Hospital Baraboo, WI

Sauk Prairie Healthcare

Sauk Prairie Healthcare in Prairie Du Sac, WI publishes cash prices for 453 common procedures listed here, from its own machine-readable price file updated Jan 29, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 224 of 447 procedures and above it for 223. Select a procedure to compare it with other hospitals nearby.

260 26th Street, Prairie du Sac, WI 53578 Collected Nov 11, 2026 Source price file Check a bill from this hospital

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONTRAST	$2,545.74	$4,654.00	$171.89–$4,775.00	7% above	45%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST	$2,545.74	$4,654.00	$3,723.20–$4,421.30	—	45%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN AP W/UPRIGHT OR DECUB	$312.34	$571.00	$102.68–$577.62	30% above	45%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN AP W/UPRIGHT OR DECUB	$312.34	$571.00	$456.80–$542.45	—	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3+ VW RT	$288.00	$526.50	$85.02–$500.18	22% above	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3+ VW LT	$288.00	$526.50	$85.02–$500.18	22% above	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3+ VW LT	$288.00	$526.50	$421.20–$500.18	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3+ VW RT	$288.00	$526.50	$421.20–$500.18	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 DOPPLER STUDIES BILATERAL LTD	$220.72	$403.50	$124.46–$659.18	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 DOPPLER STUDIES UNILATERAL	$93.82	$171.50	$137.20–$162.93	—	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONT RT	$1,448.73	$2,648.50	$102.68–$4,775.00	1% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER SURGERY PROT RT	$1,448.73	$2,648.50	$102.68–$4,775.00	1% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER SURGERY PROT LT	$1,448.73	$2,648.50	$102.68–$4,775.00	1% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONT LT	$1,448.73	$2,648.50	$102.68–$4,775.00	1% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT BIOMET SHOULDER WO CONTR RT	$1,704.46	$3,116.00	$102.68–$4,775.00	19% above	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT BIOMET SHOULDER WO CONTR LT	$1,704.46	$3,116.00	$102.68–$4,775.00	19% above	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONT RT	$1,448.73	$2,648.50	$2,118.80–$2,516.08	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER SURGERY PROT RT	$1,448.73	$2,648.50	$2,118.80–$2,516.08	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONT LT	$1,448.73	$2,648.50	$2,118.80–$2,516.08	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER SURGERY PROT LT	$1,448.73	$2,648.50	$2,118.80–$2,516.08	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT BIOMET SHOULDER WO CONTR LT	$1,704.46	$3,116.00	$2,492.80–$2,960.20	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT BIOMET SHOULDER WO CONTR RT	$1,704.46	$3,116.00	$2,492.80–$2,960.20	—	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHOGRAM	$491.48	$898.50	$171.89–$966.98	7% below	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHOGRAM	$491.48	$898.50	$718.80–$853.58	—	45%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE COMPLETE	$1,291.20	$2,360.50	$387.99–$2,242.48	13% below	45%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE COMPLETE	$1,291.20	$2,360.50	$1,888.40–$2,242.48	—	45%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST COMPLETE BILATERAL	$1,373.25	$2,510.50	$102.68–$2,384.98	—	45%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE UNILAT LT	$688.13	$1,258.00	$102.68–$1,300.00	30% above	45%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE UNILAT RT	$688.13	$1,258.00	$102.68–$1,300.00	30% above	45%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST COMPLETE BILATERAL	$1,373.25	$2,510.50	$2,008.40–$2,384.98	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE UNILAT LT	$688.13	$1,258.00	$1,006.40–$1,195.10	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE UNILAT RT	$688.13	$1,258.00	$1,006.40–$1,195.10	—	45%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BILATERAL	$987.89	$1,806.00	$85.02–$1,715.70	—	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED UNILAT RT	$495.04	$905.00	$85.02–$1,300.00	26% above	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED UNILAT LT	$495.04	$905.00	$85.02–$1,300.00	26% above	45%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED BILATERAL	$987.89	$1,806.00	$1,444.80–$1,715.70	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED UNILAT LT	$495.04	$905.00	$724.00–$859.75	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED UNILAT RT	$495.04	$905.00	$724.00–$859.75	—	45%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA GI BLEED WWO CON	$3,857.18	$7,051.50	$344.83–$6,698.93	27% above	45%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA MESENTERIC ISCHEMIA W CON	$3,857.18	$7,051.50	$344.83–$6,698.93	27% above	45%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN PELVIS W/WO CONTR	$3,857.18	$7,051.50	$344.83–$6,698.93	27% above	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA GI BLEED WWO CON	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA MESENTERIC ISCHEMIA W CON	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN PELVIS W/WO CONTR	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CONTRAST	$3,857.18	$7,051.50	$171.89–$6,698.93	86% above	45%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CONTRAST	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CONTRAST	$3,857.18	$7,051.50	$171.89–$6,698.93	90% above	45%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CONTRAST	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO CONTRAST	$3,857.18	$7,051.50	$171.89–$6,698.93	90% above	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO CONTRAST	$3,857.18	$7,051.50	$5,641.20–$6,698.93	—	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$3,766.65	$6,886.00	$233.40–$6,541.70	50% above	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL PROTOCOL	$3,766.65	$6,886.00	$233.40–$6,541.70	50% above	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT RENAL PROTOCOL	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W CONTRAST	$3,766.65	$6,886.00	$344.83–$6,541.70	17% above	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ENTEROGRAPHY W CON	$3,766.65	$6,886.00	$344.83–$6,541.70	17% above	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ENTEROGRAPHY W CON	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W CONTRAST	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W/WO CONTRAS	$4,559.25	$8,335.00	$344.83–$7,918.25	24% above	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W/WO CONTRAS	$4,559.25	$8,335.00	$6,668.00–$7,918.25	—	45%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$2,177.06	$3,980.00	$171.89–$4,775.00	33% above	45%
CT scan of the abdomen with contrast CPT 74160 CT ABD LIVER W CON	$3,766.65	$6,886.00	$171.89–$6,541.70	130% above	45%
CT scan of the abdomen with contrast CPT 74160 CT ABD PANCREAS W CON	$3,766.65	$6,886.00	$171.89–$6,541.70	130% above	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$2,177.06	$3,980.00	$3,184.00–$3,781.00	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD PANCREAS W CON	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD LIVER W CON	$3,766.65	$6,886.00	$5,508.80–$6,541.70	—	45%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$1,896.45	$3,467.00	$102.68–$4,775.00	50% above	45%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$1,896.45	$3,467.00	$2,773.60–$3,293.65	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTR	$1,823.43	$3,333.50	$102.68–$4,775.00	31% above	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTR	$1,823.43	$3,333.50	$2,666.80–$3,166.83	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,806.47	$3,302.50	$102.68–$4,775.00	40% above	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,806.47	$3,302.50	$2,642.00–$3,137.38	—	45%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$2,130.84	$3,895.50	$171.89–$4,775.00	38% above	45%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$2,130.84	$3,895.50	$3,116.40–$3,700.73	—	45%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST	$2,128.11	$3,890.50	$171.89–$4,775.00	16% above	45%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST	$2,128.11	$3,890.50	$3,112.40–$3,695.98	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTR	$1,896.45	$3,467.00	$102.68–$4,775.00	23% above	45%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTR	$1,896.45	$3,467.00	$2,773.60–$3,293.65	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTR	$1,896.45	$3,467.00	$102.68–$4,775.00	23% above	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTR	$1,896.45	$3,467.00	$2,773.60–$3,293.65	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$2,053.17	$3,753.50	$171.89–$4,775.00	25% above	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$2,053.17	$3,753.50	$3,002.80–$3,565.83	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX CAROTID BILATERAL	$1,126.82	$2,060.00	$233.40–$1,957.00	—	45%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX CAROTID BILATERAL	$1,126.82	$2,060.00	$1,648.00–$1,957.00	—	45%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST	$2,215.35	$4,050.00	$171.89–$4,775.00	4% below	45%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST	$2,215.35	$4,050.00	$3,240.00–$3,847.50	—	45%
Chest X-ray, 2 views CPT 71046 CHEST PA & LAT	$278.97	$510.00	$85.02–$484.50	30% above	45%
Chest X-ray, 2 views inpatient CPT 71046 CHEST PA & LAT	$278.97	$510.00	$408.00–$484.50	—	45%
Chest X-ray, single view CPT 71045 CHEST PA ONLY	$230.02	$420.50	$85.02–$478.28	42% above	45%
Chest X-ray, single view CPT 71045 CHEST AP	$230.02	$420.50	$85.02–$478.28	42% above	45%
Chest X-ray, single view CPT 71045 CHEST LATERAL DECUBITUS	$234.39	$428.50	$85.02–$478.28	45% above	45%
Chest X-ray, single view inpatient CPT 71045 CHEST PA ONLY	$230.02	$420.50	$336.40–$399.48	—	45%
Chest X-ray, single view inpatient CPT 71045 CHEST AP	$230.02	$420.50	$336.40–$399.48	—	45%
Chest X-ray, single view inpatient CPT 71045 CHEST LATERAL DECUBITUS	$234.39	$428.50	$342.80–$407.08	—	45%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE LT	$265.30	$485.00	$85.02–$478.28	28% above	45%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMPLETE RT	$265.30	$485.00	$85.02–$478.28	28% above	45%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMPLETE RT	$265.30	$485.00	$388.00–$460.75	—	45%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMPLETE LT	$265.30	$485.00	$388.00–$460.75	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABDOMINAL AORTA	$649.29	$1,187.00	$102.68–$1,300.00	18% above	45%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABDOMINAL AORTA	$649.29	$1,187.00	$949.60–$1,127.65	—	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY STUDY	$368.14	$673.00	$102.68–$639.35	8% below	45%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY STUDY	$368.14	$673.00	$538.40–$639.35	—	45%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR BONE DENSITY FOREARM	$187.63	$343.00	$85.02–$478.28	34% below	45%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR BONE DENSITY FOREARM	$187.63	$343.00	$274.40–$325.85	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$1,880.32	$3,437.50	$102.68–$4,775.00	31% above	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO LOW DOSE	$1,880.32	$3,437.50	$102.68–$4,775.00	31% above	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO LOW DOSE	$1,880.32	$3,437.50	$2,750.00–$3,265.63	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$1,880.32	$3,437.50	$2,750.00–$3,265.63	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST	$2,054.81	$3,756.50	$171.89–$4,775.00	25% above	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST	$2,054.81	$3,756.50	$3,005.20–$3,568.68	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT DIAG	$316.99	$579.50	$147.22–$550.53	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT DIAG	$316.99	$579.50	$463.60–$550.53	—	45%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT DIAG R	$216.89	$396.50	$116.61–$500.00	30% below	45%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT DIAG L	$216.89	$396.50	$116.61–$500.00	30% below	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT DIAG L	$216.89	$396.50	$317.20–$376.68	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT DIAG R	$216.89	$396.50	$317.20–$376.68	—	45%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LOWER EXT ARTERIAL R	$814.49	$1,489.00	$233.40–$1,414.55	41% above	45%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LOWER EXT ARTERIAL L	$814.49	$1,489.00	$233.40–$1,414.55	41% above	45%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LOWER EXT ARTERIAL R	$814.49	$1,489.00	$1,191.20–$1,414.55	—	45%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LOWER EXT ARTERIAL L	$814.49	$1,489.00	$1,191.20–$1,414.55	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXTR VEIN BILAT	$3,048.71	$5,573.50	$233.40–$5,294.83	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX EXTR VEIN BILAT	$3,048.16	$5,572.50	$4,458.00–$5,293.88	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM COMPLETE	$1,708.01	$3,122.50	$529.42–$2,966.38	3% below	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CARDIAC 2D W/M MODE WO CONT	$1,708.01	$3,122.50	$529.42–$2,966.38	3% below	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO PEDIATRIC COMPLETE WO CON	$1,708.01	$3,122.50	$529.42–$2,966.38	3% below	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CARDIAC 2D W/M MODE W CONT	$1,708.01	$3,122.50	$529.42–$2,966.38	3% below	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CARDIAC 2D W/M MODE WO CONT	$1,708.01	$3,122.50	$2,498.00–$2,966.38	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO PEDIATRIC COMPLETE WO CON	$1,708.01	$3,122.50	$2,498.00–$2,966.38	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CARDIAC 2D W/M MODE W CONT	$1,708.01	$3,122.50	$2,498.00–$2,966.38	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAM COMPLETE	$1,708.01	$3,122.50	$2,498.00–$2,966.38	—	45%
Elbow X-ray, 2 views one side CPT 73070 XRAY ELBOW 2 VIEWS RIGHT	$36.65	$67.00	$22.61–$231.92	81% below	45%
Elbow X-ray, 2 views one side CPT 73070 XRAY ELBOW 2 VIEWS LEFT	$36.65	$67.00	$22.61–$231.92	81% below	45%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VW RT	$239.04	$437.00	$85.02–$478.28	25% above	45%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VW LT	$239.04	$437.00	$85.02–$478.28	25% above	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 XRAY ELBOW 2 VIEWS RIGHT	$36.65	$67.00	$53.60–$63.65	—	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 XRAY ELBOW 2 VIEWS LEFT	$36.65	$67.00	$53.60–$63.65	—	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VW RT	$239.04	$437.00	$349.60–$415.15	—	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VW LT	$239.04	$437.00	$349.60–$415.15	—	45%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VW RT	$284.99	$521.00	$85.02–$494.95	21% above	45%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VW LT	$284.99	$521.00	$85.02–$494.95	21% above	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORB/SEL/PF/EAR WO CONTR	$1,704.46	$3,116.00	$102.68–$4,775.00	18% above	45%
Eye socket (orbit) CT scan without contrast CPT 70480 CT INT AUD CNL WO CONTR	$1,823.43	$3,333.50	$102.68–$4,775.00	26% above	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORB/SEL/PF/EAR WO CONTR	$1,704.46	$3,116.00	$2,492.80–$2,960.20	—	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT INT AUD CNL WO CONTR	$1,823.43	$3,333.50	$2,666.80–$3,166.83	—	45%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VW	$368.96	$674.50	$102.68–$640.78	23% above	45%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN 3 VW	$368.96	$674.50	$539.60–$640.78	—	45%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RADIUS & ULNA MIN 2 VW RT	$285.54	$522.00	$85.02–$495.90	45% above	45%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RADIUS & ULNA MIN 2 VW LT	$285.54	$522.00	$85.02–$495.90	45% above	45%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RADIUS & ULNA MIN 2 VW LT	$285.54	$522.00	$417.60–$495.90	—	45%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RADIUS & ULNA MIN 2 VW RT	$285.54	$522.00	$417.60–$495.90	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 PIPIDA GALLBLADDER	$1,046.42	$1,913.00	$387.99–$1,817.35	29% below	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 PIPIDA GALLBLADDER	$1,046.42	$1,913.00	$1,530.40–$1,817.35	—	45%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VW LT	$231.93	$424.00	$102.68–$577.62	23% above	45%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VW RT	$231.93	$424.00	$102.68–$577.62	23% above	45%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VW RT	$231.93	$424.00	$339.20–$402.80	—	45%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VW LT	$231.93	$424.00	$339.20–$402.80	—	45%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL MIN 2 VW LT	$240.96	$440.50	$85.02–$478.28	21% above	45%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL MIN 2 VW RT	$240.96	$440.50	$85.02–$478.28	21% above	45%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL MIN 2 VW RT	$240.96	$440.50	$352.40–$418.48	—	45%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL MIN 2 VW LT	$240.96	$440.50	$352.40–$418.48	—	45%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY 4 CHANNEL	$927.44	$1,695.50	$151.07–$5,800.00	51% above	45%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STD 4 CHANL & INTER	$1,095.37	$2,002.50	$151.07–$5,800.00	79% above	45%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP STUDY 4 CHANNEL	$927.44	$1,695.50	$1,356.40–$1,610.73	—	45%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP STD 4 CHANL & INTER	$1,095.37	$2,002.50	$1,602.00–$1,902.38	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMN TITR W/CPAP	$4,179.08	$7,640.00	$982.35–$7,258.00	14% above	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY TITR W CPAP & INTE	$5,145.63	$9,407.00	$982.35–$8,936.65	40% above	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMN TITR W/CPAP	$4,179.08	$7,640.00	$6,112.00–$7,258.00	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY TITR W CPAP & INTE	$5,145.63	$9,407.00	$7,525.60–$8,936.65	—	45%
Knee X-ray, 3 views one side CPT 73562 XRAY KNEE 3 VIEWS LEFT	$42.12	$77.00	$25.98–$231.92	83% below	45%
