	$743.00	$609.26–$743.00	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast	$1,884.00	$3,140.00	$753.60–$3,140.00	10% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w/ Contrast	$1,884.00	$3,140.00	$2,574.80–$3,140.00	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	43% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$317.40	$529.00	$126.96–$529.00	21% above	40%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$317.40	$529.00	$433.78–$529.00	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Imaging	$4,048.80	$6,748.00	$1,619.52–$6,748.00	1% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Imaging	$4,048.80	$6,748.00	$5,533.36–$6,748.00	—	40%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,008.00	$1,680.00	$403.20–$1,680.00	47% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,008.00	$1,680.00	$1,377.60–$1,680.00	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Volume	$687.00	$1,145.00	$274.80–$1,145.00	27% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 MDH US Pelvic Ltd	$687.00	$1,145.00	$274.80–$1,145.00	27% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 MDH US Pelvic Ltd	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder Volume	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete	$687.00	$1,145.00	$274.80–$1,145.00	13% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Complete	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >14 WKS SINGLE Charge	$687.00	$1,145.00	$274.80–$1,145.00	7% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >14 WKS SINGLE Charge	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US <14 WKS SINGLE Charge	$687.00	$1,145.00	$274.80–$1,145.00	3% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 weeks	$687.00	$1,145.00	$274.80–$1,145.00	3% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 weeks	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US <14 WKS SINGLE Charge	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$687.00	$1,145.00	$274.80–$1,145.00	31% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETAL Charge	$687.00	$1,145.00	$274.80–$1,145.00	31% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MDH US OB Limited	$687.00	$1,145.00	$274.80–$1,145.00	31% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MDH US OB Limited	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETAL Charge	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Screening Bilat w/ Tomo.	$311.40	$519.00	$124.56–$519.00	—	40%
Screening mammogram, both breasts CPT 77067 MA Mammogram Digital Screening.	$311.40	$519.00	$124.56–$519.00	14% above	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MA Mammogram Screening Bilat w/ Tomo.	$311.40	$519.00	$425.58–$519.00	—	40%
Screening mammogram, both breasts inpatient CPT 77067 MA Mammogram Digital Screening.	$311.40	$519.00	$425.58–$519.00	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Complete	$317.40	$529.00	$126.96–$529.00	14% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Complete	$317.40	$529.00	$433.78–$529.00	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull 2 Views	$445.80	$743.00	$178.32–$743.00	42% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull 2 Views	$445.80	$743.00	$609.26–$743.00	—	40%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study	$3,615.60	$6,026.00	$1,446.24–$6,026.00	6% below	40%
Sleep study in a lab (polysomnography) CPT 95810 95810 Polysomnography; age 6 yrs or older sleep staging with 4 or more addtl parameters of sleep	$3,615.60	$6,026.00	$1,446.24–$6,026.00	6% below	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPH Charge	$3,615.60	$6,026.00	$1,446.24–$6,026.00	6% below	40%
Sleep study in a lab (polysomnography) CPT 95810 95810 Night One	$3,615.60	$6,026.00	$1,446.24–$6,026.00	6% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPH Charge	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 Night One	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 Polysomnography; age 6 yrs or older sleep staging with 4 or more addtl parameters of sleep	$3,615.60	$6,026.00	$4,941.32–$6,026.00	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO WITH CONTRAST Charge	$2,299.20	$3,832.00	$919.68–$3,832.00	37% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Echo with Contrast	$2,299.20	$3,832.00	$919.68–$3,832.00	37% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO W/O CONTRAST Charge	$2,299.20	$3,832.00	$919.68–$3,832.00	37% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO W/O CONTRAST Charge	$2,299.20	$3,832.00	$3,142.24–$3,832.00	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Echo with Contrast	$2,299.20	$3,832.00	$3,142.24–$3,832.00	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO WITH CONTRAST Charge	$2,299.20	$3,832.00	$3,142.24–$3,832.00	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video	$430.20	$717.00	$172.08–$717.00	29% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Video	$430.20	$717.00	$587.94–$717.00	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast	$1,159.20	$1,932.00	$463.68–$1,932.00	46% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast	$1,159.20	$1,932.00	$1,584.24–$1,932.00	—	40%
Transvaginal pelvic ultrasound CPT 76830 MDH US Non-OB Transvaginal	$687.00	$1,145.00	$274.80–$1,145.00	6% above	40%
Transvaginal pelvic ultrasound CPT 76830 US Non-OB Transvaginal	$687.00	$1,145.00	$274.80–$1,145.00	6% above	40%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic Transvaginal Only	$687.00	$1,145.00	$274.80–$1,145.00	6% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic Transvaginal Only	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 MDH US Non-OB Transvaginal	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Non-OB Transvaginal	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OB Charge	$687.00	$1,145.00	$274.80–$1,145.00	30% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OB Charge	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$687.00	$1,145.00	$274.80–$1,145.00	32% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US Testicular	$687.00	$1,145.00	$274.80–$1,145.00	7% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$687.00	$1,145.00	$274.80–$1,145.00	1% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$687.00	$1,145.00	$274.80–$1,145.00	1% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$687.00	$1,145.00	$938.90–$1,145.00	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Small Bowel	$724.80	$1,208.00	$289.92–$1,208.00	3% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Small Bowel	$724.80	$1,208.00	$990.56–$1,208.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 93971 VENOUS DUPLEX LIMITED Charge	$623.40	$1,039.00	$249.36–$1,039.00	6% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 93971 VENOUS DUPLEX RT Charge	$623.40	$1,039.00	$249.36–$1,039.00	6% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 93971 VENOUS DUPLEX LT Charge	$623.40	$1,039.00	$249.36–$1,039.00	6% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Left	$623.40	$1,039.00	$249.36–$1,039.00	6% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Duplex Right	$623.40	$1,039.00	$249.36–$1,039.00	6% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 93971 VENOUS DUPLEX LIMITED Charge	$623.40	$1,039.00	$851.98–$1,039.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 93971 VENOUS DUPLEX LT Charge	$623.40	$1,039.00	$851.98–$1,039.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Duplex Left	$623.40	$1,039.00	$851.98–$1,039.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Duplex Right	$623.40	$1,039.00	$851.98–$1,039.00	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 93971 VENOUS DUPLEX RT Charge	$623.40	$1,039.00	$851.98–$1,039.00	—	40%
X-ray of the abdomen, 1 view CPT 74018 74018 Add on	$282.60	$471.00	$113.04–$471.00	6% above	40%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB	$317.40	$529.00	$126.96–$529.00	19% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 74018 Add on	$282.60	$471.00	$386.22–$471.00	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left MFB	$276.00	$460.00	$110.40–$460.00	at median	40%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right MFB	$276.00	$460.00	$110.40–$460.00	at median	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left MFB	$276.00	$460.00	$377.20–$460.00	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right MFB	$276.00	$460.00	$377.20–$460.00	—	40%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right MFB	$317.40	$529.00	$126.96–$529.00	15% above	40%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left MFB	$317.40	$529.00	$126.96–$529.00	15% above	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right MFB	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left MFB	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Min Lt	$317.40	$529.00	$126.96–$529.00	8% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Min Rt	$317.40	$529.00	$126.96–$529.00	8% below	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Min Lt	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot 3 Views Min Rt	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$445.80	$743.00	$178.32–$743.00	at median	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$445.80	$743.00	$609.26–$743.00	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views	$387.60	$646.00	$155.04–$646.00	30% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 Views	$387.60	$646.00	$529.72–$646.00	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views	$276.00	$460.00	$110.40–$460.00	8% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Minimum 3 Views	$276.00	$460.00	$377.20–$460.00	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$317.40	$529.00	$126.96–$529.00	11% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$317.40	$529.00	$433.78–$529.00	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$387.60	$646.00	$155.04–$646.00	11% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$387.60	$646.00	$529.72–$646.00	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views	$317.40	$529.00	$126.96–$529.00	8% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx Minimum 2 Views	$317.40	$529.00	$433.78–$529.00	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
