Hospital Poplar Bluff, MO

Poplar Bluff Regional Medical Center

Poplar Bluff Regional Medical Center in Poplar Bluff, MO publishes cash prices for 441 common procedures listed here, from its own machine-readable price file updated Dec 19, 2024. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 256 of 437 procedures and below it for 181. Select a procedure to compare it with other hospitals nearby.

3100 Oak Grove Rd, Poplar Bluff, MO 63901 Collected Nov 12, 2026 Source price file Check a bill from this hospital

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Poplar Bluff Regional Medical Center in Poplar Bluff, MO:

Mar 28, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen WWO	$1,770.04	$7,375.15	$149.56–$6,637.64	9% below	76%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen WWO	$1,770.04	$7,375.15	$1,770.04–$6,637.64	—	76%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2V DR - XR Abdomen 2V DR	$323.88	$1,349.52	$24.26–$1,214.57	9% above	76%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2V DR - XR Abdomen 2V DR	$323.88	$1,349.52	$323.88–$1,214.57	—	76%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$394.15	$1,642.29	$18.00–$1,478.06	—	76%
Ankle X-ray, complete, 3 or more views CPT 73610 LE-ANKLE 3VPLUS DR [BCE 161]	$197.08	$821.15	$18.00–$739.04	32% below	76%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$115.61	$481.72	$18.00–$433.55	60% below	76%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$115.61	$481.72	$18.00–$433.55	60% below	76%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$197.08	$821.15	$18.00–$739.04	32% below	76%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$197.08	$821.15	$18.00–$739.04	32% below	76%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$394.15	$1,642.29	$394.15–$1,478.06	—	76%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 LE-ANKLE 3VPLUS DR [BCE 161]	$197.08	$821.15	$197.08–$739.04	—	76%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$197.08	$821.15	$197.08–$739.04	—	76%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$197.08	$821.15	$197.08–$739.04	—	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$167.40	$697.51	$27.30–$627.76	—	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$167.40	$697.51	$27.30–$627.76	—	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US-EXT ARTERIAL LTD - Net Health - 207	$167.40	$697.51	$27.30–$627.76	46% below	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$167.40	$697.51	$167.40–$627.76	—	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$167.40	$697.51	$167.40–$627.76	—	76%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US-EXT ARTERIAL LTD - Net Health - 207	$167.40	$697.51	$167.40–$627.76	—	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Left WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Right WO	$1,081.67	$4,506.97	$89.49–$4,056.27	10% below	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Right WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Left WO	$1,081.67	$4,506.97	$1,081.67–$4,056.27	—	76%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$321.65	$1,340.19	$36.00–$1,206.17	26% below	76%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$321.65	$1,340.19	$36.00–$1,206.17	26% below	76%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$321.65	$1,340.19	$321.65–$1,206.17	—	76%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$321.65	$1,340.19	$321.65–$1,206.17	—	76%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,971.03	$8,212.62	$59.00–$7,391.36	39% above	76%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,971.03	$8,212.62	$1,971.03–$7,391.36	—	76%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$251.10	$1,046.26	$63.40–$941.63	41% below	76%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right CM	$251.10	$1,046.26	$63.40–$941.63	41% below	76%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left CM	$251.10	$1,046.26	$63.40–$941.63	41% below	76%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$251.10	$1,046.26	$63.40–$941.63	41% below	76%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right CM	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left CM	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilateral CM	$115.61	$481.72	$48.50–$433.55	—	76%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$251.10	$1,046.26	$48.50–$941.63	28% below	76%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$251.10	$1,046.26	$48.50–$941.63	28% below	76%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left CM	$251.10	$1,046.26	$48.50–$941.63	28% below	76%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right CM	$251.10	$1,046.26	$48.50–$941.63	28% below	76%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilateral CM	$115.61	$481.72	$115.61–$433.55	—	76%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right CM	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left CM	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$251.10	$1,046.26	$251.10–$941.63	—	76%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$251.10	$1,046.26	$251.10–$941.63	—	76%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen Pelvis	$1,254.39	$5,226.64	$313.04–$4,703.98	49% below	76%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen Pelvis	$1,254.39	$5,226.64	$1,254.39–$4,703.98	—	76%
CT angiography (CTA) of the head CPT 70496 CTA Head	$1,674.86	$6,978.57	$149.56–$6,280.71	14% below	76%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head	$1,674.86	$6,978.57	$1,674.86–$6,280.71	—	76%
CT angiography (CTA) of the neck CPT 70498 CTA Neck	$1,675.14	$6,979.74	$149.56–$6,281.77	16% below	76%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck	$1,675.14	$6,979.74	$1,675.14–$6,281.77	—	76%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$1,174.89	$4,895.38	$149.56–$4,405.84	39% below	76%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$1,174.89	$4,895.38	$149.56–$4,405.84	39% below	76%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$1,174.89	$4,895.38	$1,174.89–$4,405.84	—	76%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$1,174.89	$4,895.38	$1,174.89–$4,405.84	—	76%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,475.19	$10,313.31	$108.30–$9,281.98	15% above	76%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$2,475.19	$10,313.31	$108.30–$9,281.98	15% above	76%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$2,475.19	$10,313.31	$2,475.19–$9,281.98	—	76%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,475.19	$10,313.31	$2,475.19–$9,281.98	—	76%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abdomen Pelvis	$2,925.61	$12,190.05	$206.27–$10,971.04	11% above	76%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$2,925.61	$12,190.05	$206.27–$10,971.04	11% above	76%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abdomen Pelvis	$2,925.61	$12,190.05	$2,925.61–$10,971.04	—	76%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$2,925.61	$12,190.05	$2,925.61–$10,971.04	—	76%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$3,387.23	$14,113.44	$272.95–$12,702.10	6% above	76%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$3,387.23	$14,113.44	$3,387.23–$12,702.10	—	76%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$1,426.55	$5,943.97	$149.56–$5,349.57	16% below	76%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$1,426.55	$5,943.97	$1,426.55–$5,349.57	—	76%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$1,242.36	$5,176.48	$89.49–$4,658.83	6% above	76%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$1,242.36	$5,176.48	$1,242.36–$4,658.83	—	76%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$1,305.90	$5,441.26	$89.49–$4,897.13	15% above	76%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$1,305.90	$5,441.26	$89.49–$4,897.13	15% above	76%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,305.90	$5,441.26	$1,305.90–$4,897.13	—	76%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,305.90	$5,441.26	$1,305.90–$4,897.13	—	76%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$851.01	$3,545.86	$89.49–$3,191.27	32% below	76%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$851.01	$3,545.86	$89.49–$3,191.27	32% below	76%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$851.01	$3,545.86	$851.01–$3,191.27	—	76%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$851.01	$3,545.86	$851.01–$3,191.27	—	76%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$1,064.88	$4,436.99	$149.56–$3,993.29	26% below	76%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$1,064.88	$4,436.99	$1,064.88–$3,993.29	—	76%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$1,497.94	$6,241.41	$149.56–$5,617.27	15% below	76%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$1,497.94	$6,241.41	$1,497.94–$5,617.27	—	76%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$1,397.16	$5,821.50	$89.49–$5,239.35	2% below	76%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$1,397.16	$5,821.50	$1,397.16–$5,239.35	—	76%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$1,384.00	$5,766.68	$89.49–$5,190.01	12% below	76%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$1,498.78	$6,244.91	$149.56–$5,620.42	8% below	76%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$1,498.78	$6,244.91	$1,498.78–$5,620.42	—	76%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$580.03	$2,416.78	$70.00–$2,175.10	—	76%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$580.03	$2,416.78	$580.03–$2,175.10	—	76%
Chest CT scan without and with contrast CPT 71270 CT Chest Diagnostic WWO	$1,671.78	$6,965.74	$149.56–$6,269.17	10% below	76%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest Diagnostic WWO	$1,671.78	$6,965.74	$1,671.78–$6,269.17	—	76%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V CR	$115.61	$481.72	$21.87–$433.55	53% below	76%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V DR [BCE 161]	$231.23	$963.45	$21.87–$867.10	7% below	76%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$231.23	$963.45	$21.87–$867.10	7% below	76%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V CR	$115.61	$481.72	$115.61–$433.55	—	76%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V DR [BCE 161]	$231.23	$963.45	$231.23–$867.10	—	76%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$231.23	$963.45	$231.23–$867.10	—	76%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal CR	$115.61	$481.72	$11.86–$433.55	39% below	76%
Chest X-ray, single view CPT 71045 CH-CHEST 1V DR [BCE 161]	$196.24	$817.65	$11.86–$735.88	3% above	76%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal DR	$196.24	$817.65	$11.86–$735.88	3% above	76%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$196.24	$817.65	$11.86–$735.88	3% above	76%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal CR	$115.61	$481.72	$115.61–$433.55	—	76%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$196.24	$817.65	$196.24–$735.88	—	76%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal DR	$196.24	$817.65	$196.24–$735.88	—	76%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V DR [BCE 161]	$196.24	$817.65	$196.24–$735.88	—	76%
Collarbone (clavicle) X-ray, complete CPT 73000 UE-CLAVICLE DR [BCE 161]	$195.96	$816.48	$15.00–$734.83	19% below	76%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right CR	$115.61	$481.72	$15.00–$433.55	52% below	76%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left CR	$115.61	$481.72	$15.00–$433.55	52% below	76%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right DR	$195.96	$816.48	$15.00–$734.83	19% below	76%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left DR	$195.96	$816.48	$15.00–$734.83	19% below	76%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 UE-CLAVICLE DR [BCE 161]	$195.96	$816.48	$195.96–$734.83	—	76%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right DR	$195.96	$816.48	$195.96–$734.83	—	76%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left DR	$195.96	$816.48	$195.96–$734.83	—	76%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$261.74	$1,090.58	$44.00–$981.52	58% below	76%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$261.74	$1,090.58	$261.74–$981.52	—	76%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$155.64	$648.52	$89.49–$583.67	51% below	76%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$155.64	$648.52	$155.64–$583.67	—	76%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w Detail	$275.74	$1,148.90	$145.14–$1,034.01	58% below	76%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w Detail	$275.74	$1,148.90	$275.74–$1,034.01	—	76%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$1,253.55	$5,223.14	$89.49–$4,700.83	3% below	76%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT High Resolution Chest	$1,253.55	$5,223.14	$89.49–$4,700.83	3% below	76%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT High Resolution Chest	$1,253.55	$5,223.14	$1,253.55–$4,700.83	—	76%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$1,253.55	$5,223.14	$1,253.55–$4,700.83	—	76%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$1,389.32	$5,788.84	$149.56–$5,209.96	15% below	76%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W For PE	$1,389.32	$5,788.84	$149.56–$5,209.96	15% below	76%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W For PE	$1,389.32	$5,788.84	$1,389.32–$5,209.96	—	76%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$1,389.32	$5,788.84	$1,389.32–$5,209.96	—	76%
Diagnostic mammogram, both breasts both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$84.54	$352.25	$70.45–$317.03	—	76%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$84.54	$352.25	$70.45–$317.03	—	76%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$84.54	$352.25	$70.45–$317.03	—	76%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$84.54	$352.25	$84.54–$317.03	—	76%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$84.54	$352.25	$84.54–$317.03	—	76%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$84.54	$352.25	$84.54–$317.03	—	76%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$68.30	$284.60	$56.92–$256.14	71% below	76%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$68.30	$284.60	$56.92–$256.14	71% below	76%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$68.30	$284.60	$56.92–$256.14	71% below	76%
Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT	$68.30	$284.60	$56.92–$256.14	71% below	76%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$68.30	$284.60	$56.92–$256.14	71% below	76%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$68.30	$284.60	$68.30–$256.14	—	76%
Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT	$68.30	$284.60	$68.30–$256.14	—	76%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$68.30	$284.60	$68.30–$256.14	—	76%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$68.30	$284.60	$68.30–$256.14	—	76%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$68.30	$284.60	$68.30–$256.14	—	76%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$526.00	$2,191.67	$73.00–$1,972.50	—	76%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$526.00	$2,191.67	$73.00–$1,972.50	—	76%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$526.00	$2,191.67	$526.00–$1,972.50	—	76%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$526.00	$2,191.67	$526.00–$1,972.50	—	76%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$614.74	$2,561.41	$42.00–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Mapping Duplex Bilateral	$614.74	$2,561.41	$42.00–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$614.74	$2,561.41	$42.00–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Mapping Duplex Bilateral	$614.74	$2,561.41	$42.00–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$614.74	$2,561.41	$42.00–$2,305.27	19% below	76%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Lower Extremity Veins Limited Bilater - US Lowe	$614.74	$2,561.41	$42.00–$2,305.27	19% below	76%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Mapping Duplex Bilateral	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Mapping Duplex Bilateral	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Lower Extremity Veins Limited Bilater - US Lowe	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$614.74	$2,561.41	$614.74–$2,305.27	—	76%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Transthoracic Echo 2D Doppler Comp	$1,412.00	$5,883.32	$257.51–$5,294.99	16% below	76%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Transthoracic Echo 2D Doppler Comp	$1,412.00	$5,883.32	$1,412.00–$5,294.99	—	76%
Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 V Bilateral DR	$176.92	$737.16	$18.00–$663.44	—	76%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Left CR	$115.61	$481.72	$18.00–$433.55	45% below	76%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Right CR	$115.61	$481.72	$18.00–$433.55	45% below	76%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Right DR	$176.92	$737.16	$18.00–$663.44	15% below	76%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Left DR	$176.92	$737.16	$18.00–$663.44	15% below	76%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 V Bilateral DR	$176.92	$737.16	$176.92–$663.44	—	76%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Left DR	$176.92	$737.16	$176.92–$663.44	—	76%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Right DR	$176.92	$737.16	$176.92–$663.44	—	76%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral DR	$500.25	$2,084.36	$19.00–$1,875.92	—	76%
Elbow X-ray, complete, 3 or more views CPT 73080 UE-ELBOW 3V DR [BCE 161]	$250.26	$1,042.76	$19.00–$938.48	10% below	76%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Left CR	$115.61	$481.72	$19.00–$433.55	58% below	76%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right CR - XR Elbow Com	$115.61	$481.72	$19.00–$433.55	58% below	76%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$250.26	$1,042.76	$19.00–$938.48	10% below	76%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$250.26	$1,042.76	$19.00–$938.48	10% below	76%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral DR	$500.25	$2,084.36	$500.25–$1,875.92	—	76%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 UE-ELBOW 3V DR [BCE 161]	$250.26	$1,042.76	$250.26–$938.48	—	76%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right CR - XR Elbow Com	$115.61	$481.72	$115.61–$433.55	—	76%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$250.26	$1,042.76	$250.26–$938.48	—	76%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$250.26	$1,042.76	$250.26–$938.48	—	76%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Sella WO	$1,724.97	$7,187.36	$89.49–$6,468.62	35% above	76%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC Temporal WO	$1,724.97	$7,187.36	$89.49–$6,468.62	35% above	76%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Mastoids WO	$1,724.97	$7,187.36	$89.49–$6,468.62	35% above	76%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit WO	$1,724.97	$7,187.36	$89.49–$6,468.62	35% above	76%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit WO	$1,724.97	$7,187.36	$1,724.97–$6,468.62	—	76%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Sella WO	$1,724.97	$7,187.36	$1,724.97–$6,468.62	—	76%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Mastoids WO	$1,724.97	$7,187.36	$1,724.97–$6,468.62	—	76%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC Temporal WO	$1,724.97	$7,187.36	$1,724.97–$6,468.62	—	76%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches Minimum 3V DR	$192.04	$800.15	$18.00–$720.14	35% below	76%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$192.04	$800.15	$18.00–$720.14	35% below	76%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Comp Minimum 3 V CR	$192.04	$800.15	$18.00–$720.14	35% below	76%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$192.04	$800.15	$192.04–$720.14	—	76%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches Minimum 3V DR	$192.04	$800.15	$192.04–$720.14	—	76%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Comp Minimum 3 V CR	$192.04	$800.15	$192.04–$720.14	—	76%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 UE-FOREARM 2VW BI DR [BCE 161]	$373.71	$1,557.14	$19.00–$1,401.43	—	76%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 V Bilateral DR	$373.71	$1,557.14	$19.00–$1,401.43	—	76%