Knee X-ray, 3 views one side CPT 73562 XRAY KNEE 3 VIEWS RIGHT	$42.12	$77.00	$25.98–$231.92	83% below	45%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VW LT	$271.86	$497.00	$85.02–$478.28	7% above	45%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VW RT	$271.86	$497.00	$85.02–$478.28	7% above	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XRAY KNEE 3 VIEWS RIGHT	$42.12	$77.00	$61.60–$73.15	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XRAY KNEE 3 VIEWS LEFT	$42.12	$77.00	$61.60–$73.15	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VW LT	$271.86	$497.00	$397.60–$472.15	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VW RT	$271.86	$497.00	$397.60–$472.15	—	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VW RT	$324.92	$594.00	$102.68–$577.62	17% above	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE MIN 4 VW LT	$324.92	$594.00	$102.68–$577.62	17% above	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VW LT	$324.92	$594.00	$475.20–$564.30	—	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE MIN 4 VW RT	$324.92	$594.00	$475.20–$564.30	—	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT WO CONT LT	$1,704.46	$3,116.00	$102.68–$4,775.00	17% above	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT WO CONT RT	$1,704.46	$3,116.00	$102.68–$4,775.00	17% above	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT WO CONT LT	$1,704.46	$3,116.00	$2,492.80–$2,960.20	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT WO CONT RT	$1,704.46	$3,116.00	$2,492.80–$2,960.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$709.46	$1,297.00	$102.68–$1,300.00	59% above	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE LOWER BACK	$826.52	$1,511.00	$102.68–$1,435.45	86% above	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LTD	$709.46	$1,297.00	$1,037.60–$1,232.15	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SOFT TISSUE LOWER BACK	$826.52	$1,511.00	$1,208.80–$1,435.45	—	45%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND EXTREMITY LIMITED	$77.68	$142.00	$47.91–$280.09	73% below	45%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY LIMITED	$491.21	$898.00	$102.68–$1,300.00	71% above	45%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY LIMITED R	$491.21	$898.00	$102.68–$1,300.00	71% above	45%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMITY LIMITED L	$491.21	$898.00	$102.68–$1,300.00	71% above	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND EXTREMITY LIMITED	$77.68	$142.00	$113.60–$134.90	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY LIMITED	$491.21	$898.00	$718.40–$853.10	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY LIMITED R	$491.21	$898.00	$718.40–$853.10	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMITY LIMITED L	$491.21	$898.00	$718.40–$853.10	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG CANCER SCREEN LOW DOSE	$250.26	$457.50	$102.68–$4,775.00	44% below	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG CANCER SCREEN LOW DOSE	$250.26	$457.50	$366.00–$434.63	—	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA 2 VW RT	$284.99	$521.00	$85.02–$494.95	34% above	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA FIBULA 2 VW LT	$284.99	$521.00	$85.02–$494.95	34% above	45%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA 2 VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA FIBULA 2 VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$2,377.27	$4,346.00	$233.40–$4,200.00	8% above	45%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$2,377.27	$4,346.00	$3,476.80–$4,128.70	—	45%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILATERAL W/WO CONT	$2,464.24	$4,505.00	$322.21–$4,279.75	—	45%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILATERAL W/WO CONT	$2,464.24	$4,505.00	$3,604.00–$4,279.75	—	45%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI BIOMET PREP	$2,280.45	$4,169.00	$233.40–$4,200.00	3% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI BIOMET HIP LEFT WO CON	$1,724.15	$3,152.00	$233.40–$4,200.00	22% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI BIOMET HIP RIGHT WO CON	$1,724.15	$3,152.00	$233.40–$4,200.00	22% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI BIOMET KNEE LEFT WO CON	$1,900.01	$3,473.50	$233.40–$4,200.00	14% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP JOINT W/O CONTR-RIGHT	$1,900.01	$3,473.50	$233.40–$4,200.00	14% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI BIOMET KNEE RIGHT WO CON	$1,900.01	$3,473.50	$233.40–$4,200.00	14% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP JOINT W/O CONTR-LEFT	$1,900.01	$3,473.50	$233.40–$4,200.00	14% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT JNT WO CONT RT	$2,280.45	$4,169.00	$233.40–$4,200.00	3% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT JNT WO CONT LT	$2,280.45	$4,169.00	$233.40–$4,200.00	3% above	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI BIOMET PREP	$2,280.45	$4,169.00	$3,335.20–$3,960.55	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI BIOMET HIP RIGHT WO CON	$1,724.15	$3,152.00	$2,521.60–$2,994.40	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI BIOMET HIP LEFT WO CON	$1,724.15	$3,152.00	$2,521.60–$2,994.40	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI BIOMET KNEE RIGHT WO CON	$1,900.01	$3,473.50	$2,778.80–$3,299.83	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP JOINT W/O CONTR-RIGHT	$1,900.01	$3,473.50	$2,778.80–$3,299.83	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI BIOMET KNEE LEFT WO CON	$1,900.01	$3,473.50	$2,778.80–$3,299.83	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP JOINT W/O CONTR-LEFT	$1,900.01	$3,473.50	$2,778.80–$3,299.83	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXT JNT WO CONT LT	$2,280.45	$4,169.00	$3,335.20–$3,960.55	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXT JNT WO CONT RT	$2,280.45	$4,169.00	$3,335.20–$3,960.55	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP JNT W&W/O CONTR-LEFT	$2,099.66	$3,838.50	$344.83–$4,200.00	39% below	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP JNT W&W/O CONTR-RIGHT	$2,099.66	$3,838.50	$344.83–$4,200.00	39% below	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JNT W/WO CONT RT	$2,651.86	$4,848.00	$344.83–$4,605.60	22% below	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWER EXT JNT W/WO CONT LT	$2,651.86	$4,848.00	$344.83–$4,605.60	22% below	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP JNT W&W/O CONTR-RIGHT	$2,099.66	$3,838.50	$3,070.80–$3,646.58	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP JNT W&W/O CONTR-LEFT	$2,099.66	$3,838.50	$3,070.80–$3,646.58	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT JNT W/WO CONT LT	$2,651.86	$4,848.00	$3,878.40–$4,605.60	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOWER EXT JNT W/WO CONT RT	$2,651.86	$4,848.00	$3,878.40–$4,605.60	—	45%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,565.43	$4,690.00	$233.40–$4,455.50	16% above	45%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,565.43	$4,690.00	$3,752.00–$4,455.50	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O&W CONTRAST	$2,652.41	$4,849.00	$344.83–$4,606.55	22% below	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O&W CONTRAST	$2,652.41	$4,849.00	$3,879.20–$4,606.55	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$2,198.12	$4,018.50	$233.40–$4,200.00	1% below	45%
MRI of the brain, no contrast dye CPT 70551 MRI IAC W/O CONTRAST	$2,238.33	$4,092.00	$233.40–$4,200.00	1% above	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$2,198.12	$4,018.50	$3,214.80–$3,817.58	—	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC W/O CONTRAST	$2,238.33	$4,092.00	$3,273.60–$3,887.40	—	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONTRAST	$3,307.44	$6,046.50	$344.83–$5,744.18	3% below	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI INT AUD CANAL W/WO CONTRAS	$3,307.44	$6,046.50	$344.83–$5,744.18	3% below	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W&WO CONTRAST	$3,307.44	$6,046.50	$4,837.20–$5,744.18	—	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI INT AUD CANAL W/WO CONTRAS	$3,307.44	$6,046.50	$4,837.20–$5,744.18	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$2,450.29	$4,479.50	$233.40–$4,255.53	11% above	45%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$2,450.29	$4,479.50	$3,583.60–$4,255.53	—	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O&W CONTRAS	$3,629.62	$6,635.50	$344.83–$6,303.73	6% above	45%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O&W CONTRAS	$3,629.62	$6,635.50	$5,308.40–$6,303.73	—	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,450.29	$4,479.50	$233.40–$4,255.53	11% above	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,450.29	$4,479.50	$3,583.60–$4,255.53	—	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/WO CONTR	$3,661.90	$6,694.50	$344.83–$6,359.78	7% above	45%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/WO CONTR	$3,661.90	$6,694.50	$5,355.60–$6,359.78	—	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,450.29	$4,479.50	$233.40–$4,255.53	11% above	45%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,450.29	$4,479.50	$3,583.60–$4,255.53	—	45%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O&W CONTRAST	$2,593.61	$4,741.50	$344.83–$4,504.43	24% below	45%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O&W CONTRAST	$2,593.61	$4,741.50	$3,793.20–$4,504.43	—	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$2,377.27	$4,346.00	$233.40–$4,200.00	8% above	45%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$2,377.27	$4,346.00	$3,476.80–$4,128.70	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JNT WO CONT LT	$2,377.27	$4,346.00	$233.40–$4,200.00	8% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JNT WO CONT RT	$2,377.27	$4,346.00	$233.40–$4,200.00	8% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXT JNT WO CONT LT	$2,377.27	$4,346.00	$3,476.80–$4,128.70	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXT JNT WO CONT RT	$2,377.27	$4,346.00	$3,476.80–$4,128.70	—	45%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 5 VIEWS	$446.08	$815.50	$102.68–$774.73	39% above	45%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 VIEWS	$446.08	$815.50	$102.68–$774.73	39% above	45%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 VIEWS	$446.08	$815.50	$652.40–$774.73	—	45%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 5 VIEWS	$446.08	$815.50	$652.40–$774.73	—	45%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W CONTRAST	$1,719.77	$3,144.00	$171.89–$4,775.00	5% above	45%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W CONTRAST	$1,719.77	$3,144.00	$2,515.20–$2,986.80	—	45%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK WO CONTRAST	$1,582.75	$2,893.50	$102.68–$4,775.00	11% above	45%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK WO CONTRAST	$1,582.75	$2,893.50	$2,314.80–$2,748.83	—	45%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$239.59	$438.00	$85.02–$478.28	14% above	45%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$239.59	$438.00	$350.40–$416.10	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 SPECT CARDIOLYTE STRESS	$3,198.86	$5,848.00	$1,260.52–$5,555.60	4% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 SPECT CARDIOLYTE STRESS	$3,198.86	$5,848.00	$4,678.40–$5,555.60	—	45%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST	$1,880.32	$3,437.50	$102.68–$4,775.00	47% above	45%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST	$1,880.32	$3,437.50	$2,750.00–$3,265.63	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIC NONOB LTD	$76.31	$139.50	$47.07–$280.09	81% below	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED OR FOLLOW UP	$502.70	$919.00	$102.68–$1,300.00	26% above	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIC NONOB LTD	$76.31	$139.50	$111.60–$132.53	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED OR FOLLOW UP	$502.70	$919.00	$735.20–$873.05	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 FOLLICULAR MONITOR	$816.40	$1,492.50	$102.68–$1,417.88	56% above	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE	$839.92	$1,535.50	$102.68–$1,458.73	60% above	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE	$699.89	$1,279.50	$1,023.60–$1,215.53	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 FOLLICULAR MONITOR	$816.40	$1,492.50	$1,194.00–$1,417.88	—	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPL>14 WKS 1ST GEST	$877.67	$1,604.50	$102.68–$1,524.28	53% above	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPL>14 WKS 1ST GEST	$877.67	$1,604.50	$1,283.60–$1,524.28	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER 1ST GEST	$731.34	$1,337.00	$102.68–$1,300.00	43% above	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER 1ST GEST	$731.34	$1,337.00	$1,069.60–$1,270.15	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 L&D ULTRASOUND (OB)	$265.03	$484.50	$102.68–$1,300.00	28% below	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$508.44	$929.50	$102.68–$1,300.00	38% above	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 L&D ULTRASOUND (OB)	$265.03	$484.50	$387.60–$460.28	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$508.44	$929.50	$743.60–$883.03	—	45%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VW LT	$365.40	$668.00	$85.02–$634.60	63% above	45%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILAT 2 VW RT	$365.40	$668.00	$85.02–$634.60	63% above	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2 VW RT	$365.40	$668.00	$534.40–$634.60	—	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILAT 2 VW LT	$365.40	$668.00	$534.40–$634.60	—	45%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS L W PA CHEST 3V	$416.55	$761.50	$102.68–$723.43	50% above	45%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS R W PA CHEST 3V	$416.55	$761.50	$102.68–$723.43	50% above	45%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS R W PA CHEST 3V	$416.55	$761.50	$609.20–$723.43	—	45%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS L W PA CHEST 3V	$416.55	$761.50	$609.20–$723.43	—	45%
Screening mammogram, both breasts both sides CPT 77067 MAMMO BILAT SCREEN	$316.99	$579.50	$119.22–$550.53	—	45%
Screening mammogram, both breasts one side CPT 77067 MAMMO UNILAT SCREEN L	$205.40	$375.50	$119.22–$500.00	24% below	45%
Screening mammogram, both breasts one side CPT 77067 MAMMO UNILAT SCREEN R	$205.40	$375.50	$119.22–$500.00	24% below	45%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO BILAT SCREEN	$316.99	$579.50	$463.60–$550.53	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNILAT SCREEN R	$205.40	$375.50	$300.40–$356.73	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNILAT SCREEN L	$205.40	$375.50	$300.40–$356.73	—	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMP 2+ VW RT	$288.00	$526.50	$85.02–$500.18	23% above	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER COMP 2+ VW LT	$288.00	$526.50	$85.02–$500.18	23% above	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMP 2+ VW LT	$288.00	$526.50	$421.20–$500.18	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER COMP 2+ VW RT	$288.00	$526.50	$421.20–$500.18	—	45%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS COMP 3 VIEW	$360.48	$659.00	$85.02–$626.05	36% above	45%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS COMP 3 VIEW	$360.48	$659.00	$527.20–$626.05	—	45%
Skull X-ray, fewer than 4 views CPT 70250 SKULL <4 VIEWS	$340.51	$622.50	$102.68–$591.38	39% above	45%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL <4 VIEWS	$340.51	$622.50	$498.00–$591.38	—	45%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY ATTN	$3,951.81	$7,224.50	$982.35–$6,863.28	16% above	45%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY ATTN & INTERP	$5,093.94	$9,312.50	$982.35–$8,846.88	49% above	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY ATTN	$3,951.81	$7,224.50	$5,779.60–$6,863.28	—	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY ATTN & INTERP	$5,093.94	$9,312.50	$7,450.00–$8,846.88	—	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FLUORO SWALLOW STUDY	$515.55	$942.50	$171.89–$966.98	13% above	45%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FLUORO SWALLOW STUDY	$515.55	$942.50	$754.00–$895.38	—	45%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VW RT	$284.99	$521.00	$85.02–$494.95	16% above	45%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VW LT	$284.99	$521.00	$85.02–$494.95	16% above	45%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTR	$1,908.49	$3,489.00	$102.68–$4,775.00	24% above	45%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTR	$1,908.49	$3,489.00	$2,791.20–$3,314.55	—	45%
Toe X-ray, 2 or more views one side CPT 73660 TOE MIN 2 VW LT	$223.73	$409.00	$85.02–$478.28	11% above	45%
Toe X-ray, 2 or more views one side CPT 73660 TOE MIN 2 VW RT	$223.73	$409.00	$85.02–$478.28	11% above	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE MIN 2 VW LT	$223.73	$409.00	$327.20–$388.55	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE MIN 2 VW RT	$223.73	$409.00	$327.20–$388.55	—	45%
Transvaginal pelvic ultrasound CPT 76830 US PELVIS TRANSVAG	$439.52	$803.50	$102.68–$1,300.00	6% below	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIS TRANSVAG	$439.52	$803.50	$642.80–$763.33	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 US OB IVT	$366.22	$669.50	$102.68–$1,300.00	7% below	45%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB IVT	$366.22	$669.50	$535.60–$636.03	—	45%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPL	$965.73	$1,765.50	$102.68–$1,677.23	42% above	45%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPL	$965.73	$1,765.50	$1,412.40–$1,677.23	—	45%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$741.19	$1,355.00	$102.68–$1,300.00	50% above	45%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$741.19	$1,355.00	$1,084.00–$1,287.25	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$705.36	$1,289.50	$102.68–$1,300.00	38% above	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUES OF HEAD & NK	$826.52	$1,511.00	$102.68–$1,435.45	62% above	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$705.36	$1,289.50	$1,031.60–$1,225.03	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUES OF HEAD & NK	$826.52	$1,511.00	$1,208.80–$1,435.45	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI ROUTINE	$728.06	$1,331.00	$171.89–$1,264.45	6% above	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI/SMALL BOWEL	$911.03	$1,665.50	$171.89–$1,582.23	33% above	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI ROUTINE	$728.06	$1,331.00	$1,064.80–$1,264.45	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI/SMALL BOWEL	$911.03	$1,665.50	$1,332.40–$1,582.23	—	45%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VW RT	$284.99	$521.00	$85.02–$494.95	36% above	45%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VW LT	$284.99	$521.00	$85.02–$494.95	36% above	45%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENOUS INSUFFICIENCY L	$1,529.42	$2,796.00	$102.68–$2,656.20	114% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX EXTR VEINS UNIL/LMTD	$1,529.42	$2,796.00	$102.68–$2,656.20	114% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENOUS INSUFFICIENCY R	$1,529.42	$2,796.00	$102.68–$2,656.20	114% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VENOUS INSUFFICIENCY R	$1,529.42	$2,796.00	$2,236.80–$2,656.20	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX EXTR VEINS UNIL/LMTD	$1,529.42	$2,796.00	$2,236.80–$2,656.20	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VENOUS INSUFFICIENCY L	$1,529.42	$2,796.00	$2,236.80–$2,656.20	—	45%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VW LT	$240.68	$440.00	$85.02–$478.28	12% above	45%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VW RT	$240.68	$440.00	$85.02–$478.28	12% above	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VW RT	$240.68	$440.00	$352.00–$418.00	—	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VW LT	$240.68	$440.00	$352.00–$418.00	—	45%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST L W/NAVIC MIN 3 VIEW	$378.26	$691.50	$85.02–$656.93	49% above	45%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST R W/NAVIC MIN 3 VIEW	$378.26	$691.50	$85.02–$656.93	49% above	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMP 3+ VW LT	$284.99	$521.00	$85.02–$494.95	12% above	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMP 3+ VW RT	$284.99	$521.00	$85.02–$494.95	12% above	45%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST L W/NAVIC MIN 3 VIEW	$378.26	$691.50	$553.20–$656.93	—	45%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST R W/NAVIC MIN 3 VIEW	$378.26	$691.50	$553.20–$656.93	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMP 3+ VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMP 3+ VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2-3 VW RT	$271.86	$497.00	$85.02–$478.28	7% below	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP AP/LATERAL LT	$271.86	$497.00	$85.02–$478.28	7% below	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2-3 VW LT	$271.86	$497.00	$85.02–$478.28	7% below	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP AP/LATERAL RT	$271.86	$497.00	$85.02–$478.28	7% below	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2-3 VW OPERATIVE RT	$658.59	$1,204.00	$85.02–$1,143.80	126% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2-3 VW OPERATIVE LT	$658.59	$1,204.00	$85.02–$1,143.80	126% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP AP/LATERAL LT	$271.86	$497.00	$397.60–$472.15	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2-3 VW LT	$271.86	$497.00	$397.60–$472.15	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2-3 VW RT	$271.86	$497.00	$397.60–$472.15	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP AP/LATERAL RT	$271.86	$497.00	$397.60–$472.15	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2-3 VW OPERATIVE LT	$658.59	$1,204.00	$963.20–$1,143.80	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2-3 VW OPERATIVE RT	$658.59	$1,204.00	$963.20–$1,143.80	—	45%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN AP VIEW	$233.57	$427.00	$85.02–$478.28	11% above	45%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN AP VIEW	$233.57	$427.00	$341.60–$405.65	—	45%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VW RT	$239.04	$437.00	$85.02–$478.28	20% above	45%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VW LT	$239.04	$437.00	$85.02–$478.28	20% above	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VW RT	$239.04	$437.00	$349.60–$415.15	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VW LT	$239.04	$437.00	$349.60–$415.15	—	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VW RT	$223.73	$409.00	$85.02–$478.28	8% below	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VW LT	$223.73	$409.00	$85.02–$478.28	8% below	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VW RT	$223.73	$409.00	$327.20–$388.55	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VW LT	$223.73	$409.00	$327.20–$388.55	—	45%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VW LT	$212.79	$389.00	$85.02–$478.28	12% above	45%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VW RT	$212.79	$389.00	$85.02–$478.28	12% above	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VW LT	$212.79	$389.00	$311.20–$369.55	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VW RT	$212.79	$389.00	$311.20–$369.55	—	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3+ VW LT	$284.99	$521.00	$85.02–$494.95	18% above	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3+ VW RT	$284.99	$521.00	$85.02–$494.95	18% above	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3+ VW RT	$284.99	$521.00	$416.80–$494.95	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3+ VW LT	$284.99	$521.00	$416.80–$494.95	—	45%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VW RT	$285.54	$522.00	$85.02–$495.90	22% above	45%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VW LT	$285.54	$522.00	$85.02–$495.90	22% above	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VW RT	$285.54	$522.00	$417.60–$495.90	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VW LT	$285.54	$522.00	$417.60–$495.90	—	45%