AST (aspartate aminotransferase) enzyme test CPT 84450 Alanine Aminotransferase	$24.60	$41.00	$9.84–$41.00	55% below	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Alanine Aminotransferase	$24.60	$41.00	$33.62–$41.00	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel	$206.40	$344.00	$82.56–$344.00	21% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel	$206.40	$344.00	$282.08–$344.00	—	40%
Albumin blood test CPT 82040 Albumin Level	$24.00	$40.00	$9.60–$40.00	44% below	40%
Albumin blood test CPT 82040 Albumin	$24.00	$40.00	$9.60–$40.00	44% below	40%
Albumin blood test inpatient CPT 82040 Albumin Level	$24.00	$40.00	$32.80–$40.00	—	40%
Albumin blood test inpatient CPT 82040 Albumin	$24.00	$40.00	$32.80–$40.00	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$21.60	$36.00	$8.64–$36.00	61% below	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$21.60	$36.00	$29.52–$36.00	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN 13 PANEL LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen-Midwest Panel LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen-General Screen for Illinois LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T022-IgE Pecan Hickory	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 W016-IgE Marsh Elder Rough LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T015-IgE Ash White LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T014-IgE Cottonwood Tree LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T010-IgE Walnut Pollen LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 W014-IgE Pigweed Rough	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 W011-IgE Thistle Russian	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 W001-IgE Ragweed Short/Commo	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T006-IgE Cedar Mountain	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T070-IgE White Mulberry	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T011-IgE Maple Leaf Sycamore	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T008-IgE Elm American (White)	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T007-IgE Oak White	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 T001-IgE Maple/Box Elder	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatu	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 M001-IgE Penicillium chrysogen	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 G002-IgE Bermuda Grass	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE+Allergens (12) LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F010-IgE Sesame Seed LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F338-IgE Scallop LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F207-IgE Clam LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 E072-IgE Mouse Urine	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F008-IgE Corn	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 D001-IgE D pteronyssinus	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D farinae Mite	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Hair/DanderStan	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 M002-IgE Cladosporium herbaru	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 M006-IgE Alternaria alternata	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Hair/Dander	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow)	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut Food	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 F003-IgE Codfish LC	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 I006-IgE Cockroach German	$34.20	$57.00	$13.68–$57.00	24% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F008-IgE Corn	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN 13 PANEL LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen-Midwest Panel LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen-General Screen for Illinois LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T022-IgE Pecan Hickory	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W016-IgE Marsh Elder Rough LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T015-IgE Ash White LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T014-IgE Cottonwood Tree LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T010-IgE Walnut Pollen LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W014-IgE Pigweed Rough	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W011-IgE Thistle Russian	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W001-IgE Ragweed Short/Commo	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T006-IgE Cedar Mountain	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T070-IgE White Mulberry	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T011-IgE Maple Leaf Sycamore	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T008-IgE Elm American (White)	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T007-IgE Oak White	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T001-IgE Maple/Box Elder	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatu	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M001-IgE Penicillium chrysogen	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G002-IgE Bermuda Grass	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE+Allergens (12) LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F010-IgE Sesame Seed LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F338-IgE Scallop LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F207-IgE Clam LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E072-IgE Mouse Urine	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I006-IgE Cockroach German	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F003-IgE Codfish LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White LC	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256-IgE Walnut Food	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F024-IgE Shrimp	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow)	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Hair/Dander	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M006-IgE Alternaria alternata	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M002-IgE Cladosporium herbaru	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Hair/DanderStan	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D002-IgE D farinae Mite	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D001-IgE D pteronyssinus	$34.20	$57.00	$46.74–$57.00	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut	$34.20	$57.00	$46.74–$57.00	—	40%
Ammonia blood test CPT 82140 82140 Kidney Stone Urine/Saturation LC	$63.60	$106.00	$25.44–$106.00	42% below	40%
Ammonia blood test inpatient CPT 82140 82140 Kidney Stone Urine/Saturation LC	$63.60	$106.00	$86.92–$106.00	—	40%
Amylase blood test CPT 82150 Amylase Level	$33.00	$55.00	$13.20–$55.00	59% below	40%
Amylase blood test CPT 82150 Amylase Body Fluid	$33.00	$55.00	$13.20–$55.00	59% below	40%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$33.00	$55.00	$45.10–$55.00	—	40%
Amylase blood test inpatient CPT 82150 Amylase Level	$33.00	$55.00	$45.10–$55.00	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA by IFA Rfx Titer/Pattern LC	$59.40	$99.00	$23.76–$99.00	36% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 .FANA Staining Patterns RLC	$59.40	$99.00	$23.76–$99.00	36% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 .FANA Staining Patterns RLC	$59.40	$99.00	$81.18–$99.00	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA by IFA Rfx Titer/Pattern LC	$59.40	$99.00	$81.18–$99.00	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP LC	$169.80	$283.00	$67.92–$283.00	10% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT- proBNP	$169.80	$283.00	$67.92–$283.00	10% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT- proBNP	$169.80	$283.00	$232.06–$283.00	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP LC	$169.80	$283.00	$232.06–$283.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat	$37.20	$62.00	$14.88–$62.00	58% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic	$37.20	$62.00	$14.88–$62.00	58% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum	$37.20	$62.00	$14.88–$62.00	58% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue	$37.20	$62.00	$14.88–$62.00	58% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture CSF	$37.20	$62.00	$14.88–$62.00	58% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture CSF	$37.20	$62.00	$50.84–$62.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Throat	$37.20	$62.00	$50.84–$62.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Sputum	$37.20	$62.00	$50.84–$62.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Aerobic	$37.20	$62.00	$50.84–$62.00	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Tissue	$37.20	$62.00	$50.84–$62.00	—	40%
Basic metabolic panel (blood test) CPT 80048 BMP Standard	$30.00	$61.00	$14.64–$61.00	76% below	51%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP Standard	$30.00	$61.00	$50.02–$61.00	—	51%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$21.00	$35.00	$8.40–$35.00	65% below	40%
Bilirubin blood test, total CPT 82247 Bili Neonatal	$21.00	$35.00	$8.40–$35.00	65% below	40%
Bilirubin blood test, total CPT 82247 Bilirubin Neonatal	$21.00	$35.00	$8.40–$35.00	65% below	40%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Neonatal	$21.00	$35.00	$28.70–$35.00	—	40%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$21.00	$35.00	$28.70–$35.00	—	40%
