Hospital San Angelo, TX

Shannon River Crest Hospital

Shannon River Crest Hospital in San Angelo, TX publishes cash prices for 354 common procedures listed here, from its own machine-readable price file updated Dec 8, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Texas median for 240 of 354 procedures and below it for 114. Select a procedure to compare it with other hospitals nearby.

1636 Hunters Glen Road, San Angelo, TX 76901 Collected Nov 11, 2026 Source price file Check a bill from this hospital

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Shannon River Crest Hospital in San Angelo, TX:

May 16, 2025 Corrective action plan requested
Jun 4, 2025 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/WO Contrast	$3,139.50	$6,279.00	$167.16–$5,588.31	9% above	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen W/WO Contrast	$3,139.50	$6,279.00	$2,825.55–$5,588.31	—	50%
Abdominal X-ray, 2 views CPT 74019 HC Abd 2 Views Comp	$378.50	$757.00	$38.94–$673.73	at median	50%
Abdominal X-ray, 2 views inpatient CPT 74019 HC Abd 2 Views Comp	$378.50	$757.00	$340.65–$673.73	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 HC Ankle Comp Min 3 Vws Bil	$391.50	$783.00	$38.94–$696.87	10% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle Lt Comp Min 3 Vws	$392.00	$784.00	$38.94–$697.76	10% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle Rt Comp Min 3 Vws	$392.00	$784.00	$38.94–$697.76	10% above	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC Ankle Comp Min 3 Vws Bil	$391.50	$783.00	$352.35–$696.87	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle Lt Comp Min 3 Vws	$392.00	$784.00	$352.80–$697.76	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle Rt Comp Min 3 Vws	$392.00	$784.00	$352.80–$697.76	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Arterial Seg Press Bil Limited	$404.50	$809.00	$112.45–$720.01	34% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Noninvasive Arterial Stud	$478.00	$956.00	$121.03–$850.84	21% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Arterial Seg Press Bil Limited	$404.50	$809.00	$364.05–$720.01	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Noninvasive Arterial Stud	$478.00	$956.00	$430.20–$850.84	—	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity W/O Dye	$1,874.50	$3,749.00	$99.85–$3,336.61	13% above	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Shoulder W/O Bil	$1,874.50	$3,749.00	$99.85–$3,336.61	13% above	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Shoulder W/O Bil	$1,874.50	$3,749.00	$1,687.05–$3,336.61	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Upper Extremity W/O Dye	$1,874.50	$3,749.00	$1,687.05–$3,336.61	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagus Barium Swal W/F	$525.50	$1,051.00	$104.90–$935.39	1% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esophagus Barium Swal W/F	$525.50	$1,051.00	$472.95–$935.39	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Scan Whole	$2,200.00	$4,400.00	$308.74–$3,916.00	40% above	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone Scan Whole	$2,200.00	$4,400.00	$1,980.00–$3,916.00	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US Breast Complete - Bilateral	$218.00	$436.00	$60.60–$388.04	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Complete - Left	$218.00	$436.00	$60.60–$388.04	51% below	50%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Complete - Right	$218.00	$436.00	$60.60–$388.04	51% below	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US Breast Complete - Bilateral	$218.00	$436.00	$196.20–$388.04	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Complete - Left	$218.00	$436.00	$196.20–$388.04	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Complete - Right	$218.00	$436.00	$196.20–$388.04	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Wi Breast Echo Limited Uni-Rt	$218.00	$436.00	$60.60–$388.04	38% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Wi Breast Echo Limited Rt and Lt	$218.00	$436.00	$60.60–$388.04	38% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Wi Breast Echo Limited Uni-Lt	$218.00	$436.00	$60.60–$388.04	38% below	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Wi Breast Echo Limited Uni-Lt	$218.00	$436.00	$196.20–$388.04	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Wi Breast Echo Limited Rt and Lt	$218.00	$436.00	$196.20–$388.04	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Wi Breast Echo Limited Uni-Rt	$218.00	$436.00	$196.20–$388.04	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC Cta Abdomen/Pel W/WO	$4,674.00	$9,348.00	$335.34–$8,319.72	16% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC Cta Abdomen/Pel W/WO	$4,674.00	$9,348.00	$4,206.60–$8,319.72	—	50%
CT angiography (CTA) of the head CPT 70496 HC CT Angio-Head W/WO Recons	$2,272.00	$4,544.00	$167.16–$4,044.16	5% below	50%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angio-Head W/WO Recons	$2,272.00	$4,544.00	$2,044.80–$4,044.16	—	50%
CT angiography (CTA) of the neck CPT 70498 HC CT Angio-Neck W/WO Recons	$2,272.00	$4,544.00	$167.16–$4,044.16	5% below	50%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angio-Neck W/WO Recons	$2,272.00	$4,544.00	$2,044.80–$4,044.16	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio-Chest W/WO Recon	$2,615.00	$5,230.00	$167.16–$4,654.70	1% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio-Chest W/WO Recon	$2,615.00	$5,230.00	$2,353.50–$4,654.70	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Coronary Cta W/WO, With C	$2,569.00	$5,138.00	$189.36–$4,572.82	55% above	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Coronary Cta W/WO, With C	$2,569.00	$5,138.00	$2,312.10–$4,572.82	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC - CT-Heart WO Qual	$160.50	$321.00	$44.62–$285.69	15% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC - CT-Heart WO Qual	$160.50	$321.00	$144.45–$285.69	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen/Pel W/O Con	$2,626.50	$5,253.00	$199.28–$4,675.17	11% below	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abdomen/Pel W/O Con	$2,626.50	$5,253.00	$2,363.85–$4,675.17	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd/Pelvis With Cont	$2,828.50	$5,657.00	$333.99–$5,034.73	26% below	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd/Pelvis With Cont	$2,828.50	$5,657.00	$2,545.65–$5,034.73	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen/Pel W/WO Con	$3,154.50	$6,309.00	$335.34–$5,615.01	20% below	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abdomen/Pel W/WO Con	$3,154.50	$6,309.00	$2,839.05–$5,615.01	—	50%
CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Contrast	$2,531.50	$5,063.00	$167.16–$4,506.07	1% above	50%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/Contrast	$2,531.50	$5,063.00	$2,278.35–$4,506.07	—	50%
CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O	$2,352.00	$4,704.00	$99.85–$4,186.56	17% above	50%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen W/O	$2,352.00	$4,704.00	$2,116.80–$4,186.56	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Facial WO	$2,221.00	$4,442.00	$99.85–$3,953.38	33% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Facial WO	$2,221.00	$4,442.00	$1,998.90–$3,953.38	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head WO/Contrast	$1,965.50	$3,931.00	$99.85–$3,498.59	14% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head WO/Contrast	$1,965.50	$3,931.00	$1,768.95–$3,498.59	—	50%
CT scan of the head with contrast CPT 70460 HC CT Head W/Contrast	$2,130.00	$4,260.00	$161.03–$3,791.40	27% above	50%
CT scan of the head with contrast inpatient CPT 70460 HC CT Head W/Contrast	$2,130.00	$4,260.00	$1,917.00–$3,791.40	—	50%
CT scan of the head without and with contrast CPT 70470 HC CT Head W/WO Contrast	$2,746.50	$5,493.00	$167.16–$4,888.77	35% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head W/WO Contrast	$2,746.50	$5,493.00	$2,471.85–$4,888.77	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-Spine WO/Contrast	$2,964.50	$5,929.00	$99.85–$5,276.81	65% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT L-Spine WO/Contrast	$2,964.50	$5,929.00	$2,668.05–$5,276.81	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT C-Spine WO/Contrast	$2,614.50	$5,229.00	$99.85–$4,653.81	28% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT C-Spine WO/Contrast	$2,614.50	$5,229.00	$2,353.05–$4,653.81	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast	$2,334.00	$4,668.00	$167.16–$4,154.52	7% above	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast	$2,334.00	$4,668.00	$2,100.60–$4,154.52	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC Carotid Arteries Comp/Bil	$1,343.50	$2,687.00	$205.23–$2,391.43	26% above	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC Carotid Arteries Comp/Bil	$1,343.50	$2,687.00	$1,209.15–$2,391.43	—	50%
Chest CT scan without and with contrast CPT 71270 HC CT Thorax W/WO Contrast	$3,430.00	$6,860.00	$167.16–$6,105.40	35% above	50%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT Thorax W/WO Contrast	$3,430.00	$6,860.00	$3,087.00–$6,105.40	—	50%
Chest X-ray, 2 views CPT 71046 HC Chest 2 Views	$370.00	$740.00	$35.44–$658.60	5% below	50%
Chest X-ray, 2 views inpatient CPT 71046 HC Chest 2 Views	$370.00	$740.00	$333.00–$658.60	—	50%
Chest X-ray, single view CPT 71045 HC Chest 1 View	$298.50	$597.00	$27.36–$531.33	8% below	50%
Chest X-ray, single view inpatient CPT 71045 HC Chest 1 View	$298.50	$597.00	$268.65–$531.33	—	50%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 HC Clavicle - Bilat.	$390.50	$781.00	$34.03–$695.09	—	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Clavicle Comp Rt	$392.00	$784.00	$34.03–$697.76	31% above	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Clavicle Comp Lt	$392.00	$784.00	$34.03–$697.76	31% above	50%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 HC Clavicle - Bilat.	$390.50	$781.00	$351.45–$695.09	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Clavicle Comp Lt	$392.00	$784.00	$352.80–$697.76	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Clavicle Comp Rt	$392.00	$784.00	$352.80–$697.76	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Exam Back Wall Comp	$905.00	$1,810.00	$99.85–$1,610.90	28% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Exam Back Wall Comp	$905.00	$1,810.00	$814.50–$1,610.90	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Wi Dexa Bone Density	$568.50	$1,137.00	$39.99–$1,011.93	39% above	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Wi Dexa Bone Density	$568.50	$1,137.00	$511.65–$1,011.93	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Dexa Bone Density Appendicular	$568.50	$1,137.00	$32.98–$1,011.93	158% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC Dexa Bone Density Appendicular	$568.50	$1,137.00	$511.65–$1,011.93	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC Wi OB Fetal Anat Sngl Ges	$1,300.50	$2,601.00	$184.89–$2,314.89	88% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB Fetal Anat Tsbd Sgl Ge	$1,300.50	$2,601.00	$184.89–$2,314.89	88% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC Wi OB Fetal Anat Sngl Ges	$1,300.50	$2,601.00	$1,170.45–$2,314.89	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB Fetal Anat Tsbd Sgl Ge	$1,300.50	$2,601.00	$1,170.45–$2,314.89	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax WO/Contrast	$2,564.50	$5,129.00	$99.85–$4,564.81	67% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax WO/Contrast	$2,564.50	$5,129.00	$2,308.05–$4,564.81	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax W/Contrast	$2,746.00	$5,492.00	$167.16–$4,887.88	37% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax W/Contrast	$2,746.00	$5,492.00	$2,471.40–$4,887.88	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Wi Digital Add Vws Bilat	$473.00	$946.00	$102.39–$841.94	—	50%
Diagnostic mammogram, both breasts CPT 77066 HC Wi Digital Diag Mammo	$473.00	$946.00	$102.39–$841.94	29% above	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Wi Digital Add Vws Bilat	$473.00	$946.00	$425.70–$841.94	—	50%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC Wi Digital Diag Mammo	$473.00	$946.00	$425.70–$841.94	—	50%
Diagnostic mammogram, one breast one side CPT 77065 HC Wi Digital Diag Lt Unilat	$384.50	$769.00	$80.39–$684.41	41% above	50%
Diagnostic mammogram, one breast one side CPT 77065 HC Wi Digital Diag Rt Unilat	$384.50	$769.00	$80.39–$684.41	41% above	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Wi Digital Diag Lt Unilat	$384.50	$769.00	$346.05–$684.41	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Wi Digital Diag Rt Unilat	$384.50	$769.00	$346.05–$684.41	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC Duplex Lower Ext Art Bila	$1,246.50	$2,493.00	$226.97–$2,218.77	11% below	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC Duplex Lower Ext Art Bila	$1,246.50	$2,493.00	$1,121.85–$2,218.77	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Periph Venous Dop Low-Bil	$729.00	$1,458.00	$201.38–$1,297.62	53% below	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Periph Venous Dop Up - Bil	$1,458.50	$2,917.00	$201.38–$2,596.13	6% below	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Periph Venous Dop Low-Bil	$729.00	$1,458.00	$656.10–$1,297.62	—	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Periph Venous Dop Up - Bil	$1,458.50	$2,917.00	$1,312.65–$2,596.13	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tt Echo Complete-Inc Colo	$2,460.00	$4,920.00	$452.60–$4,378.80	29% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Tt Echo Complete-Inc Colo	$2,460.00	$4,920.00	$2,214.00–$4,378.80	—	50%
Elbow X-ray, 2 views both sides CPT 73070 HC Elbow 2 View Bilat.	$333.00	$666.00	$30.87–$592.74	—	50%
Elbow X-ray, 2 views one side CPT 73070 HC Elbow Lt 2 Views	$334.50	$669.00	$30.87–$595.41	6% above	50%
Elbow X-ray, 2 views one side CPT 73070 HC Elbow Rt 2 Views	$334.50	$669.00	$30.87–$595.41	6% above	50%
Elbow X-ray, 2 views inpatient both sides CPT 73070 HC Elbow 2 View Bilat.	$333.00	$666.00	$299.70–$592.74	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Elbow Lt 2 Views	$334.50	$669.00	$301.05–$595.41	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Elbow Rt 2 Views	$334.50	$669.00	$301.05–$595.41	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow Comp Min 3 Vws Bil	$406.00	$812.00	$34.39–$722.68	6% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Elbow Lt Comp Min 3 Vws	$407.00	$814.00	$34.39–$724.46	6% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Elbow Rt Comp Min 3 Vws	$407.00	$814.00	$34.39–$724.46	6% above	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Elbow Comp Min 3 Vws Bil	$406.00	$812.00	$365.40–$722.68	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Elbow Lt Comp Min 3 Vws	$407.00	$814.00	$366.30–$724.46	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Elbow Rt Comp Min 3 Vws	$407.00	$814.00	$366.30–$724.46	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Ear W/O Con - Bil	$2,219.50	$4,439.00	$99.85–$3,950.71	45% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbit W/O	$2,221.00	$4,442.00	$99.85–$3,953.38	46% above	50%