X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEE BILATERAL LAT	$560.68	$1,025.00	$85.02–$973.75	—	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VWS RT	$228.65	$418.00	$85.02–$478.28	8% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VWS LEFT	$228.65	$418.00	$85.02–$478.28	8% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE AP LAT 2 VW RT	$280.89	$513.50	$85.02–$487.83	33% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE AP LAT 2 VW LT	$280.89	$513.50	$85.02–$487.83	33% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LAT RT	$280.89	$513.50	$85.02–$487.83	33% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LAT LT	$280.89	$513.50	$85.02–$487.83	33% above	45%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE BILATERAL LAT	$560.68	$1,025.00	$820.00–$973.75	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VWS LEFT	$228.65	$418.00	$334.40–$397.10	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VWS RT	$228.65	$418.00	$334.40–$397.10	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE AP LAT 2 VW RT	$280.89	$513.50	$410.80–$487.83	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LAT RT	$280.89	$513.50	$410.80–$487.83	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LAT LT	$280.89	$513.50	$410.80–$487.83	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE AP LAT 2 VW LT	$280.89	$513.50	$410.80–$487.83	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR OBL/2V	$303.04	$554.00	$102.68–$577.62	4% above	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR ROUTINE 2-3 VW	$396.03	$724.00	$102.68–$687.80	36% above	45%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR OBL/2V	$303.04	$554.00	$443.20–$526.30	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR ROUTINE 2-3 VW	$396.03	$724.00	$579.20–$687.80	—	45%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4 VW	$536.89	$981.50	$102.68–$932.43	44% above	45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4 VW	$536.89	$981.50	$785.20–$932.43	—	45%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VW	$403.42	$737.50	$102.68–$700.63	70% above	45%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VW	$403.42	$737.50	$590.00–$700.63	—	45%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VW	$272.68	$498.50	$85.02–$478.28	12% above	45%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VW	$272.68	$498.50	$398.80–$473.58	—	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 VIEWS	$295.66	$540.50	$85.02–$513.48	23% above	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 3 VIEWS	$370.87	$678.00	$85.02–$644.10	54% above	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2 VIEWS	$295.66	$540.50	$432.40–$513.48	—	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 3 VIEWS	$370.87	$678.00	$542.40–$644.10	—	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 XRAY PELVIS 1-2 VIEWS	$39.94	$73.00	$24.63–$280.09	82% below	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP	$252.45	$461.50	$102.68–$577.62	14% above	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XRAY PELVIS 1-2 VIEWS	$39.94	$73.00	$58.40–$69.35	—	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP	$252.45	$461.50	$369.20–$438.43	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX MIN 2 VW	$282.26	$516.00	$85.02–$490.20	31% above	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN 2 VW	$282.26	$516.00	$412.80–$490.20	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$150.16	$274.50	$38.62–$260.78	32% below	45%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$150.16	$274.50	$219.60–$260.78	—	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO	$34.74	$63.50	$5.30–$60.33	1% below	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$51.70	$94.50	$5.30–$89.78	48% above	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$76.04	$139.00	$5.30–$132.05	117% above	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO	$34.74	$63.50	$50.80–$60.33	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$51.70	$94.50	$75.60–$89.78	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$76.04	$139.00	$111.20–$132.05	—	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$7.12	$13.00	$5.18–$29.14	85% below	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST SGOT	$76.04	$139.00	$5.18–$132.05	60% above	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$7.12	$13.00	$10.40–$12.35	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST SGOT	$76.04	$139.00	$111.20–$132.05	—	45%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$266.39	$487.00	$47.63–$462.65	12% below	45%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$266.39	$487.00	$389.60–$462.65	—	45%
Albumin blood test CPT 82040 ALBUMIN	$7.39	$13.50	$4.95–$27.85	80% below	45%
Albumin blood test CPT 82040 ALBUMIN SERUM	$31.18	$57.00	$4.95–$54.15	17% below	45%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$31.18	$57.00	$45.60–$54.15	—	45%
Albumin blood test inpatient CPT 82040 ALBUMIN	$50.06	$91.50	$73.20–$86.93	—	45%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$131.83	$241.00	$40.75–$229.24	32% below	45%
Aldosterone blood test CPT 82088 ALDOSTERONE	$131.83	$241.00	$40.75–$229.24	32% below	45%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$131.83	$241.00	$192.80–$228.95	—	45%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$131.83	$241.00	$192.80–$228.95	—	45%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$54.16	$99.00	$5.18–$94.05	11% above	45%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSPHATASE	$80.69	$147.50	$5.18–$140.13	66% above	45%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$54.16	$99.00	$79.20–$94.05	—	45%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSPHATASE	$80.69	$147.50	$118.00–$140.13	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EACH	$18.33	$33.50	$5.22–$31.83	27% below	45%
Allergy blood test, specific IgE, per allergen CPT 86003 SEAFOOD ALLERGEN EACH	$25.44	$46.50	$5.22–$44.18	2% above	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN OTHER	$56.35	$103.00	$5.22–$97.85	125% above	45%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST	$62.09	$113.50	$5.22–$107.83	148% above	45%
Allergy blood test, specific IgE, per allergen CPT 86003 TILAPIA IGE	$128.00	$234.00	$5.22–$222.30	412% above	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EACH	$18.33	$33.50	$26.80–$31.83	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SEAFOOD ALLERGEN EACH	$25.44	$46.50	$37.20–$44.18	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN OTHER	$56.35	$103.00	$82.40–$97.85	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST	$62.09	$113.50	$90.80–$107.83	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILAPIA IGE	$128.00	$234.00	$187.20–$222.30	—	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP SINGLE MARKER SCREEN MAT	$86.98	$159.00	$16.77–$151.05	4% above	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN	$113.51	$207.50	$16.77–$197.13	36% above	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP SINGLE MARKER SCREEN MAT	$86.98	$159.00	$127.20–$151.05	—	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN	$113.51	$207.50	$166.00–$197.13	—	45%
Ammonia blood test CPT 82140 AMMONIA	$9.85	$18.00	$12.60–$81.96	89% below	45%
Ammonia blood test inpatient CPT 82140 AMMONIA	$9.85	$18.00	$14.40–$17.10	—	45%
Amylase blood test CPT 82150 AMYLASE	$110.50	$202.00	$6.48–$191.90	79% above	45%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$110.50	$202.00	$6.48–$191.90	79% above	45%
Amylase blood test inpatient CPT 82150 AMYLASE	$110.50	$202.00	$161.60–$191.90	—	45%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$110.50	$202.00	$161.60–$191.90	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$59.35	$108.50	$12.95–$103.08	28% below	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$59.35	$108.50	$86.80–$103.08	—	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES IFA	$6.57	$12.00	$8.40–$68.01	90% below	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$17.24	$31.50	$12.09–$68.01	75% below	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA HEP-2 SUBSTRATE	$64.55	$118.00	$12.09–$112.10	6% below	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$85.61	$156.50	$12.09–$148.68	25% above	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES IFA	$6.57	$12.00	$9.60–$11.40	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES (ANA)	$17.24	$31.50	$25.20–$29.93	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA HEP-2 SUBSTRATE	$64.55	$118.00	$94.40–$112.10	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$85.61	$156.50	$125.20–$148.68	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$126.36	$231.00	$39.26–$220.86	11% below	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP	$147.97	$270.50	$39.26–$256.98	4% above	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$126.36	$231.00	$184.80–$219.45	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP	$147.97	$270.50	$216.40–$256.98	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC BACTERIAL CULTURE	$22.43	$41.00	$8.62–$48.49	57% below	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE W/ISOLATION	$30.64	$56.00	$8.62–$53.20	42% below	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONELLA SPECIES CULTURE	$62.91	$115.00	$8.62–$109.25	20% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE/MISC	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE (EAR)	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE (SPUTUM)	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE/CSF	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$158.36	$289.50	$8.62–$275.03	202% above	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC BACTERIAL CULTURE	$22.43	$41.00	$32.80–$38.95	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE W/ISOLATION	$30.64	$56.00	$44.80–$53.20	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGIONELLA SPECIES CULTURE	$62.91	$115.00	$92.00–$109.25	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE/CSF	$158.36	$289.50	$231.60–$275.03	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$158.36	$289.50	$231.60–$275.03	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE (SPUTUM)	$158.36	$289.50	$231.60–$275.03	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE (EAR)	$158.36	$289.50	$231.60–$275.03	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE/MISC	$158.36	$289.50	$231.60–$275.03	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND	$158.36	$289.50	$231.60–$275.03	—	45%
Basic metabolic panel (blood test) CPT 80048 BMP	$126.36	$231.00	$8.46–$219.45	43% above	45%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC	$126.36	$231.00	$8.46–$219.45	43% above	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP	$10.40	$19.00	$15.20–$18.05	—	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC	$126.36	$231.00	$184.80–$219.45	—	45%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$34.74	$63.50	$5.02–$60.33	26% below	45%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN	$55.25	$101.00	$5.02–$95.95	18% above	45%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$34.74	$63.50	$50.80–$60.33	—	45%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN	$55.25	$101.00	$80.80–$95.95	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SLP-SLIDE PREPARATION	$49.23	$90.00	$51.59–$290.22	77% below	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4	$96.55	$176.50	$51.59–$290.22	55% below	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL IV	$100.93	$184.50	$51.59–$290.22	53% below	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV	$161.64	$295.50	$51.59–$290.22	25% below	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SLP-SLIDE PREPARATION	$49.23	$90.00	$72.00–$85.50	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL 4	$96.55	$176.50	$141.20–$167.68	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LEVEL IV	$100.93	$184.50	$147.60–$175.28	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV	$161.64	$295.50	$236.40–$280.73	—	45%
Blood culture for bacteria CPT 87040 CULTURE (BLOOD)	$171.22	$313.00	$10.32–$297.35	100% above	45%
Blood culture for bacteria inpatient CPT 87040 CULTURE (BLOOD)	$171.22	$313.00	$250.40–$297.35	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY SESSION	$17.51	$32.00	$9.09–$51.14	19% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-WHCLI	$27.63	$50.50	$9.09–$51.14	88% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-LOCLI	$27.63	$50.50	$9.09–$51.14	88% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-PLCLI	$27.63	$50.50	$9.09–$51.14	88% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$27.63	$50.50	$9.09–$51.14	88% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE-RVCLI	$27.63	$50.50	$9.09–$51.14	88% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LEGAL BLOOD ALCOHOL DRAW	$51.97	$95.00	$9.09–$90.25	254% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRUG SCREEN COLLECTION/BLOOD	$61.54	$112.50	$9.09–$106.88	319% above	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY SESSION	$17.51	$32.00	$25.60–$30.40	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-RVCLI	$27.63	$50.50	$40.40–$47.98	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-PLCLI	$27.63	$50.50	$40.40–$47.98	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-WHCLI	$27.63	$50.50	$40.40–$47.98	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$27.63	$50.50	$40.40–$47.98	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE-LOCLI	$27.63	$50.50	$40.40–$47.98	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LEGAL BLOOD ALCOHOL DRAW	$51.97	$95.00	$76.00–$90.25	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRUG SCREEN COLLECTION/BLOOD	$61.54	$112.50	$90.00–$106.88	—	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$66.74	$122.00	$3.93–$115.90	173% above	45%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$66.74	$122.00	$97.60–$115.90	—	45%
Blood lead test CPT 83655 LEAD BLOOD PEDIATRIC	$13.41	$24.50	$12.11–$68.13	76% below	45%
Blood lead test CPT 83655 LEAD	$64.00	$117.00	$12.11–$111.15	16% above	45%
Blood lead test CPT 83655 LEAD BLOOD (GML)	$86.43	$158.00	$12.11–$150.10	57% above	45%
Blood lead test CPT 83655 LEAD URINE	$112.41	$205.50	$12.11–$195.23	104% above	45%
Blood lead test CPT 83655 HEAVY METAL SCREEN-LEAD	$224.27	$410.00	$12.11–$389.50	308% above	45%
Blood lead test inpatient CPT 83655 LEAD BLOOD PEDIATRIC	$13.41	$24.50	$19.60–$23.28	—	45%
Blood lead test inpatient CPT 83655 LEAD	$64.00	$117.00	$93.60–$111.15	—	45%
Blood lead test inpatient CPT 83655 LEAD BLOOD (GML)	$86.43	$158.00	$126.40–$150.10	—	45%
Blood lead test inpatient CPT 83655 LEAD URINE	$112.41	$205.50	$164.40–$195.23	—	45%
Blood lead test inpatient CPT 83655 HEAVY METAL SCREEN-LEAD	$224.27	$410.00	$328.00–$389.50	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG - SERUM	$143.05	$261.50	$7.52–$248.43	131% above	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG - URINE	$149.06	$272.50	$7.52–$258.88	140% above	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG - SERUM	$143.05	$261.50	$209.20–$248.43	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG - URINE	$149.06	$272.50	$218.00–$258.88	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$36.93	$67.50	$47.25–$700.17	13% below	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO-REFERENCE	$37.75	$69.00	$23.28–$339.52	11% below	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$109.13	$199.50	$67.31–$339.52	157% above	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$36.93	$67.50	$54.00–$64.13	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO-REFERENCE	$37.75	$69.00	$55.20–$65.55	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE	$109.13	$199.50	$159.60–$189.53	—	45%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$6.57	$12.00	$3.95–$22.22	74% below	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$63.18	$115.50	$92.40–$109.73	—	45%
C-peptide blood test CPT 84681 C-PEPTIDE	$89.17	$163.00	$20.81–$154.85	3% above	45%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$89.17	$163.00	$130.40–$154.85	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$80.69	$147.50	$5.18–$140.13	48% above	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$80.69	$147.50	$118.00–$140.13	—	45%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF PCR REFERENCE	$151.80	$277.50	$37.27–$263.63	1% above	45%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF TOXIN B PCR	$177.23	$324.00	$37.27–$307.80	17% above	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF PCR REFERENCE	$151.80	$277.50	$222.00–$263.63	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF TOXIN B PCR	$177.23	$324.00	$259.20–$307.80	—	45%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$121.17	$221.50	$20.81–$210.43	8% above	45%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$121.17	$221.50	$177.20–$210.43	—	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$185.98	$340.00	$20.81–$323.00	55% above	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$185.98	$340.00	$272.00–$323.00	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 NAAT	$108.04	$197.50	$51.31–$288.65	20% below	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 PCR	$117.06	$214.00	$51.31–$288.65	13% below	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 NAAT	$108.04	$197.50	$158.00–$187.63	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 PCR	$117.06	$214.00	$171.20–$203.30	—	45%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$7.12	$13.00	$5.16–$29.03	86% below	45%
Calcium blood test, total CPT 82310 CALCIUM RANDOM URINE TOTAL	$39.39	$72.00	$5.16–$68.40	25% below	45%
Calcium blood test, total inpatient CPT 82310 CALCIUM RANDOM URINE TOTAL	$39.39	$72.00	$57.60–$68.40	—	45%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$42.12	$77.00	$61.60–$73.15	—	45%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$175.04	$320.00	$18.96–$304.00	29% above	45%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$175.04	$320.00	$256.00–$304.00	—	45%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG	$54.16	$99.00	$12.88–$94.05	26% below	45%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM	$54.16	$99.00	$12.88–$94.05	26% below	45%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER AB IGG	$73.85	$135.00	$12.88–$128.25	1% above	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM	$54.16	$99.00	$79.20–$94.05	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG	$54.16	$99.00	$79.20–$94.05	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER AB IGG	$73.85	$135.00	$108.00–$128.25	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NAA	$52.24	$95.50	$35.09–$197.40	63% below	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS	$76.58	$140.00	$35.09–$197.40	46% below	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA	$96.82	$177.00	$35.09–$197.40	32% below	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NAA	$52.24	$95.50	$76.40–$90.73	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS	$76.58	$140.00	$112.00–$133.00	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA	$96.82	$177.00	$141.60–$168.15	—	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID CASCADE W GRAPH	$12.86	$23.50	$13.39–$75.33	86% below	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$94.91	$173.50	$13.39–$164.83	7% above	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID CASCADE W GRAPH	$12.86	$23.50	$18.80–$22.33	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$143.05	$261.50	$209.20–$248.43	—	45%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTOMATIC DIFFERENTIAL	$157.27	$287.50	$7.77–$273.13	117% above	45%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTOMATIC DIFFERENTIAL	$157.27	$287.50	$230.00–$273.13	—	45%