Forearm X-ray (radius and ulna), 2 views CPT 73090 UE-FOREARM 2V DR [BCE 161]	$186.16	$775.66	$19.00–$698.09	11% below	76%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Left CR	$115.61	$481.72	$19.00–$433.55	45% below	76%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Right CR	$115.61	$481.72	$19.00–$433.55	45% below	76%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Right DR	$186.16	$775.66	$19.00–$698.09	11% below	76%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Left DR	$186.16	$775.66	$19.00–$698.09	11% below	76%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 V Bilateral DR	$373.71	$1,557.14	$373.71–$1,401.43	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 UE-FOREARM 2VW BI DR [BCE 161]	$373.71	$1,557.14	$373.71–$1,401.43	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 UE-FOREARM 2V DR [BCE 161]	$186.16	$775.66	$186.16–$698.09	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Left DR	$186.16	$775.66	$186.16–$698.09	—	76%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Right DR	$186.16	$775.66	$186.16–$698.09	—	76%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System Scan 1	$1,128.70	$4,702.92	$312.39–$4,232.63	9% below	76%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary System Scan 1	$1,128.70	$4,702.92	$1,128.70–$4,232.63	—	76%
Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 V Bilateral DR	$264.26	$1,101.08	$17.00–$990.97	—	76%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Left DR	$132.13	$550.54	$17.00–$495.49	30% below	76%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Right DR	$132.13	$550.54	$17.00–$495.49	30% below	76%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 2 V Bilateral DR	$264.26	$1,101.08	$264.26–$990.97	—	76%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Left DR	$132.13	$550.54	$132.13–$495.49	—	76%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Right DR	$132.13	$550.54	$132.13–$495.49	—	76%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneus Min 2 V Bilateral DR	$392.47	$1,635.29	$13.00–$1,471.76	—	76%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 V Right DR	$196.24	$817.65	$13.00–$735.88	at median	76%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR XR Calcaneus 2 V Left DR	$196.24	$817.65	$13.00–$735.88	at median	76%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneus Min 2 V Bilateral DR	$392.47	$1,635.29	$392.47–$1,471.76	—	76%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR XR Calcaneus 2 V Left DR	$196.24	$817.65	$196.24–$735.88	—	76%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 V Right DR	$196.24	$817.65	$196.24–$735.88	—	76%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 CHRG - SLEEP TITRATE UNATT	$288.61	$1,202.56	$44.11–$1,082.30	55% below	76%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 CHRG - SLEEP TITRATE UNATT	$288.61	$1,202.56	$288.61–$1,082.30	—	76%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$2,328.79	$9,703.28	$205.37–$8,732.95	11% below	76%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$2,328.79	$9,703.28	$2,328.79–$8,732.95	—	76%
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 V Bilateral DR	$453.50	$1,889.57	$35.00–$1,700.61	—	76%
Knee X-ray, 3 views CPT 73562 LE-KNEE 3V DR [BCE 161]	$226.75	$944.78	$35.00–$850.30	16% below	76%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left CR	$115.61	$481.72	$35.00–$433.55	57% below	76%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right CR	$115.61	$481.72	$35.00–$433.55	57% below	76%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$226.75	$944.78	$35.00–$850.30	16% below	76%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$226.75	$944.78	$35.00–$850.30	16% below	76%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 V Bilateral DR	$453.50	$1,889.57	$453.50–$1,700.61	—	76%
Knee X-ray, 3 views inpatient CPT 73562 LE-KNEE 3V DR [BCE 161]	$226.75	$944.78	$226.75–$850.30	—	76%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$226.75	$944.78	$226.75–$850.30	—	76%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$226.75	$944.78	$226.75–$850.30	—	76%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Complete 4 V Bilateral DR	$155.64	$648.52	$37.00–$583.67	—	76%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Left DR	$314.37	$1,309.87	$37.00–$1,178.88	4% below	76%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Left DR	$314.37	$1,309.87	$37.00–$1,178.88	4% below	76%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Right DR	$314.37	$1,309.87	$37.00–$1,178.88	4% below	76%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Right DR	$314.37	$1,309.87	$37.00–$1,178.88	4% below	76%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Complete 4 V Bilateral DR	$155.64	$648.52	$155.64–$583.67	—	76%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Left DR	$314.37	$1,309.87	$314.37–$1,178.88	—	76%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Right DR	$314.37	$1,309.87	$314.37–$1,178.88	—	76%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Right DR	$314.37	$1,309.87	$314.37–$1,178.88	—	76%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Left DR	$314.37	$1,309.87	$314.37–$1,178.88	—	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Left WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Right WO	$1,212.68	$5,052.84	$89.49–$4,547.56	4% below	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Left WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Right WO	$1,212.68	$5,052.84	$1,212.68–$4,547.56	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Wall	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Common Bile Duct	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ascites	$508.64	$2,119.35	$20.00–$1,907.42	3% above	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Common Bile Duct	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ascites	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Wall	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$508.64	$2,119.35	$508.64–$1,907.42	—	76%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non Vascular Limited - zzUS Extremity	$251.66	$1,048.59	$11.99–$943.73	29% below	76%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Rt	$251.66	$1,048.59	$11.99–$943.73	29% below	76%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Lt	$251.66	$1,048.59	$11.99–$943.73	29% below	76%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non Vascular Limited - zzUS Extremity	$251.66	$1,048.59	$251.66–$943.73	—	76%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Lt	$251.66	$1,048.59	$251.66–$943.73	—	76%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Rt	$251.66	$1,048.59	$251.66–$943.73	—	76%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$181.96	$758.16	$77.57–$682.34	60% below	76%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$181.96	$758.16	$181.96–$682.34	—	76%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia Fibula Bilateral DR	$423.82	$1,765.93	$25.00–$1,589.34	—	76%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 LE-TIB FIB 2V DR [BCE 161]	$211.91	$882.96	$25.00–$794.66	12% below	76%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Left CR	$115.61	$481.72	$25.00–$433.55	52% below	76%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Right CR	$115.61	$481.72	$25.00–$433.55	52% below	76%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Right DR	$211.91	$882.96	$25.00–$794.66	12% below	76%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Left DR	$211.91	$882.96	$25.00–$794.66	12% below	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia Fibula Bilateral DR	$423.82	$1,765.93	$423.82–$1,589.34	—	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 LE-TIB FIB 2V DR [BCE 161]	$211.91	$882.96	$211.91–$794.66	—	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Right DR	$211.91	$882.96	$211.91–$794.66	—	76%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Left DR	$211.91	$882.96	$211.91–$794.66	—	76%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head WO	$1,674.58	$6,977.40	$199.45–$6,279.66	9% above	76%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head WO	$1,674.58	$6,977.40	$1,674.58–$6,279.66	—	76%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Ankle Bilateral WO	$1,645.74	$6,857.27	$199.45–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Knee Bilateral WO	$1,645.74	$6,857.27	$199.45–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip Bilateral WO	$1,645.74	$6,857.27	$199.45–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$1,097.07	$4,571.12	$199.45–$4,114.01	38% below	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Hip Bilateral WO	$1,645.74	$6,857.27	$1,645.74–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Ankle Bilateral WO	$1,645.74	$6,857.27	$1,645.74–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI Knee Bilateral WO	$1,645.74	$6,857.27	$1,645.74–$6,171.54	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$1,097.07	$4,571.12	$1,097.07–$4,114.01	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Hip Bilateral WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Ankle Bilateral WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Knee Bilateral WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$2,094.48	$8,727.00	$313.04–$7,854.30	8% below	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Knee Bilateral WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Hip Bilateral WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI Ankle Bilateral WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$2,094.48	$8,727.00	$2,094.48–$7,854.30	—	76%
MRI of the abdomen without contrast CPT 74181 MRI MRCP WO	$1,111.07	$4,629.44	$199.45–$4,166.50	33% below	76%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$1,111.07	$4,629.44	$199.45–$4,166.50	33% below	76%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP WO	$1,111.07	$4,629.44	$1,111.07–$4,166.50	—	76%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$1,111.07	$4,629.44	$1,111.07–$4,166.50	—	76%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$1,814.54	$7,560.60	$313.04–$6,804.54	25% below	76%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$1,814.54	$7,560.60	$1,814.54–$6,804.54	—	76%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$1,590.04	$6,625.15	$199.45–$5,962.64	3% above	76%
MRI of the brain, no contrast dye CPT 70551 MRV Brain WO	$1,590.04	$6,625.15	$199.45–$5,962.64	3% above	76%
MRI of the brain, no contrast dye inpatient CPT 70551 MRV Brain WO	$1,590.04	$6,625.15	$1,590.04–$5,962.64	—	76%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$1,590.04	$6,625.15	$1,590.04–$5,962.64	—	76%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$1,775.35	$7,397.31	$313.04–$6,657.58	28% below	76%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$1,775.35	$7,397.31	$1,775.35–$6,657.58	—	76%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$1,605.71	$6,690.47	$199.45–$6,021.42	14% below	76%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$1,605.71	$6,690.47	$1,605.71–$6,021.42	—	76%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$2,339.42	$9,747.60	$313.04–$8,772.84	5% below	76%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$2,339.42	$9,747.60	$2,339.42–$8,772.84	—	76%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$1,815.38	$7,564.10	$199.45–$6,807.69	3% above	76%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$1,815.38	$7,564.10	$1,815.38–$6,807.69	—	76%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$2,375.26	$9,896.90	$313.04–$8,907.21	4% below	76%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$2,375.26	$9,896.90	$2,375.26–$8,907.21	—	76%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$2,108.20	$8,784.16	$199.45–$7,905.74	7% above	76%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$2,108.20	$8,784.16	$2,108.20–$7,905.74	—	76%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WWO	$1,814.54	$7,560.60	$313.04–$6,804.54	27% below	76%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WWO	$1,814.54	$7,560.60	$1,814.54–$6,804.54	—	76%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$1,674.58	$6,977.40	$199.45–$6,279.66	9% below	76%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$1,674.58	$6,977.40	$1,674.58–$6,279.66	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Shoulder Bilateral WO	$1,525.93	$6,358.05	$199.45–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow Bilateral WO	$1,525.93	$6,358.05	$199.45–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist Bilateral WO	$1,525.93	$6,358.05	$199.45–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$1,525.93	$6,358.05	$199.45–$5,722.24	17% below	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Shoulder Bilateral WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow Bilateral WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist Bilateral WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$1,525.93	$6,358.05	$1,525.93–$5,722.24	—	76%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 V DR	$434.46	$1,810.25	$32.00–$1,629.22	5% above	76%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 V DR	$434.46	$1,810.25	$434.46–$1,629.22	—	76%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck W	$1,258.03	$5,241.80	$149.56–$4,717.62	13% below	76%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck W	$1,258.03	$5,241.80	$1,258.03–$4,717.62	—	76%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck WO	$1,066.00	$4,441.65	$89.49–$3,997.48	8% below	76%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck WO	$1,066.00	$4,441.65	$1,066.00–$3,997.48	—	76%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue DR	$234.03	$975.11	$10.00–$877.60	3% above	76%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue DR	$234.03	$975.11	$234.03–$877.60	—	76%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$2,182.66	$9,094.42	$266.71–$8,184.98	39% below	76%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$2,182.66	$9,094.42	$266.71–$8,184.98	39% below	76%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$2,182.66	$9,094.42	$266.71–$8,184.98	39% below	76%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$2,182.66	$9,094.42	$2,182.66–$8,184.98	—	76%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$2,182.66	$9,094.42	$2,182.66–$8,184.98	—	76%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$2,182.66	$9,094.42	$2,182.66–$8,184.98	—	76%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET w CT Scan Skull Base to Midthigh Int Scan	$3,450.49	$14,377.05	$1,273.43–$12,939.34	19% below	76%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Tumor Imaging Skull Base to Midthigh Scan	$3,450.49	$14,377.05	$1,273.43–$12,939.34	19% below	76%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET w CT Scan Skull Base to Midthigh Sub Scan	$3,450.49	$14,377.05	$1,273.43–$12,939.34	19% below	76%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET w CT Scan Skull Base to Midthigh Scan	$3,450.49	$14,377.05	$1,273.43–$12,939.34	19% below	76%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET w CT Scan Skull Base to Midthigh Sub Scan	$3,450.49	$14,377.05	$3,450.49–$12,939.34	—	76%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET w CT Scan Skull Base to Midthigh Scan	$3,450.49	$14,377.05	$3,450.49–$12,939.34	—	76%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Tumor Imaging Skull Base to Midthigh Scan	$3,450.49	$14,377.05	$3,450.49–$12,939.34	—	76%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET w CT Scan Skull Base to Midthigh Int Scan	$3,450.49	$14,377.05	$3,450.49–$12,939.34	—	76%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO	$1,232.84	$5,136.83	$89.49–$4,623.15	12% below	76%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis WO	$1,232.84	$5,136.83	$1,232.84–$4,623.15	—	76%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$172.16	$717.34	$24.00–$645.61	52% below	76%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB Limited	$172.16	$717.34	$24.00–$645.61	52% below	76%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$172.16	$717.34	$172.16–$645.61	—	76%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB Limited	$172.16	$717.34	$172.16–$645.61	—	76%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 US-PELVIS NON OB	$536.36	$2,234.82	$40.00–$2,011.34	15% below	76%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$536.36	$2,234.82	$40.00–$2,011.34	15% below	76%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 US-PELVIS NON OB	$536.36	$2,234.82	$536.36–$2,011.34	—	76%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$536.36	$2,234.82	$536.36–$2,011.34	—	76%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$478.13	$1,992.21	$56.00–$1,792.99	10% below	76%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$478.13	$1,992.21	$478.13–$1,792.99	—	76%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$448.74	$1,869.74	$42.75–$1,682.77	12% below	76%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$448.74	$1,869.74	$448.74–$1,682.77	—	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$278.26	$1,159.40	$26.00–$1,043.46	22% below	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Placenta Location	$278.26	$1,159.40	$26.00–$1,043.46	22% below	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Fetal Position	$278.26	$1,159.40	$26.00–$1,043.46	22% below	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Placenta Location	$278.26	$1,159.40	$278.26–$1,043.46	—	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$278.26	$1,159.40	$278.26–$1,043.46	—	76%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Fetal Position	$278.26	$1,159.40	$278.26–$1,043.46	—	76%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Left CR	$115.61	$481.72	$17.00–$433.55	51% below	76%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Right CR	$115.61	$481.72	$17.00–$433.55	51% below	76%
Rib X-ray, one side, 2 views one side CPT 71100 CH-RIBS UNILAT DR [BCE 161]	$213.31	$888.80	$17.00–$799.92	10% below	76%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Right DR	$213.31	$888.80	$17.00–$799.92	10% below	76%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Left DR	$213.31	$888.80	$17.00–$799.92	10% below	76%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Right DR	$213.31	$888.80	$213.31–$799.92	—	76%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Left DR	$213.31	$888.80	$213.31–$799.92	—	76%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CH-RIBS UNILAT DR [BCE 161]	$213.31	$888.80	$213.31–$799.92	—	76%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$213.31	$888.80	$17.00–$799.92	22% below	76%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$213.31	$888.80	$17.00–$799.92	22% below	76%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$213.31	$888.80	$213.31–$799.92	—	76%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$213.31	$888.80	$213.31–$799.92	—	76%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$69.98	$291.60	$58.32–$262.44	—	76%
Screening mammogram, both breasts both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$69.98	$291.60	$58.32–$262.44	—	76%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$69.98	$291.60	$58.32–$262.44	—	76%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD	$59.35	$247.28	$49.46–$233.33	66% below	76%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD	$59.35	$247.28	$49.46–$233.33	66% below	76%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$59.35	$247.28	$49.46–$233.33	66% below	76%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$59.35	$247.28	$49.46–$233.33	66% below	76%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$69.98	$291.60	$69.98–$262.44	—	76%