Eye socket (orbit) CT scan without contrast one side CPT 70480 HC CT Ear Lt W/O Cont	$2,221.00	$4,442.00	$99.85–$3,953.38	46% above	50%
Eye socket (orbit) CT scan without contrast one side CPT 70480 HC CT Ear Rt W/O Cont	$2,221.00	$4,442.00	$99.85–$3,953.38	46% above	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Ear W/O Con - Bil	$2,219.50	$4,439.00	$1,997.55–$3,950.71	—	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Orbit W/O	$2,221.00	$4,442.00	$1,998.90–$3,953.38	—	50%
Eye socket (orbit) CT scan without contrast inpatient one side CPT 70480 HC CT Ear Rt W/O Cont	$2,221.00	$4,442.00	$1,998.90–$3,953.38	—	50%
Eye socket (orbit) CT scan without contrast inpatient one side CPT 70480 HC CT Ear Lt W/O Cont	$2,221.00	$4,442.00	$1,998.90–$3,953.38	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC Facial Bones Comp Min3vws	$495.00	$990.00	$49.47–$881.10	27% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC Facial Bones Comp Min3vws	$495.00	$990.00	$445.50–$881.10	—	50%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 HC Forearm Bilat 2 Vws	$359.00	$718.00	$30.87–$639.02	—	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Forearm Lt 2 Vws	$363.00	$726.00	$30.87–$646.14	3% below	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Forearm Rt 2 Vws	$363.00	$726.00	$30.87–$646.14	3% below	50%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 HC Forearm Bilat 2 Vws	$359.00	$718.00	$323.10–$639.02	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Forearm Lt 2 Vws	$363.00	$726.00	$326.70–$646.14	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Forearm Rt 2 Vws	$363.00	$726.00	$326.70–$646.14	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepat-Biliary Scn	$650.50	$1,301.00	$180.84–$1,157.89	59% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepat-Biliary Scn	$650.50	$1,301.00	$585.45–$1,157.89	—	50%
Hand X-ray, 2 views both sides CPT 73120 HC Hand 2 View Bilat	$234.50	$469.00	$32.98–$417.41	—	50%
Hand X-ray, 2 views one side CPT 73120 HC Hand Rt 2 Views	$235.00	$470.00	$32.98–$418.30	26% below	50%
Hand X-ray, 2 views one side CPT 73120 HC Hand Lt 2 Views	$235.00	$470.00	$32.98–$418.30	26% below	50%
Hand X-ray, 2 views inpatient both sides CPT 73120 HC Hand 2 View Bilat	$234.50	$469.00	$211.05–$417.41	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Hand Lt 2 Views	$235.00	$470.00	$211.50–$418.30	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Hand Rt 2 Views	$235.00	$470.00	$211.50–$418.30	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC Os Calcis Bil Min 2 Vws	$323.50	$647.00	$30.18–$575.83	13% above	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Os Calsis Lt Min 2 Vws	$323.50	$647.00	$30.18–$575.83	13% above	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Os Calcis Rt Min 2 Vws	$323.50	$647.00	$30.18–$575.83	13% above	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC Os Calcis Bil Min 2 Vws	$323.50	$647.00	$291.15–$575.83	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Os Calsis Lt Min 2 Vws	$323.50	$647.00	$291.15–$575.83	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Os Calcis Rt Min 2 Vws	$323.50	$647.00	$291.15–$575.83	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC - Sleep Study Unattended Respirat Effort	$489.50	$979.00	$136.08–$871.31	11% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Study, Unattended W/Recording	$609.00	$1,218.00	$146.91–$1,084.02	11% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC - Sleep Study Unattended Respirat Effort	$489.50	$979.00	$440.55–$871.31	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Sleep Study, Unattended W/Recording	$609.00	$1,218.00	$548.10–$1,084.02	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC - Polysomnograph-Cpap Ge 6 Yo Ge 4 Param	$2,999.00	$5,998.00	$833.72–$5,338.22	29% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography; Age 6 Years or Older W/ Cont Positive Airway Pressure	$3,373.00	$6,746.00	$937.69–$6,003.94	20% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC - Polysomnograph-Cpap Ge 6 Yo Ge 4 Param	$2,999.00	$5,998.00	$2,699.10–$5,338.22	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Polysomnography; Age 6 Years or Older W/ Cont Positive Airway Pressure	$3,373.00	$6,746.00	$3,035.70–$6,003.94	—	50%
Knee X-ray, 3 views CPT 73562 HC Knee 3 Views	$333.50	$667.00	$42.80–$593.63	10% below	50%
Knee X-ray, 3 views inpatient CPT 73562 HC Knee 3 Views	$333.50	$667.00	$300.15–$593.63	—	50%
Knee X-ray, complete, 4 or more views both sides CPT 73564 HC Knee Bilat 4 or More Vws	$464.00	$928.00	$49.12–$825.92	—	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Knee Lt 4 Views	$469.50	$939.00	$49.12–$835.71	10% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Knee Rt 4 Views	$469.50	$939.00	$49.12–$835.71	10% above	50%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 HC Knee Bilat 4 or More Vws	$464.00	$928.00	$417.60–$825.92	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Knee Rt 4 Views	$469.50	$939.00	$422.55–$835.71	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Knee Lt 4 Views	$469.50	$939.00	$422.55–$835.71	—	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Lower Ext W/O Cont Bil	$2,223.00	$4,446.00	$99.85–$3,956.94	35% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Ext W/O Cont Rt	$2,224.50	$4,449.00	$99.85–$3,959.61	35% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Lower Ext W/O Cont Lt	$2,224.50	$4,449.00	$99.85–$3,959.61	35% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Lower Ext W/O Cont Bil	$2,223.00	$4,446.00	$2,000.70–$3,956.94	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Lower Ext W/O Cont Rt	$2,224.50	$4,449.00	$2,002.05–$3,959.61	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Lower Ext W/O Cont Lt	$2,224.50	$4,449.00	$2,002.05–$3,959.61	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC Echo Exam of Abdomen	$802.00	$1,604.00	$92.98–$1,427.56	33% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC Echo Exam of Abdomen	$802.00	$1,604.00	$721.80–$1,427.56	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC Non-Vascular Extremity	$346.00	$692.00	$31.87–$615.88	11% below	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC Non-Vascular Extremity	$346.00	$692.00	$311.40–$615.88	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC Ldct Chest WO - Lung Cancer Screening	$160.50	$321.00	$44.62–$332.01	33% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC Ldct Chest WO - Lung Cancer Screening	$160.50	$321.00	$144.45–$285.69	—	50%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 HC Leg 2 Views Bilat	$366.50	$733.00	$33.33–$652.37	—	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Leg Rt 2 Views	$368.00	$736.00	$33.33–$655.04	6% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Leg Lt 2 Views	$368.00	$736.00	$33.33–$655.04	6% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 HC Leg 2 Views Bilat	$366.50	$733.00	$329.85–$652.37	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Leg Rt 2 Views	$368.00	$736.00	$331.20–$655.04	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Leg Lt 2 Views	$368.00	$736.00	$331.20–$655.04	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head W/O Dye	$3,879.00	$7,758.00	$226.97–$6,904.62	114% above	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Mra Head W/O Dye	$3,879.00	$7,758.00	$3,491.10–$6,904.62	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye	$2,973.50	$5,947.00	$221.38–$5,292.83	36% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Jnt of Lwr Extre W/O Dye	$2,973.50	$5,947.00	$2,676.15–$5,292.83	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Joint Lwr Extr W/O & With Dye	$4,361.50	$8,723.00	$335.34–$7,763.47	45% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Joint Lwr Extr W/O & With Dye	$4,361.50	$8,723.00	$3,925.35–$7,763.47	—	50%
MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen WO Cont	$2,454.50	$4,909.00	$215.07–$4,369.01	15% above	50%
MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen Scan WO Cont	$4,195.50	$8,391.00	$215.07–$7,467.99	97% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen WO Cont	$2,454.50	$4,909.00	$2,209.05–$4,369.01	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen Scan WO Cont	$4,195.50	$8,391.00	$3,775.95–$7,467.99	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W/O & With Dye	$4,405.50	$8,811.00	$335.34–$7,841.79	44% above	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abdomen W/O & With Dye	$4,405.50	$8,811.00	$3,964.95–$7,841.79	—	50%
MRI of the brain, no contrast dye CPT 70551 HC MRI Brain Stem W/O Dye	$2,782.00	$5,564.00	$214.36–$4,951.96	47% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain Stem W/O Dye	$2,782.00	$5,564.00	$2,503.80–$4,951.96	—	50%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Post Fossa Limited	$2,075.00	$4,150.00	$335.34–$3,693.50	27% below	50%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Stem W/O & With Dye	$4,798.50	$9,597.00	$335.34–$8,541.33	70% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Post Fossa Limited	$2,075.00	$4,150.00	$1,867.50–$3,693.50	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain Stem W/O & With Dye	$4,798.50	$9,597.00	$4,318.65–$8,541.33	—	50%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Ltd L Spine WO Cont	$2,043.50	$4,087.00	$209.10–$3,637.43	7% below	50%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Cont	$3,185.50	$6,371.00	$209.10–$5,670.19	45% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Ltd L Spine WO Cont	$2,043.50	$4,087.00	$1,839.15–$3,637.43	—	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Cont	$3,185.50	$6,371.00	$2,866.95–$5,670.19	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI L-Spine W/WO Contrast	$4,489.50	$8,979.00	$335.34–$7,991.31	40% above	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI L-Spine W/WO Contrast	$4,489.50	$8,979.00	$4,040.55–$7,991.31	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Limited T Spine Wocon	$1,902.00	$3,804.00	$208.40–$3,385.56	7% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Thor Spin Scan WO Con	$2,831.00	$5,662.00	$208.40–$5,039.18	39% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Limited T Spine Wocon	$1,902.00	$3,804.00	$1,711.80–$3,385.56	—	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Thor Spin Scan WO Con	$2,831.00	$5,662.00	$2,547.90–$5,039.18	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI C-Spine W/WO Contrast	$3,777.50	$7,555.00	$335.34–$6,723.95	16% above	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI C-Spine W/WO Contrast	$3,777.50	$7,555.00	$3,399.75–$6,723.95	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cerv Spine W/O Cont	$2,733.50	$5,467.00	$208.40–$4,865.63	21% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Cerv Spine W/O Cont	$2,733.50	$5,467.00	$2,460.15–$4,865.63	—	50%
MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/WO Con	$4,621.50	$9,243.00	$335.34–$8,226.27	48% above	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis W/WO Con	$4,621.50	$9,243.00	$4,159.35–$8,226.27	—	50%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Sacrum WO	$2,777.50	$5,555.00	$226.97–$4,943.95	18% above	50%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis Scan W/O Cont	$2,777.50	$5,555.00	$226.97–$4,943.95	18% above	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis Scan W/O Cont	$2,777.50	$5,555.00	$2,499.75–$4,943.95	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Sacrum WO	$2,777.50	$5,555.00	$2,499.75–$4,943.95	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Joint Upr Extre W/O Dye	$2,785.50	$5,571.00	$221.74–$4,958.19	53% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI Joint Upr Extre W/O Dye	$2,785.50	$5,571.00	$2,506.95–$4,958.19	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine Cervical Min 4 Vws	$553.50	$1,107.00	$56.13–$985.23	1% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Spine Cervical Min 4 Vws	$553.50	$1,107.00	$498.15–$985.23	—	50%
Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck W/Contrast	$2,762.00	$5,524.00	$167.16–$4,916.36	39% above	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck W/Contrast	$2,762.00	$5,524.00	$2,485.80–$4,916.36	—	50%
Neck soft tissue CT scan without contrast CPT 70490 HC CT Neck WO/Contrast	$2,591.00	$5,182.00	$99.85–$4,611.98	67% above	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Neck WO/Contrast	$2,591.00	$5,182.00	$2,331.90–$4,611.98	—	50%
Neck soft tissue X-ray CPT 70360 HC X-Ray Exam of Neck	$351.00	$702.00	$33.33–$624.78	48% above	50%
Neck soft tissue X-ray inpatient CPT 70360 HC X-Ray Exam of Neck	$351.00	$702.00	$315.90–$624.78	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Cardiolite Multiple	$3,397.00	$6,794.00	$489.07–$6,046.66	18% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Cardiolite Multiple	$3,397.00	$6,794.00	$3,057.30–$6,046.66	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 CT Pet Detectnet Skull Base to Mid-Thigh Subsequen	$2,153.50	$4,307.00	$598.67–$5,708.78	50% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 CT Pet Detectnet Skull Base to Mid-Thigh Initial	$2,153.50	$4,307.00	$598.67–$5,708.78	50% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull Base-Mid Thi Subsequent	$3,249.00	$6,498.00	$903.22–$5,783.22	24% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull Base-Mid Thi Subsequent Medicare	$3,249.00	$6,498.00	$903.22–$5,783.22	24% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull Base-Mid Thi	$3,249.00	$6,498.00	$903.22–$5,783.22	24% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Medic (Pi)	$3,548.50	$7,097.00	$986.48–$6,316.33	17% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Initial	$3,548.50	$7,097.00	$986.48–$6,316.33	17% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Subsequent	$3,548.50	$7,097.00	$986.48–$6,316.33	17% below	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Subset (Ps Mod)	$3,548.50	$7,097.00	$986.48–$6,316.33	17% below	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 CT Pet Detectnet Skull Base to Mid-Thigh Subsequen	$2,153.50	$4,307.00	$1,938.15–$3,833.23	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 CT Pet Detectnet Skull Base to Mid-Thigh Initial	$2,153.50	$4,307.00	$1,938.15–$3,833.23	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull Base-Mid Thi Subsequent	$3,249.00	$6,498.00	$2,924.10–$5,783.22	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull Base-Mid Thi Subsequent Medicare	$3,249.00	$6,498.00	$2,924.10–$5,783.22	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull Base-Mid Thi	$3,249.00	$6,498.00	$2,924.10–$5,783.22	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Initial	$3,548.50	$7,097.00	$3,193.65–$6,316.33	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Subsequent	$3,548.50	$7,097.00	$3,193.65–$6,316.33	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Subset (Ps Mod)	$3,548.50	$7,097.00	$3,193.65–$6,316.33	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Psma Ga-68 CT Pet Skull Base to Mid Thigh Medic (Pi)	$3,548.50	$7,097.00	$3,193.65–$6,316.33	—	50%