Complete blood count (CBC), no differential CPT 85027 CBC (HEMOGRAM)	$92.45	$169.00	$6.47–$160.55	76% above	45%
Complete blood count (CBC), no differential CPT 85027 CBC WITH ANC	$110.23	$201.50	$6.47–$191.43	110% above	45%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC (HEMOGRAM)	$92.45	$169.00	$135.20–$160.55	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH ANC	$110.23	$201.50	$161.20–$191.43	—	45%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$12.59	$23.00	$10.56–$59.41	89% below	45%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC	$184.62	$337.50	$10.56–$320.63	62% above	45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$12.59	$23.00	$18.40–$21.85	—	45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC	$184.62	$337.50	$270.00–$320.63	—	45%
Cortisol blood test, total CPT 82533 CORTISOL SALIVA TOTAL	$113.51	$207.50	$16.30–$197.13	5% below	45%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$185.98	$340.00	$16.30–$323.00	55% above	45%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SALIVA TOTAL	$113.51	$207.50	$166.00–$197.13	—	45%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$185.98	$340.00	$272.00–$323.00	—	45%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL	$37.20	$68.00	$6.51–$64.60	42% below	45%
Creatine kinase (CK) blood test, total CPT 82550 CK TOTAL	$107.22	$196.00	$6.51–$186.20	68% above	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL	$37.20	$68.00	$54.40–$64.60	—	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK TOTAL	$107.22	$196.00	$156.80–$186.20	—	45%
Creatinine blood test CPT 82565 CREATININE PLASMA	$18.06	$33.00	$5.12–$31.35	43% below	45%
Creatinine blood test CPT 82565 CREATININE BLOOD	$42.12	$77.00	$5.12–$73.15	33% above	45%
Creatinine blood test CPT 82565 CREATININE SERUM	$63.18	$115.50	$5.12–$109.73	99% above	45%
Creatinine blood test inpatient CPT 82565 CREATININE PLASMA	$18.06	$33.00	$26.40–$31.35	—	45%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$42.12	$77.00	$61.60–$73.15	—	45%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$63.18	$115.50	$92.40–$109.73	—	45%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG BY ELFA	$135.11	$247.00	$14.39–$234.65	91% above	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG BY ELFA	$135.11	$247.00	$197.60–$234.65	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER - REFERENCE	$27.90	$51.00	$10.18–$57.27	65% below	45%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$161.64	$295.50	$10.18–$280.73	103% above	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER - REFERENCE	$27.90	$51.00	$40.80–$48.45	—	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$161.64	$295.50	$236.40–$280.73	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$102.02	$186.50	$22.23–$177.18	28% below	45%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$102.02	$186.50	$149.20–$177.18	—	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE SCREEN & CONF URIN	$41.30	$75.50	$52.85–$349.57	64% below	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE SCREEN URINE	$41.30	$75.50	$52.85–$349.57	64% below	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL	$89.71	$164.00	$62.14–$349.57	23% below	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 OXYCODONE/OXYMORPH SCR&CONF UR	$96.82	$177.00	$62.14–$349.57	16% below	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL URINE	$96.82	$177.00	$62.14–$349.57	16% below	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM 5 PANEL	$144.14	$263.50	$62.14–$349.57	24% above	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UMBILICAL DRUG SCREEN	$238.50	$436.00	$62.14–$414.20	106% above	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE SCREEN URINE	$41.30	$75.50	$60.40–$71.73	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE SCREEN & CONF URIN	$41.30	$75.50	$60.40–$71.73	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL	$89.71	$164.00	$131.20–$155.80	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL URINE	$96.82	$177.00	$141.60–$168.15	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OXYCODONE/OXYMORPH SCR&CONF UR	$96.82	$177.00	$141.60–$168.15	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM 5 PANEL	$144.14	$263.50	$210.80–$250.33	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UMBILICAL DRUG SCREEN	$238.50	$436.00	$348.80–$414.20	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES	$94.91	$173.50	$7.01–$164.83	94% above	45%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES	$94.91	$173.50	$138.80–$164.83	—	45%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRAL CAPSID	$14.77	$27.00	$18.14–$102.05	82% below	45%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VIRAL CAPSID	$14.77	$27.00	$21.60–$25.65	—	45%
Estradiol blood test CPT 82670 ESTRADIOL	$113.23	$207.00	$27.94–$196.65	12% below	45%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$113.23	$207.00	$165.60–$196.65	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$188.72	$345.00	$18.58–$327.75	63% above	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$188.72	$345.00	$276.00–$327.75	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$176.96	$323.50	$19.63–$307.33	6% below	45%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$176.96	$323.50	$258.80–$307.33	—	45%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$13.68	$25.00	$13.63–$76.68	85% below	45%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$13.68	$25.00	$20.00–$23.75	—	45%
Fibrinogen blood test CPT 85384 FIBRINOGEN EQUIVALENT	$34.74	$63.50	$9.72–$60.33	49% below	45%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$52.52	$96.00	$9.72–$91.20	22% below	45%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN EQUIVALENT	$34.74	$63.50	$50.80–$60.33	—	45%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$52.52	$96.00	$76.80–$91.20	—	45%
Folate (folic acid) blood test CPT 82746 FOLATE	$135.11	$247.00	$14.70–$234.65	37% above	45%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$135.11	$247.00	$197.60–$234.65	—	45%
Free T3 thyroid hormone test CPT 84481 FREE T3	$147.42	$269.50	$16.94–$256.03	51% above	45%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$147.42	$269.50	$215.60–$256.03	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$107.22	$196.00	$9.02–$186.20	33% above	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$107.22	$196.00	$156.80–$186.20	—	45%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$62.36	$114.00	$25.47–$143.28	47% below	45%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$62.36	$114.00	$91.20–$108.30	—	45%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE GAMMA GGT	$34.74	$63.50	$7.20–$60.33	35% below	45%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$81.78	$149.50	$7.20–$142.03	53% above	45%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE GAMMA GGT	$34.74	$63.50	$50.80–$60.33	—	45%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$81.78	$149.50	$119.60–$142.03	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT OB SCREEN	$66.74	$122.00	$4.75–$115.90	35% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT OB SCREEN	$66.74	$122.00	$97.60–$115.90	—	45%
Glucose tolerance test, 3 samples CPT 82951 GTT 1 HOUR PANEL	$131.83	$241.00	$12.87–$228.95	47% above	45%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR PANEL	$131.83	$241.00	$12.87–$228.95	47% above	45%
Glucose tolerance test, 3 samples CPT 82951 GTT OB 2 HR PANEL	$195.83	$358.00	$12.87–$340.10	118% above	45%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 HOUR PANEL	$195.83	$358.00	$12.87–$340.10	118% above	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 HOUR PANEL	$131.83	$241.00	$192.80–$228.95	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1 HOUR PANEL	$131.83	$241.00	$192.80–$228.95	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 HOUR PANEL	$195.83	$358.00	$286.40–$340.10	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT OB 2 HR PANEL	$195.83	$358.00	$286.40–$340.10	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NAA	$52.24	$95.50	$35.09–$197.40	63% below	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE	$76.58	$140.00	$35.09–$197.40	46% below	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC	$96.82	$177.00	$35.09–$197.40	32% below	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NAA	$52.24	$95.50	$76.40–$90.73	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE	$76.58	$140.00	$112.00–$133.00	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC	$96.82	$177.00	$141.60–$168.15	—	45%
H. pylori stool antigen test CPT 87338 HELICOBACTOR PYLORI AG STOOL	$226.46	$414.00	$14.38–$393.30	75% above	45%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTOR PYLORI AG STOOL	$226.46	$414.00	$331.20–$393.30	—	45%
HIV-1 and HIV-2 antibody test CPT 86703 MISC LAB I	$110.23	$201.50	$13.71–$191.43	42% above	45%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 MISC LAB I	$110.23	$201.50	$161.20–$191.43	—	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AB CONFIRM BY WB	$30.91	$56.50	$24.08–$135.46	70% below	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AB CONFIRM BY WB	$30.91	$56.50	$45.20–$53.68	—	45%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV	$50.88	$93.00	$35.09–$197.40	64% below	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV	$50.88	$93.00	$74.40–$88.35	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C	$98.46	$180.00	$9.71–$171.00	43% above	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C	$98.46	$180.00	$144.00–$171.00	—	45%
Hemoglobin blood test CPT 85018 HGB-HEMOGLOBIN	$46.77	$85.50	$2.37–$81.23	167% above	45%
Hemoglobin blood test inpatient CPT 85018 HGB-HEMOGLOBIN	$46.77	$85.50	$68.40–$81.23	—	45%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY (HBcAb)	$21.88	$40.00	$12.05–$67.79	73% below	45%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY	$69.75	$127.50	$12.05–$121.13	13% below	45%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB	$85.06	$155.50	$12.05–$147.73	6% above	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY (HBcAb)	$21.88	$40.00	$32.00–$38.00	—	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY	$69.75	$127.50	$102.00–$121.13	—	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB	$85.06	$155.50	$124.40–$147.73	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY(HBsAb)	$21.88	$40.00	$10.74–$60.42	70% below	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$51.70	$94.50	$10.74–$89.78	30% below	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$105.85	$193.50	$10.74–$183.83	43% above	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY(HBsAb)	$21.88	$40.00	$32.00–$38.00	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$51.70	$94.50	$75.60–$89.78	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$105.85	$193.50	$154.80–$183.83	—	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN (HBsAg)	$26.26	$48.00	$10.33–$58.11	60% below	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$42.40	$77.50	$10.33–$73.63	35% below	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN	$83.70	$153.00	$10.33–$145.35	29% above	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$137.85	$252.00	$10.33–$239.40	112% above	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN (HBsAg)	$26.26	$48.00	$38.40–$45.60	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG	$42.40	$77.50	$62.00–$73.63	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN	$62.09	$113.50	$90.80–$107.83	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$137.85	$252.00	$201.60–$239.40	—	45%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$51.70	$94.50	$14.27–$89.78	36% below	45%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C-AB	$140.04	$256.00	$14.27–$243.20	75% above	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$51.70	$94.50	$75.60–$89.78	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C-AB	$140.04	$256.00	$204.80–$243.20	—	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS PCR	$173.13	$316.50	$42.84–$300.68	27% below	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV REALTIME ABBOTT	$431.04	$788.00	$42.84–$748.60	82% above	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS PCR	$173.13	$316.50	$253.20–$300.68	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV REALTIME ABBOTT	$431.04	$788.00	$630.40–$748.60	—	45%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$64.82	$118.50	$13.19–$112.58	4% below	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$64.82	$118.50	$94.80–$112.58	—	45%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$64.82	$118.50	$19.35–$112.58	20% below	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$64.82	$118.50	$94.80–$112.58	—	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN INFECTION	$13.41	$24.50	$12.95–$72.85	83% below	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP CARDIAC	$108.04	$197.50	$12.95–$187.63	35% above	45%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN INFECTION	$13.41	$24.50	$19.60–$23.28	—	45%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP CARDIAC	$108.04	$197.50	$158.00–$187.63	—	45%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$100.93	$184.50	$17.92–$175.28	15% below	45%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$100.93	$184.50	$147.60–$175.28	—	45%
Insulin blood test CPT 83525 INSULIN TOTAL	$98.46	$180.00	$11.43–$171.00	46% above	45%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$98.46	$180.00	$144.00–$171.00	—	45%
Iron blood test (serum iron) CPT 83540 IRON	$84.24	$154.00	$6.47–$146.30	58% above	45%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$84.24	$154.00	$123.20–$146.30	—	45%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$87.25	$159.50	$8.74–$151.53	41% above	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$87.25	$159.50	$127.60–$151.53	—	45%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$143.32	$262.00	$8.68–$248.90	40% above	45%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$143.32	$262.00	$209.60–$248.90	—	45%
LH (luteinizing hormone) test CPT 83002 LH	$190.63	$348.50	$18.52–$331.08	96% above	45%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$190.63	$348.50	$278.80–$331.08	—	45%
Lactate (lactic acid) blood test CPT 83605 LACTIC VENOUS	$8.76	$16.00	$11.20–$65.09	87% below	45%
Lactate (lactic acid) blood test CPT 83605 LACTATE - VENOUS	$115.70	$211.50	$11.57–$200.93	66% above	45%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC VENOUS	$8.76	$16.00	$12.80–$15.20	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE - VENOUS	$115.70	$211.50	$169.20–$200.93	—	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$11.77	$21.50	$6.04–$33.98	76% below	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$52.24	$95.50	$6.04–$90.73	4% above	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE BF	$55.80	$102.00	$6.04–$96.90	12% above	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$11.77	$21.50	$17.20–$20.43	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$52.24	$95.50	$76.40–$90.73	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE BF	$55.80	$102.00	$81.60–$96.90	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$94.36	$172.50	$6.89–$163.88	39% above	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$7.12	$13.00	$10.40–$12.35	—	45%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$148.79	$272.00	$8.17–$258.40	46% above	45%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$148.79	$272.00	$217.60–$258.40	—	45%
Lyme disease antibody test CPT 86618 LYME IGG	$76.04	$139.00	$17.03–$132.05	9% below	45%
Lyme disease antibody test CPT 86618 LYME IGM	$76.04	$139.00	$17.03–$132.05	9% below	45%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$128.28	$234.50	$17.03–$222.78	54% above	45%
Lyme disease antibody test inpatient CPT 86618 LYME IGG	$76.04	$139.00	$111.20–$132.05	—	45%
Lyme disease antibody test inpatient CPT 86618 LYME IGM	$76.04	$139.00	$111.20–$132.05	—	45%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$128.28	$234.50	$187.60–$222.78	—	45%
Magnesium blood test CPT 83735 MAGNESIUM	$7.12	$13.00	$6.70–$37.69	86% below	45%
Magnesium blood test CPT 83735 MAGNESIUM RBC	$42.67	$78.00	$6.70–$74.10	19% below	45%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC	$42.67	$78.00	$62.40–$74.10	—	45%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$73.30	$134.00	$107.20–$127.30	—	45%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$56.89	$104.00	$12.88–$98.80	31% below	45%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$56.89	$104.00	$12.88–$98.80	31% below	45%
Measles (rubeola) antibody test CPT 86765 MEASLES AB IGG	$62.36	$114.00	$12.88–$108.30	24% below	45%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG	$56.89	$104.00	$83.20–$98.80	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM	$56.89	$104.00	$83.20–$98.80	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB IGG	$62.36	$114.00	$91.20–$108.30	—	45%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$72.76	$133.00	$5.18–$126.35	32% above	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$72.76	$133.00	$106.40–$126.35	—	45%
Mumps immunity blood test CPT 86735 MUMPS AB IGM	$54.98	$100.50	$13.05–$95.48	36% below	45%
Mumps immunity blood test CPT 86735 MUMPS AB IGG	$54.98	$100.50	$13.05–$95.48	36% below	45%
Mumps immunity blood test CPT 86735 MUMPS VIRUS IGG	$65.37	$119.50	$13.05–$113.53	24% below	45%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGG	$54.98	$100.50	$80.40–$95.48	—	45%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB IGM	$54.98	$100.50	$80.40–$95.48	—	45%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS IGG	$65.37	$119.50	$95.60–$113.53	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$50.88	$93.00	$18.39–$103.45	45% below	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$50.88	$93.00	$74.40–$88.35	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$50.88	$93.00	$18.39–$103.45	46% below	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-MONITORING TOTAL	$161.64	$295.50	$18.39–$280.73	70% above	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$50.88	$93.00	$74.40–$88.35	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-MONITORING TOTAL	$161.64	$295.50	$236.40–$280.73	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$42.12	$77.00	$41.28–$232.22	80% below	45%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT	$103.93	$190.00	$41.28–$232.22	51% below	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$42.12	$77.00	$61.60–$73.15	—	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT	$103.93	$190.00	$152.00–$180.50	—	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT - REFERENCE	$8.76	$16.00	$6.01–$33.81	83% below	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT	$54.16	$99.00	$6.01–$94.05	3% above	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT APTT	$72.48	$132.50	$6.01–$125.88	38% above	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT - REFERENCE	$8.76	$16.00	$12.80–$15.20	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT	$54.16	$99.00	$79.20–$94.05	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT APTT	$72.48	$132.50	$106.00–$125.88	—	45%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$7.12	$13.00	$4.74–$26.67	83% below	45%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS	$76.04	$139.00	$4.74–$132.05	83% above	45%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$44.04	$80.50	$64.40–$76.48	—	45%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS	$76.04	$139.00	$111.20–$132.05	—	45%
Potassium blood test CPT 84132 POTASSIUM	$7.12	$13.00	$4.76–$26.78	74% below	45%
Potassium blood test inpatient CPT 84132 POTASSIUM	$63.18	$115.50	$92.40–$109.73	—	45%
Progesterone blood test CPT 84144 PROGESTERONE	$157.27	$287.50	$20.86–$273.13	30% above	45%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$157.27	$287.50	$230.00–$273.13	—	45%