Screening mammogram, both breasts inpatient both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$69.98	$291.60	$69.98–$262.44	—	76%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$69.98	$291.60	$69.98–$262.44	—	76%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$59.35	$247.28	$59.35–$222.55	—	76%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD	$59.35	$247.28	$59.35–$222.55	—	76%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD	$59.35	$247.28	$59.35–$222.55	—	76%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$59.35	$247.28	$59.35–$222.55	—	76%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$484.57	$2,019.04	$20.00–$1,817.14	—	76%
Shoulder X-ray, complete, 2 or more views CPT 73030 UE-SHLDR 2VW PLUS DR [BCE 161]	$242.42	$1,010.10	$20.00–$909.09	8% below	76%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$115.61	$481.72	$20.00–$433.55	56% below	76%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$115.61	$481.72	$20.00–$433.55	56% below	76%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$242.42	$1,010.10	$20.00–$909.09	8% below	76%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$242.42	$1,010.10	$20.00–$909.09	8% below	76%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$484.57	$2,019.04	$484.57–$1,817.14	—	76%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UE-SHLDR 2VW PLUS DR [BCE 161]	$242.42	$1,010.10	$242.42–$909.09	—	76%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$242.42	$1,010.10	$242.42–$909.09	—	76%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$242.42	$1,010.10	$242.42–$909.09	—	76%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete CR	$115.61	$481.72	$30.00–$433.55	61% below	76%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete DR	$278.82	$1,161.73	$30.00–$1,045.56	7% below	76%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete CR	$115.61	$481.72	$115.61–$433.55	—	76%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete DR	$278.82	$1,161.73	$278.82–$1,045.56	—	76%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 V DR	$154.80	$645.02	$22.00–$580.52	40% below	76%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 V CR	$155.64	$648.52	$22.00–$583.67	39% below	76%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 V DR	$154.80	$645.02	$154.80–$580.52	—	76%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 V CR	$155.64	$648.52	$155.64–$583.67	—	76%
Sleep study in a lab (polysomnography) CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$2,148.23	$8,950.95	$122.00–$8,055.86	8% below	76%
Sleep study in a lab (polysomnography) inpatient CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$2,148.23	$8,950.95	$2,148.23–$8,055.86	—	76%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$292.53	$1,218.89	$29.00–$1,097.00	34% below	76%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$292.53	$1,218.89	$292.53–$1,097.00	—	76%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur Minimum 2 Views Bilat DR	$459.10	$1,912.90	$21.18–$1,721.61	—	76%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Right CR	$115.61	$481.72	$21.18–$433.55	55% below	76%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Left CR	$115.61	$481.72	$21.18–$433.55	55% below	76%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Right DR	$229.55	$956.45	$21.18–$860.80	11% below	76%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Left DR	$229.55	$956.45	$21.18–$860.80	11% below	76%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur Minimum 2 Views Bilat DR	$459.10	$1,912.90	$459.10–$1,721.61	—	76%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Left DR	$229.55	$956.45	$229.55–$860.80	—	76%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Right DR	$229.55	$956.45	$229.55–$860.80	—	76%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic WO	$1,255.51	$5,231.30	$89.49–$4,708.17	6% below	76%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic WO	$1,255.51	$5,231.30	$1,255.51–$4,708.17	—	76%
Toe X-ray, 2 or more views CPT 73660 LE-TOE S 2VPLUS DR [BCE 161]	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Right CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Left CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Left CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Right CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Right CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Left CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Right CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Left CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Right CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Left CR	$115.61	$481.72	$13.00–$433.55	42% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Left DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Right DR	$174.12	$725.50	$13.00–$652.95	12% below	76%
Toe X-ray, 2 or more views inpatient CPT 73660 LE-TOE S 2VPLUS DR [BCE 161]	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Left DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Right DR	$174.12	$725.50	$174.12–$652.95	—	76%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$174.12	$725.50	$174.12–$652.95	—	76%
Transvaginal pelvic ultrasound CPT 76830 76830 US-TRANSVAGINAL	$419.06	$1,746.10	$68.00–$1,571.49	19% below	76%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$419.06	$1,746.10	$68.00–$1,571.49	19% below	76%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$419.06	$1,746.10	$419.06–$1,571.49	—	76%
Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US-TRANSVAGINAL	$419.06	$1,746.10	$419.06–$1,571.49	—	76%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$177.20	$738.33	$58.50–$664.50	59% below	76%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$177.20	$738.33	$177.20–$664.50	—	76%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$656.45	$2,735.21	$56.00–$2,461.69	18% below	76%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$656.45	$2,735.21	$656.45–$2,461.69	—	76%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$440.90	$1,837.08	$31.00–$1,653.37	23% below	76%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$440.90	$1,837.08	$440.90–$1,653.37	—	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$416.54	$1,735.60	$54.00–$1,562.04	27% below	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parotid	$416.54	$1,735.60	$54.00–$1,562.04	27% below	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parathyroid	$416.54	$1,735.60	$54.00–$1,562.04	27% below	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$416.54	$1,735.60	$54.00–$1,562.04	27% below	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parotid	$416.54	$1,735.60	$416.54–$1,562.04	—	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$416.54	$1,735.60	$416.54–$1,562.04	—	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$416.54	$1,735.60	$416.54–$1,562.04	—	76%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parathyroid	$416.54	$1,735.60	$416.54–$1,562.04	—	76%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR Humerus Min 2 V Bilateral DR	$397.23	$1,655.12	$22.00–$1,489.61	—	76%
Upper arm X-ray (humerus), 2 views CPT 73060 UE-HUMERUS DR [BCE 161]	$198.75	$828.14	$22.00–$745.33	17% below	76%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Left CR	$115.61	$481.72	$22.00–$433.55	52% below	76%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Right CR	$115.61	$481.72	$22.00–$433.55	52% below	76%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Left DR	$198.75	$828.14	$22.00–$745.33	17% below	76%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Right DR	$198.75	$828.14	$22.00–$745.33	17% below	76%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR Humerus Min 2 V Bilateral DR	$397.23	$1,655.12	$397.23–$1,489.61	—	76%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 UE-HUMERUS DR [BCE 161]	$198.75	$828.14	$198.75–$745.33	—	76%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Right DR	$198.75	$828.14	$198.75–$745.33	—	76%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Left DR	$198.75	$828.14	$198.75–$745.33	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Limited Left.	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Mapping Duplex Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Mapping Duplex Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Limited Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Limited Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Limited Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Limited Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Mapping Duplex Right	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Mapping Duplex Left	$361.68	$1,506.99	$73.00–$1,356.29	41% below	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Limited Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Mapping Duplex Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Limited Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Limited Left.	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Mapping Duplex Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Limited Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Limited Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Mapping Duplex Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Mapping Duplex Right	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$361.68	$1,506.99	$361.68–$1,356.29	—	76%
Wrist X-ray, 2 views both sides CPT 73100 UE-WRIST 2VW BI DR [BCE 161]	$282.18	$1,175.73	$19.00–$1,058.16	—	76%
Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 2 V Bilateral DR	$282.18	$1,175.73	$19.00–$1,058.16	—	76%
Wrist X-ray, 2 views CPT 73100 UE-WRIST 2V DR [BCE 161]	$141.09	$587.87	$19.00–$529.08	31% below	76%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Left CR	$115.61	$481.72	$19.00–$433.55	44% below	76%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Right CR	$115.61	$481.72	$19.00–$433.55	44% below	76%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Right DR	$141.09	$587.87	$19.00–$529.08	31% below	76%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Left DR	$141.09	$587.87	$19.00–$529.08	31% below	76%
Wrist X-ray, 2 views inpatient both sides CPT 73100 UE-WRIST 2VW BI DR [BCE 161]	$282.18	$1,175.73	$282.18–$1,058.16	—	76%
Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 2 V Bilateral DR	$282.18	$1,175.73	$282.18–$1,058.16	—	76%
Wrist X-ray, 2 views inpatient CPT 73100 UE-WRIST 2V DR [BCE 161]	$141.09	$587.87	$141.09–$529.08	—	76%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Right DR	$141.09	$587.87	$141.09–$529.08	—	76%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Left DR	$141.09	$587.87	$141.09–$529.08	—	76%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$366.16	$1,525.65	$23.00–$1,373.08	—	76%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 UE-WRIST 3VW BI DR [BCE 161]	$366.16	$1,525.65	$23.00–$1,373.08	—	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Lt CR	$115.61	$481.72	$23.00–$433.55	56% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$115.61	$481.72	$23.00–$433.55	56% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$115.61	$481.72	$23.00–$433.55	56% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Rt CR	$115.61	$481.72	$23.00–$433.55	56% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$183.08	$762.83	$23.00–$686.55	30% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$183.08	$762.83	$23.00–$686.55	30% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$183.08	$762.83	$23.00–$686.55	30% below	76%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$183.08	$762.83	$23.00–$686.55	30% below	76%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$366.16	$1,525.65	$366.16–$1,373.08	—	76%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 UE-WRIST 3VW BI DR [BCE 161]	$366.16	$1,525.65	$366.16–$1,373.08	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Rt CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Lt CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$183.08	$762.83	$183.08–$686.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$183.08	$762.83	$183.08–$686.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$183.08	$762.83	$183.08–$686.55	—	76%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$183.08	$762.83	$183.08–$686.55	—	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LE-HIP PV UN2OR3V DR [BCE 161]	$176.64	$736.00	$27.84–$662.40	26% below	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views DR	$176.64	$736.00	$27.84–$662.40	26% below	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$176.64	$736.00	$27.84–$662.40	26% below	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$176.64	$736.00	$27.84–$662.40	26% below	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views DR	$176.64	$736.00	$27.84–$662.40	26% below	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LE-HIP PV UN2OR3V DR [BCE 161]	$176.64	$736.00	$176.64–$662.40	—	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$176.64	$736.00	$176.64–$662.40	—	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views DR	$176.64	$736.00	$176.64–$662.40	—	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$176.64	$736.00	$176.64–$662.40	—	76%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views DR	$176.64	$736.00	$176.64–$662.40	—	76%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB CR	$115.61	$481.72	$20.26–$433.55	44% below	76%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW DR [BCE 161]	$240.18	$1,000.77	$20.26–$900.69	16% above	76%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$240.18	$1,000.77	$20.26–$900.69	16% above	76%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$240.18	$1,000.77	$240.18–$900.69	—	76%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW DR [BCE 161]	$240.18	$1,000.77	$240.18–$900.69	—	76%
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 V Bilateral DR	$353.84	$1,474.33	$30.00–$1,326.90	—	76%
X-ray of the ankle, 2 views CPT 73600 LE-ANKLE 2V DR [BCE 161]	$176.92	$737.16	$30.00–$663.44	10% below	76%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$176.92	$737.16	$30.00–$663.44	10% below	76%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$176.92	$737.16	$30.00–$663.44	10% below	76%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 V Bilateral DR	$353.84	$1,474.33	$353.84–$1,326.90	—	76%
X-ray of the ankle, 2 views inpatient CPT 73600 LE-ANKLE 2V DR [BCE 161]	$176.92	$737.16	$176.92–$663.44	—	76%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$176.92	$737.16	$176.92–$663.44	—	76%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$176.92	$737.16	$176.92–$663.44	—	76%
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger Min 2 V 2nd Digit Bilateral DR	$115.61	$481.72	$16.00–$433.55	—	76%
X-ray of the finger(s), 2 or more views CPT 73140 UE-FINGER S 2VPLS DR [BCE 161]	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$115.61	$481.72	$16.00–$433.55	44% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$148.09	$617.03	$16.00–$555.33	28% below	76%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger Min 2 V 2nd Digit Bilateral DR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 UE-FINGER S 2VPLS DR [BCE 161]	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$148.09	$617.03	$148.09–$555.33	—	76%
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 V Bilateral DR	$152.84	$636.85	$23.00–$573.17	—	76%
X-ray of the foot, 2 views CPT 73620 LE-FOOT 2V DR [BCE 161]	$152.84	$636.85	$23.00–$573.17	27% below	76%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left CR	$115.61	$481.72	$23.00–$433.55	45% below	76%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right CR	$115.61	$481.72	$23.00–$433.55	45% below	76%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$152.84	$636.85	$23.00–$573.17	27% below	76%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$152.84	$636.85	$23.00–$573.17	27% below	76%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 V Bilateral DR	$152.84	$636.85	$152.84–$573.17	—	76%
X-ray of the foot, 2 views inpatient CPT 73620 LE-FOOT 2V DR [BCE 161]	$152.84	$636.85	$152.84–$573.17	—	76%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$152.84	$636.85	$152.84–$573.17	—	76%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$152.84	$636.85	$152.84–$573.17	—	76%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$420.46	$1,751.93	$28.00–$1,576.74	—	76%
X-ray of the foot, complete, 3 or more views CPT 73630 LE-FOOT 3V PLUS DR [BCE 161]	$210.23	$875.97	$28.00–$788.37	22% below	76%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right CR	$115.61	$481.72	$28.00–$433.55	57% below	76%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left CR	$115.61	$481.72	$28.00–$433.55	57% below	76%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$210.23	$875.97	$28.00–$788.37	22% below	76%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$210.23	$875.97	$28.00–$788.37	22% below	76%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$420.46	$1,751.93	$420.46–$1,576.74	—	76%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LE-FOOT 3V PLUS DR [BCE 161]	$210.23	$875.97	$210.23–$788.37	—	76%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$210.23	$875.97	$210.23–$788.37	—	76%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$210.23	$875.97	$210.23–$788.37	—	76%
X-ray of the hand, 3 or more views both sides CPT 73130 UE-HAND 3VWS BI DR [BCE 161]	$411.23	$1,713.44	$25.00–$1,542.10	—	76%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$411.23	$1,713.44	$25.00–$1,542.10	—	76%
X-ray of the hand, 3 or more views CPT 73130 UE-HAND 3V DR [BCE 161]	$205.75	$857.30	$25.00–$771.57	21% below	76%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right CR	$115.61	$481.72	$25.00–$433.55	56% below	76%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left CR	$115.61	$481.72	$25.00–$433.55	56% below	76%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$205.75	$857.30	$25.00–$771.57	21% below	76%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$205.75	$857.30	$25.00–$771.57	21% below	76%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$411.23	$1,713.44	$411.23–$1,542.10	—	76%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 UE-HAND 3VWS BI DR [BCE 161]	$411.23	$1,713.44	$411.23–$1,542.10	—	76%