Bilirubin blood test, total inpatient CPT 82247 Bili Neonatal	$21.00	$35.00	$28.70–$35.00	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$246.00	$410.00	$98.40–$410.00	at median	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$246.00	$410.00	$98.40–$410.00	at median	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 62 88305 AP Surgical Pathology Level IV Complexity	$246.00	$410.00	$98.40–$410.00	at median	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 62 88305 AP Surgical Pathology Level IV Complexity	$246.00	$410.00	$336.20–$410.00	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$246.00	$410.00	$336.20–$410.00	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$246.00	$410.00	$336.20–$410.00	—	40%
Blood culture for bacteria CPT 87040 Culture Blood	$45.60	$76.00	$18.24–$76.00	68% below	40%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$45.60	$76.00	$62.32–$76.00	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Specimen Draw	$13.80	$23.00	$5.52–$23.00	41% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$13.80	$23.00	$5.52–$23.00	41% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Specimen Draw	$13.80	$23.00	$18.86–$23.00	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$13.80	$23.00	$18.86–$23.00	—	40%
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$9.60	$16.00	$3.84–$16.00	76% below	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$9.60	$16.00	$13.12–$16.00	—	40%
Blood lead test CPT 83655 83655 Heavy Metals Profile Urine LC	$51.00	$85.00	$20.40–$85.00	5% below	40%
Blood lead test inpatient CPT 83655 83655 Heavy Metals Profile Urine LC	$51.00	$85.00	$69.70–$85.00	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Urine Standard	$20.00	$62.00	$14.88–$62.00	77% below	68%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum Standard	$20.00	$62.00	$14.88–$62.00	77% below	68%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Urine Standard	$20.00	$62.00	$50.84–$62.00	—	68%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum Standard	$20.00	$62.00	$50.84–$62.00	—	68%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill ABO Discrepancy	$66.60	$111.00	$26.64–$111.00	21% below	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill ABO Discrepancy	$66.60	$111.00	$91.02–$111.00	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$20.00	$41.00	$9.84–$41.00	71% below	51%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$20.00	$41.00	$33.62–$41.00	—	51%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Toxin	$185.40	$309.00	$74.16–$309.00	at median	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Molecular	$185.40	$309.00	$74.16–$309.00	at median	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Toxin	$185.40	$309.00	$253.38–$309.00	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Molecular	$185.40	$309.00	$253.38–$309.00	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 (ID Now)	$55.00	$178.00	$42.72–$178.00	52% below	69%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 (ID Now)	$55.00	$178.00	$145.96–$178.00	—	69%
Calcium blood test, total CPT 82310 Calcium Level	$21.60	$36.00	$8.64–$36.00	50% below	40%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$21.60	$36.00	$29.52–$36.00	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab IgG LC	$55.80	$93.00	$22.32–$93.00	23% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab IgM Qualitative LC	$55.80	$93.00	$22.32–$93.00	23% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab IgG LC	$55.80	$93.00	$76.26–$93.00	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab IgM Qualitative LC	$55.80	$93.00	$76.26–$93.00	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/Gonorrhea PCR GeneXpert	$75.00	$49.00	$11.76–$49.00	39% below	-53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Pap IG CtNg Aptima HPV LC	$174.00	$290.00	$69.60–$290.00	41% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IGP CtNg rfx Aptima HPV ASCU LC	$174.00	$290.00	$69.60–$290.00	41% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Pap IG Ct-Ng rfx HPV ASCU LC	$174.00	$290.00	$69.60–$290.00	41% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IGPCtNgAptimaHPVrfx16/1845 LC	$174.00	$290.00	$69.60–$290.00	41% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT.	$174.00	$290.00	$69.60–$290.00	41% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia/Gonorrhea PCR GeneXpert	$75.00	$49.00	$40.18–$49.00	—	-53%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Pap IG Ct-Ng rfx HPV ASCU LC	$174.00	$290.00	$237.80–$290.00	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Pap IG CtNg Aptima HPV LC	$174.00	$290.00	$237.80–$290.00	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT.	$174.00	$290.00	$237.80–$290.00	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IGPCtNgAptimaHPVrfx16/1845 LC	$174.00	$290.00	$237.80–$290.00	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IGP CtNg rfx Aptima HPV ASCU LC	$174.00	$290.00	$237.80–$290.00	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Standard	$9.60	$16.00	$3.84–$16.00	92% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Standard	$9.60	$16.00	$13.12–$16.00	—	40%
Complete blood count (CBC) with differential CPT 85025 Automated Differential Standard	$25.00	$57.00	$13.68–$57.00	69% below	56%
Complete blood count (CBC) with differential inpatient CPT 85025 Automated Differential Standard	$25.00	$57.00	$46.74–$57.00	—	56%
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC) automated	$28.20	$47.00	$11.28–$47.00	57% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Blood count; complete (CBC) automated	$28.20	$47.00	$38.54–$47.00	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Total Prot	$50.00	$77.00	$18.48–$77.00	67% below	35%
Comprehensive metabolic panel (blood test) CPT 80053 CMP Standard	$50.00	$77.00	$18.48–$77.00	67% below	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP Standard	$50.00	$77.00	$63.14–$77.00	—	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Total Prot	$50.00	$77.00	$63.14–$77.00	—	35%
Cortisol blood test, total CPT 82533 Salivary Cortisol MS LC	$81.60	$136.00	$32.64–$136.00	27% below	40%
Cortisol blood test, total inpatient CPT 82533 Salivary Cortisol MS LC	$81.60	$136.00	$111.52–$136.00	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Bill CMV	$70.80	$118.00	$28.32–$118.00	19% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Bill CMV	$70.80	$118.00	$96.76–$118.00	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$50.40	$84.00	$20.16–$84.00	58% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$50.40	$84.00	$68.88–$84.00	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Preemploy Drug 9 Panel	$15.00	$25.00	$6.00–$25.00	85% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Macomb N-Dot Chain of Custody	$51.00	$85.00	$20.40–$85.00	49% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ToxASSURE Select 13 (MW) LC	$128.40	$214.00	$51.36–$214.00	29% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamine Screen Urine LC	$206.40	$344.00	$82.56–$344.00	107% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Court Order 10 - UDS Order Type	$232.80	$388.00	$93.12–$388.00	134% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OB CORD STAT Charge	$268.80	$448.00	$107.52–$448.00	170% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OB MECONIUM 10 PANEL Charge	$268.80	$448.00	$107.52–$448.00	170% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OB CORD STAT W/ ALCOHOL Charge	$268.80	$448.00	$107.52–$448.00	170% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Preemploy Drug 9 Panel	$15.00	$25.00	$20.50–$25.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Macomb N-Dot Chain of Custody	$51.00	$85.00	$69.70–$85.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ToxASSURE Select 13 (MW) LC	$128.40	$214.00	$175.48–$214.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamine Screen Urine LC	$206.40	$344.00	$282.08–$344.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Court Order 10 - UDS Order Type	$232.80	$388.00	$318.16–$388.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OB CORD STAT Charge	$268.80	$448.00	$367.36–$448.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OB MECONIUM 10 PANEL Charge	$268.80	$448.00	$367.36–$448.00	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OB CORD STAT W/ ALCOHOL Charge	$268.80	$448.00	$367.36–$448.00	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 U Lytes	$31.20	$52.00	$12.48–$52.00	66% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Standard	$31.20	$52.00	$12.48–$52.00	66% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 U Lytes	$31.20	$52.00	$42.64–$52.00	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Standard	$31.20	$52.00	$42.64–$52.00	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA IgM	$89.40	$149.00	$35.76–$149.00	17% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA IgG	$89.40	$149.00	$35.76–$149.00	17% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Antibody Profile LC	$89.40	$149.00	$35.76–$149.00	17% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Antibody Profile LC	$89.40	$149.00	$122.18–$149.00	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA IgG	$89.40	$149.00	$122.18–$149.00	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA IgM	$89.40	$149.00	$122.18–$149.00	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH Serum	$96.00	$160.00	$38.40–$160.00	20% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH Serum	$96.00	$160.00	$131.20–$160.00	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum 2	$67.80	$113.00	$27.12–$113.00	48% below	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum	$67.80	$113.00	$27.12–$113.00	48% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Serum	$67.80	$113.00	$92.66–$113.00	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Serum 2	$67.80	$113.00	$92.66–$113.00	—	40%
Fibrinogen blood test CPT 85384 Fibrinogen	$41.40	$69.00	$16.56–$69.00	51% below	40%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$41.40	$69.00	$56.58–$69.00	—	40%
Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) serum	$64.20	$107.00	$25.68–$107.00	44% below	40%
Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) serum	$64.20	$107.00	$87.74–$107.00	—	40%
