SelfPayRates
Hospital Missoula, MT

Mineral Community Hospital

Mineral Community Hospital in East Superior, MT publishes cash prices for 200 common procedures listed here, from its own machine-readable price file updated Jul 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Montana median for 107 of 199 procedures and below it for 85. By typical cash price it ranks #17 of 29 Montana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1208 6th Ave East, Superior MT 59872 Collected Nov 9, 2026 Source price file Check a bill from this hospital

Scans and imaging

ProcedureCash priceList priceInsurers payvs MontanaOff list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast $2,480.24 $3,100.30 $2,480.24–$3,100.30 27% above 20%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast $2,480.24 $3,100.30 $2,480.24–$3,100.30 — 20%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views $301.95 $377.44 $301.95–$377.44 12% above 20%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views $301.95 $377.44 $301.95–$377.44 — 20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis $2,637.26 $3,296.57 $2,637.26–$3,296.57 5% below 20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis $2,637.26 $3,296.57 $2,637.26–$3,296.57 — 20%
CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head $2,296.57 $2,870.71 $2,296.57–$2,870.71 8% above 20%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head $2,296.57 $2,870.71 $2,296.57–$2,870.71 — 20%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck $2,328.70 $2,910.88 $2,328.70–$2,910.88 8% above 20%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck $2,328.70 $2,910.88 $2,328.70–$2,910.88 — 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest $2,221.83 $2,777.29 $2,221.83–$2,777.29 at median 20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest $2,221.83 $2,777.29 $2,221.83–$2,777.29 — 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast $2,645.21 $3,306.51 $2,645.21–$3,306.51 24% above 20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast $2,645.21 $3,306.51 $2,645.21–$3,306.51 — 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast $3,107.84 $3,884.80 $3,107.84–$3,884.80 10% above 20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast $3,107.84 $3,884.80 $3,107.84–$3,884.80 — 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast $3,912.52 $4,890.65 $3,912.52–$4,890.65 26% above 20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast $3,912.52 $4,890.65 $3,912.52–$4,890.65 — 20%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast $1,838.51 $2,298.14 $1,838.51–$2,298.14 2% above 20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast $1,838.51 $2,298.14 $1,838.51–$2,298.14 — 20%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast $1,362.49 $1,703.11 $1,362.49–$1,703.11 at median 20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast $1,362.49 $1,703.11 $1,362.49–$1,703.11 — 20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast $1,216.14 $1,520.18 $1,216.14–$1,520.18 2% above 20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast $1,216.14 $1,520.18 $1,216.14–$1,520.18 — 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast $1,380.98 $1,726.23 $1,380.98–$1,726.23 17% above 20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast $1,380.98 $1,726.23 $1,380.98–$1,726.23 — 20%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast $1,802.79 $2,253.49 $1,802.79–$2,253.49 25% above 20%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast $1,802.79 $2,253.49 $1,802.79–$2,253.49 — 20%
CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast $3,038.70 $3,798.38 $3,038.70–$3,798.38 68% above 20%
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast $3,038.70 $3,798.38 $3,038.70–$3,798.38 — 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast $1,723.81 $2,154.76 $1,723.81–$2,154.76 21% above 20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast $1,723.81 $2,154.76 $1,723.81–$2,154.76 — 20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast $1,664.56 $2,080.70 $1,664.56–$2,080.70 18% above 20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast $1,664.56 $2,080.70 $1,664.56–$2,080.70 — 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast $1,898.00 $2,372.50 $1,898.00–$2,372.50 18% above 20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast $1,898.00 $2,372.50 $1,898.00–$2,372.50 — 20%
Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast $2,046.41 $2,558.01 $2,046.41–$2,558.01 3% above 20%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast $2,046.41 $2,558.01 $2,046.41–$2,558.01 — 20%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views $228.58 $285.72 $228.58–$285.72 3% above 20%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views $228.58 $285.72 $228.58–$285.72 — 20%
Chest X-ray, single view CPT 71045 XR Chest 1 View $169.86 $212.33 $169.86–$212.33 8% below 20%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View $169.86 $212.33 $169.86–$212.33 — 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast $1,553.90 $1,942.37 $1,553.90–$1,942.37 12% above 20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast $1,553.90 $1,942.37 $1,553.90–$1,942.37 — 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast $1,838.51 $2,298.14 $1,838.51–$2,298.14 11% above 20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast $1,838.51 $2,298.14 $1,838.51–$2,298.14 — 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete EO $1,833.40 $2,291.75 $1,833.40–$2,291.75 17% above 20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete EO $1,833.40 $2,291.75 $1,833.40–$2,291.75 — 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast $1,533.96 $1,917.45 $1,533.96–$1,917.45 18% above 20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast $1,533.96 $1,917.45 $1,533.96–$1,917.45 — 20%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views $352.96 $441.20 $352.96–$441.20 9% above 20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views $352.96 $441.20 $352.96–$441.20 — 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Scan $1,236.62 $1,545.77 $1,236.62–$1,545.77 71% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Scan $1,236.62 $1,545.77 $1,236.62–$1,545.77 — 20%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast $1,840.53 $2,300.66 $1,840.53–$2,300.66 1% above 20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast $1,840.53 $2,300.66 $1,840.53–$2,300.66 — 20%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast $1,768.88 $2,211.10 $1,768.88–$2,211.10 1% below 20%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast $1,768.88 $2,211.10 $1,768.88–$2,211.10 — 20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast $3,077.43 $3,846.79 $3,077.43–$3,846.79 6% above 20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast $3,077.43 $3,846.79 $3,077.43–$3,846.79 — 20%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast $2,034.21 $2,542.76 $2,034.21–$2,542.76 13% above 20%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast $2,034.21 $2,542.76 $2,034.21–$2,542.76 — 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast $3,162.51 $3,953.14 $3,162.51–$3,953.14 12% above 20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast $3,162.51 $3,953.14 $3,162.51–$3,953.14 — 20%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast $2,051.72 $2,564.65 $2,051.72–$2,564.65 17% above 20%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast $2,051.72 $2,564.65 $2,051.72–$2,564.65 — 20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast $3,086.78 $3,858.48 $3,086.78–$3,858.48 16% above 20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast $3,086.78 $3,858.48 $3,086.78–$3,858.48 — 20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast $2,040.55 $2,550.69 $2,040.55–$2,550.69 16% above 20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast $2,040.55 $2,550.69 $2,040.55–$2,550.69 — 20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast $3,061.98 $3,827.48 $3,061.98–$3,827.48 14% above 20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast $3,061.98 $3,827.48 $3,061.98–$3,827.48 — 20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast $1,909.58 $2,386.97 $1,909.58–$2,386.97 6% above 20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast $1,909.58 $2,386.97 $1,909.58–$2,386.97 — 20%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast $3,012.91 $3,766.14 $3,012.91–$3,766.14 9% above 20%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast $3,012.91 $3,766.14 $3,012.91–$3,766.14 — 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast $2,034.21 $2,542.76 $2,034.21–$2,542.76 8% above 20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast $2,034.21 $2,542.76 $2,034.21–$2,542.76 — 20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views $335.08 $418.85 $335.08–$418.85 3% above 20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views $335.08 $418.85 $335.08–$418.85 — 20%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast $1,898.00 $2,372.50 $1,898.00–$2,372.50 8% above 20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast $1,898.00 $2,372.50 $1,898.00–$2,372.50 — 20%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast $1,587.35 $1,984.19 $1,587.35–$1,984.19 30% above 20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast $1,587.35 $1,984.19 $1,587.35–$1,984.19 — 20%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue $173.46 $216.82 $173.46–$216.82 11% below 20%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue $173.46 $216.82 $173.46–$216.82 — 20%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast $1,428.07 $1,785.09 $1,428.07–$1,785.09 3% above 20%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast $1,428.07 $1,785.09 $1,428.07–$1,785.09 — 20%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral $318.56 $398.20 $318.56–$398.20 — 20%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral $318.56 $398.20 $318.56–$398.20 — 20%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete $257.26 $321.57 $257.26–$321.57 at median 20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete $257.26 $321.57 $257.26–$321.57 — 20%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views $198.75 $248.44 $198.75–$248.44 16% below 20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views $198.75 $248.44 $198.75–$248.44 — 20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast $1,267.27 $1,584.09 $1,267.27–$1,584.09 11% below 20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast $1,267.27 $1,584.09 $1,267.27–$1,584.09 — 20%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View $177.82 $222.27 $177.82–$222.27 2% below 20%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View $177.82 $222.27 $177.82–$222.27 — 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views $237.97 $297.46 $237.97–$297.46 6% below 20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views $237.97 $297.46 $237.97–$297.46 — 20%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views $334.14 $417.67 $334.14–$417.67 at median 20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views $334.14 $417.67 $334.14–$417.67 — 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views $239.29 $299.11 $239.29–$299.11 7% above 20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views $239.29 $299.11 $239.29–$299.11 — 20%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views $235.99 $294.99 $235.99–$294.99 12% above 20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views $235.99 $294.99 $235.99–$294.99 — 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views $194.96 $243.70 $194.96–$243.70 9% below 20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views $194.96 $243.70 $194.96–$243.70 — 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views $220.05 $275.06 $220.05–$275.06 1% above 20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views $220.05 $275.06 $220.05–$275.06 — 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views $188.90 $236.13 $188.90–$236.13 19% below 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views $188.90 $236.13 $188.90–$236.13 — 20%

Lab tests

ProcedureCash priceList priceInsurers payvs MontanaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase $27.38 $34.23 $27.38–$34.23 47% below 20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase $27.38 $34.23 $27.38–$34.23 — 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase $21.64 $27.05 $21.64–$27.05 57% below 20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase $21.64 $27.05 $21.64–$27.05 — 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Panel (4) LC $90.84 $113.55 $90.84–$113.55 56% below 20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Panel (4) LC $90.84 $113.55 $90.84–$113.55 — 20%
Albumin blood test CPT 82040 Albumin Level $27.38 $34.23 $27.38–$34.23 11% below 20%
Albumin blood test inpatient CPT 82040 Albumin Level $27.38 $34.23 $27.38–$34.23 — 20%
Aldosterone blood test CPT 82088 Aldosterone LC/MS LC $214.46 $268.07 $214.46–$268.07 8% above 20%
Aldosterone blood test inpatient CPT 82088 Aldosterone LC/MS LC $214.46 $268.07 $214.46–$268.07 — 20%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase $87.97 $109.96 $87.97–$109.96 53% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phosphatase LC $87.97 $109.96 $87.97–$109.96 53% above 20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase $87.97 $109.96 $87.97–$109.96 — 20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alk Phosphatase LC $87.97 $109.96 $87.97–$109.96 — 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F010-IgE Sesame Seed LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F202-IgE Cashew Nut LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F008-IgE Corn LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F017-IgE Hazelnut (Filbert) LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F020-IgE Almond LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen CPT 86003 F201-IgE Pecan Nut LC $29.27 $36.59 $29.27–$36.59 38% below 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F008-IgE Corn LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F010-IgE Sesame Seed LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F017-IgE Hazelnut (Filbert) LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020-IgE Almond LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F201-IgE Pecan Nut LC $29.27 $36.59 $29.27–$36.59 — 20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202-IgE Cashew Nut LC $29.27 $36.59 $29.27–$36.59 — 20%
Ammonia blood test CPT 82140 Ammonia LC $26.39 $32.99 $26.39–$32.99 79% below 20%
Ammonia blood test inpatient CPT 82140 Ammonia LC $26.39 $32.99 $26.39–$32.99 — 20%
Amylase blood test CPT 82150 Amylase Level $76.40 $95.50 $76.40–$95.50 33% above 20%