X-ray of the hand, 3 or more views inpatient CPT 73130 UE-HAND 3V DR [BCE 161]	$205.75	$857.30	$205.75–$771.57	—	76%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$205.75	$857.30	$205.75–$771.57	—	76%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$205.75	$857.30	$205.75–$771.57	—	76%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$368.96	$1,537.32	$25.00–$1,383.59	—	76%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right CR	$115.61	$481.72	$25.00–$433.55	49% below	76%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left CR	$115.61	$481.72	$25.00–$433.55	49% below	76%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$157.04	$654.35	$25.00–$588.92	31% below	76%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$157.04	$654.35	$25.00–$588.92	31% below	76%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$368.96	$1,537.32	$368.96–$1,383.59	—	76%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$157.04	$654.35	$157.04–$588.92	—	76%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$157.04	$654.35	$157.04–$588.92	—	76%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$155.64	$648.52	$28.00–$583.67	47% below	76%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V DR [BCE 161]	$243.26	$1,013.60	$28.00–$912.24	17% below	76%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$243.26	$1,013.60	$28.00–$912.24	17% below	76%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$155.64	$648.52	$155.64–$583.67	—	76%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V DR [BCE 161]	$243.26	$1,013.60	$243.26–$912.24	—	76%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$243.26	$1,013.60	$243.26–$912.24	—	76%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$403.11	$1,679.62	$40.00–$1,511.66	5% below	76%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$403.11	$1,679.62	$403.11–$1,511.66	—	76%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V CR	$155.64	$648.52	$24.00–$583.67	38% below	76%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V DR	$189.80	$790.82	$24.00–$711.74	25% below	76%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V CR	$155.64	$648.52	$155.64–$583.67	—	76%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V DR	$189.80	$790.82	$189.80–$711.74	—	76%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V CR	$115.61	$481.72	$23.00–$433.55	54% below	76%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$226.75	$944.78	$23.00–$850.30	9% below	76%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$226.75	$944.78	$226.75–$850.30	—	76%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V CR	$115.61	$481.72	$28.00–$433.55	61% below	76%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$229.83	$957.61	$28.00–$861.85	21% below	76%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW DR [BCE 161]	$229.83	$957.61	$28.00–$861.85	21% below	76%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW DR [BCE 161]	$229.83	$957.61	$229.83–$861.85	—	76%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$229.83	$957.61	$229.83–$861.85	—	76%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$141.09	$587.87	$21.00–$529.08	36% below	76%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V CR	$155.64	$648.52	$21.00–$583.67	30% below	76%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$141.09	$587.87	$141.09–$529.08	—	76%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V CR	$155.64	$648.52	$155.64–$583.67	—	76%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V CR	$115.61	$481.72	$17.00–$433.55	55% below	76%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$217.23	$905.13	$17.00–$814.62	15% below	76%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V CR	$115.61	$481.72	$115.61–$433.55	—	76%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$217.23	$905.13	$217.23–$814.62	—	76%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone (CQ)	$328.37	$1,368.19	$23.66–$1,231.37	92% above	76%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone (CQ)	$328.37	$1,368.19	$328.37–$1,231.37	—	76%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$90.98	$379.08	$4.46–$341.17	87% above	76%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase Body Fluid	$90.98	$379.08	$4.46–$341.17	87% above	76%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$90.98	$379.08	$90.98–$341.17	—	76%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase Body Fluid	$90.98	$379.08	$90.98–$341.17	—	76%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase Body Fluid	$267.62	$1,115.08	$4.35–$1,003.57	474% above	76%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$267.62	$1,115.08	$4.35–$1,003.57	474% above	76%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase Body Fluid	$267.62	$1,115.08	$267.62–$1,003.57	—	76%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$267.62	$1,115.08	$267.62–$1,003.57	—	76%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC	$177.76	$740.66	$40.02–$666.59	26% below	76%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute	$177.76	$740.66	$40.02–$666.59	26% below	76%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute w/Reflex Confirmation - Send	$177.76	$740.66	$40.02–$666.59	26% below	76%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute	$177.76	$740.66	$177.76–$666.59	—	76%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) LC	$177.76	$740.66	$177.76–$666.59	—	76%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute w/Reflex Confirmation - Send	$177.76	$740.66	$177.76–$666.59	—	76%
Albumin blood test CPT 82040 Albumin CQ	$64.38	$268.27	$4.16–$241.44	100% above	76%
Albumin blood test CPT 82040 82040 Q7558 ALBUMIN SERUM	$64.38	$268.27	$4.16–$241.44	100% above	76%
Albumin blood test CPT 82040 Albumin Level	$64.38	$268.27	$4.16–$241.44	100% above	76%
Albumin blood test inpatient CPT 82040 Albumin Level	$64.38	$268.27	$64.38–$241.44	—	76%
Albumin blood test inpatient CPT 82040 82040 Q7558 ALBUMIN SERUM	$64.38	$268.27	$64.38–$241.44	—	76%
Albumin blood test inpatient CPT 82040 Albumin CQ	$64.38	$268.27	$64.38–$241.44	—	76%
Aldosterone blood test CPT 82088 Aldosterone LC-MS/MS - Send Out to CQ	$458.26	$1,909.40	$34.24–$1,718.46	183% above	76%
Aldosterone blood test inpatient CPT 82088 Aldosterone LC-MS/MS - Send Out to CQ	$458.26	$1,909.40	$458.26–$1,718.46	—	76%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase (CQ)	$137.17	$571.54	$4.35–$514.39	168% above	76%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$137.17	$571.54	$4.35–$514.39	168% above	76%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 Q231 PHOSPHATASE ALK	$137.17	$571.54	$4.35–$514.39	168% above	76%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase (CQ)	$137.17	$571.54	$137.17–$514.39	—	76%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 Q231 PHOSPHATASE ALK	$137.17	$571.54	$137.17–$514.39	—	76%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$137.17	$571.54	$137.17–$514.39	—	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Pork IgE - Send Out CQ	$7.28	$30.33	$4.39–$27.30	66% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Venison IgE - Send Out CQ	$7.31	$30.45	$4.39–$27.40	66% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Corn (f8) IgE - Send Out CQ	$15.03	$62.64	$4.39–$56.38	30% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata IgE - Send Out CQ	$15.03	$62.64	$4.39–$56.38	30% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat (f4) IgE - Send Out CQ	$15.03	$62.64	$4.39–$56.38	30% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lamb (f88) IgE (CQ)	$19.87	$82.81	$4.39–$74.53	8% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Hair/Dander LC	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Russian Thistle (w11) IgE Sendout to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut (f13) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach (i6) IgE CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Raspberry Rf343 IgE (CQ)	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 K087-IgE Alpha-Amylase (LC)	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 RedDyeCQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Pea (f12) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Oak (t7) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Milk (f2) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass (g10) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Greer H1 IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander (e3) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Helminthosporium halodes IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Goose Feathers (e70) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten (f79) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Garlic (f47) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Firebush (w17) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain (w9) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm (t8) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander (e5) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood (t14) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cocoa (f93) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cinnamon (Rf220) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Chicken Feathers (e85) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cheese Mold Type (f82) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander (e1) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass (g2) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple (Box Elder) (t1) IgE - Send Out Cq	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Beef (f27) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Hickory Pecan Tree (t22) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Aureobas pullulans IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White (f1) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach (i6) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Mucor Racemosus (m4) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium Herbarum IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillum Notatum (m1) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 White Ash (t15) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Marsh Elder (w16) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Pigweed (w14) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Meadow Fscue (g4) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 White Mulberry (t70) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mucor racemosus IgE Quant	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Q10715 ALLERGEN IGE	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Q10659 ALLERGEN IGE	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Q79138 ALG IGE QT	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatu LC	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Hair/Dander LC	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Q10649X ALG IGE QT	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, Total w/Rfx Peanut Comp Pnl (CQ)	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Allergy Profile w/Reflexes (CQ)	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 COMMRGWDIGECQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep Sorrel IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass (g6) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Tomato (f25) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut Tree (t10) IgE - Send Out CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen CPT 86003 Yeast (f45) IgE - Send Out to CQ	$20.44	$85.15	$4.39–$76.64	5% below	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork IgE - Send Out CQ	$7.28	$30.33	$7.28–$27.30	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venison IgE - Send Out CQ	$7.31	$30.45	$7.31–$27.40	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat (f4) IgE - Send Out CQ	$15.03	$62.64	$15.03–$56.38	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alternata IgE - Send Out CQ	$15.03	$62.64	$15.03–$56.38	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn (f8) IgE - Send Out CQ	$15.03	$62.64	$15.03–$56.38	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lamb (f88) IgE (CQ)	$19.87	$82.81	$19.87–$74.53	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Hair/Dander LC	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander (e1) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatu LC	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Grass (g2) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tomato (f25) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maple (Box Elder) (t1) IgE - Send Out Cq	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yeast (f45) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Beef (f27) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Q10649X ALG IGE QT	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigatus IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Q10715 ALLERGEN IGE	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocoa (f93) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cinnamon (Rf220) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken Feathers (e85) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cheese Mold Type (f82) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMRGWDIGECQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Pigweed (w14) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pea (f12) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak (t7) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Meadow Fscue (g4) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Milk (f2) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Hair/Dander LC	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson Grass (g10) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Mulberry (t70) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Greer H1 IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Horse Dander (e3) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mucor racemosus IgE Quant	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Helminthosporium halodes IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goose Feathers (e70) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten (f79) IgE - Send Out to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sheep Sorrel IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Garlic (f47) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RedDyeCQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Firebush (w17) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut Tree (t10) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English Plantain (w9) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Q10659 ALLERGEN IGE	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm (t8) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass (g6) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander (e5) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Q79138 ALG IGE QT	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood (t14) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hickory Pecan Tree (t22) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aureobas pullulans IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White (f1) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach (i6) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mucor Racemosus (m4) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut, Total w/Rfx Peanut Comp Pnl (CQ)	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium Herbarum IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillum Notatum (m1) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Allergy Profile w/Reflexes (CQ)	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut (f13) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Russian Thistle (w11) IgE Sendout to CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Ash (t15) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach (i6) IgE CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Raspberry Rf343 IgE (CQ)	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Marsh Elder (w16) IgE - Send Out CQ	$20.44	$85.15	$20.44–$76.64	—	76%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K087-IgE Alpha-Amylase (LC)	$20.44	$85.15	$20.44–$76.64	—	76%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker (CQ)	$103.02	$429.24	$14.09–$386.32	7% above	76%
Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Serum Alpha-Fetoprotein - Send Out to CQ	$103.02	$429.24	$14.09–$386.32	7% above	76%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Maternal Serum Alpha-Fetoprotein - Send Out to CQ	$103.02	$429.24	$103.02–$386.32	—	76%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker (CQ)	$103.02	$429.24	$103.02–$386.32	—	76%
Ammonia blood test CPT 82140 Ammonia Level	$304.85	$1,270.21	$12.25–$1,143.19	298% above	76%
Ammonia blood test CPT 82140 82140 Q442 AMMONIA	$304.85	$1,270.21	$12.25–$1,143.19	298% above	76%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$304.85	$1,270.21	$304.85–$1,143.19	—	76%
Ammonia blood test inpatient CPT 82140 82140 Q442 AMMONIA	$304.85	$1,270.21	$304.85–$1,143.19	—	76%
Amylase blood test CPT 82150 Amylase Body Fluid	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test CPT 82150 Pancreatic Amylase Blood	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test CPT 82150 Amylase Blood	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test CPT 82150 Amylase Urine Timed	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test CPT 82150 Amylase 24 Hour Urine	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test CPT 82150 Amylase Urine	$381.27	$1,588.64	$5.44–$1,429.78	565% above	76%
Amylase blood test inpatient CPT 82150 Amylase Urine	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Amylase blood test inpatient CPT 82150 Amylase Blood	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Amylase blood test inpatient CPT 82150 Amylase Urine Timed	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Amylase blood test inpatient CPT 82150 Pancreatic Amylase Blood	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Amylase blood test inpatient CPT 82150 Amylase 24 Hour Urine	$381.27	$1,588.64	$381.27–$1,429.78	—	76%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$18.48	$76.98	$10.88–$69.28	77% below	76%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG (CQ)	$18.48	$76.98	$10.88–$69.28	77% below	76%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG (CQ)	$18.48	$76.98	$18.48–$69.28	—	76%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$18.48	$76.98	$18.48–$69.28	—	76%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 Q19873 ANA	$16.80	$69.98	$10.16–$62.98	75% below	76%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 Q37491 ANA	$16.92	$70.51	$10.16–$63.46	75% below	76%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA w/Rfx Titer/Pattern/Casc (CQ)	$116.45	$485.22	$10.16–$436.70	75% above	76%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibody IFA w/Reflex Titer + Pattern	$116.45	$485.22	$10.16–$436.70	75% above	76%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Multiplex w/Rfx to DSDNA (CQ)	$116.45	$485.22	$10.16–$436.70	75% above	76%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 Q19873 ANA	$16.80	$69.98	$16.80–$62.98	—	76%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 Q37491 ANA	$16.92	$70.51	$16.92–$63.46	—	76%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibody IFA w/Reflex Titer + Pattern	$116.45	$485.22	$116.45–$436.70	—	76%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Multiplex w/Rfx to DSDNA (CQ)	$116.45	$485.22	$116.45–$436.70	—	76%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA w/Rfx Titer/Pattern/Casc (CQ)	$116.45	$485.22	$116.45–$436.70	—	76%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$308.77	$1,286.54	$32.99–$1,157.89	149% above	76%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$308.77	$1,286.54	$32.99–$1,157.89	149% above	76%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP, N-terminaln++(CQ)	$308.77	$1,286.54	$32.99–$1,157.89	149% above	76%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 proBNP, N-terminaln++(CQ)	$308.77	$1,286.54	$308.77–$1,157.89	—	76%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$308.77	$1,286.54	$308.77–$1,157.89	—	76%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$308.77	$1,286.54	$308.77–$1,157.89	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 CULTURE BACTERIA OTH	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasopharyngeal Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bone Marrow Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bone Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sinus Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Feeding Tube Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Medical Device Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Trachea Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aspirate Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 zzEnvironmental Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Transfusion Reaction Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture without Gram stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Gastric Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Foreign Body Culture	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Miscellaneous Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Abscess Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Brush Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Wash Culture without Gram Stain	$264.82	$1,103.41	$7.24–$993.07	288% above	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Feeding Tube Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 87070 CULTURE BACTERIA OTH	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture without Gram stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 zzEnvironmental Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Miscellaneous Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasopharyngeal Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Abscess Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aspirate Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Transfusion Reaction Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Gastric Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Foreign Body Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Brush Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Wash Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bone Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Trachea Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Medical Device Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sinus Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bone Marrow Culture	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture without Gram Stain	$264.82	$1,103.41	$264.82–$993.07	—	76%