Prolactin blood test CPT 84146 PROLACTIN	$124.72	$228.00	$19.38–$216.60	3% above	45%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$124.72	$228.00	$182.40–$216.60	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME - REFERENCE	$8.76	$16.00	$4.29–$24.13	74% below	45%
Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAGULANT	$49.51	$90.50	$4.29–$85.98	47% above	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$49.51	$90.50	$4.29–$85.98	47% above	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME - REFERENCE	$8.76	$16.00	$12.80–$15.20	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$49.51	$90.50	$72.40–$85.98	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAGULANT	$49.51	$90.50	$72.40–$85.98	—	45%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN RAPID GRP A	$146.05	$267.00	$16.53–$253.65	220% above	45%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN RAPID GRP A	$146.05	$267.00	$213.60–$253.65	—	45%
Renin blood test CPT 84244 RENIN ACTIVITY	$100.65	$184.00	$21.99–$174.80	32% below	45%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY	$100.65	$184.00	$147.20–$174.80	—	45%
Rh blood typing CPT 86901 RH-REFERENCE	$30.64	$56.00	$18.89–$103.38	23% below	45%
Rh blood typing CPT 86901 RH	$36.93	$67.50	$37.90–$213.20	7% below	45%
Rh blood typing inpatient CPT 86901 RH-REFERENCE	$30.64	$56.00	$44.80–$53.20	—	45%
Rh blood typing inpatient CPT 86901 RH	$36.93	$67.50	$54.00–$64.13	—	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$59.35	$108.50	$5.67–$103.08	1% above	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$87.25	$159.50	$5.67–$151.53	49% above	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$59.35	$108.50	$86.80–$103.08	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$87.25	$159.50	$127.60–$151.53	—	45%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$107.22	$196.00	$14.39–$186.20	30% above	45%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$35.29	$64.50	$51.60–$61.28	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE NON-AUTO	$14.23	$26.00	$2.70–$24.70	66% below	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE	$53.06	$97.00	$2.70–$92.15	28% above	45%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE NON-AUTO	$14.23	$26.00	$20.80–$24.70	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE	$53.06	$97.00	$77.60–$92.15	—	45%
Sodium blood test CPT 84295 SODIUM SERUM	$63.18	$115.50	$4.81–$109.73	155% above	45%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$63.18	$115.50	$92.40–$109.73	—	45%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY IGG	$35.29	$64.50	$13.24–$74.48	36% below	45%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS IGG AB	$69.47	$127.00	$13.24–$120.65	26% above	45%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY IGG	$35.29	$64.50	$51.60–$61.28	—	45%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS IGG AB	$69.47	$127.00	$101.60–$120.65	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$61.00	$111.50	$4.27–$105.93	54% above	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$61.00	$111.50	$89.20–$105.93	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$209.23	$382.50	$61.98–$363.38	17% below	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$209.23	$382.50	$306.00–$363.38	—	45%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$85.06	$155.50	$25.81–$147.73	26% below	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$85.06	$155.50	$124.40–$147.73	—	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE ANTIBODY	$51.42	$94.00	$14.55–$89.30	27% below	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB S	$84.24	$154.00	$14.55–$146.30	20% above	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE ANTIBODY	$51.42	$94.00	$75.20–$89.30	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB S	$84.24	$154.00	$123.20–$146.30	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH ULTRA SENSITIVE	$75.49	$138.00	$16.80–$131.10	16% below	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$147.42	$269.50	$16.80–$256.03	64% above	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH ULTRA SENSITIVE	$75.49	$138.00	$110.40–$131.10	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$147.42	$269.50	$215.60–$256.03	—	45%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$154.26	$282.00	$16.46–$267.90	51% above	45%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$154.26	$282.00	$225.60–$267.90	—	45%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$64.28	$117.50	$4.35–$111.63	39% above	45%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$64.28	$117.50	$94.00–$111.63	—	45%
Total thyroxine (T4) blood test CPT 84436 T4 - TOTAL - PLASMA	$80.69	$147.50	$6.87–$140.13	55% above	45%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 - TOTAL - PLASMA	$80.69	$147.50	$118.00–$140.13	—	45%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$128.28	$234.50	$14.18–$222.78	20% above	45%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$128.28	$234.50	$187.60–$222.78	—	45%
Transferrin blood test CPT 84466 TRANSFERRIN	$126.91	$232.00	$12.76–$220.40	34% above	45%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$126.91	$232.00	$185.60–$220.40	—	45%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$66.74	$122.00	$5.74–$115.90	24% above	45%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$66.74	$122.00	$97.60–$115.90	—	45%
Troponin test, quantitative CPT 84484 TROPONIN I	$135.39	$247.50	$12.47–$235.13	60% above	45%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$17.51	$32.00	$25.60–$30.40	—	45%
Uric acid blood test CPT 84550 URIC ACID	$76.86	$140.50	$4.52–$133.48	52% above	45%
Uric acid blood test inpatient CPT 84550 URIC ACID	$76.86	$140.50	$112.40–$133.48	—	45%
Urinalysis with microscope exam, automated CPT 81001 URINE COMPLETE	$96.28	$176.00	$3.17–$167.20	167% above	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE COMPLETE	$96.28	$176.00	$140.80–$167.20	—	45%
Urinalysis with microscope exam, manual CPT 81000 KETONES-URINE	$46.77	$85.50	$4.02–$81.23	274% above	45%
Urinalysis with microscope exam, manual inpatient CPT 81000 KETONES-URINE	$46.77	$85.50	$68.40–$81.23	—	45%
Urinalysis without microscope exam, automated CPT 81003 URINE SPECIFIC GRAVITY	$31.46	$57.50	$2.25–$54.63	26% above	45%
Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK	$68.65	$125.50	$2.25–$119.23	175% above	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SPECIFIC GRAVITY	$31.46	$57.50	$46.00–$54.63	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIPSTICK	$68.65	$125.50	$100.40–$119.23	—	45%
Urine microalbumin (albumin) test CPT 82043 UALB MICROALBUMIN URINE	$56.89	$104.00	$5.78–$98.80	12% below	45%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24HR UR REF	$74.12	$135.50	$5.78–$128.73	14% above	45%
Urine microalbumin (albumin) test inpatient CPT 82043 UALB MICROALBUMIN URINE	$56.89	$104.00	$83.20–$98.80	—	45%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24HR UR REF	$74.12	$135.50	$108.40–$128.73	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$135.11	$247.00	$15.08–$234.65	32% above	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$135.11	$247.00	$197.60–$234.65	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 24 HYDROXYVIT D2 AND D3	$92.99	$170.00	$29.60–$166.52	40% below	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 OH	$105.85	$193.50	$29.60–$183.83	32% below	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 24 HYDROXYVIT D2 AND D3	$92.99	$170.00	$136.00–$161.50	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 OH	$105.85	$193.50	$154.80–$183.83	—	45%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DIHYDROXY	$144.41	$264.00	$38.50–$250.80	10% below	45%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25 DIHYDROXY	$144.41	$264.00	$211.20–$250.80	—	45%
Zinc blood test CPT 84630 ZINC SERUM	$84.24	$154.00	$11.39–$146.30	5% above	45%
Zinc blood test CPT 84630 ZINC RBC	$100.93	$184.50	$11.39–$175.28	26% above	45%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$84.24	$154.00	$123.20–$146.30	—	45%
Zinc blood test inpatient CPT 84630 ZINC RBC	$100.93	$184.50	$147.60–$175.28	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B-HCG (QUANT.)	$140.04	$256.00	$15.05–$243.20	19% above	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 B-HCG (QUANT.)	$140.04	$256.00	$204.80–$243.20	—	45%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT NTRBDY CERVICAL	$12,759.33	$23,326.00	$12,423.69–$33,890.57	84% above	45%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRD ANT NTRBDY CERVICAL	$12,759.33	$23,326.00	$18,660.80–$22,159.70	—	45%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY	$2,849.33	$5,209.00	$767.60–$20,649.00	41% below	45%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY	$2,849.33	$5,209.00	$4,167.20–$4,948.55	—	45%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$2,094.74	$3,829.50	$2,680.65–$20,649.00	14% below	45%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$2,094.74	$3,829.50	$3,063.60–$3,638.03	—	45%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY	$6,484.96	$11,855.50	$4,000.05–$18,816.24	45% below	45%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY/SURGERY	$6,484.96	$11,855.50	$9,484.40–$11,262.73	—	45%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR	$7,083.87	$12,950.40	$4,369.46–$18,816.24	34% above	45%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR	$7,083.87	$12,950.40	$10,360.32–$12,302.88	—	45%
Botox injections for chronic migraine CPT 64615 CHEMODENERVATION MUSC MIGRAINE	$382.08	$698.50	$285.02–$5,947.00	48% below	45%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION MUSC MIGRAINE	$382.08	$698.50	$558.80–$663.58	—	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREOTACTIC BREAST BIOPSY LT	$2,329.13	$4,258.00	$1,564.44–$8,800.91	8% below	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREOTACTIC BREAST BIOPSY RT	$2,329.13	$4,258.00	$1,564.44–$8,800.91	8% below	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREOTACTIC BREAST BIOPSY LT	$2,329.13	$4,258.00	$3,406.40–$4,045.10	—	45%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREOTACTIC BREAST BIOPSY RT	$2,329.13	$4,258.00	$3,406.40–$4,045.10	—	45%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX FIBULA DIST NO MANIP	$278.97	$510.00	$231.62–$5,947.00	49% below	45%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$1,534.34	$2,805.00	$231.62–$5,947.00	179% above	45%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX FIBULA DIST NO MANIP	$278.97	$510.00	$408.00–$484.50	—	45%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE	$1,534.34	$2,805.00	$2,244.00–$2,664.75	—	45%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX METATARSAL NO MANIP	$142.50	$260.50	$182.35–$5,947.00	76% below	45%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TRMT FX METATARS WO MANI	$198.29	$362.50	$231.62–$5,947.00	67% below	45%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX METATARSAL NO MANIP	$142.50	$260.50	$208.40–$247.48	—	45%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TRMT FX METATARS WO MANI	$198.29	$362.50	$290.00–$344.38	—	45%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION HALLUX VALGUS	$1,893.45	$3,461.50	$2,423.05–$10,200.00	58% below	45%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION HALLUX VALGUS	$1,893.45	$3,461.50	$2,769.20–$3,288.43	—	45%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION HALLUX VALGUS	$2,090.64	$3,822.00	$2,675.40–$9,415.00	63% below	45%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION HALLUX VALGUS	$2,090.64	$3,822.00	$3,057.60–$3,630.90	—	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION NURSING	$859.34	$1,571.00	$530.06–$1,723.61	13% below	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$900.91	$1,647.00	$555.70–$1,723.61	9% below	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ARRHYTHMIA	$926.90	$1,694.50	$571.72–$1,723.61	6% below	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION NURSING	$859.34	$1,571.00	$1,256.80–$1,492.45	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$900.91	$1,647.00	$1,317.60–$1,564.65	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ARRHYTHMIA	$926.90	$1,694.50	$1,355.60–$1,609.78	—	45%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE M	$2,241.88	$4,098.50	$1,885.52–$9,415.00	1% above	45%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE M	$2,241.88	$4,098.50	$3,278.80–$3,893.58	—	45%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$387.01	$707.50	$495.25–$5,947.00	35% below	45%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$387.01	$707.50	$566.00–$672.13	—	45%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION > 28 DAYS OF AGE	$529.77	$968.50	$677.95–$9,415.00	43% below	45%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION > 28 DAYS OF AGE	$529.77	$968.50	$774.80–$920.08	—	45%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$368.68	$674.00	$471.80–$5,947.00	81% above	45%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION ON NEWBORN	$374.70	$685.00	$479.50–$5,947.00	84% above	45%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$368.68	$674.00	$539.20–$640.30	—	45%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION ON NEWBORN	$374.70	$685.00	$548.00–$650.75	—	45%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA	$269.40	$492.50	$231.62–$5,947.00	56% below	45%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX COLLES NO MANIP	$278.97	$510.00	$231.62–$5,947.00	55% below	45%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 FX COLLES NO MANIP	$278.97	$510.00	$408.00–$484.50	—	45%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA	$1,078.42	$1,971.50	$1,577.20–$1,872.93	—	45%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$1,488.94	$2,722.00	$1,138.47–$9,415.00	39% below	45%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/LESION REMOVAL	$1,488.94	$2,722.00	$2,177.60–$2,585.90	—	45%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$1,323.47	$2,419.50	$1,138.47–$9,415.00	35% below	45%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY	$1,323.47	$2,419.50	$1,935.60–$2,298.53	—	45%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$1,110.69	$2,030.50	$880.31–$9,415.00	36% below	45%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$1,110.69	$2,030.50	$1,624.40–$1,928.98	—	45%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$493.95	$903.00	$293.71–$5,947.00	9% above	45%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$493.95	$903.00	$722.40–$857.85	—	45%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$1,681.21	$3,073.50	$2,151.45–$9,415.00	61% below	45%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY AND TREATMENT	$1,681.21	$3,073.50	$2,458.80–$2,919.83	—	45%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$128.00	$234.00	$163.80–$5,947.00	87% below	45%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$510.90	$934.00	$747.20–$887.30	—	45%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$712.47	$1,302.50	$911.75–$9,415.00	37% below	45%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE	$712.47	$1,302.50	$1,042.00–$1,237.38	—	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST BGN LSN FIRST LSN	$168.21	$307.50	$191.86–$5,947.00	7% below	45%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST BGN LSN FIRST LSN	$168.21	$307.50	$246.00–$292.13	—	45%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED CERUMEN UNIL	$25.17	$46.00	$32.20–$5,947.00	73% below	45%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$33.65	$61.50	$43.05–$5,947.00	64% below	45%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED CERUMEN UNIL	$25.17	$46.00	$36.80–$43.70	—	45%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$33.65	$61.50	$49.20–$58.43	—	45%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACT CERUMEN-INST UNI	$25.17	$46.00	$32.20–$5,947.00	70% below	45%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$107.76	$197.00	$57.35–$5,947.00	29% above	45%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACT CERUMEN-INST UNI	$25.17	$46.00	$36.80–$43.70	—	45%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$107.76	$197.00	$157.60–$187.15	—	45%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$303.32	$554.50	$194.24–$5,947.00	12% above	45%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$303.32	$554.50	$443.60–$526.78	—	45%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL EPI STER INJ W/FLUORO	$769.63	$1,407.00	$668.67–$3,761.67	42% below	45%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 THORACIC EPI STER INJ W/FLUORO	$769.63	$1,407.00	$668.67–$3,761.67	42% below	45%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 THORACIC EPI STER INJ W/FLUORO	$769.63	$1,407.00	$1,125.60–$1,336.65	—	45%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL EPI STER INJ W/FLUORO	$769.63	$1,407.00	$1,125.60–$1,336.65	—	45%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$526.77	$963.00	$674.10–$5,947.00	67% below	45%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ LUMBAR/SACRAL	$605.53	$1,107.00	$774.90–$5,947.00	63% below	45%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT FACET INJ LUMBAR	$706.18	$1,291.00	$859.63–$5,947.00	56% below	45%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$526.77	$963.00	$770.40–$914.85	—	45%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET INJ LUMBAR/SACRAL	$605.53	$1,107.00	$885.60–$1,051.65	—	45%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT FACET INJ LUMBAR	$706.18	$1,291.00	$1,032.80–$1,226.45	—	45%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$1,566.89	$2,864.50	$2,005.15–$16,435.20	76% below	45%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HRN 1ST 3-10 RDC	$1,566.89	$2,864.50	$2,291.60–$2,721.28	—	45%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC	$2,107.32	$3,852.50	$2,696.75–$16,435.20	67% below	45%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HRN 1ST > 10 RDC	$2,107.32	$3,852.50	$3,082.00–$3,659.88	—	45%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$935.92	$1,711.00	$1,197.70–$15,230.00	56% below	45%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$935.92	$1,711.00	$1,368.80–$1,625.45	—	45%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEX DIAGNOSTIC	$332.31	$607.50	$204.97–$2,401.40	61% below	45%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX DIAGNOSTIC	$332.31	$607.50	$486.00–$577.13	—	45%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY CHOLECYSTECTOMY	$2,150.54	$3,931.50	$2,752.05–$28,651.00	77% below	45%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY CHOLECYSTECTOMY	$2,150.54	$3,931.50	$3,145.20–$3,734.93	—	45%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$2,335.15	$4,269.00	$2,988.30–$28,651.00	75% below	45%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$2,335.15	$4,269.00	$3,415.20–$4,055.55	—	45%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$3,487.13	$6,375.00	$940.00–$15,411.00	24% above	45%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY	$3,487.13	$6,375.00	$5,100.00–$6,056.25	—	45%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$1,407.98	$2,574.00	$1,801.80–$10,200.00	48% below	45%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$1,407.98	$2,574.00	$2,059.20–$2,445.30	—	45%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$152.07	$278.00	$194.60–$5,947.00	88% below	45%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$152.07	$278.00	$222.40–$264.10	—	45%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTRNL & EXT	$1,129.29	$2,064.50	$1,445.15–$10,200.00	67% below	45%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTRNL & EXT	$1,129.29	$2,064.50	$1,651.60–$1,961.28	—	45%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVER PREV SURG TO REPLCMT	$11,112.58	$20,315.50	$1,494.43–$28,500.00	36% above	45%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONVER PREV SURG TO REPLCMT	$11,112.58	$20,315.50	$16,252.40–$19,299.73	—	45%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY	$3,297.59	$6,028.50	$915.69–$20,649.00	13% below	45%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY	$3,297.59	$6,028.50	$4,822.80–$5,727.08	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HSG CATH AND INTR-SAL/CONTRAST	$347.35	$635.00	$214.26–$1,205.32	3% above	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HSG CATH AND INTR-SAL/CONTRAST	$347.35	$635.00	$508.00–$603.25	—	45%