Amylase blood test inpatient CPT 82150 Amylase Level $76.40 $95.50 $76.40–$95.50 — 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC $124.61 $155.76 $124.61–$155.76 29% above 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IgG/IgA Abs LC $124.61 $155.76 $124.61–$155.76 29% above 20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC $124.61 $155.76 $124.61–$155.76 — 20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IgG/IgA Abs LC $124.61 $155.76 $124.61–$155.76 — 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC $35.43 $44.29 $35.43–$44.29 52% below 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Rflx LC $91.66 $114.57 $91.66–$114.57 23% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (ANA) Qual, Multi Immunoassay LC $91.66 $114.57 $91.66–$114.57 23% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti-Nuclear Ab by IFA (RDL) LC $91.66 $114.57 $91.66–$114.57 23% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Comprehensive Plus Profile LC $91.66 $114.57 $91.66–$114.57 23% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies, IFA LC $91.66 $114.57 $91.66–$114.57 23% above 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive LC $35.43 $44.29 $35.43–$44.29 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti-Nuclear Ab by IFA (RDL) LC $91.66 $114.57 $91.66–$114.57 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Comprehensive Plus Profile LC $91.66 $114.57 $91.66–$114.57 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Rflx LC $91.66 $114.57 $91.66–$114.57 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (ANA) Qual, Multi Immunoassay LC $91.66 $114.57 $91.66–$114.57 — 20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA LC $91.66 $114.57 $91.66–$114.57 — 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP $198.56 $248.20 $198.56–$248.20 12% below 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pro BNP $198.56 $248.20 $198.56–$248.20 12% below 20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Pro BNP $198.56 $248.20 $198.56–$248.20 — 20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP $198.56 $248.20 $198.56–$248.20 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Viral Culture, Rapid Lesion LC $75.24 $94.05 $75.24–$94.05 at median 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Group B Strep Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture Superficial $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture Deep $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 VRE Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Strep Confirmation $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 State Reportable Micro $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Quantitative Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Medical Device Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Group A Strep Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Gram stain $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Blood Unit Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Blood Isolator Culture $78.70 $98.37 $78.70–$98.37 4% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MRSA Culture $130.61 $163.26 $130.61–$163.26 73% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Viral Culture, Rapid Lesion LC $75.24 $94.05 $75.24–$94.05 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture Deep $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 VRE Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Blood Isolator Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Blood Unit Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture Superficial $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 State Reportable Micro $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Gram stain $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Group A Strep Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Group B Strep Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Quantitative Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Medical Device Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Strep Confirmation $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture $78.70 $98.37 $78.70–$98.37 — 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MRSA Culture $130.61 $163.26 $130.61–$163.26 — 20%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel $150.86 $188.58 $150.86–$188.58 60% above 20%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel $150.86 $188.58 $150.86–$188.58 — 20%
Bilirubin blood test, total CPT 82247 Bilirubin Total $102.15 $127.69 $102.15–$127.69 106% above 20%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total $102.15 $127.69 $102.15–$127.69 — 20%
Blood culture for bacteria CPT 87040 Blood Culture $151.46 $189.33 $151.46–$189.33 at median 20%
Blood culture for bacteria inpatient CPT 87040 Blood Culture $151.46 $189.33 $151.46–$189.33 — 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw $24.68 $30.85 $24.68–$30.85 30% above 20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw $24.68 $30.85 $24.68–$30.85 — 20%
Blood glucose (sugar) test CPT 82947 Glucose Fasting $32.96 $41.20 $32.96–$41.20 16% below 20%
Blood glucose (sugar) test CPT 82947 Glucose 1 Hour Post Prandial OB $32.96 $41.20 $32.96–$41.20 16% below 20%
Blood glucose (sugar) test CPT 82947 Glucose 2 Hour $32.96 $41.20 $32.96–$41.20 16% below 20%
Blood glucose (sugar) test CPT 82947 Glucose 1 Hour $32.96 $41.20 $32.96–$41.20 16% below 20%
Blood glucose (sugar) test CPT 82947 Glucose Level $32.96 $41.20 $32.96–$41.20 16% below 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level $32.96 $41.20 $32.96–$41.20 — 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting $32.96 $41.20 $32.96–$41.20 — 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 2 Hour $32.96 $41.20 $32.96–$41.20 — 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 1 Hour $32.96 $41.20 $32.96–$41.20 — 20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 1 Hour Post Prandial OB $32.96 $41.20 $32.96–$41.20 — 20%
Blood lead test CPT 83655 Lead, Bld (Adult) LC $24.77 $30.96 $24.77–$30.96 58% below 20%
Blood lead test inpatient CPT 83655 Lead, Bld (Adult) LC $24.77 $30.96 $24.77–$30.96 — 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Qualitative $30.68 $38.35 $30.68–$38.35 57% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG-Serum Qual $30.68 $38.35 $30.68–$38.35 57% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG-Serum Qual $30.68 $38.35 $30.68–$38.35 — 20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Qualitative $30.68 $38.35 $30.68–$38.35 — 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH SO $54.59 $68.24 $54.59–$68.24 24% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Grouping and Rho(D) Typing LC $54.59 $68.24 $54.59–$68.24 24% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh $55.20 $69.00 $55.20–$69.00 23% below 20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Grouping and Rho(D) Typing LC $54.59 $68.24 $54.59–$68.24 — 20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/RH SO $54.59 $68.24 $54.59–$68.24 — 20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh $55.20 $69.00 $55.20–$69.00 — 20%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen $33.42 $41.78 $33.42–$41.78 30% below 20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen $33.42 $41.78 $33.42–$41.78 — 20%
C-peptide blood test CPT 84681 C-Peptide Ultrasensitive LC $40.84 $51.05 $40.84–$51.05 73% below 20%