Basic metabolic panel (blood test) CPT 80048 BMPWTCA	$306.25	$1,276.04	$7.11–$1,148.44	166% above	76%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPWTCA	$306.25	$1,276.04	$306.25–$1,148.44	—	76%
Bilirubin blood test, total CPT 82247 Bilirubin, Body Fluid CQ	$296.73	$1,236.38	$4.22–$1,112.74	500% above	76%
Bilirubin blood test, total CPT 82247 Bilirubin Total Neo	$296.73	$1,236.38	$4.22–$1,112.74	500% above	76%
Bilirubin blood test, total CPT 82247 Bilirubin Total Cord Blood	$296.73	$1,236.38	$4.22–$1,112.74	500% above	76%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$296.73	$1,236.38	$4.22–$1,112.74	500% above	76%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Cord Blood	$296.73	$1,236.38	$296.73–$1,112.74	—	76%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Neo	$296.73	$1,236.38	$296.73–$1,112.74	—	76%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$296.73	$1,236.38	$296.73–$1,112.74	—	76%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Body Fluid CQ	$296.73	$1,236.38	$296.73–$1,112.74	—	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SO PATHGROUP 88305 Cytopathology Non-Gyn FNA CEL B	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 P0NG CYTOFLD CEL BLK(88112)	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SO PATHGROUP 88305 Cytopathology Non-Gyn FLD CEL B	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 P0NG CYTOFNA CEL BLK(88173)	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SO 88305 Bill Surg Compre Review of Data	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$321.93	$1,341.36	$28.00–$1,207.22	63% above	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SO 88305 Bill Surg Compre Review of Data	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 P0NG CYTOFNA CEL BLK(88173)	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 P0NG CYTOFLD CEL BLK(88112)	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SO PATHGROUP 88305 Cytopathology Non-Gyn FNA CEL B	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SO PATHGROUP 88305 Cytopathology Non-Gyn FLD CEL B	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$321.93	$1,341.36	$321.93–$1,207.22	—	76%
Blood culture for bacteria CPT 87040 Blood Culture	$270.70	$1,127.91	$8.67–$1,015.12	143% above	76%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$270.70	$1,127.91	$270.70–$1,015.12	—	76%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg BCE	$22.68	$94.48	$8.39–$85.03	40% above	76%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$22.68	$94.48	$8.39–$85.03	40% above	76%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$3,078.72	$12,828.00	$8.39–$11,545.20	18846% above	76%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg BCE	$22.68	$94.48	$22.68–$85.03	—	76%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$22.68	$94.48	$22.68–$85.03	—	76%
Blood glucose (sugar) test CPT 82947 .GTT 3rd Hr OB	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 .Glucose Fasting	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 Glucose Level	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 Glucose Level - Send Out CQ	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 .Glucose POC	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 82947 GLUCOSE,SER PL OR WB	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 Glucose 3 Hour Postprandial	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hr OB	$83.98	$349.92	$3.31–$314.93	181% above	76%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hr OB	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level - Send Out CQ	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 3 Hour Postprandial	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 3rd Hr OB	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose Fasting	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose POC	$83.98	$349.92	$83.98–$314.93	—	76%
Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE,SER PL OR WB	$83.98	$349.92	$83.98–$314.93	—	76%
Blood lead test CPT 83655 Lead Blood Pediatric (LC)	$76.70	$319.59	$10.17–$287.63	40% above	76%
Blood lead test CPT 83655 Lead Blood (CQ)	$76.70	$319.59	$10.17–$287.63	40% above	76%
Blood lead test CPT 83655 Lead, Capillary CQ	$76.70	$319.59	$10.17–$287.63	40% above	76%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric (LC)	$76.70	$319.59	$76.70–$287.63	—	76%
Blood lead test inpatient CPT 83655 Lead Blood (CQ)	$76.70	$319.59	$76.70–$287.63	—	76%
Blood lead test inpatient CPT 83655 Lead, Capillary CQ	$76.70	$319.59	$76.70–$287.63	—	76%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Chorionic Gonadotropin Qual	$310.45	$1,293.54	$6.32–$1,164.19	482% above	76%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Human Chorionic Gonadotropin Qual	$310.45	$1,293.54	$310.45–$1,164.19	—	76%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Ref Lab ABO/Rh	$112.53	$468.89	$2.99–$422.00	125% above	76%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$112.53	$468.89	$2.99–$422.00	125% above	76%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$112.53	$468.89	$2.99–$422.00	125% above	76%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$112.53	$468.89	$2.99–$422.00	125% above	76%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$112.53	$468.89	$112.53–$422.00	—	76%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Ref Lab ABO/Rh	$112.53	$468.89	$112.53–$422.00	—	76%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$112.53	$468.89	$112.53–$422.00	—	76%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$112.53	$468.89	$112.53–$422.00	—	76%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$123.73	$515.55	$3.32–$463.99	234% above	76%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Body Fluid	$123.73	$515.55	$3.32–$463.99	234% above	76%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Body Fluid	$123.73	$515.55	$123.73–$463.99	—	76%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$123.73	$515.55	$123.73–$463.99	—	76%
C-peptide blood test CPT 84681 C-Peptide Level LC	$103.58	$431.57	$17.49–$388.41	1% below	76%
C-peptide blood test CPT 84681 C Peptide- Send Out to CQ	$103.58	$431.57	$17.49–$388.41	1% below	76%
C-peptide blood test inpatient CPT 84681 C Peptide- Send Out to CQ	$103.58	$431.57	$103.58–$388.41	—	76%
C-peptide blood test inpatient CPT 84681 C-Peptide Level LC	$103.58	$431.57	$103.58–$388.41	—	76%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein (CQ)	$43.95	$183.12	$4.35–$164.81	26% below	76%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$43.95	$183.12	$4.35–$164.81	26% below	76%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$43.95	$183.12	$43.95–$164.81	—	76%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein (CQ)	$43.95	$183.12	$43.95–$164.81	—	76%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin PCR	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE - BCE	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin A B Amp Probe	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile by DNA Amp	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) CPT 87493 Verigene C difficile Panel	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$64.67	$269.44	$31.32–$242.50	57% below	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile by DNA Amp	$64.67	$269.44	$64.67–$242.50	—	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin PCR	$64.67	$269.44	$64.67–$242.50	—	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin A B Amp Probe	$64.67	$269.44	$64.67–$242.50	—	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE - BCE	$64.67	$269.44	$64.67–$242.50	—	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Verigene C difficile Panel	$64.67	$269.44	$64.67–$242.50	—	76%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$64.67	$269.44	$64.67–$242.50	—	76%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer 19-9 - Send Out to CQ	$60.19	$250.78	$17.49–$225.70	43% below	76%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer 19-9 - Send Out to CQ	$60.19	$250.78	$60.19–$225.70	—	76%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer 125 - Send Out to CQ	$298.69	$1,244.55	$17.49–$1,120.10	174% above	76%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer 125 - Send Out to CQ	$298.69	$1,244.55	$298.69–$1,120.10	—	76%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 SARS-CoV-2 RNA Qual NAAT (CQ)	$66.35	$276.44	$43.11–$248.80	32% below	76%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$66.35	$276.44	$43.11–$248.80	32% below	76%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$66.35	$276.44	$66.35–$248.80	—	76%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 SARS-CoV-2 RNA Qual NAAT (CQ)	$66.35	$276.44	$66.35–$248.80	—	76%
Calcium blood test, total CPT 82310 Calcium Level	$89.02	$370.92	$4.33–$333.83	92% above	76%
Calcium blood test, total CPT 82310 Calcium Urine	$89.02	$370.92	$4.33–$333.83	92% above	76%
Calcium blood test, total CPT 82310 82310 Q8837 CALCIUM TOTAL	$89.02	$370.92	$4.33–$333.83	92% above	76%
Calcium blood test, total CPT 82310 Calcium BF	$89.02	$370.92	$4.33–$333.83	92% above	76%
Calcium blood test, total inpatient CPT 82310 82310 Q8837 CALCIUM TOTAL	$89.02	$370.92	$89.02–$333.83	—	76%
Calcium blood test, total inpatient CPT 82310 Calcium BF	$89.02	$370.92	$89.02–$333.83	—	76%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$89.02	$370.92	$89.02–$333.83	—	76%
Calcium blood test, total inpatient CPT 82310 Calcium Urine	$89.02	$370.92	$89.02–$333.83	—	76%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$148.65	$619.36	$15.93–$557.42	46% above	76%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pericardial Fluid CQ	$148.65	$619.36	$15.93–$557.42	46% above	76%
Carcinoembryonic antigen (CEA) test CPT 82378 zzCarcinoembryonic Ag Pleural Fluid (CQ)	$148.65	$619.36	$15.93–$557.42	46% above	76%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA CQ	$148.65	$619.36	$15.93–$557.42	46% above	76%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Pancreatic Cyst (CQ)	$148.65	$619.36	$15.93–$557.42	46% above	76%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$148.65	$619.36	$148.65–$557.42	—	76%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA CQ	$148.65	$619.36	$148.65–$557.42	—	76%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pericardial Fluid CQ	$148.65	$619.36	$148.65–$557.42	—	76%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen Pancreatic Cyst (CQ)	$148.65	$619.36	$148.65–$557.42	—	76%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 zzCarcinoembryonic Ag Pleural Fluid (CQ)	$148.65	$619.36	$148.65–$557.42	—	76%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab Immunity Scr CQ	$82.30	$342.92	$10.82–$308.63	11% above	76%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab IgM (CQ)	$82.30	$342.92	$10.82–$308.63	11% above	76%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus IgG (CQ)	$82.30	$342.92	$10.82–$308.63	11% above	76%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab IgM (CQ)	$82.30	$342.92	$82.30–$308.63	—	76%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus IgG (CQ)	$82.30	$342.92	$82.30–$308.63	—	76%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab Immunity Scr CQ	$82.30	$342.92	$82.30–$308.63	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis RNA TMA - Send Out CQ	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe 2	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Q70051 CHLMYD TRACH	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHLMYD TRACH DNA AMP	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Q16506 C TRACH PRB	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Q11363 CHLMYD TRACH	$73.90	$307.93	$29.49–$277.14	16% below	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Q11363 CHLMYD TRACH	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe 2	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Q16506 C TRACH PRB	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHLMYD TRACH DNA AMP	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Q70051 CHLMYD TRACH	$73.90	$307.93	$73.90–$277.14	—	76%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis RNA TMA - Send Out CQ	$73.90	$307.93	$73.90–$277.14	—	76%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$247.74	$1,032.26	$11.25–$929.03	143% above	76%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with LDL/HDL Ratio	$247.74	$1,032.26	$11.25–$929.03	143% above	76%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$247.74	$1,032.26	$247.74–$929.03	—	76%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with LDL/HDL Ratio	$247.74	$1,032.26	$247.74–$929.03	—	76%
Complete blood count (CBC) with differential CPT 85025 CBCADIFF	$197.35	$822.31	$6.53–$740.08	289% above	76%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/ 3 Part Diff Auto	$197.35	$822.31	$6.53–$740.08	289% above	76%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/ 3 Part Diff Auto	$197.35	$822.31	$197.35–$740.08	—	76%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCADIFF	$197.35	$822.31	$197.35–$740.08	—	76%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$133.53	$556.37	$5.43–$500.73	151% above	76%
Complete blood count (CBC), no differential CPT 85027 CBC	$133.53	$556.37	$5.43–$500.73	151% above	76%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$133.53	$556.37	$133.53–$500.73	—	76%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$133.53	$556.37	$133.53–$500.73	—	76%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$394.71	$1,644.62	$8.87–$1,480.16	230% above	76%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$394.71	$1,644.62	$394.71–$1,480.16	—	76%
Cortisol blood test, total CPT 82533 Cortisol, A.M. (CQ)	$187.84	$782.65	$13.70–$704.38	116% above	76%
Cortisol blood test, total CPT 82533 Cortisol Level	$187.84	$782.65	$13.70–$704.38	116% above	76%
Cortisol blood test, total CPT 82533 82533 Q149308CORTISOL TOTA	$187.84	$782.65	$13.70–$704.38	116% above	76%
Cortisol blood test, total CPT 82533 Cortisol Total - Send Out CQ	$187.84	$782.65	$13.70–$704.38	116% above	76%
Cortisol blood test, total CPT 82533 Cortisol PM - Send Out CQ	$187.84	$782.65	$13.70–$704.38	116% above	76%
Cortisol blood test, total inpatient CPT 82533 Cortisol, A.M. (CQ)	$187.84	$782.65	$187.84–$704.38	—	76%
Cortisol blood test, total inpatient CPT 82533 Cortisol Level	$187.84	$782.65	$187.84–$704.38	—	76%
Cortisol blood test, total inpatient CPT 82533 Cortisol PM - Send Out CQ	$187.84	$782.65	$187.84–$704.38	—	76%
Cortisol blood test, total inpatient CPT 82533 82533 Q149308CORTISOL TOTA	$187.84	$782.65	$187.84–$704.38	—	76%
Cortisol blood test, total inpatient CPT 82533 Cortisol Total - Send Out CQ	$187.84	$782.65	$187.84–$704.38	—	76%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total (CQ)	$164.04	$683.51	$5.47–$615.16	162% above	76%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$164.04	$683.51	$5.47–$615.16	162% above	76%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase w/Reflex CKMB/Relative Index	$164.04	$683.51	$5.47–$615.16	162% above	76%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase w/Reflex CKMB/Relative Index	$164.04	$683.51	$164.04–$615.16	—	76%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$164.04	$683.51	$164.04–$615.16	—	76%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase Total (CQ)	$164.04	$683.51	$164.04–$615.16	—	76%
Creatinine blood test CPT 82565 ISCREA	$122.05	$508.55	$4.30–$457.70	282% above	76%
Creatinine blood test CPT 82565 CREA	$122.05	$508.55	$4.30–$457.70	282% above	76%
Creatinine blood test inpatient CPT 82565 ISCREA	$122.05	$508.55	$122.05–$457.70	—	76%
Creatinine blood test inpatient CPT 82565 CREA	$122.05	$508.55	$122.05–$457.70	—	76%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibody IgG (CQ)	$243.26	$1,013.60	$12.09–$912.24	249% above	76%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibody IgG (CQ)	$243.26	$1,013.60	$243.26–$912.24	—	76%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$256.98	$1,070.76	$8.55–$963.68	105% above	76%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$256.98	$1,070.76	$256.98–$963.68	—	76%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (CQ)	$269.58	$1,123.24	$18.68–$1,010.92	90% above	76%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (CQ)	$269.58	$1,123.24	$269.58–$1,010.92	—	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethanol Urine (LC)	$14.91	$62.14	$12.43–$188.41	81% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen (12) Umbilical Cord Blood (LC)	$14.91	$62.14	$12.43–$188.41	81% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Umbil. Cord Tissue LC	$26.64	$111.00	$22.20–$188.41	66% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UAmpQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Qual	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Urine LC	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor Antidepressant w/Conf, Urine (CQ)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Mtr Antidepressant Serum w/Conf (CQ)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone Screen and Confirmation, Urine (CQ)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10BQualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 8 w/confirmation CQ	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10AQualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10QualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS8AQualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Screen 7 Serum - Send Out CQ	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UBarbQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UBenzQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UCocQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UOpiQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UPCPQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UTHCQl	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS9AQualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hydrocodone Qual Urine	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone Qual Urine	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamine Screen, Urine (LC)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Screen, Urine (LC)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS13QualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS7QualAuto	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen (9) Umbilical Cord Blood (LC)	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Panel 8 MedTox RLNI	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite, Serum LC	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 9 Meconium - Send Out CQ	$31.07	$129.47	$25.89–$188.41	60% below	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Urine (LC)	$14.91	$62.14	$14.91–$55.93	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen (12) Umbilical Cord Blood (LC)	$14.91	$62.14	$14.91–$55.93	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Umbil. Cord Tissue LC	$26.64	$111.00	$26.64–$99.90	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Mtr Antidepressant Serum w/Conf (CQ)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamine Screen, Urine (LC)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone Screen and Confirmation, Urine (CQ)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen, Urine (LC)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Qual	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS13QualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS8AQualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 9 Meconium - Send Out CQ	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone Qual Urine	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor Antidepressant w/Conf, Urine (CQ)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10BQualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Panel 8 w/confirmation CQ	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10AQualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10QualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hydrocodone Qual Urine	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS9AQualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UTHCQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UPCPQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS7QualAuto	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UAmpQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen (9) Umbilical Cord Blood (LC)	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Screen 7 Serum - Send Out CQ	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Panel 8 MedTox RLNI	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite Urine LC	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UOpiQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UCocQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite, Serum LC	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UBenzQl	$31.07	$129.47	$31.07–$116.52	—	76%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UBarbQl	$31.07	$129.47	$31.07–$116.52	—	76%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Panel	$221.99	$924.96	$5.89–$832.46	164% above	76%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Urine Panel	$221.99	$924.96	$5.89–$832.46	164% above	76%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Urine Panel	$221.99	$924.96	$221.99–$832.46	—	76%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Panel	$221.99	$924.96	$221.99–$832.46	—	76%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus VCA IgM (CQ)	$55.15	$229.78	$15.24–$206.80	30% below	76%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 Q6421EPSTE-BARR VCA	$55.15	$229.78	$15.24–$206.80	30% below	76%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus VCA IgG (CQ)	$55.15	$229.78	$15.24–$206.80	30% below	76%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus VCA IgM (CQ)	$55.15	$229.78	$55.15–$206.80	—	76%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus VCA IgG (CQ)	$55.15	$229.78	$55.15–$206.80	—	76%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 Q6421EPSTE-BARR VCA	$55.15	$229.78	$55.15–$206.80	—	76%