Free T3 thyroid hormone test CPT 84481 T3 Free	$84.60	$141.00	$33.84–$141.00	30% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$84.60	$141.00	$115.62–$141.00	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free	$30.00	$76.00	$18.24–$76.00	74% below	61%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free	$30.00	$76.00	$62.32–$76.00	—	61%
Free testosterone test CPT 84402 Testosterone Free+Total LC/MS LC	$93.00	$155.00	$37.20–$155.00	26% below	40%
Free testosterone test inpatient CPT 84402 Testosterone Free+Total LC/MS LC	$93.00	$155.00	$127.10–$155.00	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC	$36.00	$60.00	$14.40–$60.00	38% below	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC	$36.00	$60.00	$49.20–$60.00	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$314.40	$524.00	$125.76–$524.00	4% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$314.40	$524.00	$429.68–$524.00	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Gestational	$22.80	$38.00	$9.12–$38.00	60% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Gestational	$22.80	$38.00	$31.16–$38.00	—	40%
Glucose tolerance test, 3 samples CPT 82951 .Glucose 2 Hour	$64.80	$108.00	$25.92–$108.00	50% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose 2 Hour	$64.80	$108.00	$88.56–$108.00	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N. Gonorrhoeae DNA AMP PROBE	$29.40	$49.00	$11.76–$49.00	75% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591- Pap IG CtNg Aptima HPV LC	$174.00	$290.00	$69.60–$290.00	46% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Pap IG Ct-Ng rfx HPV ASCU LC	$174.00	$290.00	$69.60–$290.00	46% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N. Gonorrhoeae DNA AMP PROBE	$29.40	$49.00	$40.18–$49.00	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Pap IG Ct-Ng rfx HPV ASCU LC	$174.00	$290.00	$237.80–$290.00	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591- Pap IG CtNg Aptima HPV LC	$174.00	$290.00	$237.80–$290.00	—	40%
H. pylori antibody blood test CPT 86677 Rapid Urease	$124.20	$207.00	$49.68–$207.00	7% above	40%
H. pylori antibody blood test inpatient CPT 86677 Rapid Urease	$124.20	$207.00	$169.74–$207.00	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Qualitative LC	$423.60	$706.00	$169.44–$706.00	25% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Qualitative LC	$423.60	$706.00	$578.92–$706.00	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624- Pap IG CtNg Aptima HPV LC	$160.20	$267.00	$64.08–$267.00	10% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 IGP cobasHPV rfx16/18 LC	$174.00	$290.00	$69.60–$290.00	19% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV.	$174.00	$290.00	$69.60–$290.00	19% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Pap IGP Apt HPVrfx 16/1845 LC 87624	$174.00	$290.00	$69.60–$290.00	19% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624- Pap IG CtNg Aptima HPV LC	$160.20	$267.00	$218.94–$267.00	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 IGP cobasHPV rfx16/18 LC	$174.00	$290.00	$237.80–$290.00	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV.	$174.00	$290.00	$237.80–$290.00	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Pap IGP Apt HPVrfx 16/1845 LC 87624	$174.00	$290.00	$237.80–$290.00	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1C	$35.00	$81.00	$19.44–$81.00	60% below	57%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c DC	$35.00	$81.00	$19.44–$81.00	60% below	57%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1C	$35.00	$81.00	$66.42–$81.00	—	57%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c DC	$35.00	$81.00	$66.42–$81.00	—	57%
Hemoglobin blood test CPT 85018 Hemoglobin	$11.40	$19.00	$4.56–$19.00	64% below	40%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$11.40	$19.00	$15.58–$19.00	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab w Interp	$53.40	$89.00	$21.36–$89.00	43% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab	$53.40	$89.00	$21.36–$89.00	43% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab w Interp	$53.40	$89.00	$72.98–$89.00	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab	$53.40	$89.00	$72.98–$89.00	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBs Ag Screen	$51.00	$85.00	$20.40–$85.00	43% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBs Ag Screen LC	$51.00	$85.00	$20.40–$85.00	43% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBs Ag Screen	$51.00	$85.00	$69.70–$85.00	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBs Ag Screen LC	$51.00	$85.00	$69.70–$85.00	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Diagnosis LC	$212.40	$354.00	$84.96–$354.00	20% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Diagnosis LC	$212.40	$354.00	$290.28–$354.00	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 .HSV-2 IgG Supplemental Test LC	$66.00	$110.00	$26.40–$110.00	2% below	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 .HSV-2 IgG Supplemental Test LC	$66.00	$110.00	$90.20–$110.00	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 86696 HSV 1 and 2 IgM Abs Indirect LC	$96.60	$161.00	$38.64–$161.00	4% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 HSV 1 and 2 IgM Abs Indirect LC	$96.60	$161.00	$132.02–$161.00	—	40%
Homocysteine blood test CPT 83090 Homocysteine	$88.80	$148.00	$35.52–$148.00	26% below	40%
Homocysteine blood test inpatient CPT 83090 Homocysteine	$88.80	$148.00	$121.36–$148.00	—	40%
Iron blood test (serum iron) CPT 83540 Iron Level	$20.00	$55.00	$13.20–$55.00	74% below	64%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$20.00	$55.00	$45.10–$55.00	—	64%
Iron-binding capacity (TIBC) test CPT 83550 Bill TIBC	$109.80	$183.00	$43.92–$183.00	39% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Bill TIBC	$109.80	$183.00	$150.06–$183.00	—	40%
Kidney function blood test panel CPT 80069 Renal Panel Standard	$37.20	$62.00	$14.88–$62.00	75% below	40%
Kidney function blood test panel inpatient CPT 80069 Renal Panel Standard	$37.20	$62.00	$50.84–$62.00	—	40%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$97.20	$162.00	$38.88–$162.00	15% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$97.20	$162.00	$132.84–$162.00	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$27.00	$45.00	$10.80–$45.00	49% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 BF LDH Lvl	$27.00	$45.00	$10.80–$45.00	49% below	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 BF LDH Lvl	$27.00	$45.00	$36.90–$45.00	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$27.00	$45.00	$36.90–$45.00	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$34.80	$58.00	$13.92–$58.00	61% below	40%
Lipase blood test (pancreas enzyme) CPT 83690 BF Lipase Level	$34.80	$58.00	$13.92–$58.00	61% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$34.80	$58.00	$47.56–$58.00	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 BF Lipase Level	$34.80	$58.00	$47.56–$58.00	—	40%
Liver function blood test panel CPT 80076 Liver Panel	$40.20	$67.00	$16.08–$67.00	71% below	40%
Liver function blood test panel inpatient CPT 80076 Liver Panel	$40.20	$67.00	$54.94–$67.00	—	40%
Magnesium blood test CPT 83735 Magnesium RBC LC	$29.40	$49.00	$11.76–$49.00	57% below	40%
Magnesium blood test CPT 83735 83735 Kidney Stone Urine/Saturation LC	$29.40	$49.00	$11.76–$49.00	57% below	40%
Magnesium blood test inpatient CPT 83735 Magnesium RBC LC	$29.40	$49.00	$40.18–$49.00	—	40%
Magnesium blood test inpatient CPT 83735 83735 Kidney Stone Urine/Saturation LC	$29.40	$49.00	$40.18–$49.00	—	40%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies IgM LC	$64.80	$108.00	$25.92–$108.00	14% below	40%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies IgG LC	$64.80	$108.00	$25.92–$108.00	14% below	40%
Measles (rubeola) antibody test CPT 86765 Rubella Antibodies IgG LC	$64.80	$108.00	$25.92–$108.00	14% below	40%
Measles (rubeola) antibody test CPT 86765 Rubella IgG	$70.80	$118.00	$28.32–$118.00	6% below	40%
Measles (rubeola) antibody test CPT 86765 60 Rubella IgG Antibody	$70.80	$118.00	$28.32–$118.00	6% below	40%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies IgG LC	$64.80	$108.00	$88.56–$108.00	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 Rubella Antibodies IgG LC	$64.80	$108.00	$88.56–$108.00	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies IgM LC	$64.80	$108.00	$88.56–$108.00	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 Rubella IgG	$70.80	$118.00	$96.76–$118.00	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 60 Rubella IgG Antibody	$70.80	$118.00	$96.76–$118.00	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 PSA Total + % Free LC	$80.40	$134.00	$32.16–$134.00	30% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 PSA Total + % Free LC	$80.40	$134.00	$109.88–$134.00	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 IGP Apt HPVrfx 16/1845 LC	$126.60	$211.00	$50.64–$211.00	4% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 IGPrfx Aptima HPV all pth LC	$132.00	$220.00	$52.80–$220.00	at median	40%
Pap test (liquid-based, automated screening with review) CPT 88175 88175- Pap IG CtNg Aptima HPV LC	$132.00	$220.00	$52.80–$220.00	at median	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap IGP Apt HPVrfx 16/1845 LC	$132.00	$220.00	$52.80–$220.00	at median	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 IGP Apt HPVrfx 16/1845 LC	$126.60	$211.00	$173.02–$211.00	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 IGPrfx Aptima HPV all pth LC	$132.00	$220.00	$180.40–$220.00	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap IGP Apt HPVrfx 16/1845 LC	$132.00	$220.00	$180.40–$220.00	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175- Pap IG CtNg Aptima HPV LC	$132.00	$220.00	$180.40–$220.00	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 .Change IG Pap to LB Pap LC	$70.80	$118.00	$28.32–$118.00	37% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap IGP Apt HPVrfx 16/1845 LC 88142	$117.00	$195.00	$46.80–$195.00	4% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 .Change IG Pap to LB Pap LC	$70.80	$118.00	$96.76–$118.00	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pap IGP Apt HPVrfx 16/1845 LC 88142	$117.00	$195.00	$159.90–$195.00	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$178.20	$297.00	$71.28–$297.00	21% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 Rapid PTH	$178.20	$297.00	$71.28–$297.00	21% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Rapid PTH	$178.20	$297.00	$243.54–$297.00	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$178.20	$297.00	$243.54–$297.00	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$27.00	$45.00	$10.80–$45.00	59% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$27.00	$45.00	$36.90–$45.00	—	40%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$20.40	$34.00	$8.16–$34.00	65% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level	$20.40	$34.00	$27.88–$34.00	—	40%