C-peptide blood test inpatient CPT 84681 C-Peptide Ultrasensitive LC $40.84 $51.05 $40.84–$51.05 — 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP, Quant LC $117.23 $146.54 $117.23–$146.54 78% above 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein $117.23 $146.54 $117.23–$146.54 78% above 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein $117.23 $146.54 $117.23–$146.54 — 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP, Quant LC $117.23 $146.54 $117.23–$146.54 — 20%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile Toxin Gene NAA LC $114.49 $143.11 $114.49–$143.11 32% below 20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile Toxin Gene NAA LC $114.49 $143.11 $114.49–$143.11 — 20%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC $155.11 $193.89 $155.11–$193.89 17% above 20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC $155.11 $193.89 $155.11–$193.89 — 20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC $88.99 $111.24 $88.99–$111.24 29% below 20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC $88.99 $111.24 $88.99–$111.24 — 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV-2(Covid-19) PCR $118.34 $147.93 $118.34–$147.93 2% below 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 RNA (ID NOW) POCT $118.34 $147.93 $118.34–$147.93 2% below 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2, NAA LC $119.16 $148.95 $119.16–$148.95 2% below 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV-2(Covid-19) Ag $119.16 $148.95 $119.16–$148.95 2% below 20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 RNA (ID NOW) POCT $118.34 $147.93 $118.34–$147.93 — 20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV-2(Covid-19) PCR $118.34 $147.93 $118.34–$147.93 — 20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV-2(Covid-19) Ag $119.16 $148.95 $119.16–$148.95 — 20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2, NAA LC $119.16 $148.95 $119.16–$148.95 — 20%
Calcium blood test, total CPT 82310 Calcium Level Total $79.70 $99.62 $79.70–$99.62 129% above 20%
Calcium blood test, total CPT 82310 Calcium LC $79.70 $99.62 $79.70–$99.62 129% above 20%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total $79.70 $99.62 $79.70–$99.62 — 20%
Calcium blood test, total inpatient CPT 82310 Calcium LC $79.70 $99.62 $79.70–$99.62 — 20%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC $19.84 $24.80 $19.84–$24.80 81% below 20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC $19.84 $24.80 $19.84–$24.80 — 20%
Chickenpox (varicella) immunity blood test CPT 86787 Vit D, 25-Hydroxy Rflx LC $41.18 $51.47 $41.18–$51.47 17% below 20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC $41.18 $51.47 $41.18–$51.47 17% below 20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC $41.18 $51.47 $41.18–$51.47 — 20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Vit D, 25-Hydroxy Rflx LC $41.18 $51.47 $41.18–$51.47 — 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia NAA LC $19.62 $24.53 $19.62–$24.53 78% below 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C trach NAA LC $19.62 $24.53 $19.62–$24.53 78% below 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC $19.62 $24.53 $19.62–$24.53 78% below 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C trach NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Pnl $153.01 $191.26 $153.01–$191.26 84% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel LC $153.01 $191.26 $153.01–$191.26 84% above 20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel LC $153.01 $191.26 $153.01–$191.26 — 20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Pnl $153.01 $191.26 $153.01–$191.26 — 20%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Diff $85.31 $106.64 $85.31–$106.64 8% above 20%
Complete blood count (CBC) with differential CPT 85025 CBC With Differential/Platelet LC $85.31 $106.64 $85.31–$106.64 8% above 20%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Man Diff $85.31 $106.64 $85.31–$106.64 8% above 20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Man Diff $85.31 $106.64 $85.31–$106.64 — 20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Diff $85.31 $106.64 $85.31–$106.64 — 20%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC With Differential/Platelet LC $85.31 $106.64 $85.31–$106.64 — 20%
Complete blood count (CBC), no differential CPT 85027 CBC w/o Diff $61.87 $77.34 $61.87–$77.34 23% above 20%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/o Diff $61.87 $77.34 $61.87–$77.34 — 20%
Comprehensive metabolic panel (blood test) CPT 80053 Comp. Metabolic Panel (14) LC $195.94 $244.93 $195.94–$244.93 50% above 20%
Comprehensive metabolic panel (blood test) CPT 80053 CMP $195.94 $244.93 $195.94–$244.93 50% above 20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comp. Metabolic Panel (14) LC $195.94 $244.93 $195.94–$244.93 — 20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP $195.94 $244.93 $195.94–$244.93 — 20%
Cortisol blood test, total CPT 82533 Cortisol - AM LC $38.91 $48.64 $38.91–$48.64 65% below 20%
Cortisol blood test, total inpatient CPT 82533 Cortisol - AM LC $38.91 $48.64 $38.91–$48.64 — 20%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase $77.69 $97.11 $77.69–$97.11 39% above 20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase $77.69 $97.11 $77.69–$97.11 — 20%
Creatinine blood test CPT 82565 Creatinine $48.71 $60.89 $48.71–$60.89 13% above 20%
Creatinine blood test inpatient CPT 82565 Creatinine $48.71 $60.89 $48.71–$60.89 — 20%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC $34.58 $43.22 $34.58–$43.22 67% below 20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC $34.58 $43.22 $34.58–$43.22 — 20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC $38.82 $48.52 $38.82–$48.52 74% below 20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate LC $38.82 $48.52 $38.82–$48.52 — 20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel $70.57 $88.21 $70.57–$88.21 4% below 20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel $70.57 $88.21 $70.57–$88.21 — 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Antibody Profile LC $52.41 $65.51 $52.41–$65.51 44% below 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 DHEA, Serum LC $113.63 $142.04 $113.63–$142.04 20% above 20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Antibody Profile LC $52.41 $65.51 $52.41–$65.51 — 20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 DHEA, Serum LC $113.63 $142.04 $113.63–$142.04 — 20%
Estradiol blood test CPT 82670 Estradiol LC $35.98 $44.97 $35.98–$44.97 76% below 20%
Estradiol blood test inpatient CPT 82670 Estradiol LC $35.98 $44.97 $35.98–$44.97 — 20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH LC $16.71 $20.89 $16.71–$20.89 87% below 20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH LC $16.71 $20.89 $16.71–$20.89 — 20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC $245.44 $306.80 $245.44–$306.80 5% below 20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal LC $245.44 $306.80 $245.44–$306.80 — 20%
Ferritin blood test (iron stores) CPT 82728 Ferritin Level $16.20 $20.25 $16.20–$20.25 83% below 20%
Ferritin blood test (iron stores) CPT 82728 Ferritin, Serum LC $16.20 $20.25 $16.20–$20.25 83% below 20%
Ferritin blood test (iron stores) CPT 82728 Immunoglobulin E, Total LC $36.17 $45.21 $36.17–$45.21 61% below 20%
Ferritin blood test (iron stores) CPT 82728 Ferritin $88.18 $110.23 $88.18–$110.23 5% below 20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin, Serum LC $16.20 $20.25 $16.20–$20.25 — 20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Level $16.20 $20.25 $16.20–$20.25 — 20%
Ferritin blood test (iron stores) inpatient CPT 82728 Immunoglobulin E, Total LC $36.17 $45.21 $36.17–$45.21 — 20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $88.18 $110.23 $88.18–$110.23 — 20%
Fibrinogen blood test CPT 85384 Fibrinogen Activity: LC $114.75 $143.44 $114.75–$143.44 23% above 20%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity: LC $114.75 $143.44 $114.75–$143.44 — 20%