Estradiol blood test CPT 82670 82670 Q36169 ESTRADIOL	$39.19	$163.30	$23.47–$146.97	72% below	76%
Estradiol blood test CPT 82670 Estradiol - Send Out CQ	$353.28	$1,472.00	$23.47–$1,324.80	149% above	76%
Estradiol blood test CPT 82670 Estradiol Level	$353.28	$1,472.00	$23.47–$1,324.80	149% above	76%
Estradiol blood test CPT 82670 Estradiol Ultrasensitive LC-MS/MS - Send Out to CQ	$353.28	$1,472.00	$23.47–$1,324.80	149% above	76%
Estradiol blood test inpatient CPT 82670 82670 Q36169 ESTRADIOL	$39.19	$163.30	$39.19–$146.97	—	76%
Estradiol blood test inpatient CPT 82670 Estradiol - Send Out CQ	$353.28	$1,472.00	$353.28–$1,324.80	—	76%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$353.28	$1,472.00	$353.28–$1,324.80	—	76%
Estradiol blood test inpatient CPT 82670 Estradiol Ultrasensitive LC-MS/MS - Send Out to CQ	$353.28	$1,472.00	$353.28–$1,324.80	—	76%
FSH (follicle-stimulating hormone) test CPT 83001 83001 Q7137 FSH	$219.19	$913.29	$15.61–$821.96	113% above	76%
FSH (follicle-stimulating hormone) test CPT 83001 FSH and LH (CQ)	$219.19	$913.29	$15.61–$821.96	113% above	76%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone (CQ)	$219.19	$913.29	$15.61–$821.96	113% above	76%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$219.19	$913.29	$15.61–$821.96	113% above	76%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone (CQ)	$219.19	$913.29	$219.19–$821.96	—	76%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH and LH (CQ)	$219.19	$913.29	$219.19–$821.96	—	76%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 83001 Q7137 FSH	$219.19	$913.29	$219.19–$821.96	—	76%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$219.19	$913.29	$219.19–$821.96	—	76%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool - Send Out CQ	$94.34	$393.08	$16.49–$353.77	50% below	76%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool - Send Out CQ	$94.34	$393.08	$94.34–$353.77	—	76%
Ferritin blood test (iron stores) CPT 82728 Ferritin CQ	$122.33	$509.72	$11.46–$458.75	28% above	76%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$122.33	$509.72	$11.46–$458.75	28% above	76%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin CQ	$122.33	$509.72	$122.33–$458.75	—	76%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$122.33	$509.72	$122.33–$458.75	—	76%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$111.42	$464.23	$8.17–$417.81	21% above	76%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$111.42	$464.23	$111.42–$417.81	—	76%
Folate (folic acid) blood test CPT 82746 Folate Level	$70.26	$292.77	$12.35–$263.49	14% below	76%
Folate (folic acid) blood test CPT 82746 Folate, Serum CQ	$70.26	$292.77	$12.35–$263.49	14% below	76%
Folate (folic acid) blood test inpatient CPT 82746 Folate, Serum CQ	$70.26	$292.77	$70.26–$263.49	—	76%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$70.26	$292.77	$70.26–$263.49	—	76%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free	$241.02	$1,004.27	$14.23–$903.84	143% above	76%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free (CQ)	$241.02	$1,004.27	$14.23–$903.84	143% above	76%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free	$241.02	$1,004.27	$241.02–$903.84	—	76%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free (CQ)	$241.02	$1,004.27	$241.02–$903.84	—	76%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$47.59	$198.29	$7.58–$178.46	38% below	76%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free (CQ)	$47.59	$198.29	$7.58–$178.46	38% below	76%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, Free CQ	$47.59	$198.29	$7.58–$178.46	38% below	76%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$47.59	$198.29	$47.59–$178.46	—	76%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, Free CQ	$47.59	$198.29	$47.59–$178.46	—	76%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free (CQ)	$47.59	$198.29	$47.59–$178.46	—	76%
Free testosterone test CPT 84402 84402 Q36170 TESTOST FREE	$135.77	$565.70	$21.40–$509.13	11% above	76%
Free testosterone test CPT 84402 Testosterone Free Direct LC	$135.77	$565.70	$21.40–$509.13	11% above	76%
Free testosterone test CPT 84402 Testosterone Free - Send Out CQ	$135.77	$565.70	$21.40–$509.13	11% above	76%
Free testosterone test inpatient CPT 84402 84402 Q36170 TESTOST FREE	$135.77	$565.70	$135.77–$509.13	—	76%
Free testosterone test inpatient CPT 84402 Testosterone Free - Send Out CQ	$135.77	$565.70	$135.77–$509.13	—	76%
Free testosterone test inpatient CPT 84402 Testosterone Free Direct LC	$135.77	$565.70	$135.77–$509.13	—	76%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$97.70	$407.07	$6.05–$366.36	70% above	76%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT - BCE	$97.70	$407.07	$6.05–$366.36	70% above	76%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase Body Fluid	$97.70	$407.07	$6.05–$366.36	70% above	76%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT - BCE	$97.70	$407.07	$97.70–$366.36	—	76%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase Body Fluid	$97.70	$407.07	$97.70–$366.36	—	76%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$97.70	$407.07	$97.70–$366.36	—	76%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 $ General Health Panel	$261.74	$1,090.58	$23.56–$981.52	9% below	76%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 $ General Health Panel	$261.74	$1,090.58	$261.74–$981.52	—	76%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Postprandial	$120.09	$500.39	$3.99–$450.35	183% above	76%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 1st Hr OB	$120.09	$500.39	$3.99–$450.35	183% above	76%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Postprandial	$120.09	$500.39	$3.99–$450.35	183% above	76%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Postprandial	$120.09	$500.39	$120.09–$450.35	—	76%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Postprandial	$120.09	$500.39	$120.09–$450.35	—	76%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 1st Hr OB	$120.09	$500.39	$120.09–$450.35	—	76%
Glucose tolerance test, 3 samples CPT 82951 .LTT Fasting	$15.36	$64.00	$10.81–$57.60	83% below	76%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$143.89	$599.53	$10.81–$539.58	58% above	76%
Glucose tolerance test, 3 samples inpatient CPT 82951 .LTT Fasting	$15.36	$64.00	$15.36–$57.60	—	76%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$143.89	$599.53	$143.89–$539.58	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Q70051 N.GONORRHO,DN	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Q16506 NG AMP PRB	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea DNA Amplified Probe 2	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Q11363 N.GONORRHO DN	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea Chlamydia RNA TMA (CQ)	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea DNA Amplified Probe	$85.10	$354.59	$29.49–$319.13	6% above	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Q16506 NG AMP PRB	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea DNA Amplified Probe 2	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea DNA Amplified Probe	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea Chlamydia RNA TMA (CQ)	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Q11363 N.GONORRHO DN	$85.10	$354.59	$85.10–$319.13	—	76%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Q70051 N.GONORRHO,DN	$85.10	$354.59	$85.10–$319.13	—	76%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgG	$146.41	$610.03	$14.16–$549.03	83% above	76%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgM (LC)	$146.41	$610.03	$14.16–$549.03	83% above	76%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgM (LC)	$146.41	$610.03	$146.41–$549.03	—	76%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgG	$146.41	$610.03	$146.41–$549.03	—	76%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Ag EIA Stool (CQ)	$120.93	$503.88	$6.12–$453.49	2% above	76%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$120.93	$503.88	$6.12–$453.49	2% above	76%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$120.93	$503.88	$120.93–$453.49	—	76%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Ag EIA Stool (CQ)	$120.93	$503.88	$120.93–$453.49	—	76%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 RNA Quantitative Reflex HIV1 Genotype - Send	$705.44	$2,939.33	$71.51–$2,645.40	102% above	76%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV 1 RNA Quantitative RT PCR - Send Out CQ	$705.44	$2,939.33	$71.51–$2,645.40	102% above	76%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 RNA Quantitative Reflex HIV1 Genotype - Send	$705.44	$2,939.33	$705.44–$2,645.40	—	76%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV 1 RNA Quantitative RT PCR - Send Out CQ	$705.44	$2,939.33	$705.44–$2,645.40	—	76%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SO 87624 AP Bill HPV High Risk Types	$48.99	$204.12	$29.49–$183.71	56% below	76%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SO 87624 AP Bill HPV High Risk Types	$48.99	$204.12	$48.99–$183.71	—	76%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (CQ)	$270.70	$1,127.91	$8.16–$1,015.12	349% above	76%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$270.70	$1,127.91	$8.16–$1,015.12	349% above	76%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$270.70	$1,127.91	$270.70–$1,015.12	—	76%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (CQ)	$270.70	$1,127.91	$270.70–$1,015.12	—	76%
Hemoglobin blood test CPT 85018 85018 Q35489 HEMOGLOBIN	$80.06	$333.59	$2.00–$300.23	189% above	76%
Hemoglobin blood test CPT 85018 Hemoglobin	$80.06	$333.59	$2.00–$300.23	189% above	76%
Hemoglobin blood test CPT 85018 85018 HEMOGLOBIN 171	$80.06	$333.59	$2.00–$300.23	189% above	76%
Hemoglobin blood test inpatient CPT 85018 85018 HEMOGLOBIN 171	$80.06	$333.59	$80.06–$300.23	—	76%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$80.06	$333.59	$80.06–$300.23	—	76%
Hemoglobin blood test inpatient CPT 85018 85018 Q35489 HEMOGLOBIN	$80.06	$333.59	$80.06–$300.23	—	76%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab Total (CQ)	$136.05	$566.87	$10.13–$510.18	103% above	76%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Ab Total (CQ)	$136.05	$566.87	$136.05–$510.18	—	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab w/Interp	$132.41	$551.71	$9.03–$496.54	97% above	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody w/Interp	$132.41	$551.71	$9.03–$496.54	97% above	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab Qual (CQ)	$132.41	$551.71	$9.03–$496.54	97% above	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB - BCE	$132.41	$551.71	$9.03–$496.54	97% above	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab Qual (CQ)	$132.41	$551.71	$132.41–$496.54	—	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody w/Interp	$132.41	$551.71	$132.41–$496.54	—	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB - BCE	$132.41	$551.71	$132.41–$496.54	—	76%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab w/Interp	$132.41	$551.71	$132.41–$496.54	—	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Confirmation (CQ)	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag w/Reflex Confirm (CQ)	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Donor, Hep BS Ag w/Rfx Conf (CQ)	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag w/Interp	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG- BCE	$161.24	$671.85	$8.68–$604.67	158% above	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG- BCE	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Donor, Hep BS Ag w/Rfx Conf (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag w/Reflex Confirm (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Confirmation (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag w/Interp	$161.24	$671.85	$161.24–$604.67	—	76%
Hepatitis C antibody blood test (screening) CPT 86803 HCAB2	$210.51	$877.13	$11.99–$789.42	171% above	76%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody (LC)	$210.51	$877.13	$11.99–$789.42	171% above	76%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C IgG Antibody	$210.51	$877.13	$11.99–$789.42	171% above	76%
Hepatitis C antibody blood test (screening) one side CPT 86803 Hepatitis C Antibody w/Reflex HCV RNA Quan RT PCR	$210.51	$877.13	$11.99–$789.42	171% above	76%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C IgG Antibody	$210.51	$877.13	$210.51–$789.42	—	76%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCAB2	$210.51	$877.13	$210.51–$789.42	—	76%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody (LC)	$210.51	$877.13	$210.51–$789.42	—	76%
Hepatitis C antibody blood test (screening) inpatient one side CPT 86803 Hepatitis C Antibody w/Reflex HCV RNA Quan RT PCR	$210.51	$877.13	$210.51–$789.42	—	76%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$294.49	$1,227.05	$36.00–$1,104.34	1% below	76%
Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA, Quantitative Real Time PCR (CQ)	$294.49	$1,227.05	$36.00–$1,104.34	1% below	76%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Quant PCR (CQ)	$294.49	$1,227.05	$36.00–$1,104.34	1% below	76%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Quant Progess Genotyping (CQ	$294.49	$1,227.05	$36.00–$1,104.34	1% below	76%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$294.49	$1,227.05	$36.00–$1,104.34	1% below	76%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV RNA, Quantitative Real Time PCR (CQ)	$294.49	$1,227.05	$294.49–$1,104.34	—	76%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Quant Progess Genotyping (CQ	$294.49	$1,227.05	$294.49–$1,104.34	—	76%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Quant PCR (CQ)	$294.49	$1,227.05	$294.49–$1,104.34	—	76%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$294.49	$1,227.05	$294.49–$1,104.34	—	76%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$294.49	$1,227.05	$294.49–$1,104.34	—	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Q8542XHSV1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 Type Specific Antibody IgG	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Q6447 HERPES SMP TP1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 HERPES SIMP TYPE 1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Q90849HERPES SMP TP1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Q90851HERPES SMP TP1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 .Herpes Simplex Virus 1 IgM Titer - Send Out CQ	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Q17169 HSV1	$91.54	$381.41	$11.09–$343.27	43% above	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Q8542XHSV1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Q17169 HSV1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Q6447 HERPES SMP TP1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Q90851HERPES SMP TP1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Q90849HERPES SMP TP1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 HERPES SIMP TYPE 1	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 Type Specific Antibody IgG	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 .Herpes Simplex Virus 1 IgM Titer - Send Out CQ	$91.54	$381.41	$91.54–$343.27	—	76%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus 2 Specific Antibody IgG (LC)	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Q8542X HSV2	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Q6447 HERPES SMP TP2	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Q90851HERPES SMP TP2	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Q90849HERPES SMP TP2	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Q17169 HSV2	$27.99	$116.64	$16.26–$104.98	56% below	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Q90851HERPES SMP TP2	$27.99	$116.64	$27.99–$104.98	—	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Q17169 HSV2	$27.99	$116.64	$27.99–$104.98	—	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Q8542X HSV2	$27.99	$116.64	$27.99–$104.98	—	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus 2 Specific Antibody IgG (LC)	$27.99	$116.64	$27.99–$104.98	—	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Q90849HERPES SMP TP2	$27.99	$116.64	$27.99–$104.98	—	76%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Q6447 HERPES SMP TP2	$27.99	$116.64	$27.99–$104.98	—	76%
High-sensitivity CRP (hs-CRP) test CPT 86141 Cardio IQ(R) hs-CRP CQ	$75.58	$314.93	$10.88–$283.44	5% above	76%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitivity (CQ)	$75.58	$314.93	$10.88–$283.44	5% above	76%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Cardio IQ(R) hs-CRP CQ	$75.58	$314.93	$75.58–$283.44	—	76%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein High Sensitivity (CQ)	$75.58	$314.93	$75.58–$283.44	—	76%
Homocysteine blood test CPT 83090 Homocysteine - Send Out to CQ	$604.94	$2,520.59	$15.06–$2,268.53	398% above	76%
Homocysteine blood test inpatient CPT 83090 Homocysteine - Send Out to CQ	$604.94	$2,520.59	$604.94–$2,268.53	—	76%
Insulin blood test CPT 83525 Insulin - Send Out to CQ	$201.27	$838.64	$9.60–$754.78	234% above	76%
Insulin blood test CPT 83525 Insulin LC	$201.27	$838.64	$9.60–$754.78	234% above	76%
Insulin blood test inpatient CPT 83525 Insulin - Send Out to CQ	$201.27	$838.64	$201.27–$754.78	—	76%
Insulin blood test inpatient CPT 83525 Insulin LC	$201.27	$838.64	$201.27–$754.78	—	76%