Pelvic CT scan without contrast CPT 72192 HC CT Pel W/O	$2,179.00	$4,358.00	$99.85–$3,878.62	34% above	50%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pel W/O	$2,179.00	$4,358.00	$1,961.10–$3,878.62	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC Pelvis Limited (Bladder)	$407.50	$815.00	$53.33–$725.35	16% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC Pelvis Limited (Bladder)	$407.50	$815.00	$366.75–$725.35	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC Pelvic Echo	$786.00	$1,572.00	$99.85–$1,399.08	3% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC Pelvic Echo	$786.00	$1,572.00	$707.40–$1,399.08	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC Usob>14wks Tansabd Sgl Ge	$1,327.50	$2,655.00	$99.85–$2,362.95	116% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC Wi OB Complete > 14 Weeks	$1,327.50	$2,655.00	$99.85–$2,362.95	116% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC Usob>14wks Tansabd Sgl Ge	$1,327.50	$2,655.00	$1,194.75–$2,362.95	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC Wi OB Complete > 14 Weeks	$1,327.50	$2,655.00	$1,194.75–$2,362.95	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB Complete < 14 Weeks	$547.00	$1,094.00	$99.85–$973.66	8% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC Wi OB Complete < 14 Weeks	$547.00	$1,094.00	$99.85–$973.66	8% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB<14 Wks W/Transvaginal	$547.00	$1,094.00	$99.85–$973.66	8% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB<14 Wks W/Transvaginal	$547.00	$1,094.00	$492.30–$973.66	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB Complete < 14 Weeks	$547.00	$1,094.00	$492.30–$973.66	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC Wi OB Complete < 14 Weeks	$547.00	$1,094.00	$492.30–$973.66	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC Pregnant Uterus Limited	$885.50	$1,771.00	$85.95–$1,576.19	93% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC Pregnant Uterus Limited	$885.50	$1,771.00	$796.95–$1,576.19	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Uni Rt 2 Vws	$366.00	$732.00	$38.94–$651.48	19% above	50%
Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Uni Lt 2 Vws	$366.00	$732.00	$38.94–$651.48	19% above	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs Uni Lt 2 Vws	$366.00	$732.00	$329.40–$651.48	—	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs Uni Rt 2 Vws	$366.00	$732.00	$329.40–$651.48	—	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC - Ch-Rib Uni Pa Cxr Cr	$201.00	$402.00	$44.56–$359.78	49% below	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC - Ch-Rib Uni Pa Cxr Dr	$311.50	$623.00	$44.56–$554.47	21% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC - Ch-Rib Uni Pa Cxr Cr	$201.00	$402.00	$180.90–$357.78	—	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC - Ch-Rib Uni Pa Cxr Dr	$311.50	$623.00	$280.35–$554.47	—	50%
Screening mammogram, both breasts CPT 77067 HC Wi Digital Screen Mammo	$377.00	$754.00	$84.67–$671.06	27% above	50%
Screening mammogram, both breasts inpatient CPT 77067 HC Wi Digital Screen Mammo	$377.00	$754.00	$339.30–$671.06	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Comp Min 2vwsbil	$276.50	$553.00	$36.49–$492.17	14% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Shoulder Comp Min 2vws Lt	$427.00	$854.00	$36.49–$760.06	33% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Shoulder Comp Min 2vws Rt	$427.00	$854.00	$36.49–$760.06	33% above	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder Comp Min 2vwsbil	$276.50	$553.00	$248.85–$492.17	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Shoulder Comp Min 2vws Rt	$427.00	$854.00	$384.30–$760.06	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Shoulder Comp Min 2vws Lt	$427.00	$854.00	$384.30–$760.06	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinu Paran Comp Min 3 Vws	$640.00	$1,280.00	$39.65–$1,139.20	58% above	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Sinu Paran Comp Min 3 Vws	$640.00	$1,280.00	$576.00–$1,139.20	—	50%
Skull X-ray, fewer than 4 views CPT 70250 HC Skull 1 View	$404.50	$809.00	$37.89–$720.01	26% above	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Skull 1 View	$404.50	$809.00	$364.05–$720.01	—	50%
Sleep study in a lab (polysomnography) CPT 95810 HC - Polysomnography Ge 6 Yo Ge 4 Param	$2,760.00	$5,520.00	$767.28–$4,912.80	33% below	50%
Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography; Age 6 Years or Older, W/ Modifier 52	$3,049.00	$6,098.00	$847.62–$5,427.22	26% below	50%
Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography; Age 6 Years or Older W/O Modifier 52	$3,049.00	$6,098.00	$847.62–$5,427.22	26% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC - Polysomnography Ge 6 Yo Ge 4 Param	$2,760.00	$5,520.00	$2,484.00–$4,912.80	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography; Age 6 Years or Older W/O Modifier 52	$3,049.00	$6,098.00	$2,744.10–$5,427.22	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography; Age 6 Years or Older, W/ Modifier 52	$3,049.00	$6,098.00	$2,744.10–$5,427.22	—	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Stress Echo Pharm Induced	$2,622.50	$5,245.00	$499.53–$4,668.05	2% below	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Stress Echo Pharm Induced	$2,622.50	$5,245.00	$2,360.25–$4,668.05	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Dysphagiagram	$640.00	$1,280.00	$134.02–$1,139.20	6% above	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Dysphagiagram	$640.00	$1,280.00	$576.00–$1,139.20	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Femur Min 2 Vw Bil	$426.00	$852.00	$37.54–$758.28	30% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Femur Min 2 Vw Lt	$427.00	$854.00	$37.54–$760.06	31% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Femur Min 2 Vw Rt	$427.00	$854.00	$37.54–$760.06	31% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC Femur Min 2 Vw Bil	$426.00	$852.00	$383.40–$758.28	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Femur Min 2 Vw Lt	$427.00	$854.00	$384.30–$760.06	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Femur Min 2 Vw Rt	$427.00	$854.00	$384.30–$760.06	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT T-Spine WO/Contrast	$2,330.50	$4,661.00	$99.85–$4,148.29	23% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT T-Spine WO/Contrast	$2,330.50	$4,661.00	$2,097.45–$4,148.29	—	50%
Toe X-ray, 2 or more views CPT 73660 HC X-Ray Exam of Toes	$291.50	$583.00	$30.87–$518.87	7% above	50%
Toe X-ray, 2 or more views inpatient CPT 73660 HC X-Ray Exam of Toes	$291.50	$583.00	$262.35–$518.87	—	50%
Transvaginal pelvic ultrasound CPT 76830 HC Transvaginal Echo	$692.50	$1,385.00	$99.85–$1,232.65	15% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC Transvaginal Echo	$692.50	$1,385.00	$623.25–$1,232.65	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC Wi OB Transvaginal	$547.00	$1,094.00	$97.89–$973.66	7% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 HC 0b Trsvag Addon to Tsbd	$547.00	$1,094.00	$97.89–$973.66	7% above	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC 0b Trsvag Addon to Tsbd	$547.00	$1,094.00	$492.30–$973.66	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC Wi OB Transvaginal	$547.00	$1,094.00	$492.30–$973.66	—	50%
Ultrasound of the abdomen, complete CPT 76700 HC Abdomen Compl Echo B-Mode	$992.50	$1,985.00	$99.85–$1,766.65	26% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC Abdomen Compl Echo B-Mode	$992.50	$1,985.00	$893.25–$1,766.65	—	50%
Ultrasound of the scrotum and testicles CPT 76870 HC Scrotum Contents/Doppler	$710.00	$1,420.00	$99.85–$1,263.80	16% above	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC Scrotum Contents/Doppler	$710.00	$1,420.00	$639.00–$1,263.80	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC Thyroid Echo B-Mode	$752.50	$1,505.00	$99.85–$1,339.45	19% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC Wi Neck Soft Tissue	$752.50	$1,505.00	$99.85–$1,339.45	19% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC Thyroid Echo B-Mode	$752.50	$1,505.00	$677.25–$1,339.45	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC Wi Neck Soft Tissue	$752.50	$1,505.00	$677.25–$1,339.45	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC - Fl-Upper GI Single Contrast	$501.00	$1,002.00	$131.21–$891.78	30% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC - Fl-Upper GI Single Contrast	$501.00	$1,002.00	$450.90–$891.78	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 HC Humerus Bil Min 2 Vws	$374.50	$749.00	$34.03–$666.61	7% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Humerus Rt Min 2 Vws	$392.00	$784.00	$34.03–$697.76	12% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Humerus Lt Min 2 Vws	$392.00	$784.00	$34.03–$697.76	12% above	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Humerus Bil Min 2 Vws	$374.50	$749.00	$337.05–$666.61	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Humerus Lt Min 2 Vws	$392.00	$784.00	$352.80–$697.76	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Humerus Rt Min 2 Vws	$392.00	$784.00	$352.80–$697.76	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Periph Venous Dop - Rt	$732.00	$1,464.00	$99.85–$1,302.96	6% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Periph Venous Dop - Lt	$732.00	$1,464.00	$99.85–$1,302.96	6% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Periph Venous Dop - Rt	$732.00	$1,464.00	$658.80–$1,302.96	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Periph Venous Dop - Lt	$732.00	$1,464.00	$658.80–$1,302.96	—	50%
Wrist X-ray, 2 views both sides CPT 73100 HC Wrist 2 Views Bilat	$285.50	$571.00	$35.79–$508.19	—	50%
Wrist X-ray, 2 views one side CPT 73100 HC Wrist Rt 2 Views	$286.50	$573.00	$35.79–$509.97	5% below	50%
Wrist X-ray, 2 views one side CPT 73100 HC Wrist Lt 2 Views	$286.50	$573.00	$35.79–$509.97	5% below	50%
Wrist X-ray, 2 views inpatient both sides CPT 73100 HC Wrist 2 Views Bilat	$285.50	$571.00	$256.95–$508.19	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Wrist Rt 2 Views	$286.50	$573.00	$257.85–$509.97	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Wrist Lt 2 Views	$286.50	$573.00	$257.85–$509.97	—	50%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC Wrist Min 3 Vws Bilateral	$343.50	$687.00	$43.16–$611.43	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Wrist Lt Min 3 Views	$514.50	$1,029.00	$43.16–$915.81	40% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Wrist Rt Min 3 Views	$514.50	$1,029.00	$43.16–$915.81	40% above	50%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC Wrist Min 3 Vws Bilateral	$343.50	$687.00	$309.15–$611.43	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Wrist Rt Min 3 Views	$514.50	$1,029.00	$463.05–$915.81	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Wrist Lt Min 3 Views	$514.50	$1,029.00	$463.05–$915.81	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC Hip Jt 2-3 Vws Pedi Bil	$186.00	$372.00	$49.47–$331.08	49% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip Jt 2-3 Vws W Pel Rt	$370.00	$740.00	$49.47–$658.60	1% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip Jt 2-3 Vws W Pel Lt	$370.00	$740.00	$49.47–$658.60	1% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC Hip Jt 2-3 Vws Pedi Bil	$186.00	$372.00	$167.40–$331.08	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip Jt 2-3 Vws W Pel Lt	$370.00	$740.00	$333.00–$658.60	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip Jt 2-3 Vws W Pel Rt	$370.00	$740.00	$333.00–$658.60	—	50%
X-ray of the abdomen, 1 view CPT 74018 HC X-Ray of the Abdomen, 1 View	$363.00	$726.00	$31.58–$646.14	7% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-Ray of the Abdomen, 1 View	$363.00	$726.00	$326.70–$646.14	—	50%
X-ray of the ankle, 2 views both sides CPT 73600 HC Ankle 2 Views Bilat	$266.00	$532.00	$34.39–$473.48	—	50%
X-ray of the ankle, 2 views one side CPT 73600 HC Ankle Lt 2 View	$269.50	$539.00	$34.39–$479.71	10% below	50%
X-ray of the ankle, 2 views one side CPT 73600 HC Ankle Rt 2 View	$269.50	$539.00	$34.39–$479.71	10% below	50%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC Ankle 2 Views Bilat	$266.00	$532.00	$239.40–$473.48	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle Lt 2 View	$269.50	$539.00	$242.55–$479.71	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle Rt 2 View	$269.50	$539.00	$242.55–$479.71	—	50%
X-ray of the finger(s), 2 or more views both sides CPT 73140 HC - Ue-Finger 2 Vw Bi Dr	$230.00	$460.00	$39.99–$409.40	—	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger (S) Min 2 Vw Rt	$169.50	$339.00	$39.99–$301.71	30% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger (S) Min 2 Vw Lt	$169.50	$339.00	$39.99–$301.71	30% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Lt 5th Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Rt 2nd Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Rt 5th Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger- Rt Thumb	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Lt Thumb	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Rt 4th Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Rt 3rd Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Lt 2nd Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Lt 3rd Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger - Lt 4th Digit	$302.50	$605.00	$39.99–$538.45	25% above	50%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 HC - Ue-Finger 2 Vw Bi Dr	$230.00	$460.00	$207.00–$409.40	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger (S) Min 2 Vw Lt	$169.50	$339.00	$152.55–$301.71	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger (S) Min 2 Vw Rt	$169.50	$339.00	$152.55–$301.71	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger- Rt Thumb	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Rt 4th Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Rt 3rd Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Lt 3rd Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Lt 4th Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Lt 5th Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Rt 2nd Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Rt 5th Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Lt Thumb	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger - Lt 2nd Digit	$302.50	$605.00	$272.25–$538.45	—	50%