Folate (folic acid) blood test CPT 82746 Folate LC $95.63 $119.54 $95.63–$119.54 5% above 20%
Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) LC $95.63 $119.54 $95.63–$119.54 5% above 20%
Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) LC $95.63 $119.54 $95.63–$119.54 — 20%
Folate (folic acid) blood test inpatient CPT 82746 Folate LC $95.63 $119.54 $95.63–$119.54 — 20%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine (T3), Free LC $15.21 $19.01 $15.21–$19.01 86% below 20%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free LC $15.21 $19.01 $15.21–$19.01 — 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free Direct LC $96.41 $120.51 $96.41–$120.51 28% above 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level $96.41 $120.51 $96.41–$120.51 28% above 20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free Direct LC $96.41 $120.51 $96.41–$120.51 — 20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level $96.41 $120.51 $96.41–$120.51 — 20%
Free testosterone test CPT 84402 Testosterone LC $19.02 $23.78 $19.02–$23.78 86% below 20%
Free testosterone test CPT 84402 Free Testost Direct LC $46.45 $58.06 $46.45–$58.06 65% below 20%
Free testosterone test CPT 84402 Testosterone, Free, Direct LC $46.45 $58.06 $46.45–$58.06 65% below 20%
Free testosterone test inpatient CPT 84402 Testosterone LC $19.02 $23.78 $19.02–$23.78 — 20%
Free testosterone test inpatient CPT 84402 Free Testost Direct LC $46.45 $58.06 $46.45–$58.06 — 20%
Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC $46.45 $58.06 $46.45–$58.06 — 20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase $50.70 $63.37 $50.70–$63.37 20% above 20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC $50.70 $63.37 $50.70–$63.37 20% above 20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase $50.70 $63.37 $50.70–$63.37 — 20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC $50.70 $63.37 $50.70–$63.37 — 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus NAA LC $19.62 $24.53 $19.62–$24.53 80% below 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N gonorrhoeae NAA LC $19.62 $24.53 $19.62–$24.53 80% below 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae, NAA LC $19.62 $24.53 $19.62–$24.53 80% below 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonococcus NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae, NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N gonorrhoeae NAA LC $19.62 $24.53 $19.62–$24.53 — 20%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Stool Ag, EIA LC $74.30 $92.88 $74.30–$92.88 13% below 20%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Stool Ag, EIA LC $74.30 $92.88 $74.30–$92.88 — 20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/O/2, 4th Generation LC $34.75 $43.44 $34.75–$43.44 56% below 20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/O/2, 4th Generation LC $34.75 $43.44 $34.75–$43.44 — 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c $89.55 $111.94 $89.55–$111.94 34% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c LC $89.55 $111.94 $89.55–$111.94 34% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c LC $89.55 $111.94 $89.55–$111.94 — 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1c $89.55 $111.94 $89.55–$111.94 — 20%
Hemoglobin blood test CPT 85018 Hgb $27.38 $34.23 $27.38–$34.23 5% below 20%
Hemoglobin blood test CPT 85018 Hemoglobin $27.38 $34.23 $27.38–$34.23 5% below 20%
Hemoglobin blood test inpatient CPT 85018 Hgb $27.38 $34.23 $27.38–$34.23 — 20%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin $27.38 $34.23 $27.38–$34.23 — 20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf Antigen Scr LC $26.74 $33.42 $26.74–$33.42 65% below 20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surf Antigen Scr LC $26.74 $33.42 $26.74–$33.42 — 20%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody reflex to NAA LC $39.25 $49.06 $39.25–$49.06 66% below 20%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab LC $39.25 $49.06 $39.25–$49.06 66% below 20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody reflex to NAA LC $39.25 $49.06 $39.25–$49.06 — 20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab LC $39.25 $49.06 $39.25–$49.06 — 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA by PCR, Reflex to Geno LC $803.91 $1,004.89 $803.91–$1,004.89 58% above 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RealTime Abbott LC $803.91 $1,004.89 $803.91–$1,004.89 58% above 20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR, Reflex to Geno LC $803.91 $1,004.89 $803.91–$1,004.89 — 20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RealTime Abbott LC $803.91 $1,004.89 $803.91–$1,004.89 — 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive Protein, Cardiac LC $103.26 $129.08 $103.26–$129.08 33% above 20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-reactive Protein, Cardiac LC $103.26 $129.08 $103.26–$129.08 — 20%
Homocysteine blood test CPT 83090 Homocyst(e)ine LC $23.74 $29.67 $23.74–$29.67 82% below 20%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine LC $23.74 $29.67 $23.74–$29.67 — 20%
Insulin blood test CPT 83525 Insulin LC $42.03 $52.54 $42.03–$52.54 52% below 20%
Insulin blood test inpatient CPT 83525 Insulin LC $42.03 $52.54 $42.03–$52.54 — 20%
Iron blood test (serum iron) CPT 83540 Iron LC $34.14 $42.68 $34.14–$42.68 46% below 20%
Iron blood test (serum iron) CPT 83540 Iron Level $34.14 $42.68 $34.14–$42.68 46% below 20%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level $34.14 $42.68 $34.14–$42.68 — 20%
Iron blood test (serum iron) inpatient CPT 83540 Iron LC $34.14 $42.68 $34.14–$42.68 — 20%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity $6.26 $7.82 $6.26–$7.82 91% below 20%
Iron-binding capacity (TIBC) test CPT 83550 Iron Bind.Cap.(TIBC) LC $6.26 $7.82 $6.26–$7.82 91% below 20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Bind.Cap.(TIBC) LC $6.26 $7.82 $6.26–$7.82 — 20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity $6.26 $7.82 $6.26–$7.82 — 20%
Kidney function blood test panel CPT 80069 Renal Pnl $229.88 $287.35 $229.88–$287.35 106% above 20%
Kidney function blood test panel inpatient CPT 80069 Renal Pnl $229.88 $287.35 $229.88–$287.35 — 20%
LH (luteinizing hormone) test CPT 83002 LH LC $16.71 $20.89 $16.71–$20.89 85% below 20%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (LH), S LC $16.71 $20.89 $16.71–$20.89 85% below 20%
LH (luteinizing hormone) test inpatient CPT 83002 LH LC $16.71 $20.89 $16.71–$20.89 — 20%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone (LH), S LC $16.71 $20.89 $16.71–$20.89 — 20%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Level $142.94 $178.67 $142.94–$178.67 3% above 20%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Level $142.94 $178.67 $142.94–$178.67 — 20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH LC $49.57 $61.96 $49.57–$61.96 5% above 20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDL Cholesterol (Direct) LC $49.57 $61.96 $49.57–$61.96 5% above 20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH LC $49.57 $61.96 $49.57–$61.96 — 20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDL Cholesterol (Direct) LC $49.57 $61.96 $49.57–$61.96 — 20%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $96.41 $120.51 $96.41–$120.51 11% above 20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level $96.41 $120.51 $96.41–$120.51 — 20%
Liver function blood test panel CPT 80076 Hep Fnct Pnl $154.04 $192.55 $154.04–$192.55 99% above 20%