Iron blood test (serum iron) CPT 83540 83540 IRON	$70.26	$292.77	$5.43–$263.49	54% above	76%
Iron blood test (serum iron) CPT 83540 83540 Q7573 IRON	$70.26	$292.77	$5.43–$263.49	54% above	76%
Iron blood test (serum iron) CPT 83540 IRON	$70.26	$292.77	$5.43–$263.49	54% above	76%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$70.26	$292.77	$70.26–$263.49	—	76%
Iron blood test (serum iron) inpatient CPT 83540 83540 Q7573 IRON	$70.26	$292.77	$70.26–$263.49	—	76%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$70.26	$292.77	$70.26–$263.49	—	76%
Iron-binding capacity (TIBC) test CPT 83550 83550 Q7573 IRON BINDING C	$70.26	$292.77	$7.34–$263.49	5% above	76%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity DM	$70.26	$292.77	$7.34–$263.49	5% above	76%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACIT	$70.26	$292.77	$7.34–$263.49	5% above	76%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING CAPACIT	$70.26	$292.77	$70.26–$263.49	—	76%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 Q7573 IRON BINDING C	$70.26	$292.77	$70.26–$263.49	—	76%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity DM	$70.26	$292.77	$70.26–$263.49	—	76%
Kidney function blood test panel CPT 80069 RFP	$282.73	$1,178.06	$7.30–$1,060.25	159% above	76%
Kidney function blood test panel inpatient CPT 80069 RFP	$282.73	$1,178.06	$282.73–$1,060.25	—	76%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$246.34	$1,026.43	$15.56–$923.79	142% above	76%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (CQ)	$246.34	$1,026.43	$15.56–$923.79	142% above	76%
LH (luteinizing hormone) test CPT 83002 83002 Q7137 LH	$246.34	$1,026.43	$15.56–$923.79	142% above	76%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$246.34	$1,026.43	$246.34–$923.79	—	76%
LH (luteinizing hormone) test inpatient CPT 83002 83002 Q7137 LH	$246.34	$1,026.43	$246.34–$923.79	—	76%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone (CQ)	$246.34	$1,026.43	$246.34–$923.79	—	76%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex	$75.30	$313.76	$9.72–$282.38	14% below	76%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid	$75.30	$313.76	$9.72–$282.38	14% below	76%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid w/ Reflex LA	$75.30	$313.76	$9.72–$282.38	14% below	76%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex 2	$75.30	$313.76	$9.72–$282.38	14% below	76%
Lactate (lactic acid) blood test CPT 83605 .Lactate POC	$75.30	$313.76	$9.72–$282.38	14% below	76%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex	$75.30	$313.76	$75.30–$282.38	—	76%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid	$75.30	$313.76	$75.30–$282.38	—	76%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid w/ Reflex LA	$75.30	$313.76	$75.30–$282.38	—	76%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactate POC	$75.30	$313.76	$75.30–$282.38	—	76%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex 2	$75.30	$313.76	$75.30–$282.38	—	76%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$88.18	$367.42	$5.07–$330.68	72% above	76%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$88.18	$367.42	$5.07–$330.68	72% above	76%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase (CQ)	$88.18	$367.42	$5.07–$330.68	72% above	76%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase (CQ)	$88.18	$367.42	$88.18–$330.68	—	76%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$88.18	$367.42	$88.18–$330.68	—	76%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$88.18	$367.42	$88.18–$330.68	—	76%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$292.53	$1,218.89	$5.79–$1,097.00	290% above	76%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Peritoneal Fluid Sendout to CQ	$292.53	$1,218.89	$5.79–$1,097.00	290% above	76%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid	$292.53	$1,218.89	$5.79–$1,097.00	290% above	76%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$292.53	$1,218.89	$292.53–$1,097.00	—	76%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Peritoneal Fluid Sendout to CQ	$292.53	$1,218.89	$292.53–$1,097.00	—	76%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid	$292.53	$1,218.89	$292.53–$1,097.00	—	76%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$328.92	$1,370.52	$6.87–$1,233.47	192% above	76%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$328.92	$1,370.52	$328.92–$1,233.47	—	76%
Lyme disease antibody test CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$45.35	$188.96	$14.31–$170.06	51% below	76%
Lyme disease antibody test CPT 86618 Borrelia burgdorferi Antibody Total EIA (CQ)	$45.35	$188.96	$14.31–$170.06	51% below	76%
Lyme disease antibody test inpatient CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$45.35	$188.96	$45.35–$170.06	—	76%
Lyme disease antibody test inpatient CPT 86618 Borrelia burgdorferi Antibody Total EIA (CQ)	$45.35	$188.96	$45.35–$170.06	—	76%
Magnesium blood test CPT 83735 Magnesium Urine	$313.25	$1,305.20	$5.63–$1,174.68	559% above	76%
Magnesium blood test CPT 83735 Magnesium Serum	$313.25	$1,305.20	$5.63–$1,174.68	559% above	76%
Magnesium blood test CPT 83735 83735 Q442 MAGNESIUM	$313.25	$1,305.20	$5.63–$1,174.68	559% above	76%
Magnesium blood test CPT 83735 Magnesium Red Blood Cell - Send Out to NQ CQ	$313.25	$1,305.20	$5.63–$1,174.68	559% above	76%
Magnesium blood test CPT 83735 83735 Q14460 MAGNESIUM	$313.25	$1,305.20	$5.63–$1,174.68	559% above	76%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$313.25	$1,305.20	$313.25–$1,174.68	—	76%
Magnesium blood test inpatient CPT 83735 83735 Q442 MAGNESIUM	$313.25	$1,305.20	$313.25–$1,174.68	—	76%
Magnesium blood test inpatient CPT 83735 Magnesium Urine	$313.25	$1,305.20	$313.25–$1,174.68	—	76%
Magnesium blood test inpatient CPT 83735 83735 Q14460 MAGNESIUM	$313.25	$1,305.20	$313.25–$1,174.68	—	76%
Magnesium blood test inpatient CPT 83735 Magnesium Red Blood Cell - Send Out to NQ CQ	$313.25	$1,305.20	$313.25–$1,174.68	—	76%
Measles (rubeola) antibody test CPT 86765 Measles Antibody IgM IFA - Send Out CQ	$35.27	$146.97	$10.82–$132.27	31% below	76%
Measles (rubeola) antibody test CPT 86765 Measles IgG (Rubeola) - Send Out CQ	$35.27	$146.97	$10.82–$132.27	31% below	76%
Measles (rubeola) antibody test inpatient CPT 86765 Measles IgG (Rubeola) - Send Out CQ	$35.27	$146.97	$35.27–$132.27	—	76%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Antibody IgM IFA - Send Out CQ	$35.27	$146.97	$35.27–$132.27	—	76%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$122.89	$512.05	$4.35–$460.84	197% above	76%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$122.89	$512.05	$122.89–$460.84	—	76%
Mumps immunity blood test CPT 86735 Mumps Virus IgG - Send Out CQ	$137.17	$571.54	$10.96–$514.39	132% above	76%
Mumps immunity blood test CPT 86735 Mumps Virus Antibodies IgG IgM Sendout to CQ	$137.17	$571.54	$10.96–$514.39	132% above	76%
Mumps immunity blood test CPT 86735 Mumps Virus Ab (IgM) CQ	$137.17	$571.54	$10.96–$514.39	132% above	76%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibodies IgG IgM Sendout to CQ	$137.17	$571.54	$137.17–$514.39	—	76%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus IgG - Send Out CQ	$137.17	$571.54	$137.17–$514.39	—	76%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab (IgM) CQ	$137.17	$571.54	$137.17–$514.39	—	76%
Obstetric blood test panel CPT 80055 Obstetric Panel CS	$1,077.19	$4,488.31	$36.52–$4,039.48	265% above	76%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS	$1,077.19	$4,488.31	$1,077.19–$4,039.48	—	76%
PSA (prostate-specific antigen) blood test, free CPT 84154 84154 Q31348 PSA FREE	$52.07	$216.95	$15.46–$195.26	35% below	76%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 Q31348 PSA FREE	$52.07	$216.95	$52.07–$195.26	—	76%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 Q31348 PSA TOTAL	$252.22	$1,050.93	$15.46–$945.84	221% above	76%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$252.22	$1,050.93	$15.46–$945.84	221% above	76%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 Q31348 PSA TOTAL	$252.22	$1,050.93	$252.22–$945.84	—	76%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$252.22	$1,050.93	$252.22–$945.84	—	76%
Parathyroid hormone (PTH) blood test CPT 83970 83970 Q8837 PARATHORMONE P	$401.15	$1,671.45	$34.68–$1,504.30	127% above	76%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$401.15	$1,671.45	$34.68–$1,504.30	127% above	76%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Intraop	$401.15	$1,671.45	$34.68–$1,504.30	127% above	76%
Parathyroid hormone (PTH) blood test CPT 83970 zzParathyroid Hormone Intact (CQ)	$401.15	$1,671.45	$34.68–$1,504.30	127% above	76%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact w/o Calcium CQ	$401.15	$1,671.45	$34.68–$1,504.30	127% above	76%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Intraop	$401.15	$1,671.45	$401.15–$1,504.30	—	76%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 zzParathyroid Hormone Intact (CQ)	$401.15	$1,671.45	$401.15–$1,504.30	—	76%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 83970 Q8837 PARATHORMONE P	$401.15	$1,671.45	$401.15–$1,504.30	—	76%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$401.15	$1,671.45	$401.15–$1,504.30	—	76%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact w/o Calcium CQ	$401.15	$1,671.45	$401.15–$1,504.30	—	76%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 Q7079 THROMBOPLAST T	$8.40	$34.99	$5.05–$31.49	84% below	76%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$160.40	$668.35	$5.05–$601.52	197% above	76%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thromboplastin Time (CQ)	$160.40	$668.35	$5.05–$601.52	197% above	76%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 Q7079 THROMBOPLAST T	$8.40	$34.99	$8.40–$31.49	—	76%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Thromboplastin Time (CQ)	$160.40	$668.35	$160.40–$601.52	—	76%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$160.40	$668.35	$160.40–$601.52	—	76%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum	$207.15	$863.14	$3.98–$776.83	453% above	76%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum	$207.15	$863.14	$207.15–$776.83	—	76%
Potassium blood test CPT 84132 84132 POTASSIUM SER PL WB	$52.35	$218.12	$4.00–$196.31	33% above	76%
Potassium blood test CPT 84132 Potassium Serum	$52.35	$218.12	$4.00–$196.31	33% above	76%
Potassium blood test inpatient CPT 84132 Potassium Serum	$52.35	$218.12	$52.35–$196.31	—	76%
Potassium blood test inpatient CPT 84132 84132 POTASSIUM SER PL WB	$52.35	$218.12	$52.35–$196.31	—	76%
Progesterone blood test CPT 84144 Progesterone - Send Out CQ	$223.39	$930.79	$17.53–$837.71	105% above	76%
Progesterone blood test inpatient CPT 84144 Progesterone - Send Out CQ	$223.39	$930.79	$223.39–$837.71	—	76%
Prolactin blood test CPT 84146 Prolactin - Send Out to CQ	$271.26	$1,130.24	$16.28–$1,017.22	132% above	76%
Prolactin blood test CPT 84146 Prolactin Level	$271.26	$1,130.24	$16.28–$1,017.22	132% above	76%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$271.26	$1,130.24	$271.26–$1,017.22	—	76%
Prolactin blood test inpatient CPT 84146 Prolactin - Send Out to CQ	$271.26	$1,130.24	$271.26–$1,017.22	—	76%
Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC	$106.93	$445.56	$3.60–$401.00	275% above	76%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$106.93	$445.56	$3.60–$401.00	275% above	76%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC	$106.93	$445.56	$106.93–$401.00	—	76%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$106.93	$445.56	$106.93–$401.00	—	76%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen Result	$115.33	$480.56	$12.45–$432.50	95% above	76%
Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen Result	$115.33	$480.56	$12.45–$432.50	95% above	76%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$115.33	$480.56	$12.45–$432.50	95% above	76%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen Result	$115.33	$480.56	$115.33–$432.50	—	76%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$115.33	$480.56	$115.33–$432.50	—	76%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen Result	$115.33	$480.56	$115.33–$432.50	—	76%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 .Rapid Strep A POC	$22.12	$92.15	$12.87–$82.94	51% below	76%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Streptococcus A Antigen IA1	$22.12	$92.15	$12.87–$82.94	51% below	76%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A FIA	$22.12	$92.15	$12.87–$82.94	51% below	76%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 .Rapid Strep A POC	$22.12	$92.15	$22.12–$82.94	—	76%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A FIA	$22.12	$92.15	$22.12–$82.94	—	76%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Streptococcus A Antigen IA1	$22.12	$92.15	$22.12–$82.94	—	76%
Renin blood test CPT 84244 Plasma Renin Activity LC/MS/MS CQ	$399.19	$1,663.29	$18.48–$1,496.96	216% above	76%
Renin blood test inpatient CPT 84244 Plasma Renin Activity LC/MS/MS CQ	$399.19	$1,663.29	$399.19–$1,496.96	—	76%
Rh blood typing CPT 86901 BB Bill Rh Test	$102.74	$428.07	$2.99–$385.26	129% above	76%
Rh blood typing inpatient CPT 86901 BB Bill Rh Test	$102.74	$428.07	$102.74–$385.26	—	76%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (CQ)	$7.94	$33.07	$4.77–$29.76	84% below	76%
Rheumatoid factor (RF) test CPT 86431 86431 Q37491 RHEUMATOID FA	$7.94	$33.07	$4.77–$29.76	84% below	76%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Titer	$46.75	$194.79	$4.77–$175.31	5% below	76%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (CQ)	$7.94	$33.07	$7.94–$29.76	—	76%
Rheumatoid factor (RF) test inpatient CPT 86431 86431 Q37491 RHEUMATOID FA	$7.94	$33.07	$7.94–$29.76	—	76%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Titer	$46.75	$194.79	$46.75–$175.31	—	76%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$101.62	$423.40	$12.09–$381.06	98% above	76%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgM - Send Out CQ	$101.62	$423.40	$12.09–$381.06	98% above	76%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody	$101.62	$423.40	$12.09–$381.06	98% above	76%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG - Send Out to CQ	$101.62	$423.40	$12.09–$381.06	98% above	76%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$101.62	$423.40	$101.62–$381.06	—	76%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgM - Send Out CQ	$101.62	$423.40	$101.62–$381.06	—	76%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG - Send Out to CQ	$101.62	$423.40	$101.62–$381.06	—	76%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody	$101.62	$423.40	$101.62–$381.06	—	76%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESRA	$176.36	$734.83	$2.27–$661.35	413% above	76%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESRA	$176.36	$734.83	$176.36–$661.35	—	76%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis w/Differential	$233.75	$973.94	$10.35–$876.55	58% above	76%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis w/Differential	$233.75	$973.94	$233.75–$876.55	—	76%
Sodium blood test CPT 84295 Sodium Serum	$83.42	$347.59	$4.04–$312.83	112% above	76%
Sodium blood test CPT 84295 84295 SODIUM,SER PL OR WB	$83.42	$347.59	$4.04–$312.83	112% above	76%
Sodium blood test inpatient CPT 84295 Sodium Serum	$83.42	$347.59	$83.42–$312.83	—	76%
Sodium blood test inpatient CPT 84295 84295 SODIUM,SER PL OR WB	$83.42	$347.59	$83.42–$312.83	—	76%
Stool test for hidden blood (guaiac FOBT) CPT 82270 FOBT	$80.90	$337.09	$3.68–$303.38	272% above	76%
Stool test for hidden blood (guaiac FOBT) CPT 82270 .POCFecOB	$80.90	$337.09	$3.68–$303.38	272% above	76%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 FOBT	$80.90	$337.09	$80.90–$303.38	—	76%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 .POCFecOB	$80.90	$337.09	$80.90–$303.38	—	76%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Ab PA (CQ)	$123.45	$514.38	$11.12–$462.94	142% above	76%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponema Ab Absorption (CQ)	$123.45	$514.38	$11.12–$462.94	142% above	76%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody Cascading Reflex Sendout to CQ	$123.45	$514.38	$11.12–$462.94	142% above	76%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponema Ab Absorption (CQ)	$123.45	$514.38	$123.45–$462.94	—	76%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Ab PA (CQ)	$123.45	$514.38	$123.45–$462.94	—	76%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Antibody Cascading Reflex Sendout to CQ	$123.45	$514.38	$123.45–$462.94	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF CQ	$5.88	$24.49	$3.59–$22.04	79% below	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SerumCQ	$207.99	$866.64	$3.59–$779.98	643% above	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR,(DX)w/Reflex to Titer & Confirmatory Testing C	$207.99	$866.64	$3.59–$779.98	643% above	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Monitor w/Reflex Titer (CQ)	$207.99	$866.64	$3.59–$779.98	643% above	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual	$207.99	$866.64	$3.59–$779.98	643% above	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$207.99	$866.64	$3.59–$779.98	643% above	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF CQ	$5.88	$24.49	$5.88–$22.04	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual	$207.99	$866.64	$207.99–$779.98	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Monitor w/Reflex Titer (CQ)	$207.99	$866.64	$207.99–$779.98	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR,(DX)w/Reflex to Titer & Confirmatory Testing C	$207.99	$866.64	$207.99–$779.98	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$207.99	$866.64	$207.99–$779.98	—	76%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, SerumCQ	$207.99	$866.64	$207.99–$779.98	—	76%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus, 1 Tube CQ	$93.78	$390.74	$52.08–$351.67	48% below	76%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Q36971 TB QFT PL 4TU - BCE	$93.78	$390.74	$52.08–$351.67	48% below	76%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon(R)-TB Gold Plus, 4T, Incubated (CQ)	$93.78	$390.74	$52.08–$351.67	48% below	76%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Q36971 TB QFT PL 4TU - BCE	$93.78	$390.74	$93.78–$351.67	—	76%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon(R)-TB Gold Plus, 4T, Incubated (CQ)	$93.78	$390.74	$93.78–$351.67	—	76%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus, 1 Tube CQ	$93.78	$390.74	$93.78–$351.67	—	76%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total LC-MS/MS - Send Out to CQ	$299.25	$1,246.88	$21.69–$1,122.19	151% above	76%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 Q36170 TESTOST TOTAL	$299.25	$1,246.88	$21.69–$1,122.19	151% above	76%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Males - Send Out CQ	$299.25	$1,246.88	$21.69–$1,122.19	151% above	76%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$299.25	$1,246.88	$21.69–$1,122.19	151% above	76%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$299.25	$1,246.88	$299.25–$1,122.19	—	76%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total Males - Send Out CQ	$299.25	$1,246.88	$299.25–$1,122.19	—	76%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total LC-MS/MS - Send Out to CQ	$299.25	$1,246.88	$299.25–$1,122.19	—	76%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 Q36170 TESTOST TOTAL	$299.25	$1,246.88	$299.25–$1,122.19	—	76%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 Q37491 MICROSOMAL AB	$20.37	$84.86	$12.23–$76.37	74% below	76%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 Q19873 MICROSOML AB	$20.44	$85.15	$12.23–$76.64	74% below	76%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsome IgG - Send Out to CQ	$87.06	$362.75	$12.23–$326.48	11% above	76%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (CQ)	$87.06	$362.75	$12.23–$326.48	11% above	76%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 Q37491 MICROSOMAL AB	$20.37	$84.86	$20.37–$76.37	—	76%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 Q19873 MICROSOML AB	$20.44	$85.15	$20.44–$76.64	—	76%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (CQ)	$87.06	$362.75	$87.06–$326.48	—	76%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Kidney Microsome IgG - Send Out to CQ	$87.06	$362.75	$87.06–$326.48	—	76%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 NBS THYROID STIM TSH	$29.39	$122.47	$14.12–$110.22	28% below	76%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$251.38	$1,047.43	$14.12–$942.69	519% above	76%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone (CQ)	$251.38	$1,047.43	$14.12–$942.69	519% above	76%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$251.38	$1,047.43	$14.12–$942.69	519% above	76%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex to T4 Total	$251.38	$1,047.43	$14.12–$942.69	519% above	76%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 NBS THYROID STIM TSH	$29.39	$122.47	$29.39–$110.22	—	76%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone (CQ)	$251.38	$1,047.43	$251.38–$942.69	—	76%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$251.38	$1,047.43	$251.38–$942.69	—	76%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex to T4 Total	$251.38	$1,047.43	$251.38–$942.69	—	76%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$251.38	$1,047.43	$251.38–$942.69	—	76%