Potassium blood test CPT 84132 Potassium Level	$20.40	$34.00	$8.16–$34.00	53% below	40%
Potassium blood test inpatient CPT 84132 Potassium Level	$20.40	$34.00	$27.88–$34.00	—	40%
Progesterone blood test CPT 84144 Progesterone Level	$103.80	$173.00	$41.52–$173.00	26% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$103.80	$173.00	$141.86–$173.00	—	40%
Prolactin blood test CPT 84146 Prolactin	$105.00	$175.00	$42.00–$175.00	19% below	40%
Prolactin blood test inpatient CPT 84146 Prolactin	$105.00	$175.00	$143.50–$175.00	—	40%
Renin blood test CPT 84244 Renin Activity Plasma LC	$108.60	$181.00	$43.44–$181.00	6% below	40%
Renin blood test inpatient CPT 84244 Renin Activity Plasma LC	$108.60	$181.00	$148.42–$181.00	—	40%
Rh blood typing CPT 86901 86901	$52.20	$87.00	$20.88–$87.00	22% below	40%
Rh blood typing inpatient CPT 86901 86901	$52.20	$87.00	$71.34–$87.00	—	40%
Rheumatoid factor (RF) test CPT 86431 RA TITER	$28.80	$48.00	$11.52–$48.00	54% below	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) IgA LC	$28.80	$48.00	$11.52–$48.00	54% below	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) IgG LC	$28.80	$48.00	$11.52–$48.00	54% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) IgG LC	$28.80	$48.00	$39.36–$48.00	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER	$28.80	$48.00	$39.36–$48.00	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) IgA LC	$28.80	$48.00	$39.36–$48.00	—	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgM LC	$70.80	$118.00	$28.32–$118.00	3% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgM LC	$70.80	$118.00	$96.76–$118.00	—	40%
Sodium blood test CPT 84295 Sodium Level	$18.00	$30.00	$7.20–$30.00	63% below	40%
Sodium blood test inpatient CPT 84295 Sodium Level	$18.00	$30.00	$24.60–$30.00	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Diagnostic Single	$18.60	$31.00	$7.44–$31.00	35% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Diagnostic Single	$18.60	$31.00	$25.42–$31.00	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Screen. 1-3	$69.00	$115.00	$27.60–$115.00	7% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Screen. 1-3	$69.00	$115.00	$94.30–$115.00	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis: Treponemal Antibodies TPPA LC	$66.00	$110.00	$26.40–$110.00	at median	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab (FTA-Ab) LC	$66.00	$110.00	$26.40–$110.00	at median	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab (FTA-Ab) LC	$66.00	$110.00	$90.20–$110.00	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis: Treponemal Antibodies TPPA LC	$66.00	$110.00	$90.20–$110.00	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Rfx Qn RPR/Confirm TP LC	$21.00	$35.00	$8.40–$35.00	59% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Quant	$71.40	$119.00	$28.56–$119.00	40% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Qualitative	$71.40	$119.00	$28.56–$119.00	40% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Rfx Qn RPR/Confirm TP LC	$21.00	$35.00	$28.70–$35.00	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Qualitative	$71.40	$119.00	$97.58–$119.00	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Quant	$71.40	$119.00	$97.58–$119.00	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total LC/MS LC	$93.00	$155.00	$37.20–$155.00	27% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 Testosterone Free+Total LC/MS LC	$93.00	$155.00	$37.20–$155.00	27% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Serum LC	$93.00	$155.00	$37.20–$155.00	27% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone	$128.40	$214.00	$51.36–$214.00	1% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Serum LC	$93.00	$155.00	$127.10–$155.00	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 Testosterone Free+Total LC/MS LC	$93.00	$155.00	$127.10–$155.00	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total LC/MS LC	$93.00	$155.00	$127.10–$155.00	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone	$128.40	$214.00	$175.48–$214.00	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$117.00	$195.00	$46.80–$195.00	47% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC	$117.00	$195.00	$159.90–$195.00	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$30.00	$140.00	$33.60–$140.00	73% below	79%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Reflex to FT4	$81.60	$140.00	$33.60–$140.00	27% below	42%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$30.00	$140.00	$114.80–$140.00	—	79%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Reflex to FT4	$81.60	$140.00	$114.80–$140.00	—	42%
Total IgE blood test CPT 82785 Immunoglobulin E Total	$82.20	$137.00	$32.88–$137.00	6% below	40%
Total IgE blood test CPT 82785 Immunocap Children 0-3 #604870	$82.20	$137.00	$32.88–$137.00	6% below	40%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E Total	$82.20	$137.00	$112.34–$137.00	—	40%
Total IgE blood test inpatient CPT 82785 Immunocap Children 0-3 #604870	$82.20	$137.00	$112.34–$137.00	—	40%
Total cholesterol blood test CPT 82465 Cholesterol Total	$20.00	$35.00	$8.40–$35.00	53% below	43%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total	$20.00	$35.00	$28.70–$35.00	—	43%
Total thyroxine (T4) blood test CPT 84436 Thyroxine	$30.00	$50.00	$12.00–$50.00	64% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine	$30.00	$50.00	$41.00–$50.00	—	40%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC	$70.20	$117.00	$28.08–$117.00	27% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC	$70.20	$117.00	$95.94–$117.00	—	40%
Transferrin blood test CPT 84466 Transferrin LC	$64.20	$107.00	$25.68–$107.00	33% below	40%
Transferrin blood test inpatient CPT 84466 Transferrin LC	$64.20	$107.00	$87.74–$107.00	—	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas PCR (GeneXpert)	$75.00	$164.00	$39.36–$164.00	40% below	54%
Trichomonas test (NAAT) CPT 87661 Trich vag by NAA LC	$174.00	$290.00	$69.60–$290.00	40% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas PCR (GeneXpert)	$75.00	$164.00	$134.48–$164.00	—	54%
Trichomonas test (NAAT) inpatient CPT 87661 Trich vag by NAA LC	$174.00	$290.00	$237.80–$290.00	—	40%
Triglycerides blood test CPT 84478 Triglycerides	$20.00	$48.00	$11.52–$48.00	58% below	58%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$20.00	$48.00	$39.36–$48.00	—	58%
Troponin test, quantitative CPT 84484 Troponin-I High Sensitivity	$50.00	$90.00	$21.60–$90.00	67% below	44%
Troponin test, quantitative inpatient CPT 84484 Troponin-I High Sensitivity	$50.00	$90.00	$73.80–$90.00	—	44%
Uric acid blood test CPT 84550 Uric Acid	$19.20	$32.00	$7.68–$32.00	73% below	40%
Uric acid blood test inpatient CPT 84550 Uric Acid	$19.20	$32.00	$26.24–$32.00	—	40%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Microscopic Standard	$20.00	$29.00	$6.96–$29.00	69% below	31%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Microscopic Standard	$20.00	$29.00	$23.78–$29.00	—	31%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick Standard	$10.00	$24.00	$5.76–$24.00	56% below	58%
Urinalysis without microscope exam, manual CPT 81002 UA w Culture if Ind	$14.40	$24.00	$5.76–$24.00	36% below	40%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC	$14.40	$24.00	$5.76–$24.00	36% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick Standard	$10.00	$24.00	$19.68–$24.00	—	58%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC	$14.40	$24.00	$19.68–$24.00	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA w Culture if Ind	$14.40	$24.00	$19.68–$24.00	—	40%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture - MDH	$21.00	$35.00	$8.40–$35.00	77% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture - MDH	$21.00	$35.00	$28.70–$35.00	—	40%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hour Urine 2	$29.40	$49.00	$11.76–$49.00	56% below	40%
Urine microalbumin (albumin) test CPT 82043 U Microalbumin	$29.40	$49.00	$11.76–$49.00	56% below	40%
Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin	$29.40	$49.00	$11.76–$49.00	56% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level 24 Hour Urine 2	$29.40	$49.00	$40.18–$49.00	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Urine Microalbumin	$29.40	$49.00	$40.18–$49.00	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 U Microalbumin	$29.40	$49.00	$40.18–$49.00	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level 1	$50.00	$112.00	$26.88–$112.00	61% below	55%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$67.20	$112.00	$26.88–$112.00	48% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level 1	$50.00	$112.00	$91.84–$112.00	—	55%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$67.20	$112.00	$91.84–$112.00	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$147.60	$246.00	$59.04–$246.00	19% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$147.60	$246.00	$201.72–$246.00	—	40%
Zinc blood test CPT 84630 Zinc RBC LC	$56.40	$94.00	$22.56–$94.00	21% below	40%
Zinc blood test CPT 84630 Zinc Plasma or Serum LC	$56.40	$94.00	$22.56–$94.00	21% below	40%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum LC	$56.40	$94.00	$77.08–$94.00	—	40%