Liver function blood test panel inpatient CPT 80076 Hep Fnct Pnl $154.04 $192.55 $154.04–$192.55 — 20%
Magnesium blood test CPT 83735 Magnesium Level $76.40 $95.50 $76.40–$95.50 18% above 20%
Magnesium blood test inpatient CPT 83735 Magnesium Level $76.40 $95.50 $76.40–$95.50 — 20%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen $70.66 $88.32 $70.66–$88.32 8% above 20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen $70.66 $88.32 $70.66–$88.32 — 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Scrn $108.45 $135.56 $108.45–$135.56 3% below 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diag $108.45 $135.56 $108.45–$135.56 3% below 20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Scrn $108.45 $135.56 $108.45–$135.56 — 20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diag $108.45 $135.56 $108.45–$135.56 — 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC $43.45 $54.31 $43.45–$54.31 79% below 20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC $43.45 $54.31 $43.45–$54.31 — 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 aPTT: LC $96.41 $120.51 $96.41–$120.51 66% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, Activated $96.41 $120.51 $96.41–$120.51 66% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT, Activated LC $96.41 $120.51 $96.41–$120.51 66% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus APTT LC $96.41 $120.51 $96.41–$120.51 66% above 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated LC $96.41 $120.51 $96.41–$120.51 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated $96.41 $120.51 $96.41–$120.51 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus APTT LC $96.41 $120.51 $96.41–$120.51 — 20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 aPTT: LC $96.41 $120.51 $96.41–$120.51 — 20%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level $36.59 $45.74 $36.59–$45.74 31% below 20%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level $36.59 $45.74 $36.59–$45.74 — 20%
Potassium blood test CPT 84132 Potassium Level $52.88 $66.10 $52.88–$66.10 10% above 20%
Potassium blood test inpatient CPT 84132 Potassium Level $52.88 $66.10 $52.88–$66.10 — 20%
Progesterone blood test CPT 84144 Progesterone LC $14.22 $17.78 $14.22–$17.78 89% below 20%
Progesterone blood test inpatient CPT 84144 Progesterone LC $14.22 $17.78 $14.22–$17.78 — 20%
Prolactin blood test CPT 84146 Prolactin LC $16.46 $20.57 $16.46–$20.57 86% below 20%
Prolactin blood test inpatient CPT 84146 Prolactin LC $16.46 $20.57 $16.46–$20.57 — 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PT: LC $63.80 $79.75 $63.80–$79.75 93% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR POCT $63.80 $79.75 $63.80–$79.75 93% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Prothrombin Time LC $63.80 $79.75 $63.80–$79.75 93% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT) LC $63.80 $79.75 $63.80–$79.75 93% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PT $63.80 $79.75 $63.80–$79.75 93% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 INR POCT $64.00 $80.00 $64.00–$80.00 94% above 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT) LC $63.80 $79.75 $63.80–$79.75 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT: LC $63.80 $79.75 $63.80–$79.75 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR POCT $63.80 $79.75 $63.80–$79.75 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT $63.80 $79.75 $63.80–$79.75 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Prothrombin Time LC $63.80 $79.75 $63.80–$79.75 — 20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POCT $64.00 $80.00 $64.00–$80.00 — 20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine (12) $107.00 $134.25 $107.00–$134.25 9% below 20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Screen Urine $115.05 $143.81 $115.05–$143.81 2% below 20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Screen Urine (12) $107.00 $134.25 $107.00–$134.25 — 20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Screen Urine $115.05 $143.81 $115.05–$143.81 — 20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Test POCT $85.31 $106.64 $85.31–$106.64 75% above 20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep Test POCT $85.31 $106.64 $85.31–$106.64 — 20%
Renin blood test CPT 84244 Renin Activity LC $62.98 $78.73 $62.98–$78.73 63% below 20%
Renin blood test inpatient CPT 84244 Renin Activity LC $62.98 $78.73 $62.98–$78.73 — 20%
Rh blood typing CPT 86901 Rh $55.38 $69.22 $55.38–$69.22 1% below 20%
Rh blood typing inpatient CPT 86901 Rh $55.38 $69.22 $55.38–$69.22 — 20%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC $34.54 $43.17 $34.54–$43.17 42% below 20%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF), LC $76.40 $95.50 $76.40–$95.50 28% above 20%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor LC $34.54 $43.17 $34.54–$43.17 — 20%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF), LC $76.40 $95.50 $76.40–$95.50 — 20%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC $66.89 $83.61 $66.89–$83.61 3% above 20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC $66.89 $83.61 $66.89–$83.61 — 20%
Sodium blood test CPT 84295 Sodium Level $88.48 $110.60 $88.48–$110.60 91% above 20%
Sodium blood test inpatient CPT 84295 Sodium Level $88.48 $110.60 $88.48–$110.60 — 20%
Stool ova and parasites exam CPT 87177 Ova + Parasite Status LC $59.17 $73.96 $59.17–$73.96 14% below 20%
Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite Status LC $59.17 $73.96 $59.17–$73.96 — 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool POCT $39.17 $48.96 $39.17–$48.96 9% above 20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool POCT $39.17 $48.96 $39.17–$48.96 — 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC $37.58 $46.97 $37.58–$46.97 26% below 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC $37.58 $46.97 $37.58–$46.97 26% below 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC $37.58 $46.97 $37.58–$46.97 — 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR LC $37.58 $46.97 $37.58–$46.97 — 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT-TB Plus (Client Incubated) LC $70.95 $88.69 $70.95–$88.69 63% below 20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QFT-TB Plus (Client Incubated) LC $70.95 $88.69 $70.95–$88.69 — 20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone LC $19.02 $23.78 $19.02–$23.78 86% below 20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone LC $19.02 $23.78 $19.02–$23.78 — 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC $34.32 $42.90 $34.32–$42.90 63% below 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Ab LC $34.32 $42.90 $34.32–$42.90 63% below 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Ab LC $34.32 $42.90 $34.32–$42.90 — 20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC $34.32 $42.90 $34.32–$42.90 — 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone $116.94 $146.17 $116.94–$146.17 29% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with Reflex to FT4 $116.94 $146.17 $116.94–$146.17 29% above 20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone $116.94 $146.17 $116.94–$146.17 — 20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with Reflex to FT4 $116.94 $146.17 $116.94–$146.17 — 20%
Total cholesterol blood test CPT 82465 Cholesterol Total $88.22 $110.28 $88.22–$110.28 151% above 20%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total $88.22 $110.28 $88.22–$110.28 — 20%
Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) LC $26.74 $33.42 $26.74–$33.42 53% below 20%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) LC $26.74 $33.42 $26.74–$33.42 — 20%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC $37.54 $46.92 $37.54–$46.92 58% below 20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC $37.54 $46.92 $37.54–$46.92 — 20%
Transferrin blood test CPT 84466 Transferrin LC $76.70 $95.87 $76.70–$95.87 31% below 20%
Transferrin blood test inpatient CPT 84466 Transferrin LC $76.70 $95.87 $76.70–$95.87 — 20%
Trichomonas test (NAAT) CPT 87661 Trich vag by NAA LC $165.14 $206.42 $165.14–$206.42 56% above 20%
Trichomonas test (NAAT) CPT 87661 Trich vag NAA LC $165.14 $206.42 $165.14–$206.42 56% above 20%
Trichomonas test (NAAT) inpatient CPT 87661 Trich vag by NAA LC $165.14 $206.42 $165.14–$206.42 — 20%
Trichomonas test (NAAT) inpatient CPT 87661 Trich vag NAA LC $165.14 $206.42 $165.14–$206.42 — 20%
Triglycerides blood test CPT 84478 Triglycerides $121.86 $152.33 $121.86–$152.33 190% above 20%
Triglycerides blood test inpatient CPT 84478 Triglycerides $121.86 $152.33 $121.86–$152.33 — 20%
Troponin test, quantitative CPT 84484 hs Troponin-I $151.46 $189.33 $151.46–$189.33 65% above 20%
Troponin test, quantitative inpatient CPT 84484 hs Troponin-I $151.46 $189.33 $151.46–$189.33 — 20%
Uric acid blood test CPT 84550 Uric Acid $41.10 $51.37 $41.10–$51.37 at median 20%
Uric acid blood test inpatient CPT 84550 Uric Acid $41.10 $51.37 $41.10–$51.37 — 20%
Urinalysis with microscope exam, automated CPT 81001 UA w Micro if Ind & Cult if Ind $44.26 $55.33 $44.26–$55.33 1% above 20%
Urinalysis with microscope exam, automated CPT 81001 UA w Micro $44.26 $55.33 $44.26–$55.33 1% above 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA w Micro if Ind & Cult if Ind $44.26 $55.33 $44.26–$55.33 — 20%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA w Micro $44.26 $55.33 $44.26–$55.33 — 20%
Urinalysis without microscope exam, automated CPT 81003 UA Complete w/Cult if Ind $10.42 $13.02 $10.42–$13.02 62% below 20%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick POCT $10.50 $13.13 $10.50–$13.13 61% below 20%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Complete w/Cult if Ind $10.42 $13.02 $10.42–$13.02 — 20%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick POCT $10.50 $13.13 $10.50–$13.13 — 20%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture $112.26 $140.33 $112.26–$140.33 24% above 20%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture $112.26 $140.33 $112.26–$140.33 — 20%
Urine microalbumin (albumin) test CPT 82043 Urine Protein Level $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test CPT 82043 A/G Ratio $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test CPT 82043 U Microalb/Creat $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Semi-Qnt $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Level Urine $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test CPT 82043 Albumin, Ur LC $66.24 $82.80 $66.24–$82.80 21% above 20%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level Urine $66.24 $82.80 $66.24–$82.80 — 20%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Semi-Qnt $66.24 $82.80 $66.24–$82.80 — 20%
Urine microalbumin (albumin) test inpatient CPT 82043 A/G Ratio $66.24 $82.80 $66.24–$82.80 — 20%
Urine microalbumin (albumin) test inpatient CPT 82043 U Microalb/Creat $66.24 $82.80 $66.24–$82.80 — 20%
Urine microalbumin (albumin) test inpatient CPT 82043 Urine Protein Level $66.24 $82.80 $66.24–$82.80 — 20%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, Ur LC $66.24 $82.80 $66.24–$82.80 — 20%
Urine pregnancy test, read by color change CPT 81025 Beta hCG Qualitative Urine $20.60 $25.75 $20.60–$25.75 53% below 20%
Urine pregnancy test, read by color change CPT 81025 Beta hCG Urine POCT $20.60 $25.75 $20.60–$25.75 53% below 20%
Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Urine POCT $20.60 $25.75 $20.60–$25.75 — 20%
Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Qualitative Urine $20.60 $25.75 $20.60–$25.75 — 20%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 LC $92.21 $115.26 $92.21–$115.26 at median 20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 LC $92.21 $115.26 $92.21–$115.26 — 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy LC $38.43 $48.04 $38.43–$48.04 72% below 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC $38.43 $48.04 $38.43–$48.04 72% below 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy LC $38.43 $48.04 $38.43–$48.04 — 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC $38.43 $48.04 $38.43–$48.04 — 20%
Zinc blood test CPT 84630 Zinc LC $88.99 $111.24 $88.99–$111.24 7% below 20%
Zinc blood test inpatient CPT 84630 Zinc LC $88.99 $111.24 $88.99–$111.24 — 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit, Qnt LC $141.91 $177.39 $141.91–$177.39 23% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative $141.91 $177.39 $141.91–$177.39 23% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG,Beta Subunit, Qnt LC $141.91 $177.39 $141.91–$177.39 — 20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative $141.91 $177.39 $141.91–$177.39 — 20%

Surgery and procedures

ProcedureCash priceList priceInsurers payvs MontanaOff list
Colonoscopy with polyp removal CPT 45385 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion by snare techniq $1,920.00 $2,400.00 $1,920.00–$2,400.00 9% below 20%
Colonoscopy with polyp removal inpatient CPT 45385 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion by snare techniq $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Colonoscopy with tissue sample CPT 45380 45380 Colonoscopy, flexible; with biopsy $1,920.00 $2,400.00 $1,920.00–$2,400.00 at median 20%
Colonoscopy with tissue sample inpatient CPT 45380 45380 Colonoscopy, flexible; with biopsy $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Colonoscopy, diagnostic CPT 45378 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, $1,920.00 $2,400.00 $1,920.00–$2,400.00 7% above 20%
Colonoscopy, diagnostic inpatient CPT 45378 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 69436 TYMPANOSTOMY GENERAL $2,198.33 $2,747.91 $2,198.33–$2,747.91 55% above 20%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 69436 TYMPANOSTOMY GENERAL $2,198.33 $2,747.91 $2,198.33–$2,747.91 — 20%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 69433 TYMPANOSTOMY W/LOCAL $1,033.01 $1,291.26 $1,033.01–$1,291.26 137% above 20%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 69433 TYMPANOSTOMY W/LOCAL $1,033.01 $1,291.26 $1,033.01–$1,291.26 — 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washin $1,920.00 $2,400.00 $1,920.00–$2,400.00 76% above 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washin $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 COLONOSCOPY SCREENING $1,920.00 $2,400.00 $1,920.00–$2,400.00 at median 20%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0121 COLONOSCOPY SCREENING $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Upper endoscopy (EGD) with biopsy CPT 43239 43239 EGD FLEX TRANSORAL W/BX SINGLE/MULT $1,920.00 $2,400.00 $1,920.00–$2,400.00 24% above 20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 EGD FLEX TRANSORAL W/BX SINGLE/MULT $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other $1,560.00 $1,950.00 $1,560.00–$1,950.00 15% below 20%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 43251 Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other $1,560.00 $1,950.00 $1,560.00–$1,950.00 — 20%