X-ray of the foot, 2 views both sides CPT 73620 HC Foot 2 Views Bilat	$242.50	$485.00	$29.82–$431.65	—	50%
X-ray of the foot, 2 views one side CPT 73620 HC Foot Rt 2 Views	$245.00	$490.00	$29.82–$436.10	26% below	50%
X-ray of the foot, 2 views one side CPT 73620 HC Foot Lt 2 Views	$245.00	$490.00	$29.82–$436.10	26% below	50%
X-ray of the foot, 2 views inpatient both sides CPT 73620 HC Foot 2 Views Bilat	$242.50	$485.00	$218.25–$431.65	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot Rt 2 Views	$245.00	$490.00	$220.50–$436.10	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot Lt 2 Views	$245.00	$490.00	$220.50–$436.10	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot Comp Min 3 Vws Bil	$357.00	$714.00	$36.13–$635.46	4% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot Rt Comp Min 3 Vws	$358.50	$717.00	$36.13–$638.13	4% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot Lt Comp Min 3 Vws	$358.50	$717.00	$36.13–$638.13	4% below	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC Foot Comp Min 3 Vws Bil	$357.00	$714.00	$321.30–$635.46	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot Rt Comp Min 3 Vws	$358.50	$717.00	$322.65–$638.13	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot Lt Comp Min 3 Vws	$358.50	$717.00	$322.65–$638.13	—	50%
X-ray of the hand, 3 or more views CPT 73130 HC Hand Min Vws Bil	$327.00	$654.00	$38.94–$582.06	15% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HC Hand Rt Min 3 Vws	$331.00	$662.00	$38.94–$589.18	14% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HC Hand Lt Min 3 Vws	$331.00	$662.00	$38.94–$589.18	14% below	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC Hand Min Vws Bil	$327.00	$654.00	$294.30–$582.06	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand Rt Min 3 Vws	$331.00	$662.00	$297.90–$589.18	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand Lt Min 3 Vws	$331.00	$662.00	$297.90–$589.18	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1-2 Vws Bil	$349.00	$698.00	$36.13–$621.22	18% above	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee Lt 1 or 2 Views	$349.50	$699.00	$36.13–$622.11	19% above	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee Rt 1 or 2 Views	$349.50	$699.00	$36.13–$622.11	19% above	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC Knee 1-2 Vws Bil	$349.00	$698.00	$314.10–$621.22	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee Lt 1 or 2 Views	$349.50	$699.00	$314.55–$622.11	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee Rt 1 or 2 Views	$349.50	$699.00	$314.55–$622.11	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbo-Sacral 2-3vws	$481.50	$963.00	$42.11–$857.07	8% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine Lumbo-Sacral 2-3vws	$481.50	$963.00	$433.35–$857.07	—	50%
X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbar Min 4 Vws	$819.00	$1,638.00	$54.02–$1,457.82	41% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine Lumbar Min 4 Vws	$819.00	$1,638.00	$737.10–$1,457.82	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2 Vws	$299.50	$599.00	$34.73–$533.11	26% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine Thoracic 2 Vws	$299.50	$599.00	$269.55–$533.11	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Nose Comp Min 3 Vws	$392.00	$784.00	$40.35–$697.76	43% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Nose Comp Min 3 Vws	$392.00	$784.00	$352.80–$697.76	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2 or 3 Views	$439.50	$879.00	$41.75–$782.31	20% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 2 or 3 Views	$439.50	$879.00	$395.55–$782.31	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-Ray Exam of Pelvis, 1 or 2 Vws	$481.00	$962.00	$29.46–$856.18	53% above	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-Ray Exam of Pelvis, 1 or 2 Vws	$481.00	$962.00	$432.90–$856.18	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Coccyx & Sacrum Min 2 Vws	$411.00	$822.00	$34.39–$731.58	34% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Coccyx & Sacrum Min 2 Vws	$411.00	$822.00	$369.90–$731.58	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 HC Adrenocortictrophic Horm.	$307.00	$614.00	$38.62–$546.46	60% above	50%
ACTH blood test inpatient CPT 82024 HC Adrenocortictrophic Horm.	$307.00	$614.00	$276.30–$546.46	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt (Alt)	$126.00	$252.00	$5.30–$224.28	152% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Sgpt (Alt)	$126.00	$252.00	$113.40–$224.28	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Sgot (Ast)	$119.00	$238.00	$5.18–$211.82	131% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Sgot (Ast)	$119.00	$238.00	$107.10–$211.82	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel	$307.50	$615.00	$47.63–$547.35	20% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel	$307.50	$615.00	$276.75–$547.35	—	50%
Albumin blood test CPT 82040 HC Albumin, Serum	$79.00	$158.00	$4.95–$140.62	112% above	50%
Albumin blood test inpatient CPT 82040 HC Albumin, Serum	$79.00	$158.00	$71.10–$140.62	—	50%
Aldosterone blood test CPT 82088 HC Aldosterone Serum	$286.00	$572.00	$40.75–$509.08	117% above	50%
Aldosterone blood test inpatient CPT 82088 HC Aldosterone Serum	$286.00	$572.00	$257.40–$509.08	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Alkaline Phosphatase	$122.50	$245.00	$5.18–$218.05	156% above	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alkaline Phosphatase	$122.50	$245.00	$110.25–$218.05	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Specific Ige	$24.50	$49.00	$5.22–$43.61	2% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Specific Ige	$24.50	$49.00	$22.05–$43.61	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Feto Protein-Tumor	$88.00	$176.00	$16.77–$156.64	7% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Fetoprotein-M.S.	$285.50	$571.00	$16.77–$508.19	202% above	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Feto Protein-Tumor	$88.00	$176.00	$79.20–$156.64	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Fetoprotein-M.S.	$285.50	$571.00	$256.95–$508.19	—	50%
Ammonia blood test CPT 82140 HC Ammonia	$67.50	$135.00	$14.57–$120.15	52% below	50%
Ammonia blood test inpatient CPT 82140 HC Ammonia	$67.50	$135.00	$60.75–$120.15	—	50%
Amylase blood test CPT 82150 HC Amylase	$152.50	$305.00	$6.48–$271.45	96% above	50%
Amylase blood test inpatient CPT 82150 HC Amylase	$152.50	$305.00	$137.25–$271.45	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Citrullinated Antibody, S	$182.50	$365.00	$12.95–$324.85	229% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Citrullinated Antibody, S	$182.50	$365.00	$164.25–$324.85	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Anti-Nuclear Antibodies	$234.00	$468.00	$12.09–$416.52	204% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Anti-Nuclear Antibodies	$234.00	$468.00	$210.60–$416.52	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC B Naturiuretic Peptide	$140.50	$281.00	$39.06–$250.09	9% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC B Naturiuretic Peptide	$140.50	$281.00	$126.45–$250.09	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture, Routine	$212.50	$425.00	$8.62–$378.25	217% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture, Routine	$212.50	$425.00	$191.25–$378.25	—	50%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel	$180.00	$360.00	$8.46–$320.40	14% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel	$180.00	$360.00	$162.00–$320.40	—	50%
Bilirubin blood test, total CPT 82247 HC Bilirubin, Total	$110.50	$221.00	$5.02–$196.69	94% above	50%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin, Total	$110.50	$221.00	$99.45–$196.69	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Surg.Path Level IV,G & M	$422.50	$845.00	$50.17–$752.05	42% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Surg.Path Level IV,G & M	$422.50	$845.00	$380.25–$752.05	—	50%
Blood culture for bacteria CPT 87040 HC Culture, Blood Presum ID	$191.50	$383.00	$10.32–$340.87	6% below	50%
Blood culture for bacteria inpatient CPT 87040 HC Culture, Blood Presum ID	$191.50	$383.00	$172.35–$340.87	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Routine Venipuncture	$25.50	$51.00	$7.09–$45.39	42% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Routine Venipuncture	$25.50	$51.00	$22.95–$45.39	—	50%
Blood glucose (sugar) test CPT 82947 HC Glucose, Blood	$111.00	$222.00	$3.93–$197.58	166% above	50%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose, Blood	$111.00	$222.00	$99.90–$197.58	—	50%
Blood lead test CPT 83655 HC Lead	$172.50	$345.00	$12.11–$307.05	271% above	50%
Blood lead test inpatient CPT 83655 HC Lead	$172.50	$345.00	$155.25–$307.05	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Hcg Qual-Serum	$192.00	$384.00	$7.52–$341.76	40% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Hcg Qual-Serum	$192.00	$384.00	$172.80–$341.76	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Serologic Abo	$43.00	$86.00	$3.14–$366.34	51% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Discrepancy Ubs	$79.00	$158.00	$3.14–$366.34	11% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Type	$83.00	$166.00	$3.14–$366.34	6% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Type-Cord Blood	$83.00	$166.00	$3.14–$366.34	6% below	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Serologic Abo	$43.00	$86.00	$38.70–$76.54	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Discrepancy Ubs	$79.00	$158.00	$71.10–$140.62	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Type	$83.00	$166.00	$74.70–$147.74	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Type-Cord Blood	$83.00	$166.00	$74.70–$147.74	—	50%
Blood urea nitrogen (BUN) test CPT 84520 HC Urea Nitrogen; Quantitative	$90.00	$180.00	$3.95–$160.20	70% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Urea Nitrogen; Quantitative	$90.00	$180.00	$81.00–$160.20	—	50%
C-peptide blood test CPT 84681 HC Assay of C-Peptide	$95.50	$191.00	$20.81–$169.99	31% above	50%
C-peptide blood test CPT 84681 HC C-Peptide	$99.00	$198.00	$20.81–$176.22	36% above	50%
C-peptide blood test inpatient CPT 84681 HC Assay of C-Peptide	$95.50	$191.00	$85.95–$169.99	—	50%
C-peptide blood test inpatient CPT 84681 HC C-Peptide	$99.00	$198.00	$89.10–$176.22	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C - Reactive Protein	$129.00	$258.00	$5.18–$229.62	148% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C - Reactive Protein	$129.00	$258.00	$116.10–$229.62	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Clostridium Difficile - Rapid Pcr	$149.00	$298.00	$37.27–$265.22	15% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Clostridium Difficile - Rapid Pcr	$149.00	$298.00	$134.10–$265.22	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 HC Carbohydrate Ag 19-9	$188.50	$377.00	$20.81–$335.53	42% above	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Carbohydrate Ag 19-9	$188.50	$377.00	$169.65–$335.53	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Carbohydrate Ag 125	$212.50	$425.00	$20.81–$378.25	41% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Carbohydrate Ag 125	$212.50	$425.00	$191.25–$378.25	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sars-Cov-2 Amplified Probe Technique	$110.50	$221.00	$30.72–$196.69	20% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Sars-Cov-2 Amplified Probe Technique	$110.50	$221.00	$99.45–$196.69	—	50%
Calcium blood test, total CPT 82310 HC Calcium,Total	$85.50	$171.00	$5.16–$152.19	43% above	50%
Calcium blood test, total inpatient CPT 82310 HC Calcium,Total	$85.50	$171.00	$76.95–$152.19	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea	$209.50	$419.00	$18.96–$372.91	57% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea	$209.50	$419.00	$188.55–$372.91	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella-Zoster Virus Lgg	$27.00	$54.00	$7.51–$48.06	56% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 HC Antibody; Varicella-Zoster	$135.50	$271.00	$12.88–$241.19	121% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella-Zoster Virus Lgg	$27.00	$54.00	$24.30–$48.06	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Antibody; Varicella-Zoster	$135.50	$271.00	$121.95–$241.19	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Dna	$224.00	$448.00	$35.09–$398.72	80% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Dna	$224.00	$448.00	$201.60–$398.72	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel	$251.50	$503.00	$13.39–$447.67	70% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel	$251.50	$503.00	$226.35–$447.67	—	50%
Complete blood count (CBC) with differential CPT 85025 HC Cbc-Auto & Wbc Differ	$159.00	$318.00	$7.77–$283.02	74% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc-Auto & Wbc Differ	$159.00	$318.00	$143.10–$283.02	—	50%
Complete blood count (CBC), no differential CPT 85027 HC Cbc - Automated	$133.00	$266.00	$6.47–$236.74	42% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc - Automated	$133.00	$266.00	$119.70–$236.74	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comp. Metabolic Panel	$483.00	$966.00	$10.56–$859.74	95% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comp. Metabolic Panel	$483.00	$966.00	$434.70–$859.74	—	50%
Cortisol blood test, total CPT 82533 HC Cortisol, Serum	$149.00	$298.00	$16.30–$265.22	78% above	50%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol, Serum	$149.00	$298.00	$134.10–$265.22	—	50%
Creatine kinase (CK) blood test, total CPT 82550 HC Creatine Phosphokinase	$145.00	$290.00	$6.51–$258.10	127% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Creatine Phosphokinase	$145.00	$290.00	$130.50–$258.10	—	50%
Creatinine blood test CPT 82565 HC Creatinine, Serum	$97.00	$194.00	$5.12–$172.66	81% above	50%
Creatinine blood test CPT 82565 HC POCT Creatinine	$102.00	$204.00	$5.12–$181.56	90% above	50%
Creatinine blood test inpatient CPT 82565 HC Creatinine, Serum	$97.00	$194.00	$87.30–$172.66	—	50%
Creatinine blood test inpatient CPT 82565 HC POCT Creatinine	$102.00	$204.00	$91.80–$181.56	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Ab Igg -L	$40.00	$80.00	$11.12–$71.20	44% below	50%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cytomegalovirus Ab Igg	$168.50	$337.00	$14.39–$299.93	137% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Ab Igg -L	$40.00	$80.00	$36.00–$71.20	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cytomegalovirus Ab Igg	$168.50	$337.00	$151.65–$299.93	—	50%