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD	$263.39	$481.50	$99.99–$5,947.00	13% below	45%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD	$263.39	$481.50	$385.20–$457.43	—	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$51.15	$93.50	$65.45–$5,947.00	82% below	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$64.28	$117.50	$82.25–$5,947.00	78% below	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$64.28	$117.50	$94.00–$111.63	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$204.31	$373.50	$298.80–$354.83	—	45%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$1,421.66	$2,599.00	$1,819.30–$12,606.00	77% below	45%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5 YR	$1,421.66	$2,599.00	$2,079.20–$2,469.05	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$183.80	$336.00	$235.20–$5,947.00	46% below	45%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 US TENDON SHEATH/LIGAMENT INJ	$569.16	$1,040.50	$285.02–$5,947.00	67% above	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$46.23	$84.50	$67.60–$80.28	—	45%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 US TENDON SHEATH/LIGAMENT INJ	$569.16	$1,040.50	$832.40–$988.48	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$190.09	$347.50	$243.25–$5,947.00	56% below	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT ASPIRATION MAJOR JNT LT	$296.48	$542.00	$285.02–$5,947.00	32% below	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECT ASPIRATION MAJOR JNT RT	$296.48	$542.00	$285.02–$5,947.00	32% below	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 CT MAJOR JOINT INJ LEFT	$628.78	$1,149.50	$285.02–$5,947.00	45% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 CT MAJOR JOINT INJ RIGHT	$628.78	$1,149.50	$285.02–$5,947.00	45% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT ASPIRATION MAJOR JNT RT	$296.48	$542.00	$433.60–$514.90	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECT ASPIRATION MAJOR JNT LT	$296.48	$542.00	$433.60–$514.90	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 CT MAJOR JOINT INJ RIGHT	$628.78	$1,149.50	$919.60–$1,092.03	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 CT MAJOR JOINT INJ LEFT	$628.78	$1,149.50	$919.60–$1,092.03	—	45%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NON-BIODEG DRUG IMPLANT	$376.34	$688.00	$124.46–$10,200.00	43% above	45%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT NON-BIODEG DRUG IMPLANT	$376.34	$688.00	$550.40–$653.60	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT INTERMEDIATE JOINT RT	$306.87	$561.00	$285.02–$5,947.00	4% below	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECT INTERMEDIATE JOINT LT	$306.87	$561.00	$285.02–$5,947.00	4% below	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECTION INTERM JOINT RT	$345.98	$632.50	$285.02–$5,947.00	8% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJECTION INTERM JOINT LT	$345.98	$632.50	$285.02–$5,947.00	8% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$124.72	$228.00	$182.40–$216.60	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT INTERMEDIATE JOINT RT	$306.87	$561.00	$448.80–$532.95	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECT INTERMEDIATE JOINT LT	$306.87	$561.00	$448.80–$532.95	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECTION INTERM JOINT LT	$345.98	$632.50	$506.00–$600.88	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJECTION INTERM JOINT RT	$345.98	$632.50	$506.00–$600.88	—	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$142.77	$261.00	$182.70–$5,947.00	62% below	45%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR SMALL JOINT BURSA INJECT LT	$234.39	$428.50	$285.02–$5,947.00	37% below	45%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR SMALL JOINT BURSA INJECT RT	$234.39	$428.50	$285.02–$5,947.00	37% below	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$114.33	$209.00	$167.20–$198.55	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 XR SMALL JOINT BURSA INJECT LT	$234.39	$428.50	$342.80–$407.08	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 XR SMALL JOINT BURSA INJECT RT	$234.39	$428.50	$342.80–$407.08	—	45%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY	$4,516.86	$8,257.50	$2,786.08–$8,546.14	35% below	45%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE ARTHROSCOPY/SURGERY	$4,516.86	$8,257.50	$6,606.00–$7,844.63	—	45%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$4,177.66	$7,637.40	$2,576.86–$8,546.14	16% below	45%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY/SURGERY	$4,177.66	$7,637.40	$6,109.92–$7,255.53	—	45%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$4,471.73	$8,175.00	$2,758.25–$8,546.14	19% below	45%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY	$4,471.73	$8,175.00	$6,540.00–$7,766.25	—	45%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCOPY KNEE DEBRIDE/SHAVE	$4,012.91	$7,336.20	$2,475.23–$8,546.14	30% above	45%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCOPY KNEE DEBRIDE/SHAVE	$4,012.91	$7,336.20	$5,868.96–$6,969.39	—	45%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$1,638.82	$2,996.00	$2,097.20–$28,651.00	64% below	45%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$1,638.82	$2,996.00	$2,396.80–$2,846.20	—	45%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY	$3,530.34	$6,454.00	$4,517.80–$28,651.00	29% above	45%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY FUNDOPLASTY	$3,530.34	$6,454.00	$5,163.20–$6,131.30	—	45%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$1,171.68	$2,142.00	$1,499.40–$28,651.00	57% below	45%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT	$1,171.68	$2,142.00	$1,713.60–$2,034.90	—	45%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$1,525.04	$2,788.00	$1,951.60–$28,651.00	79% below	45%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR	$1,525.04	$2,788.00	$2,230.40–$2,648.60	—	45%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$1,768.46	$3,233.00	$2,263.10–$28,651.00	28% below	45%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$1,768.46	$3,233.00	$2,586.40–$3,071.35	—	45%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY	$3,519.95	$6,435.00	$950.86–$28,651.00	59% below	45%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP SLEEVE GASTRECTOMY	$3,519.95	$6,435.00	$5,148.00–$6,113.25	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAY T S 2.5 CM	$142.50	$260.50	$182.35–$5,947.00	73% below	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$478.36	$874.50	$385.77–$5,947.00	9% below	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$95.73	$175.00	$140.00–$166.25	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAY T S 2.5 CM	$142.50	$260.50	$208.40–$247.48	—	45%
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR EPI STER INJ W/FLUORO	$908.02	$1,660.00	$668.67–$3,761.67	21% below	45%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR EPI STER INJ W/FLUORO	$908.02	$1,660.00	$1,328.00–$1,577.00	—	45%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$836.09	$1,528.50	$859.63–$5,947.00	1% above	45%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$836.09	$1,528.50	$1,222.80–$1,452.08	—	45%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$629.60	$1,151.00	$805.70–$5,947.00	41% below	45%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFORMINAL LUMB SINGLE	$1,805.93	$3,301.50	$859.63–$5,947.00	69% above	45%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT LUMBAR NERVE ROOT INJ	$2,106.23	$3,850.50	$859.63–$5,947.00	97% above	45%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$629.60	$1,151.00	$920.80–$1,093.45	—	45%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSFORMINAL LUMB SINGLE	$1,805.93	$3,301.50	$2,641.20–$3,136.43	—	45%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT LUMBAR NERVE ROOT INJ	$2,106.23	$3,850.50	$3,080.40–$3,657.98	—	45%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY 1 LEVEL LUMBAR	$6,268.62	$11,460.00	$6,897.70–$18,816.24	60% below	45%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY 1 LEVEL LUMBAR	$6,268.62	$11,460.00	$9,168.00–$10,887.00	—	45%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRD CMBN 1NTRSPC LUMBAR	$13,668.99	$24,989.00	$17,492.30–$48,438.49	209% above	45%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRD CMBN 1NTRSPC LUMBAR	$13,668.99	$24,989.00	$19,991.20–$23,739.55	—	45%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHROD POST INTRBDY SNGL LUMB	$10,077.39	$18,423.00	$12,896.10–$48,438.49	37% above	45%
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630 ARTHROD POST INTRBDY SNGL LUMB	$10,077.39	$18,423.00	$14,738.40–$17,501.85	—	45%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETEC & FORAMOT LUMBAR	$7,160.78	$13,091.00	$6,897.70–$18,816.24	41% below	45%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAM FACETEC & FORAMOT LUMBAR	$7,160.78	$13,091.00	$10,472.80–$12,436.45	—	45%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POST SNGL LEV LUM	$10,473.41	$19,147.00	$13,402.90–$48,438.49	38% above	45%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POST SNGL LEV LUM	$10,473.41	$19,147.00	$15,317.60–$18,189.65	—	45%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$2,126.19	$3,887.00	$2,720.90–$10,200.00	33% below	45%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$2,126.19	$3,887.00	$3,109.60–$3,692.65	—	45%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,291.19	$6,016.80	$4,211.76–$17,177.21	54% below	45%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,291.19	$6,016.80	$4,813.44–$5,715.96	—	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LSN 0.5 CM	$64.28	$117.50	$82.25–$5,947.00	82% below	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$302.22	$552.50	$386.75–$5,947.00	13% below	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LSN 0.5 CM	$64.28	$117.50	$94.00–$111.63	—	45%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$241.51	$441.50	$353.20–$419.43	—	45%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LSN 0.5 CM	$64.28	$117.50	$82.25–$5,947.00	88% below	45%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BGN LSN FACE .5 CM AND <	$355.01	$649.00	$454.30–$5,947.00	31% below	45%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LSN 0.5 CM	$64.28	$117.50	$94.00–$111.63	—	45%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BGN LSN FACE .5 CM AND <	$71.11	$130.00	$104.00–$123.50	—	45%
Nail removal (partial or complete), one nail CPT 11730 NAIL AVUL SIMP EACH	$64.28	$117.50	$82.25–$5,947.00	73% below	45%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE	$186.81	$341.50	$191.86–$5,947.00	21% below	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE	$46.77	$85.50	$68.40–$81.23	—	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL AVUL SIMP EACH	$64.28	$117.50	$94.00–$111.63	—	45%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK OF OCCIPITAL NERVE	$88.89	$162.50	$113.75–$5,947.00	81% below	45%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$303.32	$554.50	$285.02–$5,947.00	34% below	45%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLOCK OF OCCIPITAL NERVE	$88.89	$162.50	$130.00–$154.38	—	45%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$303.32	$554.50	$443.60–$526.78	—	45%
Paracentesis with imaging guidance CPT 49083 ABDL PARACENTESIS W/ IMAGING	$171.22	$313.00	$219.10–$9,415.00	87% below	45%
Paracentesis with imaging guidance CPT 49083 US ABDOMIN PARACENT W/GUID	$771.00	$1,409.50	$905.27–$9,415.00	40% below	45%
Paracentesis with imaging guidance CPT 49083 CT ABDOMIN PARACENTESIS W/GUID	$796.71	$1,456.50	$905.27–$9,415.00	38% below	45%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,057.36	$1,933.00	$905.27–$9,415.00	18% below	45%
Paracentesis with imaging guidance inpatient CPT 49083 ABDL PARACENTESIS W/ IMAGING	$171.22	$313.00	$250.40–$297.35	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 US ABDOMIN PARACENT W/GUID	$771.00	$1,409.50	$1,127.60–$1,339.03	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 CT ABDOMIN PARACENTESIS W/GUID	$796.71	$1,456.50	$1,165.20–$1,383.68	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,057.36	$1,933.00	$1,546.40–$1,836.35	—	45%
Partial knee replacement (one compartment) CPT 27446 ARTHROP KNEE COND&PLAT MED/LAT	$7,296.44	$13,339.00	$9,337.30–$33,890.57	30% above	45%
Partial knee replacement (one compartment) inpatient CPT 27446 ARTHROP KNEE COND&PLAT MED/LAT	$7,296.44	$13,339.00	$10,671.20–$12,672.05	—	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION	$189.54	$346.50	$242.55–$5,947.00	42% below	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCIS NAIL & MATRIX PERM REMOV	$461.40	$843.50	$385.77–$5,947.00	41% above	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION	$189.54	$346.50	$277.20–$329.18	—	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCIS NAIL & MATRIX PERM REMOV	$461.40	$843.50	$674.80–$801.33	—	45%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$454.29	$830.50	$581.35–$9,415.00	70% below	45%
Prostate biopsy CPT 55700 BIOPSY PROSTATE	$1,071.85	$1,959.50	$1,300.00–$9,415.00	30% below	45%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE	$454.29	$830.50	$664.40–$788.98	—	45%
Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE	$1,071.85	$1,959.50	$1,567.60–$1,861.53	—	45%
Removal of a breast lump, open surgery CPT 19120 EXC BREAST CYST ONE OR > LSN	$1,112.06	$2,033.00	$1,423.10–$10,200.00	44% below	45%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST CYST ONE OR > LSN	$222.63	$407.00	$325.60–$386.65	—	45%
Removal of a foreign object under the skin, simple CPT 10120 FB REM SIMPLE SUBQ	$64.28	$117.50	$82.25–$5,947.00	81% below	45%
Removal of a foreign object under the skin, simple CPT 10120 INCIS & REMOV FB SUBCUT SIMPLE	$231.39	$423.00	$296.10–$5,947.00	31% below	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REM SIMPLE SUBQ	$64.28	$117.50	$94.00–$111.63	—	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS & REMOV FB SUBCUT SIMPLE	$231.39	$423.00	$338.40–$401.85	—	45%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT	$2,326.67	$4,253.50	$2,977.45–$15,367.42	12% below	45%
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMY UNILAT	$2,326.67	$4,253.50	$3,402.80–$4,040.83	—	45%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCPY SCREEN NOT HI RISK	$1,110.69	$2,030.50	$880.31–$9,415.00	42% below	45%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCPY SCREEN NOT HI RISK	$1,110.69	$2,030.50	$1,624.40–$1,928.98	—	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREEN HIGH RISK	$1,110.69	$2,030.50	$880.31–$9,415.00	41% below	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREEN HIGH RISK	$1,110.69	$2,030.50	$1,624.40–$1,928.98	—	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$1,884.15	$3,444.50	$2,411.15–$15,230.00	80% below	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE	$1,884.15	$3,444.50	$2,755.60–$3,272.28	—	45%
Short arm cast (elbow to hand) CPT 29075 APPLIC CAST ELBOW TO FINGER	$173.95	$318.00	$222.60–$5,947.00	31% below	45%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLIC CAST ELBOW TO FINGER	$43.49	$79.50	$63.60–$75.53	—	45%
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM STATIC	$25.17	$46.00	$32.20–$5,947.00	86% below	45%
Short arm splint (forearm and hand) CPT 29125 APPLIC SPLINT FOREARM TO HAND	$171.76	$314.00	$124.46–$5,947.00	2% below	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM STATIC	$25.17	$46.00	$36.80–$43.70	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLIC SPLINT FOREARM TO HAND	$171.76	$314.00	$251.20–$298.30	—	45%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$44.86	$82.00	$57.40–$5,947.00	81% below	45%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$224.27	$410.00	$328.00–$389.50	—	45%
Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG REPLACE	$25.17	$46.00	$32.20–$5,947.00	88% below	45%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$34.74	$63.50	$44.45–$5,947.00	83% below	45%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG REPLACE	$25.17	$46.00	$36.80–$43.70	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$172.58	$315.50	$252.40–$299.73	—	45%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHRO SHLDR DIS CLAVE MUMFORD	$4,368.35	$7,986.00	$2,694.48–$8,546.14	30% above	45%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHRO SHLDR DIS CLAVE MUMFORD	$4,368.35	$7,986.00	$6,388.80–$7,586.70	—	45%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$4,344.06	$7,941.60	$151.65–$7,544.52	99% above	45%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$4,344.06	$7,941.60	$6,353.28–$7,544.52	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR WND NON FACE SMPL 2.5CM	$318.63	$582.50	$191.86–$5,947.00	2% below	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR WND NON FACE SMPL 2.5CM	$79.59	$145.50	$116.40–$138.23	—	45%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LSN	$64.55	$118.00	$82.60–$5,947.00	73% below	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LSN	$258.74	$473.00	$378.40–$449.35	—	45%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$419.55	$767.00	$536.90–$5,947.00	14% above	45%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$419.55	$767.00	$613.60–$728.65	—	45%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS 1-15	$25.17	$46.00	$32.20–$5,947.00	82% below	45%
Skin tag removal, up to 15 tags CPT 11200 REMOV SKIN TAGS UP TO 15 LSNS	$156.17	$285.50	$191.86–$5,947.00	10% above	45%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS 1-15	$25.17	$46.00	$36.80–$43.70	—	45%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOV SKIN TAGS UP TO 15 LSNS	$38.84	$71.00	$56.80–$67.45	—	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$394.39	$721.00	$504.70–$5,947.00	35% below	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$395.21	$722.50	$505.75–$3,761.67	35% below	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$441.71	$807.50	$565.25–$5,947.00	27% below	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$394.39	$721.00	$576.80–$684.95	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$395.21	$722.50	$578.00–$686.38	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$441.71	$807.50	$646.00–$767.13	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE 2.6-7.5	$64.28	$117.50	$82.25–$5,947.00	68% below	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$423.38	$774.00	$191.86–$5,947.00	110% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE 2.6-7.5	$64.28	$117.50	$94.00–$111.63	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$423.38	$774.00	$619.20–$735.30	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC FACE 2.5 CM	$64.28	$117.50	$82.25–$5,947.00	79% below	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$421.74	$771.00	$191.86–$5,947.00	36% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC FACE 2.5 CM	$64.28	$117.50	$94.00–$111.63	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$421.74	$771.00	$616.80–$732.45	—	45%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$2,676.20	$4,892.50	$3,424.75–$13,390.01	49% below	45%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PROSTATECTOMY (TURP)	$2,676.20	$4,892.50	$3,914.00–$4,647.88	—	45%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN	$257.37	$470.50	$191.86–$5,947.00	7% above	45%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN	$257.37	$470.50	$376.40–$446.98	—	45%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGING GUIDE	$142.50	$260.50	$182.35–$5,947.00	88% below	45%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS OF PLEU CAV	$620.58	$1,134.50	$596.97–$5,947.00	48% below	45%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$755.69	$1,381.50	$596.97–$5,947.00	37% below	45%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W IMAGING GUIDE	$142.50	$260.50	$208.40–$247.48	—	45%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS OF PLEU CAV	$620.58	$1,134.50	$907.60–$1,077.78	—	45%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$755.69	$1,381.50	$1,105.20–$1,312.43	—	45%
Total hip replacement CPT 27130 ARTHR/ ACETAB & PROX FEMORAL	$9,505.77	$17,378.00	$12,164.60–$33,890.57	162% above	45%
Total hip replacement inpatient CPT 27130 ARTHR/ ACETAB & PROX FEMORAL	$9,505.77	$17,378.00	$13,902.40–$16,509.10	—	45%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$10,166.82	$18,586.50	$12,423.69–$33,890.57	62% above	45%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$10,166.82	$18,586.50	$14,869.20–$17,657.18	—	45%
Total shoulder replacement CPT 23472 REVERSE TOTAL SHOULDER	$4,778.32	$8,735.50	$6,114.85–$48,438.49	21% below	45%