Upper endoscopy (EGD), diagnostic CPT 43235 43235 EGD FLEX TRANSORAL DX W/BX $1,920.00 $2,400.00 $1,920.00–$2,400.00 82% above 20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 EGD FLEX TRANSORAL DX W/BX $1,920.00 $2,400.00 $1,920.00–$2,400.00 — 20%

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs MontanaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Product Administration $456.00 $570.00 $456.00–$570.00 40% below 20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Product Administration $456.00 $570.00 $456.00–$570.00 — 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for acute airway obstruction Tech Fee $49.92 $62.40 $49.92–$62.40 55% below 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation treatment for acute airway obstruction Tech Fee $49.92 $62.40 $49.92–$62.40 — 20%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care, First Hour $1,656.00 $2,070.00 $1,656.00–$2,070.00 11% below 20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care, First Hour $1,656.00 $2,070.00 $1,656.00–$2,070.00 — 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG POC - Nursing $188.00 $235.00 $188.00–$235.00 22% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG POC - Nursing $188.00 $235.00 $188.00–$235.00 — 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1 $179.20 $224.00 $179.20–$224.00 14% below 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1 $179.20 $224.00 $179.20–$224.00 — 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2 $312.00 $390.00 $312.00–$390.00 12% below 20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2 $312.00 $390.00 $312.00–$390.00 — 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3 $516.00 $645.00 $516.00–$645.00 3% below 20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3 $516.00 $645.00 $516.00–$645.00 — 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4 $873.60 $1,092.00 $873.60–$1,092.00 3% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4 $873.60 $1,092.00 $873.60–$1,092.00 — 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5 $1,316.00 $1,645.00 $1,316.00–$1,645.00 3% above 20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5 $1,316.00 $1,645.00 $1,316.00–$1,645.00 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION INIT UP TO 1HR $256.47 $320.59 $256.47–$320.59 1% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion for Hydration Initial 31 to 60 Minutes 96360 $268.02 $335.03 $268.02–$335.03 6% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour $304.00 $380.00 $304.00–$380.00 20% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION INIT UP TO 1HR $256.47 $320.59 $256.47–$320.59 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion for Hydration Initial 31 to 60 Minutes 96360 $268.02 $335.03 $268.02–$335.03 — 20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour $304.00 $380.00 $304.00–$380.00 — 20%
IV infusion of a medicine, first hour CPT 96365 96365 IV DRUG INFUSION UP TO 1 HR CHARGE $396.64 $495.80 $396.64–$495.80 15% above 20%
IV infusion of a medicine, first hour CPT 96365 Inf for Therapy, Prophylaxis, Dx Initial up to 1 Hour 96365 $418.50 $523.12 $418.50–$523.12 22% above 20%
IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour $486.40 $608.00 $486.40–$608.00 41% above 20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV DRUG INFUSION UP TO 1 HR CHARGE $396.64 $495.80 $396.64–$495.80 — 20%
IV infusion of a medicine, first hour inpatient CPT 96365 Inf for Therapy, Prophylaxis, Dx Initial up to 1 Hour 96365 $418.50 $523.12 $418.50–$523.12 — 20%
IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour $486.40 $608.00 $486.40–$608.00 — 20%
IV push of a medicine, first drug CPT 96374 96374- IV Injection, single/initial $132.80 $166.00 $132.80–$166.00 17% below 20%
IV push of a medicine, first drug CPT 96374 96374 IV PUSH SING/INITIAL $133.12 $166.40 $133.12–$166.40 17% below 20%
IV push of a medicine, first drug CPT 96374 Tx Prophylactic or Diag IVP Single or Initial Drug 96374 $133.12 $166.40 $133.12–$166.40 17% below 20%
IV push of a medicine, first drug inpatient CPT 96374 96374- IV Injection, single/initial $132.80 $166.00 $132.80–$166.00 — 20%
IV push of a medicine, first drug inpatient CPT 96374 Tx Prophylactic or Diag IVP Single or Initial Drug 96374 $133.12 $166.40 $133.12–$166.40 — 20%
IV push of a medicine, first drug inpatient CPT 96374 96374 IV PUSH SING/INITIAL $133.12 $166.40 $133.12–$166.40 — 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ IM/SUB THERAPUTIC/DIAGNOS $83.20 $104.00 $83.20–$104.00 6% above 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapy, Prophylactic, Diagnostic Injection SQ or IM 96372 $86.96 $108.70 $86.96–$108.70 11% above 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection $87.20 $109.00 $87.20–$109.00 11% above 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJ IM/SUB THERAPUTIC/DIAGNOS $83.20 $104.00 $83.20–$104.00 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapy, Prophylactic, Diagnostic Injection SQ or IM 96372 $86.96 $108.70 $86.96–$108.70 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection $87.20 $109.00 $87.20–$109.00 — 20%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit $395.20 $494.00 $395.20–$494.00 9% above 20%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit $395.20 $494.00 $395.20–$494.00 — 20%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units $187.20 $234.00 $187.20–$234.00 2% above 20%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units $187.20 $234.00 $187.20–$234.00 — 20%
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 TA15 THERAPUDIC ACTIVITES EA 15 MI $92.80 $116.00 $92.80–$116.00 7% above 20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 TA15 THERAPUDIC ACTIVITES EA 15 MI $92.80 $116.00 $92.80–$116.00 — 20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Ther Phleb $134.03 $167.54 $134.03–$167.54 18% below 20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Ther Phleb $134.03 $167.54 $134.03–$167.54 — 20%

Vaccines

ProcedureCash priceList priceInsurers payvs MontanaOff list
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B adult vaccine 20 mcg/mL Sus [MNRL] $205.00 $255.71 $205.00–$255.71 469% above 20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B adult vaccine 20 mcg/mL Sus [MNRL] $205.00 $255.71 $205.00–$255.71 — 20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal 13-valent conjugate vaccine - Sus UD [MNRL] $672.00 $839.53 $672.00–$839.53 134% above 20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal 13-valent conjugate vaccine - Sus UD [MNRL] $672.00 $839.53 $672.00–$839.53 — 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2 units-15.5 mcg/0.5 mL IM Susp 0 mL [MNRL] $141.00 $176.53 $141.00–$176.53 36% above 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria/pertussis, acel (Tdap) 5 units-2 units-15.5 mcg/0.5 mL IM Susp 0 mL [MNRL] $141.00 $176.53 $141.00–$176.53 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADMIN PNEUMOCOC VACC CHARGE $68.06 $85.07 $68.06–$85.07 40% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471  IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE TechFee $159.65 $199.56 $159.65–$199.56 227% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 ADMIN PNEUMOCOC VACC CHARGE $68.06 $85.07 $68.06–$85.07 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471  IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE TechFee $159.65 $199.56 $159.65–$199.56 — 20%
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://mineralcommunityhospital.com/wp-content/uploads/2026/07/Mineral-Community-Hospital_standardcharges2026.csv