Zinc blood test inpatient CPT 84630 Zinc RBC LC	$56.40	$94.00	$77.08–$94.00	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 AFP Tetra LC	$74.40	$124.00	$29.76–$124.00	31% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 AFP Tetra LC	$74.40	$124.00	$101.68–$124.00	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Botox injections for chronic migraine CPT 64615 64615 Chemodenervation Chronic Migraine	$435.00	$725.00	$174.00–$725.00	6% above	40%
Botox injections for chronic migraine inpatient CPT 64615 64615 Chemodenervation Chronic Migraine	$435.00	$725.00	$594.50–$725.00	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MDH MA Stereo Biopsy 1st Lesion Rt	$3,418.80	$5,698.00	$1,367.52–$5,698.00	11% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MDH MA Stereo Biopsy 1st Lesion Rt	$3,418.80	$5,698.00	$4,672.36–$5,698.00	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TOE FX W/O MAN.	$374.40	$624.00	$149.76–$624.00	42% below	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TOE FX W/O MAN.	$374.40	$624.00	$511.68–$624.00	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL NONEMERGENCY Charge	$960.60	$1,601.00	$384.24–$1,601.00	19% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$2,560.80	$4,268.00	$1,024.32–$4,268.00	115% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL NONEMERGENCY Charge	$960.60	$1,601.00	$1,312.82–$1,601.00	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$2,560.80	$4,268.00	$3,499.76–$4,268.00	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM OTH THN CLAMP	$2,803.20	$4,672.00	$1,121.28–$4,672.00	12% above	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUM OTH THN CLAMP	$2,803.20	$4,672.00	$3,831.04–$4,672.00	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 OB CIRCUMCISION CLAMP Charge	$1,354.80	$2,258.00	$541.92–$2,258.00	19% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 OB CIRCUMCISION SURGICAL Charge	$1,354.80	$2,258.00	$541.92–$2,258.00	19% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 OB CIRCUMCISION CLAMP Charge	$1,354.80	$2,258.00	$1,851.56–$2,258.00	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 OB CIRCUMCISION SURGICAL Charge	$1,354.80	$2,258.00	$1,851.56–$2,258.00	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 DISTAL WRIST FX/DIS	$308.40	$514.00	$123.36–$514.00	41% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 DISTAL WRIST FX/DIS	$308.40	$514.00	$421.48–$514.00	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ANY METH	$100.80	$168.00	$40.32–$168.00	39% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ANY METH	$100.80	$168.00	$137.76–$168.00	—	40%
Earwax removal with instruments, one ear CPT 69210 IRRIGATE EAR ED	$107.40	$179.00	$42.96–$179.00	14% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 IRRIGATE EAR ED	$107.40	$179.00	$146.78–$179.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection Sing (Not Indwell Cath)Not Incl Neurolyt SubstWwo Contrast; cervical	$1,138.80	$1,898.00	$455.52–$1,898.00	37% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Cervical/Thoracic Epidural with Guidance	$1,138.80	$1,898.00	$455.52–$1,898.00	37% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Cervical/Thoracic Epidural with Guidance	$1,138.80	$1,898.00	$1,556.36–$1,898.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Injection Sing (Not Indwell Cath)Not Incl Neurolyt SubstWwo Contrast; cervical	$1,138.80	$1,898.00	$1,556.36–$1,898.00	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 Injection(s) diagnostic or therapeutic agent paravertebral facet (zygapophyseal) joint (or n	$1,597.80	$2,663.00	$639.12–$2,663.00	3% above	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 Lumbar/Sacral facet joint or joint nerve single level..	$1,597.80	$2,663.00	$639.12–$2,663.00	3% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 Injection(s) diagnostic or therapeutic agent paravertebral facet (zygapophyseal) joint (or n	$1,597.80	$2,663.00	$2,183.66–$2,663.00	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 Lumbar/Sacral facet joint or joint nerve single level..	$1,597.80	$2,663.00	$2,183.66–$2,663.00	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 MDH Intro Contr Hysteros	$572.40	$954.00	$228.96–$954.00	47% above	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 MDH Intro Contr Hysteros	$572.40	$954.00	$782.28–$954.00	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SKIN ABSCESS	$362.40	$604.00	$144.96–$604.00	8% below	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SKIN ABSCESS	$362.40	$604.00	$495.28–$604.00	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection Single Tendon Sheath/Ligament Aponeurosis RHI	$423.00	$705.00	$169.20–$705.00	2% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 Injection Single Tendon Sheath/Ligament Aponeurosis RHI	$423.00	$705.00	$578.10–$705.00	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT ASPIRATION	$462.00	$770.00	$184.80–$770.00	6% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Joint injection large joint without ultrasound guidance..	$554.40	$924.00	$221.76–$924.00	12% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis aspiration and/or injection major joint or bursa; without ultrasound guidance	$554.40	$924.00	$221.76–$924.00	12% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JOINT ASPIRATION	$462.00	$770.00	$631.40–$770.00	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Joint injection large joint without ultrasound guidance..	$554.40	$924.00	$757.68–$924.00	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis aspiration and/or injection major joint or bursa; without ultrasound guidance	$554.40	$924.00	$757.68–$924.00	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTER	$254.40	$424.00	$101.76–$424.00	39% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Joint Injection medium joint (Elbow wrist etc.) without ultrasound guidance..	$435.00	$725.00	$174.00–$725.00	5% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis aspiration and/or injection intermediate joint or bursa	$435.00	$725.00	$174.00–$725.00	5% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTER	$254.40	$424.00	$347.68–$424.00	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Joint Injection medium joint (Elbow wrist etc.) without ultrasound guidance..	$435.00	$725.00	$594.50–$725.00	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Arthrocentesis aspiration and/or injection intermediate joint or bursa	$435.00	$725.00	$594.50–$725.00	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMAL	$235.80	$393.00	$94.32–$393.00	25% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthocentesis aspiration and/or injection small joint bursa; without ultrasound guidance	$435.00	$725.00	$174.00–$725.00	39% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMAL	$235.80	$393.00	$322.26–$393.00	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Arthocentesis aspiration and/or injection small joint bursa; without ultrasound guidance	$435.00	$725.00	$594.50–$725.00	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 Injection Sing (Not Indwell Cath)Not Incl Neurolyt SubstWwo Contrast; lumbar	$1,138.80	$1,898.00	$455.52–$1,898.00	21% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 62323 Lumbar/Sacral epidural with guidance	$1,138.80	$1,898.00	$455.52–$1,898.00	21% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Injection Sing (Not Indwell Cath)Not Incl Neurolyt SubstWwo Contrast; lumbar	$1,138.80	$1,898.00	$1,556.36–$1,898.00	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 Lumbar/Sacral epidural with guidance	$1,138.80	$1,898.00	$1,556.36–$1,898.00	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 62322 Lumbar/Sacral epidural w/o guidance	$1,138.20	$1,897.00	$455.28–$1,897.00	22% below	40%
Lower-back epidural injection, without imaging guidance CPT 62322 62322 ESI Lumbar CHARGE	$1,138.20	$1,897.00	$455.28–$1,897.00	22% below	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 Lumbar/Sacral epidural w/o guidance	$1,138.20	$1,897.00	$1,555.54–$1,897.00	—	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 ESI Lumbar CHARGE	$1,138.20	$1,897.00	$1,555.54–$1,897.00	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 Lumbar/Sacral transforaminal single level..	$1,444.20	$2,407.00	$577.68–$2,407.00	2% above	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection Anesthetic Agent And/Or Steroid Transforaminal Epidural; Lumbar Or Sacral Single	$1,444.20	$2,407.00	$577.68–$2,407.00	2% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Injection Anesthetic Agent And/Or Steroid Transforaminal Epidural; Lumbar Or Sacral Single	$1,444.20	$2,407.00	$1,973.74–$2,407.00	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 Lumbar/Sacral transforaminal single level..	$1,444.20	$2,407.00	$1,973.74–$2,407.00	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESI	$499.20	$832.00	$199.68–$832.00	21% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESI	$499.20	$832.00	$682.24–$832.00	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESI 2	$496.20	$827.00	$198.48–$827.00	20% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LESI 2	$496.20	$827.00	$678.14–$827.00	—	40%
Occipital nerve block (injection for headaches) CPT 64405 Injection Anesthetic Agent; Greater Occipital Nerve	$681.00	$1,135.00	$272.40–$1,135.00	31% above	40%
Occipital nerve block (injection for headaches) CPT 64405 64405 Greater Occipital Nerve Block CHARGE	$681.00	$1,135.00	$272.40–$1,135.00	31% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection Anesthetic Agent; Greater Occipital Nerve	$681.00	$1,135.00	$930.70–$1,135.00	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 Greater Occipital Nerve Block CHARGE	$681.00	$1,135.00	$930.70–$1,135.00	—	40%