Total shoulder replacement inpatient CPT 23472 REVERSE TOTAL SHOULDER	$4,778.32	$8,735.50	$6,988.40–$8,298.73	—	45%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL/COMPLETE	$3,020.81	$5,522.50	$3,865.75–$20,649.00	11% below	45%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL/COMPLETE	$3,020.81	$5,522.50	$4,418.00–$5,246.38	—	45%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$1,580.83	$2,890.00	$1,545.29–$9,415.00	5% above	45%
Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH	$1,580.83	$2,890.00	$2,312.00–$2,745.50	—	45%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$40.76	$74.50	$52.15–$5,947.00	89% below	45%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINTS 1 OR 2 MUSC	$483.28	$883.50	$285.02–$5,947.00	36% above	45%
Trigger point injections, 1 or 2 muscles CPT 20552 US TRIGGER POINTS INJ	$545.64	$997.50	$285.02–$5,947.00	54% above	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$163.83	$299.50	$239.60–$284.53	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINTS 1 OR 2 MUSC	$483.28	$883.50	$706.80–$839.33	—	45%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 US TRIGGER POINTS INJ	$545.64	$997.50	$798.00–$947.63	—	45%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$1,009.22	$1,845.00	$1,291.50–$28,651.00	28% below	45%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$1,009.22	$1,845.00	$1,476.00–$1,752.75	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US PERQ BRST BX NDL CORE RT	$1,986.71	$3,632.00	$1,300.00–$9,415.00	2% below	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US PERQ BRST BX NDL CORE LT	$1,986.71	$3,632.00	$1,300.00–$9,415.00	2% below	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US PERQ BRST BX NDL CORE LT	$1,986.71	$3,632.00	$2,905.60–$3,450.40	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US PERQ BRST BX NDL CORE RT	$1,986.71	$3,632.00	$2,905.60–$3,450.40	—	45%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$563.96	$1,031.00	$721.70–$9,415.00	79% below	45%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30 MM	$563.96	$1,031.00	$824.80–$979.45	—	45%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$973.12	$1,779.00	$905.27–$9,415.00	38% below	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$973.12	$1,779.00	$1,423.20–$1,690.05	—	45%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W DIRECT SUBMUCOSAL INJECT	$1,080.88	$1,976.00	$905.27–$9,415.00	29% below	45%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W DIRECT SUBMUCOSAL INJECT	$1,080.88	$1,976.00	$1,580.80–$1,877.20	—	45%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH POLYP SNARE TECHNIQUE	$599.52	$1,096.00	$767.20–$9,415.00	73% below	45%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD WITH POLYP SNARE TECHNIQUE	$599.52	$1,096.00	$876.80–$1,041.20	—	45%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$915.96	$1,674.50	$905.27–$9,415.00	51% below	45%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION	$915.96	$1,674.50	$1,339.60–$1,590.78	—	45%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY DIAGNOSTIC	$843.21	$1,541.50	$905.27–$5,947.00	43% below	45%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY DIAGNOSTIC	$843.21	$1,541.50	$1,233.20–$1,464.43	—	45%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$1,244.98	$2,276.00	$1,593.20–$13,390.01	57% below	45%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$1,244.98	$2,276.00	$1,820.80–$2,162.20	—	45%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$1,319.92	$2,413.00	$1,689.10–$13,390.01	37% below	45%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$1,319.92	$2,413.00	$1,930.40–$2,292.35	—	45%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY	$5,661.45	$10,350.00	$2,177.41–$20,649.00	10% above	45%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY	$5,661.45	$10,350.00	$8,280.00–$9,832.50	—	45%
Vaginal delivery, including prenatal and postpartum care CPT 59400 ROUTINE OBSTETRIC CARE	$5,362.25	$9,803.00	$2,101.95–$20,649.00	—	45%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ROUTINE OBSTETRIC CARE	$5,362.25	$9,803.00	$7,842.40–$9,312.85	—	45%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$1,244.98	$2,276.00	$1,593.20–$9,415.00	21% below	45%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S)	$311.25	$569.00	$455.20–$540.55	—	45%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-4	$203.76	$372.50	$191.86–$5,947.00	4% above	45%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 5-9	$244.79	$447.50	$191.86–$5,947.00	24% above	45%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 10-14	$316.99	$579.50	$191.86–$5,947.00	61% above	45%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-4	$203.76	$372.50	$298.00–$353.88	—	45%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 5-9	$244.79	$447.50	$358.00–$425.13	—	45%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 10-14	$316.99	$579.50	$463.60–$550.53	—	45%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN SUBCU 1ST 20 CM	$80.69	$147.50	$103.25–$9,415.00	85% below	45%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN SUBCU 1ST 20 CM	$64.28	$117.50	$94.00–$111.63	—	45%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$3,877.96	$7,089.50	$4,962.65–$18,816.24	57% below	45%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$3,877.96	$7,089.50	$5,671.60–$6,735.03	—	45%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD PRODUCT TRANSFUSION	$262.84	$480.50	$336.35–$5,947.00	55% below	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD PRODUCT TRANSFUSION	$359.66	$657.50	$526.00–$624.63	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI ADMINISTRATION	$38.57	$70.50	$23.79–$535.72	55% below	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED/ADD'L TX	$59.90	$109.50	$36.95–$535.72	31% below	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER	$62.09	$113.50	$38.29–$535.72	28% below	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED 1ST TX	$74.12	$135.50	$45.72–$535.72	14% below	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED ADD'L TX	$182.98	$334.50	$112.86–$535.72	112% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI ADMINISTRATION	$38.57	$70.50	$56.40–$66.98	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL MED/ADD'L TX	$59.90	$109.50	$87.60–$104.03	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER	$62.09	$113.50	$90.80–$107.83	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL MED 1ST TX	$74.12	$135.50	$108.40–$128.73	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL MED ADD'L TX	$182.98	$334.50	$267.60–$317.78	—	45%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE AUDIOMETRY	$210.33	$384.50	$129.73–$412.11	36% above	45%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHENSIVE AUDIOMETRY	$210.33	$384.50	$307.60–$365.28	—	45%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MINUTES	$669.53	$1,224.00	$412.98–$2,219.39	63% below	45%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN	$2,606.46	$4,765.00	$813.59–$13,950.00	46% above	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MINUTES	$669.53	$1,224.00	$979.20–$1,162.80	—	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MIN	$2,606.46	$4,765.00	$3,812.00–$4,526.75	—	45%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG W INTERP & REPORT	$109.13	$199.50	$13.14–$189.53	62% above	45%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG W INTERP & REPORT	$109.13	$199.50	$159.60–$189.53	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$66.74	$122.00	$41.16–$156.46	55% below	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ### EKG TRACING ONLY	$66.74	$122.00	$41.16–$156.46	55% below	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE	$154.26	$282.00	$57.35–$267.90	5% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ### EKG TRACING ONLY	$66.74	$122.00	$97.60–$115.90	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY	$66.74	$122.00	$97.60–$115.90	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG ROUTINE	$154.26	$282.00	$225.60–$267.90	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL I PROFESSIONAL	$145.78	$266.50	$85.02–$253.18	22% below	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL I FACILITY	$314.53	$575.00	$85.02–$1,000.00	68% above	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL I PROFESSIONAL	$145.78	$266.50	$213.20–$253.18	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL I FACILITY	$314.53	$575.00	$460.00–$546.25	—	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II PROFESSIONAL	$231.93	$424.00	$143.06–$417.11	28% below	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II FACILITY	$637.81	$1,166.00	$152.91–$2,200.00	97% above	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL II PROFESSIONAL	$231.93	$424.00	$339.20–$402.80	—	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL II FACILITY	$637.81	$1,166.00	$932.80–$1,107.70	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL III FACILITY	$1,160.74	$2,122.00	$267.35–$7,000.00	96% above	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL III FACILITY	$1,160.74	$2,122.00	$1,697.60–$2,015.90	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL IV FACILITY	$1,958.54	$3,580.50	$411.15–$12,500.00	113% above	45%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL IV FACILITY	$1,958.54	$3,580.50	$2,864.40–$3,401.48	—	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL V FACILITY	$2,933.84	$5,363.50	$591.98–$13,000.00	100% above	45%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL V FACILITY	$2,933.84	$5,363.50	$4,290.80–$5,095.33	—	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 ### STRESS TEST TRACING	$272.41	$498.00	$168.03–$820.21	66% below	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$553.02	$1,011.00	$300.68–$960.45	30% below	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ### STRESS TEST TRACING	$272.41	$498.00	$398.40–$473.10	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$553.02	$1,011.00	$808.80–$960.45	—	45%
Eye exam, returning patient, intermediate CPT 92012 EYE EXAM & TREATMENT	$205.68	$376.00	$124.43–$357.20	115% above	45%
Eye exam, returning patient, intermediate inpatient CPT 92012 EYE EXAM & TREATMENT	$205.68	$376.00	$300.80–$357.20	—	45%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PYSCHOTHER W/PT 50 MIN	$362.12	$662.00	$155.14–$628.90	91% above	45%
Family therapy with the patient, 50 minutes CPT 90847 TH FAM PSYCHOTHER W/PT 50 MIN	$362.12	$662.00	$155.14–$628.90	91% above	45%
Family therapy with the patient, 50 minutes inpatient CPT 90847 TH FAM PSYCHOTHER W/PT 50 MIN	$362.12	$662.00	$529.60–$628.90	—	45%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PYSCHOTHER W/PT 50 MIN	$362.12	$662.00	$529.60–$628.90	—	45%
Family therapy without the patient, 50 minutes CPT 90846 TH FAM PSYCHOTHER WO PT 50 MIN	$347.08	$634.50	$155.14–$602.78	90% above	45%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PYSCHOTHER WO PT 50 MIN	$347.35	$635.00	$155.14–$603.25	90% above	45%
Family therapy without the patient, 50 minutes inpatient CPT 90846 TH FAM PSYCHOTHER WO PT 50 MIN	$347.08	$634.50	$507.60–$602.78	—	45%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PYSCHOTHER WO PT 50 MIN	$347.35	$635.00	$508.00–$603.25	—	45%
Group psychotherapy session CPT 90853 GROUP PYSCHOTHER NOT MULT FAM	$98.74	$180.50	$60.90–$243.64	31% above	45%
Group psychotherapy session CPT 90853 TH GRP PSYCHOTHER NOT MULT FAM	$98.74	$180.50	$60.90–$243.64	31% above	45%
Group psychotherapy session inpatient CPT 90853 TH GRP PSYCHOTHER NOT MULT FAM	$98.74	$180.50	$144.40–$171.48	—	45%
Group psychotherapy session inpatient CPT 90853 GROUP PYSCHOTHER NOT MULT FAM	$98.74	$180.50	$144.40–$171.48	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDR 31-60 MIN	$175.32	$320.50	$108.14–$554.95	39% below	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31-60 MINUTES	$278.43	$509.00	$171.74–$554.95	2% below	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION	$278.43	$509.00	$171.74–$554.95	2% below	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDR 31-60 MIN	$175.32	$320.50	$256.40–$304.48	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31-60 MINUTES	$278.43	$509.00	$407.20–$483.55	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION	$278.43	$509.00	$407.20–$483.55	—	45%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL	$281.44	$514.50	$173.59–$554.95	11% below	45%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION	$281.44	$514.50	$173.59–$554.95	11% below	45%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL 1 HR	$372.51	$681.00	$203.43–$646.95	17% above	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION	$281.44	$514.50	$411.60–$488.78	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL	$283.35	$518.00	$414.40–$492.10	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL 1 HR	$372.51	$681.00	$544.80–$646.95	—	45%
IV push of a medicine, first drug CPT 96374 IV PUSH MEDICATION INITIAL	$65.64	$120.00	$40.49–$554.95	60% below	45%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH INITIAL	$158.09	$289.00	$97.51–$554.95	4% below	45%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH MEDICATION INITIAL	$65.64	$120.00	$96.00–$114.00	—	45%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH INITIAL	$158.09	$289.00	$231.20–$274.55	—	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION MEDICATION	$58.26	$106.50	$35.93–$187.46	28% below	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION MEDICATION	$58.26	$106.50	$85.20–$101.18	—	45%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$586.94	$1,073.00	$155.14–$1,019.35	167% above	45%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 TELEHLTH PSYCHIATRIC DIAG EVAL	$586.94	$1,073.00	$155.14–$1,019.35	167% above	45%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$586.94	$1,073.00	$858.40–$1,019.35	—	45%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 TELEHLTH PSYCHIATRIC DIAG EVAL	$586.94	$1,073.00	$858.40–$1,019.35	—	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15 MIN	$141.95	$259.50	$31.14–$500.00	48% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 30 MIN	$283.62	$518.50	$31.14–$500.00	197% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 45 MIN	$425.02	$777.00	$31.14–$738.15	345% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 60 MIN	$566.70	$1,036.00	$31.14–$984.20	493% above	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15 MIN	$141.95	$259.50	$207.60–$246.53	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 30 MIN	$283.62	$518.50	$414.80–$492.58	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 45 MIN	$425.02	$777.00	$621.60–$738.15	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 60 MIN	$566.70	$1,036.00	$828.80–$984.20	—	45%
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW DETAILED	$61.82	$113.00	$38.13–$281.81	69% below	45%
New patient office visit, about 30 minutes CPT 99203 TELEHEALTH NEW DETAILED	$309.61	$566.00	$103.31–$537.70	57% above	45%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT NEW DETAILED	$247.80	$453.00	$362.40–$430.35	—	45%
New patient office visit, about 30 minutes inpatient CPT 99203 TELEHEALTH NEW DETAILED	$309.61	$566.00	$452.80–$537.70	—	45%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$348.99	$638.00	$155.08–$606.10	55% above	45%
New patient office visit, about 45 minutes CPT 99204 TELEHEALTH NEW COMP MODERATE	$436.24	$797.50	$155.08–$757.63	94% above	45%
New patient office visit, about 45 minutes inpatient CPT 99204 TELEHEALTH NEW COMP MODERATE	$436.24	$797.50	$638.00–$757.63	—	45%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45-59 MIN	$436.24	$797.50	$638.00–$757.63	—	45%
New patient office visit, about 60 minutes CPT 99205 OFFICE VIS NEW COMPREHEN HIGH	$553.02	$1,011.00	$204.46–$960.45	82% above	45%
New patient office visit, about 60 minutes CPT 99205 TELEHEALTH NEW COMP HIGH	$553.02	$1,011.00	$204.46–$960.45	82% above	45%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VIS NEW COMPREHEN HIGH	$553.02	$1,011.00	$808.80–$960.45	—	45%
New patient office visit, about 60 minutes inpatient CPT 99205 TELEHEALTH NEW COMP HIGH	$553.02	$1,011.00	$808.80–$960.45	—	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15-29 MIN	$167.39	$306.00	$66.74–$290.70	28% above	45%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 TELEHEALTH NEW EXPANDED PROB	$209.23	$382.50	$66.74–$363.38	60% above	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 TELEHEALTH NEW EXPANDED PROB	$209.23	$382.50	$306.00–$363.38	—	45%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15-29 MIN	$209.23	$382.50	$306.00–$363.38	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER ASSESS 15 MIN	$39.94	$73.00	$24.63–$105.50	33% below	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$50.88	$93.00	$31.38–$105.50	15% below	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER ASSESS 30 MIN	$79.59	$145.50	$34.59–$138.23	33% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER ASSESS 45 MIN	$119.25	$218.00	$34.59–$207.10	99% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR THER ASSESS 60 MIN	$158.91	$290.50	$34.59–$275.98	165% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER ASSESS 15 MIN	$39.94	$73.00	$58.40–$69.35	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV IN	$50.88	$93.00	$74.40–$88.35	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER ASSESS 30 MIN	$79.59	$145.50	$116.40–$138.23	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER ASSESS 45 MIN	$119.25	$218.00	$174.40–$207.10	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR THER ASSESS 60 MIN	$158.91	$290.50	$232.40–$275.98	—	45%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY	$193.10	$353.00	$97.60–$500.00	4% above	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY	$193.10	$353.00	$282.40–$335.35	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY	$342.97	$627.00	$95.13–$595.65	9% above	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY	$342.97	$627.00	$501.60–$595.65	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY	$182.43	$333.50	$95.13–$500.00	1% below	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY	$182.43	$333.50	$266.80–$316.83	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MEDIUM COMPLEXITY	$249.98	$457.00	$95.13–$500.00	at median	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MEDIUM COMPLEXITY	$249.98	$457.00	$365.60–$434.15	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN	$141.95	$259.50	$26.40–$246.53	47% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 30 MIN	$283.62	$518.50	$26.40–$500.00	193% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 45 MIN	$425.02	$777.00	$26.40–$738.15	339% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 60 MIN	$566.70	$1,036.00	$26.40–$984.20	485% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN	$141.95	$259.50	$207.60–$246.53	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 30 MIN	$283.62	$518.50	$414.80–$492.58	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 45 MIN	$425.02	$777.00	$621.60–$738.15	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 60 MIN	$566.70	$1,036.00	$828.80–$984.20	—	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERPEUTIC EXERICISE PER 15MIN	$121.17	$221.50	$27.97–$210.43	25% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 15 MIN	$121.17	$221.50	$27.97–$500.00	25% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 30 MIN	$220.17	$402.50	$27.97–$500.00	127% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 45 MIN	$363.21	$664.00	$27.97–$630.80	275% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE 60 MIN	$440.07	$804.50	$27.97–$764.28	354% above	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 15 MIN	$110.23	$201.50	$161.20–$191.43	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERPEUTIC EXERICISE PER 15MIN	$121.17	$221.50	$177.20–$210.43	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 30 MIN	$242.33	$443.00	$354.40–$420.85	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 45 MIN	$363.21	$664.00	$531.20–$630.80	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE 60 MIN	$484.37	$885.50	$708.40–$841.23	—	45%
Preventive checkup, new patient aged 18–39 CPT 99385 # PREV HLTH VIS NEW PTNT 18-39	$169.03	$309.00	$104.26–$368.35	21% above	45%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV HLTH VISIT NEW PTNT 18-39	$377.98	$691.00	$120.77–$656.45	171% above	45%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 # PREV HLTH VIS NEW PTNT 18-39	$68.93	$126.00	$100.80–$119.70	—	45%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV HLTH VISIT NEW PTNT 18-39	$377.98	$691.00	$552.80–$656.45	—	45%