D-dimer blood test (blood clot marker) CPT 85379 HC D-Dimer	$64.50	$129.00	$10.18–$114.81	62% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-Dimer	$64.50	$129.00	$58.05–$114.81	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea Sulfate (Dhea-S)	$152.50	$305.00	$22.23–$271.45	1% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dhea Sulfate (Dhea-S)	$152.50	$305.00	$137.25–$271.45	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test(S), Presumptive, Any Number of Classes	$219.00	$438.00	$60.88–$389.82	252% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen-Single Class	$296.50	$593.00	$62.14–$527.77	377% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Class List A	$709.00	$1,418.00	$62.14–$1,262.02	1041% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test(S), Presumptive, Any Number of Classes	$219.00	$438.00	$197.10–$389.82	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen-Single Class	$296.50	$593.00	$266.85–$527.77	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Class List A	$709.00	$1,418.00	$638.10–$1,262.02	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel	$214.00	$428.00	$7.01–$380.92	34% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel	$214.00	$428.00	$192.60–$380.92	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Ebv Vca	$61.50	$123.00	$17.10–$109.47	29% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Eb Virus,Iqg Viral Capsid	$157.50	$315.00	$18.14–$280.35	83% above	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Ebv Vca	$61.50	$123.00	$55.35–$109.47	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Eb Virus,Iqg Viral Capsid	$157.50	$315.00	$141.75–$280.35	—	50%
Estradiol blood test CPT 82670 HC Estradiol	$241.00	$482.00	$27.94–$428.98	94% above	50%
Estradiol blood test inpatient CPT 82670 HC Estradiol	$241.00	$482.00	$216.90–$428.98	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh	$261.00	$522.00	$18.58–$464.58	67% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh	$261.00	$522.00	$234.90–$464.58	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin Fecal	$124.00	$248.00	$19.63–$220.72	42% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin Fecal	$124.00	$248.00	$111.60–$220.72	—	50%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin	$137.00	$274.00	$13.63–$243.86	64% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin	$137.00	$274.00	$123.30–$243.86	—	50%
Fibrinogen blood test CPT 85384 HC Fibrinogen Activity - K, Angle	$40.00	$80.00	$9.72–$71.20	54% below	50%
Fibrinogen blood test CPT 85384 HC Fibrinogen	$163.00	$326.00	$9.72–$290.14	88% above	50%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Activity - K, Angle	$40.00	$80.00	$36.00–$71.20	—	50%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen	$163.00	$326.00	$146.70–$290.14	—	50%
Folate (folic acid) blood test CPT 82746 HC Folic Acid	$136.50	$273.00	$14.70–$242.97	69% above	50%
Folate (folic acid) blood test inpatient CPT 82746 HC Folic Acid	$136.50	$273.00	$122.85–$242.97	—	50%
Free T3 thyroid hormone test CPT 84481 HC T3, Free, Serum	$234.00	$468.00	$16.94–$416.52	68% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3, Free, Serum	$234.00	$468.00	$210.60–$416.52	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4, Free	$129.00	$258.00	$9.02–$229.62	73% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4, Free	$129.00	$258.00	$116.10–$229.62	—	50%
Free testosterone test CPT 84402 HC Testosterone, Free	$135.00	$270.00	$25.47–$240.30	27% above	50%
Free testosterone test inpatient CPT 84402 HC Testosterone, Free	$135.00	$270.00	$121.50–$240.30	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Ggt	$113.50	$227.00	$7.20–$202.03	93% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Ggt	$113.50	$227.00	$102.15–$202.03	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel	$932.50	$1,865.00	$113.38–$1,659.85	117% above	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC General Health Panel	$932.50	$1,865.00	$839.25–$1,659.85	—	50%
Glucose tolerance test, 3 samples CPT 82951 HC Gtt 1st 3 Specimens	$216.50	$433.00	$12.87–$385.37	42% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Gtt 1st 3 Specimens	$216.50	$433.00	$194.85–$385.37	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.Gonorrhoeae Dna	$234.00	$468.00	$35.09–$416.52	80% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.Gonorrhoeae Dna	$234.00	$468.00	$210.60–$416.52	—	50%
H. pylori stool antigen test CPT 87338 HC H Pylori Ag Feces	$39.50	$79.00	$10.98–$70.31	52% below	50%
H. pylori stool antigen test inpatient CPT 87338 HC H Pylori Ag Feces	$39.50	$79.00	$35.55–$70.31	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv-Type I, Qnt by Pcr	$515.50	$1,031.00	$85.10–$917.59	70% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv-Type I, Qnt by Pcr	$515.50	$1,031.00	$463.95–$917.59	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv-1/2 Antibody Evaluation	$28.00	$56.00	$7.78–$49.84	67% below	50%
HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv Ab Type 1&2	$214.00	$428.00	$13.71–$380.92	149% above	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Hiv-1/2 Antibody Evaluation	$28.00	$56.00	$25.20–$49.84	—	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Hiv Ab Type 1&2	$214.00	$428.00	$192.60–$380.92	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$214.00	$428.00	$24.08–$380.92	58% above	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab	$214.00	$428.00	$192.60–$380.92	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv , High Risk, (Thin Prep)	$136.50	$273.00	$35.09–$242.97	92% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv , High Risk, (Thin Prep)	$136.50	$273.00	$122.85–$242.97	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin Aic	$137.00	$274.00	$9.71–$243.86	64% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin Aic	$137.00	$274.00	$123.30–$243.86	—	50%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$57.00	$114.00	$2.37–$101.46	27% above	50%
Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin	$57.00	$114.00	$51.30–$101.46	—	50%
Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Antib Total	$66.50	$133.00	$12.05–$118.37	8% below	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Core Antib Total	$66.50	$133.00	$59.85–$118.37	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hep B Surface Antibody	$122.50	$245.00	$10.74–$218.05	89% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hep B Surface Antibody	$122.50	$245.00	$110.25–$218.05	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hepatitis B S Ag	$135.00	$270.00	$10.33–$240.30	93% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hepatitis B S Ag	$135.00	$270.00	$121.50–$240.30	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Ab	$94.50	$189.00	$14.27–$168.21	11% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hepatitis C Ab	$94.50	$189.00	$85.05–$168.21	—	50%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HC Hcv Qnt by Rt-Pcr	$535.50	$1,071.00	$42.84–$953.19	127% above	50%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HC Hcv Qnt by Rt-Pcr	$535.50	$1,071.00	$481.95–$953.19	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv Type 1	$68.50	$137.00	$13.19–$121.93	5% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv Type 1 Igg	$116.00	$232.00	$13.19–$206.48	61% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsv Type 1	$68.50	$137.00	$61.65–$121.93	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsv Type 1 Igg	$116.00	$232.00	$104.40–$206.48	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC Hsv Type 2	$68.50	$137.00	$19.04–$121.93	19% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 HC Hsv Type 2 Igg	$116.00	$232.00	$19.35–$206.48	38% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Hsv Type 2	$68.50	$137.00	$61.65–$121.93	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Hsv Type 2 Igg	$116.00	$232.00	$104.40–$206.48	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-React,Prot.Cardiac Hs	$71.50	$143.00	$12.95–$127.27	5% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-React,Prot.Cardiac Hs	$71.50	$143.00	$64.35–$127.27	—	50%
Homocysteine blood test CPT 83090 HC Homosystine	$277.50	$555.00	$17.92–$493.95	85% above	50%
Homocysteine blood test inpatient CPT 83090 HC Homosystine	$277.50	$555.00	$249.75–$493.95	—	50%
Insulin blood test CPT 83525 HC Insulin, Random	$50.00	$100.00	$11.43–$89.00	27% below	50%
Insulin blood test CPT 83525 HC Insulin, Serum	$63.00	$126.00	$11.43–$112.14	8% below	50%
Insulin blood test inpatient CPT 83525 HC Insulin, Random	$50.00	$100.00	$45.00–$89.00	—	50%
Insulin blood test inpatient CPT 83525 HC Insulin, Serum	$63.00	$126.00	$56.70–$112.14	—	50%
Iron blood test (serum iron) CPT 83540 HC Assay of Iron	$76.00	$152.00	$6.47–$135.28	3% above	50%
Iron blood test (serum iron) inpatient CPT 83540 HC Assay of Iron	$76.00	$152.00	$68.40–$135.28	—	50%
Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Cap. Tibc	$100.00	$200.00	$8.74–$178.00	9% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Cap. Tibc	$100.00	$200.00	$90.00–$178.00	—	50%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$136.50	$273.00	$8.68–$242.97	23% below	50%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$136.50	$273.00	$122.85–$242.97	—	50%
LH (luteinizing hormone) test CPT 83002 HC Lutenizing Hormone	$264.50	$529.00	$18.52–$470.81	89% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 HC Lutenizing Hormone	$264.50	$529.00	$238.05–$470.81	—	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid - Cardio	$128.00	$256.00	$11.57–$227.84	34% above	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid	$128.00	$256.00	$11.57–$227.84	34% above	50%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid POC	$135.50	$271.00	$11.57–$241.19	42% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid	$128.00	$256.00	$115.20–$227.84	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid - Cardio	$128.00	$256.00	$115.20–$227.84	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid POC	$135.50	$271.00	$121.95–$241.19	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehdrogenase (Ld), Body Fluid	$63.50	$127.00	$6.04–$113.03	43% above	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase	$107.00	$214.00	$6.04–$190.46	140% above	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehdrogenase (Ld), Body Fluid	$63.50	$127.00	$57.15–$113.03	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogenase	$107.00	$214.00	$96.30–$190.46	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase Serum	$160.00	$320.00	$6.89–$284.80	132% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase Serum	$160.00	$320.00	$144.00–$284.80	—	50%
Liver function blood test panel CPT 80076 HC Hepatic Function Panel	$266.00	$532.00	$8.17–$473.48	37% above	50%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel	$266.00	$532.00	$239.40–$473.48	—	50%
Lyme disease antibody test CPT 86618 HC Lyme Disease Evaluation	$193.00	$386.00	$17.03–$343.54	157% above	50%
Lyme disease antibody test inpatient CPT 86618 HC Lyme Disease Evaluation	$193.00	$386.00	$173.70–$343.54	—	50%
Magnesium blood test CPT 83735 HC Magnesium	$122.00	$244.00	$6.70–$217.16	157% above	50%
Magnesium blood test inpatient CPT 83735 HC Magnesium	$122.00	$244.00	$109.80–$217.16	—	50%
Measles (rubeola) antibody test CPT 86765 HC Measles (Rubeola) Antibody	$35.50	$71.00	$9.87–$63.19	3% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 HC Measles (Rubeola) Antibody	$35.50	$71.00	$31.95–$63.19	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Mono Test Screen	$163.00	$326.00	$5.18–$290.14	92% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mono Test Screen	$163.00	$326.00	$146.70–$290.14	—	50%
Mumps immunity blood test CPT 86735 HC Mumps Virus Lgg	$27.00	$54.00	$7.51–$48.06	54% below	50%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Virus Lgg	$27.00	$54.00	$24.30–$48.06	—	50%
Obstetric blood test panel CPT 80055 HC OB Panel	$78.00	$156.00	$21.68–$160.64	69% below	50%
Obstetric blood test panel inpatient CPT 80055 HC OB Panel	$78.00	$156.00	$70.20–$138.84	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa,Free	$223.50	$447.00	$18.39–$397.83	98% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa,Free	$223.50	$447.00	$201.15–$397.83	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Spec Ag-Psa	$214.00	$428.00	$18.39–$380.92	145% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Spec Ag-Psa	$214.00	$428.00	$192.60–$380.92	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 HC - Pap Diag Auto Man Rs	$76.50	$153.00	$21.27–$136.17	1% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC - Pap Diag Auto Man Rs	$76.50	$153.00	$68.85–$136.17	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Pap Smear,Thin Prepatatio	$85.50	$171.00	$20.26–$152.19	6% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Pap Smear,Thin Prepatatio	$85.50	$171.00	$76.95–$152.19	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathormone	$300.00	$600.00	$41.28–$534.00	48% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathormone	$300.00	$600.00	$270.00–$534.00	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt-D Heparin Reflex Bill	$122.00	$244.00	$6.01–$217.16	138% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt	$126.00	$252.00	$6.01–$224.28	146% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt-D Heparin Reflex Bill	$122.00	$244.00	$109.80–$217.16	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt	$126.00	$252.00	$113.40–$224.28	—	50%
Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus	$91.50	$183.00	$4.74–$162.87	47% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus	$91.50	$183.00	$82.35–$162.87	—	50%
Potassium blood test CPT 84132 HC Potassium, Serum - Cardio	$67.50	$135.00	$4.76–$120.15	8% above	50%
Potassium blood test CPT 84132 HC Potassium, Serum	$67.50	$135.00	$4.76–$120.15	8% above	50%
Potassium blood test inpatient CPT 84132 HC Potassium, Serum	$67.50	$135.00	$60.75–$120.15	—	50%
Potassium blood test inpatient CPT 84132 HC Potassium, Serum - Cardio	$67.50	$135.00	$60.75–$120.15	—	50%
Progesterone blood test CPT 84144 HC Progesterone	$235.50	$471.00	$20.86–$419.19	133% above	50%
Progesterone blood test inpatient CPT 84144 HC Progesterone	$235.50	$471.00	$211.95–$419.19	—	50%
Prolactin blood test CPT 84146 HC Prolactin	$145.00	$290.00	$19.38–$258.10	32% above	50%
Prolactin blood test inpatient CPT 84146 HC Prolactin	$145.00	$290.00	$130.50–$258.10	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Pt-D	$64.50	$129.00	$4.29–$114.81	42% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time (Pt)	$94.50	$189.00	$4.29–$168.21	108% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Pt-D	$64.50	$129.00	$58.05–$114.81	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time (Pt)	$94.50	$189.00	$85.05–$168.21	—	50%
Rapid flu test (influenza antigen) CPT 87804 HC Flu Screen B	$102.00	$204.00	$16.55–$181.56	9% above	50%