Paracentesis with imaging guidance CPT 49083 US Guided Paracentesis	$1,345.80	$2,243.00	$538.32–$2,243.00	6% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 US Guided Paracentesis	$1,345.80	$2,243.00	$1,839.26–$2,243.00	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REM OF NAIL MATRIX (	$465.60	$776.00	$186.24–$776.00	26% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REM OF NAIL MATRIX (	$465.60	$776.00	$636.32–$776.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of paravertebral facet joint (single) w/ guidance; lumbar or sacral	$2,708.40	$4,514.00	$1,083.36–$4,514.00	2% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 64635 RF L/S facet 1st Level..	$2,708.40	$4,514.00	$1,083.36–$4,514.00	2% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destruction of paravertebral facet joint (single) w/ guidance; lumbar or sacral	$2,708.40	$4,514.00	$3,701.48–$4,514.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 64635 RF L/S facet 1st Level..	$2,708.40	$4,514.00	$3,701.48–$4,514.00	—	40%
Removal of a foreign object under the skin, simple CPT 10120 INCSN RMVL FB; SUBQ	$762.60	$1,271.00	$305.04–$1,271.00	58% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCSN RMVL FB; SUBQ	$762.60	$1,271.00	$1,042.22–$1,271.00	—	40%
Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST	$278.40	$464.00	$111.36–$464.00	7% below	40%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST	$278.40	$464.00	$380.48–$464.00	—	40%
Short arm splint (forearm and hand) CPT 29125 APPLY SHRTARM SPLINT	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) CPT 29125 Ulnar gutter splint applied - Treatments Done	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) CPT 29125 Volar splint applied - Treatments Done	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Wrist left - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Forearm right - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Forearm left - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Lower leg left - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Lower leg right - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Wrist right - Treatment Site	$226.20	$377.00	$90.48–$377.00	9% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Volar splint applied - Treatments Done	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHRTARM SPLINT	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Ulnar gutter splint applied - Treatments Done	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Lower leg left - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Forearm left - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Wrist left - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Forearm right - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Wrist right - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Lower leg right - Treatment Site	$226.20	$377.00	$309.14–$377.00	—	40%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST ED	$276.60	$461.00	$110.64–$461.00	22% below	40%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST ED	$276.60	$461.00	$378.02–$461.00	—	40%
Short leg splint (calf to foot) CPT 29515 APPLY SHRTLEG SPLINT	$277.20	$462.00	$110.88–$462.00	3% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHRTLEG SPLINT	$277.20	$462.00	$378.84–$462.00	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LACERATION <2.5 CM	$417.00	$695.00	$166.80–$695.00	13% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LACERATION <2.5 CM	$417.00	$695.00	$569.90–$695.00	—	40%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy of skin; single lesion	$432.60	$721.00	$173.04–$721.00	16% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy of skin; single lesion	$432.60	$721.00	$591.22–$721.00	—	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS/ANY	$179.40	$299.00	$71.76–$299.00	28% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS/ANY	$179.40	$299.00	$245.18–$299.00	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Spinal puncture lumbar diagnostic	$726.00	$1,210.00	$290.40–$1,210.00	25% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE Charge	$726.00	$1,210.00	$290.40–$1,210.00	25% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 Spinal puncture lumbar diagnostic	$726.00	$1,210.00	$992.20–$1,210.00	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE Charge	$726.00	$1,210.00	$992.20–$1,210.00	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LACERATION > 2.5 CM	$417.00	$695.00	$166.80–$695.00	at median	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LACERATION > 2.5 CM	$417.00	$695.00	$569.90–$695.00	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACERATION < 2.5 CM	$417.00	$695.00	$166.80–$695.00	3% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LACERATION < 2.5 CM	$417.00	$695.00	$569.90–$695.00	—	40%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ US	$1,348.80	$2,248.00	$539.52–$2,248.00	8% above	40%
Thoracentesis with imaging guidance CPT 32555 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,348.80	$2,248.00	$539.52–$2,248.00	8% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ US	$1,348.80	$2,248.00	$1,843.36–$2,248.00	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,348.80	$2,248.00	$1,843.36–$2,248.00	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1/2	$376.20	$627.00	$150.48–$627.00	28% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection(s); single or multiple trigger point(s) 1 or 2 muscle(s) Charge	$435.00	$725.00	$174.00–$725.00	16% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PNT 1/2	$376.20	$627.00	$514.14–$627.00	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection(s); single or multiple trigger point(s) 1 or 2 muscle(s) Charge	$435.00	$725.00	$594.50–$725.00	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Rt	$2,281.20	$3,802.00	$912.48–$3,802.00	6% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Lt	$4,368.00	$7,280.00	$1,747.20–$7,280.00	80% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy Rt	$2,281.20	$3,802.00	$3,117.64–$3,802.00	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy Lt	$4,368.00	$7,280.00	$5,969.60–$7,280.00	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & S	$564.00	$940.00	$225.60–$940.00	18% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN & S	$564.00	$940.00	$770.80–$940.00	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS ADMIN	$805.20	$1,342.00	$322.08–$1,342.00	7% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION once per day CHARGE	$805.20	$1,342.00	$322.08–$1,342.00	7% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin	$805.20	$1,342.00	$322.08–$1,342.00	7% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration	$805.20	$1,342.00	$322.08–$1,342.00	7% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS ADMIN	$805.20	$1,342.00	$1,100.44–$1,342.00	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION once per day CHARGE	$805.20	$1,342.00	$1,100.44–$1,342.00	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration	$805.20	$1,342.00	$1,100.44–$1,342.00	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admin	$805.20	$1,342.00	$1,100.44–$1,342.00	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosal with Peak flow	$126.60	$211.00	$50.64–$211.00	34% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AERONEB TREAT/PEAK FLOW Charge	$126.60	$211.00	$50.64–$211.00	34% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Subsequent	$126.60	$211.00	$50.64–$211.00	34% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Subsequent	$126.60	$211.00	$173.02–$211.00	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosal with Peak flow	$126.60	$211.00	$173.02–$211.00	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AERONEB TREAT/PEAK FLOW Charge	$126.60	$211.00	$173.02–$211.00	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION initial >15min up to one hour CHARGE	$637.20	$1,062.00	$254.88–$1,062.00	at median	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION initial >15min up to one hour CHARGE	$637.20	$1,062.00	$870.84–$1,062.00	—	40%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care - Lynx Visit Level	$2,095.20	$3,492.00	$838.08–$3,492.00	1% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care - Lynx Visit Level	$2,095.20	$3,492.00	$2,863.44–$3,492.00	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG <40 MINS AWAKE Charge	$704.40	$1,174.00	$281.76–$1,174.00	19% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG <40 MINS AWAKE Charge	$704.40	$1,174.00	$962.68–$1,174.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Interpretation	$34.80	$58.00	$13.92–$58.00	85% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 Lead EKG to be interpreted by Blessing Clinic MD	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Acquisition	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 zz12 Lead EKG to be interpreted by Blessing Clinic MD.	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD CHARGE	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead	$266.40	$444.00	$106.56–$444.00	15% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12-Lead Interpretation	$34.80	$58.00	$47.56–$58.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD CHARGE	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 Lead EKG to be interpreted by Blessing Clinic MD	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 zz12 Lead EKG to be interpreted by Blessing Clinic MD.	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$266.40	$444.00	$364.08–$444.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG 12-Lead Acquisition	$266.40	$444.00	$364.08–$444.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2 - Lynx Visit Level	$342.00	$570.00	$136.80–$570.00	15% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Level 2 FCT Charge	$342.00	$570.00	$136.80–$570.00	15% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 Level 2 FCT Charge	$342.00	$570.00	$467.40–$570.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2 - Lynx Visit Level	$342.00	$570.00	$467.40–$570.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3 - Lynx Visit Level	$595.20	$992.00	$238.08–$992.00	15% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3 - Lynx Visit Level	$595.20	$992.00	$813.44–$992.00	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Nuclear	$1,208.40	$2,014.00	$483.36–$2,014.00	25% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Pharmacological	$1,208.40	$2,014.00	$483.36–$2,014.00	25% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST PF	$1,208.40	$2,014.00	$483.36–$2,014.00	25% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Regular Treadmill	$1,208.40	$2,014.00	$483.36–$2,014.00	25% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Nuclear	$1,208.40	$2,014.00	$1,651.48–$2,014.00	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Pharmacological	$1,208.40	$2,014.00	$1,651.48–$2,014.00	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST PF	$1,208.40	$2,014.00	$1,651.48–$2,014.00	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Regular Treadmill	$1,208.40	$2,014.00	$1,651.48–$2,014.00	—	40%