Preventive checkup, new patient aged 40–64 CPT 99386 # PREV HLTH VIS NEW PTNT 40-64	$134.57	$246.00	$83.00–$424.53	11% below	45%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV HLTH VISIT NEW PTNT 40-64	$443.62	$811.00	$139.19–$770.45	194% above	45%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 # PREV HLTH VIS NEW PTNT 40-64	$134.57	$246.00	$196.80–$233.70	—	45%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV HLTH VISIT NEW PTNT 40-64	$443.62	$811.00	$648.80–$770.45	—	45%
Preventive checkup, new patient aged 65 or older CPT 99387 # PREV HLTH VIS NEW PTNT >65	$271.04	$495.50	$151.30–$470.73	52% above	45%
Preventive checkup, new patient aged 65 or older CPT 99387 PREV HLTH VISIT NEW PTNT >65	$479.72	$877.00	$151.30–$833.15	169% above	45%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 # PREV HLTH VIS NEW PTNT >65	$271.04	$495.50	$396.40–$470.73	—	45%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREV HLTH VISIT NEW PTNT >65	$479.72	$877.00	$701.60–$833.15	—	45%
Preventive checkup, returning patient aged 18–39 CPT 99395 # PREV HLTH VIS EST PTNT 18-39	$138.48	$253.15	$85.41–$332.36	11% below	45%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV HLTH VIS EST PTNT 18-39	$309.61	$566.00	$108.97–$537.70	99% above	45%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 # PREV HLTH VIS EST PTNT 18-39	$45.13	$82.50	$66.00–$78.38	—	45%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV HLTH VIS EST PTNT 18-39	$309.61	$566.00	$452.80–$537.70	—	45%
Preventive checkup, returning patient aged 40–64 CPT 99396 # PREV HLTH VIS EST PTNT 40-64	$170.67	$312.00	$105.27–$353.13	1% above	45%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV HLTH VIS EST PTNT 40-64	$342.15	$625.50	$115.78–$594.23	103% above	45%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 # PREV HLTH VIS EST PTNT 40-64	$219.08	$400.50	$320.40–$380.48	—	45%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV HLTH VIS EST PTNT 40-64	$342.15	$625.50	$500.40–$594.23	—	45%
Preventive checkup, returning patient aged 65 or older CPT 99397 # PREV HLTH VISIT EST PTNT >65	$205.40	$375.50	$124.90–$380.95	38% above	45%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV HLTH VISIT ESTAB PTNT >65	$376.34	$688.00	$124.90–$653.60	152% above	45%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 # PREV HLTH VISIT EST PTNT >65	$253.81	$464.00	$371.20–$440.80	—	45%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV HLTH VISIT ESTAB PTNT >65	$376.34	$688.00	$550.40–$653.60	—	45%
Psychotherapy for crisis, first 60 minutes CPT 90839 TH CRISIS PSYCHOTH FIRST 60MIN	$522.12	$954.50	$155.14–$906.78	77% above	45%
Psychotherapy for crisis, first 60 minutes CPT 90839 CRISIS PSYCHOTHER FIRST 60 MIN	$522.12	$954.50	$155.14–$906.78	77% above	45%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 TH CRISIS PSYCHOTH FIRST 60MIN	$522.12	$954.50	$763.60–$906.78	—	45%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 CRISIS PSYCHOTHER FIRST 60 MIN	$522.12	$954.50	$763.60–$906.78	—	45%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN W/PT	$277.61	$507.50	$155.14–$482.13	161% above	45%
Psychotherapy session, 30 minutes CPT 90832 TELEHLTH PSYCHOTHER 30MIN W/PT	$277.61	$507.50	$155.14–$482.13	161% above	45%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN W/PT	$277.61	$507.50	$406.00–$482.13	—	45%
Psychotherapy session, 30 minutes inpatient CPT 90832 TELEHLTH PSYCHOTHER 30MIN W/PT	$277.61	$507.50	$406.00–$482.13	—	45%
Psychotherapy session, 45 minutes CPT 90834 TELEHLTH PSYCHOTHER 45MIN W/PT	$366.22	$669.50	$155.14–$636.03	159% above	45%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN W/PT	$366.22	$669.50	$155.14–$636.03	159% above	45%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN W/PT	$366.22	$669.50	$535.60–$636.03	—	45%
Psychotherapy session, 45 minutes inpatient CPT 90834 TELEHLTH PSYCHOTHER 45MIN W/PT	$366.22	$669.50	$535.60–$636.03	—	45%
Psychotherapy session, 60 minutes CPT 90837 TELEHLTH PSYCHOTHER 60MIN W/PT	$542.63	$992.00	$155.14–$942.40	155% above	45%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN W/PT	$542.63	$992.00	$155.14–$942.40	155% above	45%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN W/PT	$542.63	$992.00	$793.60–$942.40	—	45%
Psychotherapy session, 60 minutes inpatient CPT 90837 TELEHLTH PSYCHOTHER 60MIN W/PT	$542.63	$992.00	$793.60–$942.40	—	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO COUNS 3-10 MIN	$26.53	$48.50	$16.36–$78.47	8% below	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO CESS 3-10 MIN	$44.31	$81.00	$27.33–$78.47	53% above	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO COUNS 3-10 MIN	$26.53	$48.50	$38.80–$46.08	—	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO CESS 3-10 MIN	$44.31	$81.00	$64.80–$76.95	—	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT EST COMPREHENSIVE	$383.73	$701.50	$167.73–$666.43	30% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEHEALTH EST COMPREHENSIVE	$383.73	$701.50	$167.73–$666.43	30% above	45%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 UR LEVEL V FACILITY	$602.53	$1,101.50	$61.98–$1,046.43	104% above	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT EST COMPREHENSIVE	$306.87	$561.00	$448.80–$532.95	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TELEHEALTH EST COMPREHENSIVE	$383.73	$701.50	$561.20–$666.43	—	45%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 UR LEVEL V FACILITY	$602.53	$1,101.50	$881.20–$1,046.43	—	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DOT PAPERWORK	$48.41	$88.50	$29.86–$231.63	71% below	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BREAST FEEDING CONSULT-COMPLEX	$121.99	$223.00	$75.24–$231.63	26% below	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$137.03	$250.50	$84.52–$237.98	17% below	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BUS DRIVER W TB	$151.25	$276.50	$84.91–$262.68	8% below	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SCHOOL EMPLOYEE W TB	$151.25	$276.50	$84.91–$262.68	8% below	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DOT EXAM W URINE DIP	$163.56	$299.00	$84.91–$284.05	at median	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEHEALTH EST EXPANDED PROB	$170.94	$312.50	$84.91–$296.88	4% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 UR LEVEL III FACILITY	$264.21	$483.00	$61.98–$775.00	61% above	45%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OBO LEVEL III	$641.36	$1,172.50	$84.91–$1,113.88	290% above	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DOT PAPERWORK	$48.41	$88.50	$70.80–$84.08	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BREAST FEEDING CONSULT-COMPLEX	$121.99	$223.00	$178.40–$211.85	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20-29 MIN	$137.03	$250.50	$200.40–$237.98	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SCHOOL EMPLOYEE W TB	$151.25	$276.50	$221.20–$262.68	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BUS DRIVER W TB	$151.25	$276.50	$221.20–$262.68	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DOT EXAM W URINE DIP	$163.56	$299.00	$239.20–$284.05	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TELEHEALTH EST EXPANDED PROB	$170.94	$312.50	$250.00–$296.88	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 UR LEVEL III FACILITY	$264.21	$483.00	$386.40–$458.85	—	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OBO LEVEL III	$641.36	$1,172.50	$938.00–$1,113.88	—	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEHEALTH EST DETAILED	$265.03	$484.50	$119.43–$460.28	42% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT EST DETAILED	$265.03	$484.50	$119.43–$460.28	42% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 UR LEVEL IV FACILITY	$402.87	$736.50	$61.98–$775.00	116% above	45%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OBO LEVEL IV	$758.69	$1,387.00	$119.43–$1,317.65	307% above	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT EST DETAILED	$212.24	$388.00	$310.40–$368.60	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TELEHEALTH EST DETAILED	$265.03	$484.50	$387.60–$460.28	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 UR LEVEL IV FACILITY	$402.87	$736.50	$589.20–$699.68	—	45%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OBO LEVEL IV	$758.69	$1,387.00	$1,109.60–$1,317.65	—	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST PROBLEM FOCUS	$24.89	$45.50	$15.35–$143.45	74% below	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BREAST FEEDING CONSULT-MODERAT	$94.36	$172.50	$52.59–$163.88	2% below	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PRE PLACEMENT EXAM	$113.51	$207.50	$52.59–$197.13	18% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEHEALTH EST PROBLEM FOCUSED	$123.08	$225.00	$52.59–$213.75	27% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 UR LEVEL II FACILITY	$180.51	$330.00	$52.59–$775.00	87% above	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OBO LEVEL II	$517.47	$946.00	$52.59–$898.70	436% above	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 BREAST FEEDING CONSULT-MODERAT	$94.36	$172.50	$138.00–$163.88	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PRE PLACEMENT EXAM	$113.51	$207.50	$166.00–$197.13	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TELEHEALTH EST PROBLEM FOCUSED	$123.08	$225.00	$180.00–$213.75	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT EST PROBLEM FOCUS	$123.08	$225.00	$180.00–$213.75	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 UR LEVEL II FACILITY	$180.51	$330.00	$264.00–$313.50	—	45%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OBO LEVEL II	$517.47	$946.00	$756.80–$898.70	—	45%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION DETAILED	$345.16	$631.00	$104.70–$599.45	72% above	45%
Specialist consultation, low complexity or 30+ minutes CPT 99243 TELEHEALTH CONSULT DETAILED	$345.16	$631.00	$104.70–$599.45	72% above	45%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION DETAILED	$345.16	$631.00	$504.80–$599.45	—	45%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 TELEHEALTH CONSULT DETAILED	$345.16	$631.00	$504.80–$599.45	—	45%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 TH CONSULT COMPREH MODERATE	$438.70	$802.00	$149.40–$761.90	37% above	45%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT COMPREHEN MOD	$438.70	$802.00	$149.40–$761.90	37% above	45%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULT COMPREHEN MOD	$438.70	$802.00	$641.60–$761.90	—	45%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 TH CONSULT COMPREH MODERATE	$438.70	$802.00	$641.60–$761.90	—	45%
Speech and language evaluation CPT 92523 EVAL SPCH SND PROD W EVAL LANG	$441.71	$807.50	$217.22–$767.13	24% above	45%
Speech and language evaluation inpatient CPT 92523 EVAL SPCH SND PROD W EVAL LANG	$441.71	$807.50	$646.00–$767.13	—	45%
Speech therapy session, individual CPT 92507 SPCH PATH TREAT IND	$218.53	$399.50	$73.02–$500.00	14% below	45%
Speech therapy session, individual inpatient CPT 92507 SPCH PATH TREAT IND	$218.53	$399.50	$319.60–$379.53	—	45%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$102.84	$188.00	$63.43–$412.11	63% below	45%
Spirometry (breathing test) CPT 94010 PFT/FLOW VOL LOOP	$148.52	$271.50	$91.60–$412.11	47% below	45%
Spirometry (breathing test) CPT 94010 PFT COMPLETE	$148.52	$271.50	$91.60–$412.11	47% below	45%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$102.84	$188.00	$150.40–$178.60	—	45%
Spirometry (breathing test) inpatient CPT 94010 PFT/FLOW VOL LOOP	$148.52	$271.50	$217.20–$257.93	—	45%
Spirometry (breathing test) inpatient CPT 94010 PFT COMPLETE	$148.52	$271.50	$217.20–$257.93	—	45%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY BRONCHO ADMIM	$155.90	$285.00	$96.16–$820.21	68% below	45%
Spirometry before and after a bronchodilator CPT 94060 PFT COMPLETE WITH B2	$232.75	$425.50	$143.56–$820.21	52% below	45%
Spirometry before and after a bronchodilator CPT 94060 P FT W & W/O B2	$232.75	$425.50	$143.56–$820.21	52% below	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY BRONCHO ADMIM	$155.90	$285.00	$228.00–$270.75	—	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 P FT W & W/O B2	$232.75	$425.50	$340.40–$404.23	—	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT COMPLETE WITH B2	$232.75	$425.50	$340.40–$404.23	—	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES 15 MIN	$121.17	$221.50	$33.53–$500.00	35% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES 30 MIN	$242.33	$443.00	$33.53–$500.00	169% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVIES 30 MIN	$242.33	$443.00	$33.53–$500.00	169% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES 45 MIN	$363.21	$664.00	$33.53–$630.80	304% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVITIES 45 MIN	$363.21	$664.00	$33.53–$630.80	304% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACTIVIES 60 MIN	$484.37	$885.50	$33.53–$841.23	438% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES 60 MIN	$484.37	$885.50	$33.53–$841.23	438% above	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES 15 MIN	$121.17	$221.50	$177.20–$210.43	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACTIVIES 30 MIN	$242.33	$443.00	$354.40–$420.85	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES 30 MIN	$242.33	$443.00	$354.40–$420.85	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES 45 MIN	$363.21	$664.00	$531.20–$630.80	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACTIVITIES 45 MIN	$363.21	$664.00	$531.20–$630.80	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES 60 MIN	$484.37	$885.50	$708.40–$841.23	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACTIVIES 60 MIN	$484.37	$885.50	$708.40–$841.23	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$123.08	$225.00	$75.92–$339.52	38% below	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$123.08	$225.00	$180.00–$213.75	—	45%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CLINIC STRESS TEST x	$351.18	$642.00	$68.03–$609.90	13% below	45%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CLINIC STRESS TEST x	$351.18	$642.00	$513.60–$609.90	—	45%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wisconsin	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE LIVE 1350 UNIT/(0.5 ML) VIAL (PF)	$309.95	$566.62	$191.18–$538.29	89% above	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE LIVE 1350 UNIT/(0.5 ML) VIAL (PF)	$309.95	$566.62	$453.30–$538.29	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIP/TET/ACEL PERTUSSIS (6weeks-6yr) VACCINE (0.5ML) VIAL	$70.35	$128.60	$43.39–$122.17	70% above	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIP/TET/ACEL PERTUSSIS (6weeks-6yr) VACCINE (0.5ML) VIAL	$70.35	$128.60	$102.88–$122.17	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TS2025-26(6MOS UP)/PF (45 MCG/0.5 ML) SYRINGE	$53.71	$98.19	$18.58–$93.28	68% above	45%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TS2025-26(6MOS UP)/PF (45 MCG/0.5 ML) SYRINGE	$53.71	$98.19	$78.55–$93.28	—	45%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (1440UNIT/ML) SYR-ADULT	$137.66	$251.65	$98.02–$239.07	4% above	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (1440UNIT/ML) SYR-ADULT	$137.66	$251.65	$201.32–$239.07	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACCINE (720UNIT/0.5ML) SYR-PED	$71.77	$131.20	$44.27–$124.64	38% above	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACCINE (720UNIT/0.5ML) SYR-PED	$71.77	$131.20	$104.96–$124.64	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE (10MCG/0.5ML) SYR-PF (PED)	$53.00	$96.88	$25.34–$92.04	6% below	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE (10MCG/0.5ML) SYR-PF (PED)	$53.00	$96.88	$77.50–$92.04	—	45%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMPH B POLYSAC CONJ-MENIN/PF (7.5 MCG/0.5 ML) VIAL	$71.46	$130.63	$44.07–$124.10	42% above	45%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMPH B POLYSAC CONJ-MENIN/PF (7.5 MCG/0.5 ML) VIAL	$71.46	$130.63	$104.50–$124.10	—	45%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX/PF (10 MCG/0.5 ML)	$37.18	$67.96	$22.93–$64.56	11% below	45%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX/PF (10 MCG/0.5 ML)	$37.18	$67.96	$54.37–$64.56	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC TS2025-26(65YR UP)/PF (180 MCG/0.5 ML) SYRINGE	$140.82	$257.43	$78.53–$267.77	78% above	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC TS2025-26(65YR UP)/PF (180 MCG/0.5 ML) SYRINGE	$140.82	$257.43	$205.94–$244.56	—	45%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE (0.5ML) VIAL	$173.64	$317.44	$107.10–$301.57	13% above	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE (0.5ML) VIAL	$173.64	$317.44	$253.95–$301.57	—	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA (0.5 ML) VIAL	$443.99	$811.67	$273.86–$771.09	75% above	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLES/MUMPS/RUBELLA/VARICELLA (0.5 ML) VIAL	$443.99	$811.67	$649.34–$771.09	—	45%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W-135 DIP/PF VACCINE (0.5ML)	$207.51	$379.36	$128.00–$360.39	10% below	45%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VAC A,C,Y,W-135 DIP/PF VACCINE (0.5ML)	$207.51	$379.36	$303.49–$360.39	—	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP VACCINE (0.5 ML)	$270.98	$495.39	$167.14–$470.62	17% above	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP VACCINE (0.5 ML)	$270.98	$495.39	$396.31–$470.62	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL (0.5ML) SYR-PF	$406.26	$742.70	$250.32–$853.57	39% above	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL (0.5ML) SYR-PF	$406.26	$742.70	$594.16–$705.57	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL (25 MCG/0.5 ML) SYR (ADULT)	$206.78	$378.01	$106.78–$364.09	47% above	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL (25 MCG/0.5 ML) SYR (ADULT)	$206.78	$378.01	$302.41–$359.11	—	45%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOMYELITIS VACCINE, KILLED VIAL (5ML MDV)	$97.29	$177.85	$60.01–$168.96	63% above	45%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOMYELITIS VACCINE, KILLED VIAL (5ML MDV)	$97.29	$177.85	$142.28–$168.96	—	45%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (PCEC) (RABAVERT) (2.5 UNIT/ML) VIAL	$542.23	$991.27	$313.68–$941.71	7% below	45%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (IMOVAX) (2.5UNIT/ML) VIAL	$588.72	$1,076.27	$313.68–$1,022.46	1% above	45%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (PCEC) (RABAVERT) (2.5 UNIT/ML) VIAL	$542.23	$991.27	$793.02–$941.71	—	45%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (IMOVAX) (2.5UNIT/ML) VIAL	$588.72	$1,076.27	$861.02–$1,022.46	—	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS LIVE VACCINE (2 ML) ORAL.SUSP	$153.62	$280.83	$94.75–$266.79	32% above	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS LIVE VACCINE (2 ML) ORAL.SUSP	$153.62	$280.83	$224.66–$266.79	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPHTHERIA (7yr & older) (0.5ML) VACCINE	$93.10	$170.20	$46.14–$161.69	125% above	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPHTHERIA (7yr & older) (0.5ML) VACCINE	$93.10	$170.20	$136.16–$161.69	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIP/TET/ACEL PERTUSSIS (BOOSTER) (0.5ML) SYR	$86.29	$157.74	$53.08–$149.85	6% above	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIP/TET/ACEL PERTUSSIS (BOOSTER) (0.5ML) SYR	$103.66	$189.49	$151.59–$180.02	—	45%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI VACCINE (25MCG/0.5ML) SYR	$269.62	$492.90	$166.30–$468.26	116% above	45%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI VACCINE (25MCG/0.5ML) SYR	$269.62	$492.90	$394.32–$468.26	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL VACC ADMINISTRAT	$49.78	$91.00	$30.70–$187.46	29% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE IMMUNIZATION	$49.78	$91.00	$30.70–$187.46	29% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU VACCINE ADMINISTRATION	$49.78	$91.00	$30.70–$187.46	29% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE IMMUNIZATION	$49.78	$91.00	$72.80–$86.45	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU VACCINE ADMINISTRATION	$49.78	$91.00	$72.80–$86.45	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL VACC ADMINISTRAT	$49.78	$91.00	$72.80–$86.45	—	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADDITIONAL VACCINE	$49.78	$91.00	$13.63–$86.45	53% above	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADDITIONAL VACCINE	$49.78	$91.00	$72.80–$86.45	—	45%

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/9451/390872080_sauk-prairie-healthcare_standardcharges.csv