Rapid flu test (influenza antigen) CPT 87804 HC Flu Screen A	$102.00	$204.00	$16.55–$181.56	9% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Flu Screen A	$102.00	$204.00	$91.80–$181.56	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Flu Screen B	$102.00	$204.00	$91.80–$181.56	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Immunoassay	$130.00	$260.00	$16.53–$231.40	33% above	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Strep a Immunoassay	$130.00	$260.00	$117.00–$231.40	—	50%
Renin blood test CPT 84244 HC Renin	$145.50	$291.00	$21.99–$258.99	43% above	50%
Renin blood test inpatient CPT 84244 HC Renin	$145.50	$291.00	$130.95–$258.99	—	50%
Rh blood typing CPT 86901 HC Rh (D) Type Cord Blood	$83.00	$166.00	$3.14–$147.74	31% above	50%
Rh blood typing CPT 86901 HC Rh(D) Type	$83.00	$166.00	$3.14–$147.74	31% above	50%
Rh blood typing inpatient CPT 86901 HC Rh (D) Type Cord Blood	$83.00	$166.00	$74.70–$147.74	—	50%
Rh blood typing inpatient CPT 86901 HC Rh(D) Type	$83.00	$166.00	$74.70–$147.74	—	50%
Rheumatoid factor (RF) test CPT 86431 HC R a Titer	$124.50	$249.00	$5.67–$221.61	173% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 HC R a Titer	$124.50	$249.00	$112.05–$221.61	—	50%
Rubella antibody test (immunity check) CPT 86762 HC Rubella	$54.00	$108.00	$14.39–$96.12	6% above	50%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab	$105.50	$211.00	$14.39–$187.79	108% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella	$54.00	$108.00	$48.60–$96.12	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Ab	$105.50	$211.00	$94.95–$187.79	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sedimentation Rate	$130.50	$261.00	$2.70–$232.29	113% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sedimentation Rate	$130.50	$261.00	$117.45–$232.29	—	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC Semen Analysis-Complete	$72.00	$144.00	$12.31–$128.16	44% below	50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC Semen Analysis-Complete	$72.00	$144.00	$64.80–$128.16	—	50%
Sodium blood test CPT 84295 HC Sodium, Serum	$41.50	$83.00	$4.81–$73.87	33% below	50%
Sodium blood test CPT 84295 HC Sodium, Serum - Cardio	$41.50	$83.00	$4.81–$73.87	33% below	50%
Sodium blood test inpatient CPT 84295 HC Sodium, Serum	$41.50	$83.00	$37.35–$73.87	—	50%
Sodium blood test inpatient CPT 84295 HC Sodium, Serum - Cardio	$41.50	$83.00	$37.35–$73.87	—	50%
Stool ova and parasites exam CPT 87177 HC Ova & Parasite, Stool	$172.50	$345.00	$8.90–$307.05	157% above	50%
Stool ova and parasites exam inpatient CPT 87177 HC Ova & Parasite, Stool	$172.50	$345.00	$155.25–$307.05	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood, Stool	$78.00	$156.00	$15.92–$138.84	18% above	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Blood, Stool	$78.00	$156.00	$70.20–$138.84	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Pallidum Antibody by Tp-Pa	$51.50	$103.00	$13.24–$91.67	16% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Antibody Treponema Pallidum (Inhouse)	$97.00	$194.00	$13.24–$172.66	119% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Pallidum Antibody by Tp-Pa	$51.50	$103.00	$46.35–$91.67	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Antibody Treponema Pallidum (Inhouse)	$97.00	$194.00	$87.30–$172.66	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non-Trep Qual	$72.00	$144.00	$4.27–$128.16	69% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non-Trep Qual	$72.00	$144.00	$64.80–$128.16	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Quantiferon - TB Gold in-Tube	$187.50	$375.00	$52.13–$333.75	8% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Quantiferon - TB Gold in-Tube	$187.50	$375.00	$168.75–$333.75	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone, Total --L	$135.00	$270.00	$25.81–$240.30	35% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone Total	$280.00	$560.00	$25.81–$498.40	180% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone, Total --L	$135.00	$270.00	$121.50–$240.30	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone Total	$280.00	$560.00	$252.00–$498.40	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibody	$157.50	$315.00	$14.55–$280.35	122% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibody	$157.50	$315.00	$141.75–$280.35	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hor	$294.00	$588.00	$16.80–$523.32	180% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hor	$294.00	$588.00	$264.60–$523.32	—	50%
Total IgE blood test CPT 82785 HC Immunoglobulin E	$252.00	$504.00	$16.46–$448.56	217% above	50%
Total IgE blood test inpatient CPT 82785 HC Immunoglobulin E	$252.00	$504.00	$226.80–$448.56	—	50%
Total cholesterol blood test CPT 82465 HC Cholesterol,Serum	$128.50	$257.00	$4.35–$228.73	132% above	50%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol,Serum	$128.50	$257.00	$115.65–$228.73	—	50%
Total thyroxine (T4) blood test CPT 84436 HC T-4 Thyroxine	$166.00	$332.00	$6.87–$295.48	107% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 HC T-4 Thyroxine	$166.00	$332.00	$149.40–$295.48	—	50%
Total triiodothyronine (T3) blood test CPT 84480 HC T3, Total, Serum	$129.00	$258.00	$14.18–$229.62	3% above	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3, Total, Serum	$129.00	$258.00	$116.10–$229.62	—	50%
Transferrin blood test CPT 84466 HC Transferrin	$137.00	$274.00	$12.76–$243.86	15% above	50%
Transferrin blood test inpatient CPT 84466 HC Transferrin	$137.00	$274.00	$123.30–$243.86	—	50%
Trichomonas test (NAAT) CPT 87661 HC Iadna Trichomonas Vaginalis Amplified Probe Tech	$83.00	$166.00	$23.07–$147.74	5% below	50%
Trichomonas test (NAAT) inpatient CPT 87661 HC Iadna Trichomonas Vaginalis Amplified Probe Tech	$83.00	$166.00	$74.70–$147.74	—	50%
Triglycerides blood test CPT 84478 HC Triglycerides	$165.00	$330.00	$5.74–$293.70	143% above	50%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides	$165.00	$330.00	$148.50–$293.70	—	50%
Troponin test, quantitative CPT 84484 HC Troponin I	$200.50	$401.00	$12.47–$356.89	76% above	50%
Troponin test, quantitative inpatient CPT 84484 HC Troponin I	$200.50	$401.00	$180.45–$356.89	—	50%
Uric acid blood test CPT 84550 HC Uric Acid, Serum	$135.50	$271.00	$4.52–$241.19	73% above	50%
Uric acid blood test inpatient CPT 84550 HC Uric Acid, Serum	$135.50	$271.00	$121.95–$241.19	—	50%
Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis-Auto W/Micro	$115.00	$230.00	$3.17–$204.70	23% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis-Auto W/Micro	$115.00	$230.00	$103.50–$204.70	—	50%
Urinalysis with microscope exam, manual CPT 81000 HC Urinalysis Non Auto W/ Micro	$39.00	$78.00	$4.02–$69.42	1% below	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC Urinalysis Non Auto W/ Micro	$39.00	$78.00	$35.10–$69.42	—	50%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis,Auto W/O Micro	$76.00	$152.00	$2.25–$135.28	58% above	50%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis,Man W/O Micro	$76.00	$152.00	$2.25–$135.28	58% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis,Man W/O Micro	$76.00	$152.00	$68.40–$135.28	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis,Auto W/O Micro	$76.00	$152.00	$68.40–$135.28	—	50%
Urinalysis without microscope exam, manual CPT 81002 Hths Ua Non Auto W/O Micro	$76.00	$152.00	$3.48–$135.28	159% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Hths Ua Non Auto W/O Micro	$76.00	$152.00	$68.40–$135.28	—	50%
Urine culture for bacteria, with colony count CPT 87086 HC Culture, Routine Urine	$151.50	$303.00	$8.07–$269.67	17% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture, Routine Urine	$151.50	$303.00	$136.35–$269.67	—	50%
Urine microalbumin (albumin) test CPT 82043 HC Microalbumin, Ua	$163.00	$326.00	$5.78–$290.14	220% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin, Ua	$163.00	$326.00	$146.70–$290.14	—	50%
Urine pregnancy test, read by color change CPT 81025 HC Hcg Urine	$200.50	$401.00	$8.61–$356.89	136% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Hcg Urine	$200.50	$401.00	$180.45–$356.89	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 HC B12, Vitamine	$105.00	$210.00	$15.08–$186.90	16% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC B12, Vitamine	$105.00	$210.00	$94.50–$186.90	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D, 25-Hydroxy	$182.50	$365.00	$29.60–$324.85	53% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vitamin D, 25-Hydroxy	$182.50	$365.00	$164.25–$324.85	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vitamin D 1,25 Dihydroxy	$324.00	$648.00	$38.50–$576.72	111% above	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Vitamin D 1,25 Dihydroxy	$324.00	$648.00	$291.60–$576.72	—	50%
Zinc blood test CPT 84630 HC Zinc	$85.50	$171.00	$11.39–$152.19	25% above	50%
Zinc blood test inpatient CPT 84630 HC Zinc	$85.50	$171.00	$76.95–$152.19	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg Quant	$286.00	$572.00	$15.05–$509.08	155% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg Quant	$286.00	$572.00	$257.40–$509.08	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Breast Bio 1st Lesion Lt	$4,566.00	$9,132.00	$510.77–$8,127.48	31% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Breast Bio 1st Lesion Rt	$4,566.00	$9,132.00	$510.77–$8,127.48	31% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Breast Bio 1st Lesion Rt	$4,566.00	$9,132.00	$4,109.40–$8,127.48	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Breast Bio 1st Lesion Lt	$4,566.00	$9,132.00	$4,109.40–$8,127.48	—	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC Left Heart Cath W/Coronary Inj	$9,345.00	$18,690.00	$2,597.91–$16,634.10	11% below	50%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC Left Heart Cath W/Coronary Inj	$9,345.00	$18,690.00	$8,410.50–$16,634.10	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion-External	$1,078.00	$2,156.00	$299.68–$1,918.84	19% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion - Icu	$1,137.00	$2,274.00	$316.09–$2,023.86	15% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion-External	$1,078.00	$2,156.00	$970.20–$1,918.84	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion - Icu	$1,137.00	$2,274.00	$1,023.30–$2,023.86	—	50%
Catheter ablation for atrial fibrillation CPT 93656 HC Ep Ablation of Af by Pvi W/ Transseptal and Ep Evaluation	$36,102.50	$72,205.00	$10,036.50–$64,262.45	19% above	50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC Ep Ablation of Af by Pvi W/ Transseptal and Ep Evaluation	$36,102.50	$72,205.00	$32,492.25–$64,262.45	—	50%
Coronary stent placement, one artery CPT 92928 HC Stent Ri	$15,708.50	$31,417.00	$4,366.96–$30,121.78	34% above	50%
Coronary stent placement, one artery CPT 92928 Stent Lm	$15,708.50	$31,417.00	$4,366.96–$30,121.78	34% above	50%
Coronary stent placement, one artery CPT 92928 HC Stent Rc	$15,708.50	$31,417.00	$4,366.96–$30,121.78	34% above	50%
Coronary stent placement, one artery CPT 92928 HC Stent Ld	$15,708.50	$31,417.00	$4,366.96–$30,121.78	34% above	50%
Coronary stent placement, one artery CPT 92928 HC Stent Lc	$15,708.50	$31,417.00	$4,366.96–$30,121.78	34% above	50%
Coronary stent placement, one artery inpatient CPT 92928 HC Stent Rc	$15,708.50	$31,417.00	$14,137.65–$27,961.13	—	50%
Coronary stent placement, one artery inpatient CPT 92928 Stent Lm	$15,708.50	$31,417.00	$14,137.65–$27,961.13	—	50%
Coronary stent placement, one artery inpatient CPT 92928 HC Stent Ri	$15,708.50	$31,417.00	$14,137.65–$27,961.13	—	50%
Coronary stent placement, one artery inpatient CPT 92928 HC Stent Lc	$15,708.50	$31,417.00	$14,137.65–$27,961.13	—	50%
Coronary stent placement, one artery inpatient CPT 92928 HC Stent Ld	$15,708.50	$31,417.00	$14,137.65–$27,961.13	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystoscopy	$1,214.00	$2,428.00	$250.06–$2,160.92	3% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystoscopy	$1,214.00	$2,428.00	$1,092.60–$2,160.92	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Inj Spine Cer/Tube	$953.00	$1,906.00	$264.93–$1,781.39	34% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Epidurogram Cervical/Thoracic	$1,022.50	$2,045.00	$276.00–$1,820.05	29% below	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Inj Spine Cer/Tube	$953.00	$1,906.00	$857.70–$1,696.34	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Epidurogram Cervical/Thoracic	$1,022.50	$2,045.00	$920.25–$1,820.05	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Facet Jt Inj Lumbar	$2,426.00	$4,852.00	$357.81–$4,318.28	40% above	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Facet Jt Inj Lumbar	$2,426.00	$4,852.00	$2,183.40–$4,318.28	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Intro Saline/Con Hsg	$337.00	$674.00	$93.69–$599.86	10% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Inject.Proced.Hsg	$337.00	$674.00	$93.69–$599.86	10% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Intro Saline/Con Hsg	$337.00	$674.00	$303.30–$599.86	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Inject.Proced.Hsg	$337.00	$674.00	$303.30–$599.86	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I & D Simple	$403.50	$807.00	$68.31–$718.23	7% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I & D Simple	$403.50	$807.00	$363.15–$718.23	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Injection(S) Single Tendon Sheath or Ligament, Aponeurosis	$441.50	$883.00	$24.72–$785.87	11% above	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Injection(S) Single Tendon Sheath or Ligament, Aponeurosis	$441.50	$883.00	$397.35–$785.87	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Major Jt	$934.00	$1,868.00	$29.36–$1,662.52	58% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentisis, Major Jt	$934.00	$1,868.00	$29.36–$1,662.52	58% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentisis, Major Jt	$934.00	$1,868.00	$840.60–$1,662.52	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Major Jt	$934.00	$1,868.00	$840.60–$1,662.52	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Inj Tennis Elbow	$520.00	$1,040.00	$24.72–$925.60	12% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentisis,Inter. Jt	$934.00	$1,868.00	$24.72–$1,662.52	59% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Inj Tennis Elbow	$520.00	$1,040.00	$468.00–$925.60	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentisis,Inter. Jt	$934.00	$1,868.00	$840.60–$1,662.52	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Small Jt	$934.00	$1,868.00	$23.84–$1,662.52	121% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis, Small Jt	$934.00	$1,868.00	$23.84–$1,662.52	121% above	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis, Small Jt	$934.00	$1,868.00	$840.60–$1,662.52	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis Small Jt	$934.00	$1,868.00	$840.60–$1,662.52	—	50%
Left heart catheterization, diagnostic one side CPT 93452 HC Left Heart Cath Without Coronary Injection	$5,225.50	$10,451.00	$1,452.69–$9,301.39	44% below	50%