Family therapy with the patient, 50 minutes CPT 90847 90847 FAMILY PSYCHOTHERAPY W/ PT CHARGE	$187.80	$313.00	$75.12–$313.00	5% above	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 FAMILY PSYCHOTHERAPY W/ PT CHARGE	$187.80	$313.00	$256.66–$313.00	—	40%
Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYCHOTHERAPY W/O PT CHARGE	$187.80	$313.00	$75.12–$313.00	at median	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYCHOTHERAPY W/O PT CHARGE	$187.80	$313.00	$256.66–$313.00	—	40%
Group psychotherapy session CPT 90853 90853 GROUP PSYCHOTHERAPY CHARGE	$97.80	$163.00	$39.12–$163.00	24% below	40%
Group psychotherapy session CPT 90853 90853 GROUP PSYCHOTHERAPY 60 MIN CHARGE	$97.80	$163.00	$39.12–$163.00	24% below	40%
Group psychotherapy session inpatient CPT 90853 90853 GROUP PSYCHOTHERAPY 60 MIN CHARGE	$97.80	$163.00	$133.66–$163.00	—	40%
Group psychotherapy session inpatient CPT 90853 90853 GROUP PSYCHOTHERAPY CHARGE	$97.80	$163.00	$133.66–$163.00	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION- HYDRATION first hour >30 min CHARGE	$340.20	$567.00	$136.08–$567.00	1% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31-60MN	$380.40	$634.00	$152.16–$634.00	13% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION- HYDRATION first hour >30 min CHARGE	$340.20	$567.00	$464.94–$567.00	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31-60MN	$380.40	$634.00	$519.88–$634.00	—	40%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION- INITIAL INFUSION up to one hour CHARGE	$375.60	$626.00	$150.24–$626.00	7% below	40%
IV infusion of a medicine, first hour CPT 96365 IV INFUS INITIAL HR	$380.40	$634.00	$152.16–$634.00	6% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION- INITIAL INFUSION up to one hour CHARGE	$375.60	$626.00	$513.32–$626.00	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS INITIAL HR	$380.40	$634.00	$519.88–$634.00	—	40%
IV push of a medicine, first drug CPT 96374 Bubble Study Test MCDO	$192.00	$320.00	$76.80–$320.00	11% below	40%
IV push of a medicine, first drug CPT 96374 INJECTION- IV PUSH single or initial <15 min CHARGE	$192.00	$320.00	$76.80–$320.00	11% below	40%
IV push of a medicine, first drug CPT 96374 INJ IV PUSH INI DRUG	$438.60	$731.00	$175.44–$731.00	104% above	40%
IV push of a medicine, first drug inpatient CPT 96374 Bubble Study Test MCDO	$192.00	$320.00	$262.40–$320.00	—	40%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION- IV PUSH single or initial <15 min CHARGE	$192.00	$320.00	$262.40–$320.00	—	40%
IV push of a medicine, first drug inpatient CPT 96374 INJ IV PUSH INI DRUG	$438.60	$731.00	$599.42–$731.00	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SUBQ IM EA INJEC	$124.80	$208.00	$49.92–$208.00	14% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ or IM each and every same or different drug CHARGE	$132.00	$220.00	$52.80–$220.00	20% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ IM EA INJEC	$124.80	$208.00	$170.56–$208.00	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SQ or IM each and every same or different drug CHARGE	$132.00	$220.00	$180.40–$220.00	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION CHARGE	$181.20	$302.00	$72.48–$302.00	31% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION CHARGE	$181.20	$302.00	$247.64–$302.00	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL 15 MIN Charge	$42.00	$70.00	$16.80–$70.00	20% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL 15 MIN Charge	$42.00	$70.00	$57.40–$70.00	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Crisis first 60 minutes	$171.00	$285.00	$68.40–$285.00	32% below	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 PSYCHIATRIC CRISIS INITIAL 60 MIN CHARGE	$171.00	$285.00	$68.40–$285.00	32% below	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 Crisis first 60 minutes	$171.00	$285.00	$233.70–$285.00	—	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 PSYCHIATRIC CRISIS INITIAL 60 MIN CHARGE	$171.00	$285.00	$233.70–$285.00	—	40%
Psychotherapy session, 30 minutes CPT 90832 90832 PSYCHOTHERAPY PT AND/OR FAMILY 30 MIN CHARGE	$187.80	$313.00	$75.12–$313.00	1% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 90832 PSYCHOTHERAPY PT AND/OR FAMILY 30 MIN CHARGE	$187.80	$313.00	$256.66–$313.00	—	40%
Psychotherapy session, 45 minutes CPT 90834 90834 PSYCHOTHERAPY PT AND/OR FAMILY 45 MIN CHARGE	$187.80	$313.00	$75.12–$313.00	2% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 90834 PSYCHOTHERAPY PT AND/OR FAMILY 45 MIN CHARGE	$187.80	$313.00	$256.66–$313.00	—	40%
Psychotherapy session, 60 minutes CPT 90837 90837 PSYCHOTHERAPY PT AND/OR FAMILY 60 MIN CHARGE	$187.80	$313.00	$75.12–$313.00	32% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 90837 PSYCHOTHERAPY PT AND/OR FAMILY 60 MIN CHARGE	$187.80	$313.00	$256.66–$313.00	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ROE physical	$61.80	$103.00	$24.72–$103.00	59% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TWOPX Bus Driver and DOT Contract PX	$93.00	$155.00	$37.20–$155.00	39% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Level 3 Established Patient Office Visit	$108.00	$180.00	$43.20–$180.00	29% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 - LACTATION CONSULT GREATER THAN 1 HR	$180.00	$300.00	$72.00–$300.00	18% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ROE physical	$61.80	$103.00	$84.46–$103.00	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TWOPX Bus Driver and DOT Contract PX	$93.00	$155.00	$127.10–$155.00	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Level 3 Established Patient Office Visit	$108.00	$180.00	$147.60–$180.00	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 - LACTATION CONSULT GREATER THAN 1 HR	$180.00	$300.00	$246.00–$300.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 DOT Physical	$60.00	$100.00	$24.00–$100.00	68% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 DOT Physical	$60.00	$100.00	$82.00–$100.00	—	40%
Spirometry (breathing test) CPT 94010 Spirometry incl graphic record ttl and timed vital capacityexpiratory flow rate measuremnt	$168.60	$281.00	$67.44–$281.00	43% below	40%
Spirometry (breathing test) inpatient CPT 94010 Spirometry incl graphic record ttl and timed vital capacityexpiratory flow rate measuremnt	$168.60	$281.00	$230.42–$281.00	—	40%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre & Post	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator CPT 94060 PFT Pre & Post [MDH]	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator CPT 94060 RT Pre & Post Spiro Charge	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre & Post (PFT Pre & Post)	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator CPT 94060 PFT PULMONARY FUNCTION TEST Charge	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator CPT 94060 Pre & Post Bronchodilator	$603.60	$1,006.00	$241.44–$1,006.00	11% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Pre & Post [MDH]	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pre & Post Bronchodilator	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Pre & Post (PFT Pre & Post)	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT Pre & Post Spiro Charge	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PULMONARY FUNCTION TEST Charge	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Pre & Post	$603.60	$1,006.00	$824.92–$1,006.00	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$187.20	$312.00	$74.88–$312.00	13% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$187.20	$312.00	$255.84–$312.00	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Client - Fluad 65+	$19.00	$62.00	$14.88–$62.00	84% below	69%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Client - Fluad 65+	$19.00	$62.00	$50.84–$62.00	—	69%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CLIENT - INFLUENZA VACCINE	$12.00	$22.00	$5.28–$22.00	66% below	45%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CLIENT - INFLUENZA VACCINE	$12.00	$22.00	$18.04–$22.00	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMIN	$19.80	$33.00	$7.92–$33.00	65% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 - Immunization admin	$19.80	$33.00	$7.92–$33.00	65% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration; 1 vaccine single or combination vaccine/toxoid	$19.80	$33.00	$7.92–$33.00	65% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin. Tetanus Inject	$144.00	$240.00	$57.60–$240.00	151% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IMMUNIZATION ADMIN	$19.80	$33.00	$27.06–$33.00	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 - Immunization admin	$19.80	$33.00	$27.06–$33.00	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Immunization administration; 1 vaccine single or combination vaccine/toxoid	$19.80	$33.00	$27.06–$33.00	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin. Tetanus Inject	$144.00	$240.00	$196.80–$240.00	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 - Immunization admin each add	$14.40	$24.00	$5.76–$24.00	63% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 - Immunization admin each add	$14.40	$24.00	$19.68–$24.00	—	40%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.mdh.org/documents/376016777_mcdonough-county-hospital-district_standardcharges.csv