Left heart catheterization, diagnostic inpatient one side CPT 93452 HC Left Heart Cath Without Coronary Injection	$5,225.50	$10,451.00	$4,702.95–$9,301.39	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Epidurogram Lumbar/Sacral	$1,022.50	$2,045.00	$276.00–$1,820.05	39% below	50%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Inject Spine L/S	$1,613.00	$3,226.00	$276.00–$2,871.14	4% below	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Epidurogram Lumbar/Sacral	$1,022.50	$2,045.00	$920.25–$1,820.05	—	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Inject Spine L/S	$1,613.00	$3,226.00	$1,451.70–$2,871.14	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC CT Nerve Root Blk Trans Lum	$2,075.00	$4,150.00	$357.81–$3,693.50	40% above	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC CT Nerve Root Blk Trans Lum	$2,075.00	$4,150.00	$1,867.50–$3,693.50	—	50%
Occipital nerve block (injection for headaches) CPT 64405 HC Nerve Block/Injection, Greater Occipital Nerve	$478.00	$956.00	$31.69–$850.84	12% above	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Nerve Block/Injection, Greater Occipital Nerve	$478.00	$956.00	$430.20–$850.84	—	50%
Pacemaker implant (dual chamber) CPT 33208 HC Insertion Perm Pacer Dual	$19,931.00	$39,862.00	$5,540.82–$35,477.18	5% above	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC Insertion Perm Pacer Dual	$19,931.00	$39,862.00	$17,937.90–$35,477.18	—	50%
Paracentesis with imaging guidance CPT 49083 HC Abdominal Paracentesis/US	$1,504.00	$3,008.00	$351.70–$2,677.12	3% above	50%
Paracentesis with imaging guidance CPT 49083 HC Abdominal Paracentesis/CT	$2,838.00	$5,676.00	$351.70–$5,051.64	95% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abdominal Paracentesis/US	$1,504.00	$3,008.00	$1,353.60–$2,677.12	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abdominal Paracentesis/CT	$2,838.00	$5,676.00	$2,554.20–$5,051.64	—	50%
Prostate biopsy CPT 55700 HC Biopsy, Prostate; Needle or Punch, Single or Multiple, Any Approach	$3,150.00	$6,300.00	$685.44–$5,607.00	20% above	50%
Prostate biopsy inpatient CPT 55700 HC Biopsy, Prostate; Needle or Punch, Single or Multiple, Any Approach	$3,150.00	$6,300.00	$2,835.00–$5,607.00	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC IR Guided Rhizotomy Lum/ Sac	$3,141.00	$6,282.00	$692.94–$5,590.98	12% above	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC IR Guided Rhizotomy Lum/ Sac	$3,141.00	$6,282.00	$2,826.90–$5,590.98	—	50%
Short arm splint (forearm and hand) CPT 29125 HC - Splt Shrt Arm St Ot	$238.00	$476.00	$66.16–$423.64	5% above	50%
Short arm splint (forearm and hand) CPT 29125 HC - Splint Application Short Arm Static Ot	$240.00	$480.00	$66.72–$427.20	6% above	50%
Short arm splint (forearm and hand) inpatient CPT 29125 HC - Splt Shrt Arm St Ot	$238.00	$476.00	$214.20–$423.64	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 HC - Splint Application Short Arm Static Ot	$240.00	$480.00	$216.00–$427.20	—	50%
Skin biopsy, punch, one lesion CPT 11104 HC Biopsy Colllection	$536.50	$1,073.00	$83.43–$954.97	27% above	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Biopsy Colllection	$536.50	$1,073.00	$482.85–$954.97	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Fluid Tap-Lumbar	$881.00	$1,762.00	$244.92–$1,781.39	16% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Fluid Tap-Lumbar	$881.00	$1,762.00	$792.90–$1,568.18	—	50%
Thoracentesis with imaging guidance CPT 32555 HC US Guided Thoracentesis	$3,535.50	$7,071.00	$234.94–$6,293.19	151% above	50%
Thoracentesis with imaging guidance CPT 32555 HC CT Guided Thoracentesis	$3,535.50	$7,071.00	$234.94–$6,293.19	151% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC CT Guided Thoracentesis	$3,535.50	$7,071.00	$3,181.95–$6,293.19	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 HC US Guided Thoracentesis	$3,535.50	$7,071.00	$3,181.95–$6,293.19	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC Wi Breast Biopsy US 1st Lesion Lt	$4,566.00	$9,132.00	$510.77–$8,127.48	66% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC Wi Breast Biopsy US 1st Lesion Rt	$4,566.00	$9,132.00	$510.77–$8,127.48	66% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC Wi Breast Biopsy US 1st Lesion Lt	$4,566.00	$9,132.00	$4,109.40–$8,127.48	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC Wi Breast Biopsy US 1st Lesion Rt	$4,566.00	$9,132.00	$4,109.40–$8,127.48	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Wound Debridement(Subq-Ti	$575.00	$1,150.00	$150.23–$1,023.50	43% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Wound Debridement(Subq-Ti	$575.00	$1,150.00	$517.50–$1,023.50	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Admin 1-4 Hrs	$1,329.50	$2,659.00	$32.27–$2,366.51	74% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Admin 1-4 Hrs	$1,329.50	$2,659.00	$1,196.55–$2,366.51	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 South Campus - Inhalation Trtmt Sub	$145.00	$290.00	$40.31–$645.70	28% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Ipv/Metaneb Therapy	$333.50	$667.00	$92.71–$645.70	65% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Aerosol/Mdi/Ippb Treatment	$347.50	$695.00	$96.61–$645.70	72% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 South Campus - Inhalation Trtmt Sub	$145.00	$290.00	$130.50–$258.10	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Ipv/Metaneb Therapy	$333.50	$667.00	$300.15–$593.63	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Aerosol/Mdi/Ippb Treatment	$347.50	$695.00	$312.75–$618.55	—	50%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo IV Initial 1st Hr	$422.50	$845.00	$117.46–$778.63	22% below	50%
Chemotherapy IV infusion, first hour CPT 96413 HC Chemo IV Initial 1st Hour	$592.50	$1,185.00	$164.72–$1,054.65	10% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo IV Initial 1st Hr	$422.50	$845.00	$380.25–$752.05	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo IV Initial 1st Hour	$592.50	$1,185.00	$533.25–$1,054.65	—	50%
Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 30-74 Min	$785.50	$1,571.00	$218.37–$3,119.97	69% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critical Care 30-74 Min	$785.50	$1,571.00	$706.95–$1,398.19	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Ceribell Eeg Awake & Drowsy (95816)	$436.00	$872.00	$121.21–$1,090.42	54% below	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy	$1,079.50	$2,159.00	$292.40–$1,921.51	13% above	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Ceribell Eeg Awake & Drowsy (95816)	$436.00	$872.00	$392.40–$776.08	—	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake & Drowsy	$1,079.50	$2,159.00	$971.55–$1,921.51	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ecg 12 Lead Trac Only	$366.50	$733.00	$55.78–$652.37	35% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Ecg 12 Lead Trac Only	$366.50	$733.00	$329.85–$652.37	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Sane Cac 99281	$156.50	$313.00	$43.51–$325.82	33% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Sane - Sane Exam - Examiner Fee	$156.50	$313.00	$43.51–$325.82	33% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Level 1 Emergency Care	$251.00	$502.00	$69.78–$446.78	7% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC Sane - Sane Exam - Examiner Fee	$156.50	$313.00	$140.85–$278.57	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC Sane Cac 99281	$156.50	$313.00	$140.85–$278.57	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC Level 1 Emergency Care	$251.00	$502.00	$225.90–$446.78	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Level 2 Emergency Care	$490.00	$980.00	$136.22–$872.20	13% above	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC Level 2 Emergency Care	$490.00	$980.00	$441.00–$872.20	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Level 3 Emergency Care	$775.00	$1,550.00	$215.45–$1,379.50	2% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC Level 3 Emergency Care	$775.00	$1,550.00	$697.50–$1,379.50	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC Level 4 Emergency Care	$1,234.00	$2,468.00	$343.05–$2,196.52	6% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC Level 4 Emergency Care	$1,234.00	$2,468.00	$1,110.60–$2,196.52	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC Trauma W/O Prenotification Level V	$828.50	$1,657.00	$230.32–$2,361.11	53% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC Level 5 Emergency Care	$2,289.50	$4,579.00	$575.69–$4,075.31	29% above	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC Trauma W/O Prenotification Level V	$828.50	$1,657.00	$745.65–$1,474.73	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC Level 5 Emergency Care	$2,289.50	$4,579.00	$2,060.55–$4,075.31	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Crdio Stres Tst Trac Only	$995.00	$1,990.00	$276.61–$1,771.10	21% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Crdio Stres Tst Trac Only	$995.00	$1,990.00	$895.50–$1,771.10	—	50%
Group psychotherapy session CPT 90853 HC Rc Group Iop	$100.50	$201.00	$27.94–$534.00	38% below	50%
Group psychotherapy session inpatient CPT 90853 HC Rc Group Iop	$100.50	$201.00	$90.45–$178.89	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration-Intl31m-1hr	$224.00	$448.00	$62.27–$494.58	48% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Initial, 31	$235.00	$470.00	$65.33–$494.58	46% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Initial	$273.00	$546.00	$75.89–$494.58	37% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration-Intl31m-1hr	$224.00	$448.00	$201.60–$398.72	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration Initial, 31	$235.00	$470.00	$211.50–$418.30	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration Initial	$273.00	$546.00	$245.70–$485.94	—	50%
IV infusion of a medicine, first hour CPT 96365 HC Ivmedinfus Intlhr Intlmed	$302.00	$604.00	$83.96–$537.56	33% below	50%
IV infusion of a medicine, first hour CPT 96365 HC IV Therapeutic Initial 1s	$407.00	$814.00	$113.15–$724.46	9% below	50%
IV infusion of a medicine, first hour CPT 96365 HC Ther/Proph/Diag IV Inf Initial	$442.00	$884.00	$122.88–$786.76	2% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC Ivmedinfus Intlhr Intlmed	$302.00	$604.00	$271.80–$537.56	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Therapeutic Initial 1s	$407.00	$814.00	$366.30–$724.46	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 HC Ther/Proph/Diag IV Inf Initial	$442.00	$884.00	$397.80–$786.76	—	50%
IV push of a medicine, first drug CPT 96374 HC Therapeutic Push Initial	$118.00	$236.00	$32.80–$494.58	48% below	50%
IV push of a medicine, first drug CPT 96374 HC IV Med Push Initial	$317.50	$635.00	$88.27–$565.15	39% above	50%
IV push of a medicine, first drug CPT 96374 HC Bubble Study Injection	$333.50	$667.00	$92.71–$593.63	46% above	50%
IV push of a medicine, first drug CPT 96374 HC Ther/Proph/Diag/IV Push	$692.00	$1,384.00	$132.40–$1,231.76	203% above	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Therapeutic Push Initial	$118.00	$236.00	$106.20–$210.04	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC IV Med Push Initial	$317.50	$635.00	$285.75–$565.15	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Bubble Study Injection	$333.50	$667.00	$300.15–$593.63	—	50%
IV push of a medicine, first drug inpatient CPT 96374 HC Ther/Proph/Diag/IV Push	$692.00	$1,384.00	$622.80–$1,231.76	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Im/Subcu	$175.00	$350.00	$48.65–$311.50	19% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Therapeutic Injection Sq	$175.00	$350.00	$48.65–$311.50	19% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC in/Sq Inj-Non Vaccine	$319.00	$638.00	$66.83–$567.82	117% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Inj Im/Subcutaneous	$394.00	$788.00	$66.83–$701.32	168% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Therapeutic Injection Sq	$175.00	$350.00	$157.50–$311.50	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Im/Subcu	$175.00	$350.00	$157.50–$311.50	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC in/Sq Inj-Non Vaccine	$319.00	$638.00	$287.10–$567.82	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Inj Im/Subcutaneous	$394.00	$788.00	$354.60–$701.32	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Evaluation	$227.50	$455.00	$63.25–$404.95	41% below	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Psych Evaluation	$227.50	$455.00	$204.75–$404.95	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction; 7-8 Studies	$126.00	$252.00	$35.03–$731.00	82% below	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC Nerve Conduction; 7-8 Studies	$126.00	$252.00	$113.40–$224.28	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuro Reeducation	$64.50	$129.00	$17.93–$150.00	43% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuro Re-Education 15 Min	$64.50	$129.00	$17.93–$125.24	43% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 HC Neuro Re-Education	$72.50	$145.00	$20.16–$150.00	36% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuro Reeducation	$64.50	$129.00	$58.05–$114.81	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuro Re-Education 15 Min	$64.50	$129.00	$58.05–$114.81	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuro Re-Education	$72.50	$145.00	$65.25–$129.05	—	50%
New patient office visit, about 30 minutes CPT 99203 HC New OP Visit - Intermed	$405.00	$810.00	$112.59–$720.90	79% above	50%
New patient office visit, about 30 minutes inpatient CPT 99203 HC New OP Visit - Intermed	$405.00	$810.00	$364.50–$720.90	—	50%
New patient office visit, about 45 minutes CPT 99204 HC New Patient Level 4	$441.00	$882.00	$122.60–$784.98	51% above	50%
New patient office visit, about 45 minutes inpatient CPT 99204 HC New Patient Level 4	$441.00	$882.00	$396.90–$784.98	—	50%
New patient office visit, about 60 minutes CPT 99205 HC Sane Cac 99205	$65.50	$131.00	$18.21–$600.88	78% below	50%
New patient office visit, about 60 minutes CPT 99205 HC New Patient Level 5	$549.00	$1,098.00	$152.62–$977.22	87% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Sane Cac 99205	$65.50	$131.00	$58.95–$116.59	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 HC New Patient Level 5	$549.00	$1,098.00	$494.10–$977.22	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC New OP Visit - Limited	$332.00	$664.00	$92.30–$590.96	123% above	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC New OP Visit - Limited	$332.00	$664.00	$298.80–$590.96	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC - Mnt Initial Ea 15 Mn	$44.00	$88.00	$12.23–$121.45	12% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC - Mnt Initial Ea 15 Mn	$44.00	$88.00	$39.60–$78.32	—	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (75 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (90 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (45 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (120 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (15 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (30 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Evaluation Low (60 Minutes)	$212.50	$425.00	$59.08–$378.25	13% below	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (120 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (30 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (15 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (45 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (60 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (75 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Evaluation Low (90 Minutes)	$212.50	$425.00	$191.25–$378.25	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (45 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (60 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (30 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (15 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (120 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (90 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Evaluation High (75 Minutes)	$234.00	$468.00	$65.05–$416.52	19% below	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (120 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (75 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (15 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (30 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (45 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (60 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Evaluation High (90 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (75 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (15 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (30 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (45 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (60 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (90 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Evaluation Low (120 Minutes)	$234.00	$468.00	$65.05–$416.52	17% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (15 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (120 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (90 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (60 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (45 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (75 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Evaluation Low (30 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (30 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (15 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (45 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (60 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (90 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (120 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate (75 Minutes)	$234.00	$468.00	$65.05–$416.52	2% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (30 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (15 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (75 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (120 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (90 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (60 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate (45 Minutes)	$234.00	$468.00	$210.60–$416.52	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Therapy 15 Min	$81.50	$163.00	$22.66–$145.07	26% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Manual Therapy 15 Min	$81.50	$163.00	$73.35–$145.07	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapuetic Exer. 15 Min	$86.00	$172.00	$23.91–$153.08	23% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Exer 15 Min	$97.50	$195.00	$27.11–$173.55	13% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapuetic Exer. 15 Min	$86.00	$172.00	$77.40–$153.08	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapeutic Exer 15 Min	$97.50	$195.00	$87.75–$173.55	—	50%
Psychiatric evaluation with medical services CPT 90792 HC Psych Evaluation W Medical Service	$227.50	$455.00	$63.25–$404.95	31% below	50%
Psychiatric evaluation with medical services inpatient CPT 90792 HC Psych Evaluation W Medical Service	$227.50	$455.00	$204.75–$404.95	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Tobacco Use Cessation Intermediate 3-10 Minutes	$44.00	$88.00	$12.23–$78.32	3% above	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Tobacco Use Cessation Intermediate 3-10 Minutes	$44.00	$88.00	$39.60–$78.32	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Estab OP Visit -Complex	$293.00	$586.00	$81.45–$521.54	3% above	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Estab OP Visit -Complex	$293.00	$586.00	$263.70–$521.54	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Estab OP Visit - Intermed	$175.50	$351.00	$48.79–$312.39	3% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OB Check Eval & Mgmt	$386.50	$773.00	$107.45–$687.97	128% above	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Estab OP Visit - Intermed	$175.50	$351.00	$157.95–$312.39	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OB Check Eval & Mgmt	$386.50	$773.00	$347.85–$687.97	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Estab OP Visit - Exten	$175.50	$351.00	$48.79–$312.39	9% below	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Estab OP Visit - Exten	$175.50	$351.00	$157.95–$312.39	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Est Pt Visit Level 2	$149.50	$299.00	$41.56–$266.11	18% above	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Est Pt Visit Level 2	$149.50	$299.00	$134.55–$266.11	—	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (15 Min)	$461.50	$923.00	$128.30–$821.47	24% above	50%
Speech and language evaluation CPT 92523 HC Eval of Speech Prod W/Lang Comp	$470.50	$941.00	$130.80–$837.49	27% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (75 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (90 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (60 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (30 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (45 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC St Evaluation of Lang Comp & Expression (120 Min)	$477.00	$954.00	$132.61–$849.06	29% above	50%
Speech and language evaluation CPT 92523 HC Eval of Lang Comp & Expresstion	$501.00	$1,002.00	$139.28–$891.78	35% above	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (15 Min)	$461.50	$923.00	$415.35–$821.47	—	50%
Speech and language evaluation inpatient CPT 92523 HC Eval of Speech Prod W/Lang Comp	$470.50	$941.00	$423.45–$837.49	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (120 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (90 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (75 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (60 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (45 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC St Evaluation of Lang Comp & Expression (30 Min)	$477.00	$954.00	$429.30–$849.06	—	50%
Speech and language evaluation inpatient CPT 92523 HC Eval of Lang Comp & Expresstion	$501.00	$1,002.00	$450.90–$891.78	—	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing (120 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing Therapy Ind (15 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing Therapy Ind (30 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing Therapy Ind (45 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing Therapy Ind (60 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing Therapy Ind (75 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual CPT 92507 HC Speech/Hearing (90 Minutes)	$180.00	$360.00	$50.04–$320.40	17% below	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing (90 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing (120 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing Therapy Ind (15 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing Therapy Ind (30 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing Therapy Ind (45 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing Therapy Ind (60 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Speech therapy session, individual inpatient CPT 92507 HC Speech/Hearing Therapy Ind (75 Minutes)	$180.00	$360.00	$162.00–$320.40	—	50%
Spirometry (breathing test) CPT 94010 HC Spirometry W/Grph Readout	$539.00	$1,078.00	$146.91–$959.42	51% above	50%
Spirometry (breathing test) inpatient CPT 94010 HC Spirometry W/Grph Readout	$539.00	$1,078.00	$485.10–$959.42	—	50%
Spirometry before and after a bronchodilator CPT 94060 HC Spiro Pre/Post Bronch W/G	$674.00	$1,348.00	$157.68–$1,199.72	13% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spiro Pre/Post Bronch W/G	$674.00	$1,348.00	$606.60–$1,199.72	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Functional/Therapeutic Activity	$83.00	$166.00	$23.07–$147.74	26% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Therapeutic Activities	$84.00	$168.00	$23.35–$149.52	26% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Funcional/Therapeuitic Activity	$87.00	$174.00	$24.19–$154.86	23% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Functional/Therapeutic Activity	$83.00	$166.00	$74.70–$147.74	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Therapeutic Activities	$84.00	$168.00	$75.60–$149.52	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Funcional/Therapeuitic Activity	$87.00	$174.00	$78.30–$154.86	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Therapeutic Phlebotomy	$219.00	$438.00	$60.88–$389.82	1% above	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Therapeutic Phlebotomy	$219.00	$438.00	$197.10–$389.82	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella vacc per 0.5 ml	$460.85	$921.70	$128.12–$820.31	18% above	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella vacc per 0.5 ml	$460.85	$921.70	$414.77–$820.31	—	50%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 dip-pert(a)-tet-polio-hib vaccine 15 Lf unit-20 mcg-5 Lf/0.5 mL kit 1 each KIT	$265.99	$531.98	$73.95–$473.46	5% below	50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 dip-pert(a)-tet-polio-hib vaccine 15 Lf unit-20 mcg-5 Lf/0.5 mL kit 1 each KIT	$265.99	$531.98	$239.39–$473.46	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza vaccine per 0.5 mL	$66.72	$133.43	$18.55–$118.75	78% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza vaccine per 0.5 mL	$66.72	$133.43	$40.03–$118.75	—	50%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis a vaccine per 1 ml	$204.61	$409.21	$56.88–$364.20	12% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis a vaccine per 1 ml	$204.61	$409.21	$184.14–$364.20	—	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B virus vacc.rec(PF) 20 mL syringe 1 mL Syringe	$181.73	$363.46	$50.52–$323.48	16% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B virus vacc.rec(PF) 20 mL syringe 1 mL Syringe	$181.73	$363.46	$109.04–$323.48	—	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B virus vaccince rec.(PF) 10 0.5 mL syringe 0.5 mL Syringe	$73.40	$146.80	$20.41–$130.65	10% below	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B virus vaccince rec.(PF) 10 0.5 mL syringe 0.5 mL Syringe	$73.40	$146.80	$44.04–$130.65	—	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate 7.5 0.5 mL solution 0.5 mL Vial	$76.74	$153.48	$21.33–$136.60	5% above	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate 7.5 0.5 mL solution 0.5 mL Vial	$76.74	$153.48	$69.07–$136.60	—	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza per 0.5 mL	$199.20	$398.40	$55.38–$354.58	34% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza per 0.5 mL	$199.20	$398.40	$119.52–$354.58	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles, mumps & rubella vac per 0.5 mL	$238.96	$477.92	$66.43–$425.35	21% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles, mumps & rubella vac per 0.5 mL	$238.96	$477.92	$215.06–$425.35	—	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles-mumps-rubella-varicella 10exp3-4.3-3- 3.99 TCID50/0.5 suspension for reconstitution 1 each Vial	$699.71	$1,399.41	$194.52–$1,245.47	186% above	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles-mumps-rubella-varicella 10exp3-4.3-3- 3.99 TCID50/0.5 suspension for reconstitution 1 each Vial	$699.71	$1,399.41	$629.73–$1,245.47	—	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 pneumococcal vac 13-val per 0.5 mL	$570.29	$1,140.58	$158.54–$1,015.12	17% above	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 pneumococcal vac 13-val per 0.5 mL	$570.29	$1,140.58	$342.17–$1,015.12	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal vac 20-val per 0.5 mL	$713.37	$1,426.74	$198.32–$1,269.80	27% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal vac 20-val per 0.5 mL	$713.37	$1,426.74	$428.02–$1,269.80	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal vac polyvalent per 0.5 mL	$295.05	$590.09	$82.02–$525.18	17% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal vac polyvalent per 0.5 mL	$295.05	$590.09	$177.03–$525.18	—	50%
Rabies vaccine, one dose CPT 90675 rabies vaccine per 1 mL	$942.90	$1,885.80	$262.13–$1,678.36	8% below	50%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine per 1 mL	$942.90	$1,885.80	$848.61–$1,678.36	—	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 varicella-zoster gE 50 0.5 mL suspension for reconstitution 1 each KIT	$543.08	$1,086.16	$150.98–$966.68	165% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 varicella-zoster gE 50 0.5 mL suspension for reconstitution 1 each KIT	$543.08	$1,086.16	$488.77–$966.68	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus-diphth-acell pertussis per 0.5 mL	$121.90	$243.79	$33.89–$216.97	7% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus-diphth-acell pertussis per 0.5 mL	$121.90	$243.79	$109.71–$216.97	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Admin - Hep B	$96.00	$192.00	$26.69–$212.25	31% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Adm-Single Inj	$99.00	$198.00	$27.52–$212.25	35% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Admin - Hep B	$96.00	$192.00	$86.40–$170.88	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Adm-Single Inj	$99.00	$198.00	$89.10–$176.22	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Vaccine Adm-Inj Ea Addl	$41.50	$83.00	$11.54–$73.87	11% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Vaccine Adm-Inj Ea Addl	$41.50	$83.00	$37.35–$73.87	—	50%

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://sthpiprd.blob.core.windows.net/machine-readable-files/12617/752559845_shannon-river-crest-hospital_standardcharges.csv