Total IgE blood test CPT 82785 82785 Q10659 GAMMAGLOB IGE	$41.43	$172.63	$13.83–$155.37	43% below	76%
Total IgE blood test CPT 82785 82785 Q10649X GAMMAGLB IGE	$41.43	$172.63	$13.83–$155.37	43% below	76%
Total IgE blood test CPT 82785 Immunoglobulin E Total (LC)	$41.43	$172.63	$13.83–$155.37	43% below	76%
Total IgE blood test CPT 82785 Immunoglobulin E (CQ)	$41.43	$172.63	$13.83–$155.37	43% below	76%
Total IgE blood test inpatient CPT 82785 82785 Q10649X GAMMAGLB IGE	$41.43	$172.63	$41.43–$155.37	—	76%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E Total (LC)	$41.43	$172.63	$41.43–$155.37	—	76%
Total IgE blood test inpatient CPT 82785 82785 Q10659 GAMMAGLOB IGE	$41.43	$172.63	$41.43–$155.37	—	76%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E (CQ)	$41.43	$172.63	$41.43–$155.37	—	76%
Total cholesterol blood test CPT 82465 Cholesterol	$7.00	$29.16	$3.66–$26.24	79% below	76%
Total cholesterol blood test CPT 82465 Cholesterol Body Fluid	$7.00	$29.16	$3.66–$26.24	79% below	76%
Total cholesterol blood test inpatient CPT 82465 Cholesterol	$7.00	$29.16	$7.00–$26.24	—	76%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Body Fluid	$7.00	$29.16	$7.00–$26.24	—	76%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 Total	$332.84	$1,386.85	$5.78–$1,248.16	462% above	76%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 Total (CQ)	$332.84	$1,386.85	$5.78–$1,248.16	462% above	76%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 (LC)	$332.84	$1,386.85	$5.78–$1,248.16	462% above	76%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 Total (CQ)	$332.84	$1,386.85	$332.84–$1,248.16	—	76%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 (LC)	$332.84	$1,386.85	$332.84–$1,248.16	—	76%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 Total	$332.84	$1,386.85	$332.84–$1,248.16	—	76%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine 3 Total (CQ)	$146.97	$612.36	$11.91–$551.12	95% above	76%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (LC)	$146.97	$612.36	$11.91–$551.12	95% above	76%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine 3 Total (CQ)	$146.97	$612.36	$146.97–$551.12	—	76%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (LC)	$146.97	$612.36	$146.97–$551.12	—	76%
Transferrin blood test CPT 84466 Transferrin - Send Out to CQ	$166.56	$694.01	$10.73–$624.61	97% above	76%
Transferrin blood test inpatient CPT 84466 Transferrin - Send Out to CQ	$166.56	$694.01	$166.56–$624.61	—	76%
Trichomonas test (NAAT) CPT 87661 Trichomonasvaginalis RNA,Qual TMA CQ	$157.88	$657.85	$29.49–$592.07	15% above	76%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis RNA Ql TMA Males (CQ)	$157.88	$657.85	$29.49–$592.07	15% above	76%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonasvaginalis RNA,Qual TMA CQ	$157.88	$657.85	$157.88–$592.07	—	76%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis RNA Ql TMA Males (CQ)	$157.88	$657.85	$157.88–$592.07	—	76%
Triglycerides blood test CPT 84478 Triglycerides	$185.04	$770.99	$4.83–$693.89	311% above	76%
Triglycerides blood test CPT 84478 Triglycerides Body Fluid	$185.04	$770.99	$4.83–$693.89	311% above	76%
Triglycerides blood test inpatient CPT 84478 Triglycerides Body Fluid	$185.04	$770.99	$185.04–$693.89	—	76%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$185.04	$770.99	$185.04–$693.89	—	76%
Troponin test, quantitative CPT 84484 .Troponin I HS 4 Hour	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 Troponin I Quant	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 Troponin I HS	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 Troponin I HS x 3 Series	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 Troponin T Quant	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 .ISTAT cTroponin I POC	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 .Troponin I HS 3 Hour	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 .Troponin I HS 1 Hour	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 Troponin I (LC)	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 .Troponin I HS 2 Hour	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative CPT 84484 .Troponin I Quant POC	$188.96	$787.32	$10.48–$708.59	71% above	76%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 4 Hour	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 1 Hour	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 Troponin I HS	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 3 Hour	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 2 Hour	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 Troponin I (LC)	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 Troponin T Quant	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 Troponin I Quant	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant POC	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 .ISTAT cTroponin I POC	$188.96	$787.32	$188.96–$708.59	—	76%
Troponin test, quantitative inpatient CPT 84484 Troponin I HS x 3 Series	$188.96	$787.32	$188.96–$708.59	—	76%
Uric acid blood test CPT 84550 Uric Acid Level	$235.99	$983.28	$3.80–$884.95	467% above	76%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$235.99	$983.28	$235.99–$884.95	—	76%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Microscopic Automated	$110.85	$461.89	$2.66–$415.70	217% above	76%
Urinalysis with microscope exam, automated CPT 81001 Perform Microscopic - Yes	$110.85	$461.89	$2.66–$415.70	217% above	76%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$110.85	$461.89	$2.66–$415.70	217% above	76%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$110.85	$461.89	$110.85–$415.70	—	76%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Microscopic Automated	$110.85	$461.89	$110.85–$415.70	—	76%
Urinalysis with microscope exam, automated inpatient CPT 81001 Perform Microscopic - Yes	$110.85	$461.89	$110.85–$415.70	—	76%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis w/Microscopic Manual	$10.92	$45.49	$3.38–$40.94	59% below	76%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis w/Microscopic Manual	$10.92	$45.49	$10.92–$40.94	—	76%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic Automated	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated CPT 81003 Reflex Microscopic Type? - Not Required	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated CPT 81003 Perform Microscopic - No	$79.50	$331.26	$1.89–$298.13	254% above	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 Reflex Microscopic Type? - Not Required	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 Perform Microscopic - No	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic Automated	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$79.50	$331.26	$79.50–$298.13	—	76%
Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc	$55.71	$232.11	$2.93–$208.90	304% above	76%
Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql	$55.71	$232.11	$2.93–$208.90	304% above	76%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis w/o Microscopic Manual	$55.71	$232.11	$2.93–$208.90	304% above	76%
Urinalysis without microscope exam, manual CPT 81002 .Urinalysis Manual w/o MicroSc POC	$55.71	$232.11	$2.93–$208.90	304% above	76%
Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual	$55.71	$232.11	$2.93–$208.90	304% above	76%
Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual	$55.71	$232.11	$55.71–$208.90	—	76%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Urinalysis Manual w/o MicroSc POC	$55.71	$232.11	$55.71–$208.90	—	76%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc	$55.71	$232.11	$55.71–$208.90	—	76%
Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql	$55.71	$232.11	$55.71–$208.90	—	76%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis w/o Microscopic Manual	$55.71	$232.11	$55.71–$208.90	—	76%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$245.78	$1,024.10	$6.78–$921.69	267% above	76%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$245.78	$1,024.10	$245.78–$921.69	—	76%
Urine microalbumin (albumin) test CPT 82043 82043 Q6517 MICROALB QNT	$54.87	$228.61	$4.85–$205.75	59% above	76%
Urine microalbumin (albumin) test CPT 82043 Microalbumin, Random Urine CQ	$54.87	$228.61	$4.85–$205.75	59% above	76%
Urine microalbumin (albumin) test CPT 82043 MicroAlb QNT Random	$54.87	$228.61	$4.85–$205.75	59% above	76%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine 24 Hour	$54.87	$228.61	$4.85–$205.75	59% above	76%
Urine microalbumin (albumin) test CPT 82043 Creatinine, Random Urine CQ	$54.87	$228.61	$4.85–$205.75	59% above	76%
Urine microalbumin (albumin) test inpatient CPT 82043 Creatinine, Random Urine CQ	$54.87	$228.61	$54.87–$205.75	—	76%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin, Random Urine CQ	$54.87	$228.61	$54.87–$205.75	—	76%
Urine microalbumin (albumin) test inpatient CPT 82043 MicroAlb QNT Random	$54.87	$228.61	$54.87–$205.75	—	76%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 24 Hour	$54.87	$228.61	$54.87–$205.75	—	76%
Urine microalbumin (albumin) test inpatient CPT 82043 82043 Q6517 MICROALB QNT	$54.87	$228.61	$54.87–$205.75	—	76%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Negative	$319.97	$1,333.20	$7.24–$1,199.88	560% above	76%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Positive	$319.97	$1,333.20	$7.24–$1,199.88	560% above	76%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$319.97	$1,333.20	$7.24–$1,199.88	560% above	76%
Urine pregnancy test, read by color change CPT 81025 .HCG Urine Ql POC	$319.97	$1,333.20	$7.24–$1,199.88	560% above	76%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$319.97	$1,333.20	$7.24–$1,199.88	560% above	76%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$319.97	$1,333.20	$319.97–$1,199.88	—	76%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Negative	$319.97	$1,333.20	$319.97–$1,199.88	—	76%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$319.97	$1,333.20	$319.97–$1,199.88	—	76%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Positive	$319.97	$1,333.20	$319.97–$1,199.88	—	76%
Urine pregnancy test, read by color change inpatient CPT 81025 .HCG Urine Ql POC	$319.97	$1,333.20	$319.97–$1,199.88	—	76%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$81.46	$339.42	$12.67–$305.48	4% above	76%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Serum - Send Out CQ	$81.46	$339.42	$12.67–$305.48	4% above	76%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Serum - Send Out CQ	$81.46	$339.42	$81.46–$305.48	—	76%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$81.46	$339.42	$81.46–$305.48	—	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$114.21	$475.89	$24.87–$428.30	16% below	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$114.21	$475.89	$24.87–$428.30	16% below	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 OH LC-MS/MS - Send Out to CQ	$114.21	$475.89	$24.87–$428.30	16% below	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy LC	$114.21	$475.89	$24.87–$428.30	16% below	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$114.21	$475.89	$114.21–$428.30	—	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$114.21	$475.89	$114.21–$428.30	—	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 OH LC-MS/MS - Send Out to CQ	$114.21	$475.89	$114.21–$428.30	—	76%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy LC	$114.21	$475.89	$114.21–$428.30	—	76%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol Level (LC)	$178.04	$741.83	$32.35–$667.65	3% above	76%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D1 25 OH LC-MS/MS - Send Out to CQ	$178.04	$741.83	$32.35–$667.65	3% above	76%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol Level (LC)	$178.04	$741.83	$178.04–$667.65	—	76%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D1 25 OH LC-MS/MS - Send Out to CQ	$178.04	$741.83	$178.04–$667.65	—	76%
Zinc blood test CPT 84630 Zinc (CQ)	$161.24	$671.85	$9.57–$604.67	171% above	76%
Zinc blood test CPT 84630 Zinc, RBC (CQ)	$161.24	$671.85	$9.57–$604.67	171% above	76%
Zinc blood test CPT 84630 Zinc 24 Hr Urine (CQ)	$161.24	$671.85	$9.57–$604.67	171% above	76%
Zinc blood test CPT 84630 Zinc Plasma or Serum (LC)	$161.24	$671.85	$9.57–$604.67	171% above	76%
Zinc blood test inpatient CPT 84630 Zinc, RBC (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (LC)	$161.24	$671.85	$161.24–$604.67	—	76%
Zinc blood test inpatient CPT 84630 Zinc 24 Hr Urine (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
Zinc blood test inpatient CPT 84630 Zinc (CQ)	$161.24	$671.85	$161.24–$604.67	—	76%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$279.10	$1,162.90	$11.54–$1,046.61	232% above	76%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Total Quantitative -	$279.10	$1,162.90	$11.54–$1,046.61	232% above	76%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Total Quantitative -	$279.10	$1,162.90	$279.10–$1,046.61	—	76%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$279.10	$1,162.90	$279.10–$1,046.61	—	76%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$12,482.64	$52,011.00	$199.51–$46,809.90	187% above	76%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRD ANT NTRBDY CERVICAL	$49,056.48	$204,402.00	$363.00–$183,961.80	248% above	76%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$3,229.44	$13,456.00	$143.77–$12,110.40	762% above	76%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST 1ST LESION STRTCTC	$1,804.56	$7,519.00	$250.00–$6,767.10	22% below	76%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$1,125.06	$4,687.76	$250.00–$4,218.98	51% below	76%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$1,125.06	$4,687.76	$250.00–$4,218.98	51% below	76%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Rt	$1,125.06	$4,687.76	$1,125.06–$4,218.98	—	76%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w Loc w Stereo 1 Lsn Lt	$1,125.06	$4,687.76	$1,125.06–$4,218.98	—	76%
Bunion correction with removal of part of the big toe joint CPT 28292 COR HLX VLGS RSC PRX PHLX BS	$12,591.84	$52,466.00	$250.00–$47,219.40	286% above	76%
Cardiac catheterization with coronary angiogram CPT 93458 IC-L HRT ARTERY/VENTRICLE ANGIO [MOPB]	$9,425.72	$39,273.85	$165.64–$35,346.46	1% above	76%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$20,760.96	$86,504.00	$165.64–$77,853.60	123% above	76%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 IC-L HRT ARTERY/VENTRICLE ANGIO [MOPB]	$9,425.72	$39,273.85	$9,425.72–$35,346.46	—	76%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$912.59	$3,802.46	$52.02–$3,422.21	14% below	76%
Cardioversion, elective (restoring heart rhythm) CPT 92960 IC-CARDIOVERSION ELECTIVE EXT T [MOPB]	$912.59	$3,802.46	$76.00–$3,422.21	14% below	76%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion	$912.59	$3,802.46	$52.02–$3,422.21	14% below	76%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$912.59	$3,802.46	$52.02–$3,422.21	14% below	76%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$4,003.92	$16,683.00	$76.00–$15,014.70	277% above	76%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$912.59	$3,802.46	$912.59–$3,422.21	—	76%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$912.59	$3,802.46	$912.59–$3,422.21	—	76%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 IC-CARDIOVERSION ELECTIVE EXT T [MOPB]	$912.59	$3,802.46	$912.59–$3,422.21	—	76%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion	$912.59	$3,802.46	$912.59–$3,422.21	—	76%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$16,210.56	$67,544.00	$320.00–$60,789.60	536% above	76%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$13,180.56	$54,919.00	$186.39–$49,427.10	376% above	76%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$6,478.56	$26,994.00	$250.00–$24,294.60	281% above	76%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$6,480.96	$27,004.00	$250.00–$24,303.60	330% above	76%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$4,774.32	$19,893.00	$250.00–$17,903.70	184% above	76%
Coronary stent placement, one artery CPT 92928 IC-PERC CARD STENT/ANGIO 1 VSL [MOPB]	$18,560.32	$77,334.65	$320.00–$69,601.18	33% above	76%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL	$44,767.68	$186,532.00	$320.00–$167,878.80	222% above	76%
Coronary stent placement, one artery inpatient CPT 92928 IC-PERC CARD STENT/ANGIO 1 VSL [MOPB]	$18,560.32	$77,334.65	$18,560.32–$69,601.18	—	76%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$3,711.36	$15,464.00	$357.42–$13,917.60	28% below	76%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$22,728.96	$94,704.00	$277.06–$85,233.60	516% above	76%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$11,475.36	$47,814.00	$148.94–$43,032.60	252% above	76%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$906.96	$3,779.00	$13.76–$3,401.10	721% above	76%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$11,919.36	$49,664.00	$44.34–$44,697.60	11391% above	76%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL	$27,489.12	$114,538.00	$297.00–$103,084.20	232% above	76%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS	$27,489.12	$114,538.00	$169.83–$103,084.20	729% above	76%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS	$22,157.04	$92,321.00	$251.07–$83,088.90	173% above	76%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,083.84	$4,516.00	$235.49–$4,064.40	29% below	76%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR Inj Catheter Placement C-T w Imaging	$1,223.60	$5,098.33	$235.49–$4,588.50	20% below	76%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR Inj Catheter Placement C-T w Imaging	$1,223.60	$5,098.33	$1,223.60–$4,588.50	—	76%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT Inj Paravert Facet Joint L S 1 Lvl	$882.64	$3,677.66	$160.11–$3,309.89	19% below	76%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR Inj Paravert Facet Joint L S 1 Lvl	$882.64	$3,677.66	$160.11–$3,309.89	19% below	76%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,093.20	$4,555.00	$160.11–$4,099.50	1% above	76%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT Inj Paravert Facet Joint L S 1 Lvl	$882.64	$3,677.66	$882.64–$3,309.89	—	76%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 IR Inj Paravert Facet Joint L S 1 Lvl	$882.64	$3,677.66	$882.64–$3,309.89	—	76%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC	$25,308.48	$105,452.00	$297.00–$94,906.80	121% above	76%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$22,461.12	$93,588.00	$297.00–$84,229.20	475% above	76%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$3,538.80	$14,745.00	$164.24–$13,270.50	184% above	76%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$22,059.60	$91,915.00	$363.00–$82,723.50	266% above	76%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$27,805.20	$115,855.00	$363.00–$104,269.50	361% above	76%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$21,646.80	$90,195.00	$250.00–$81,175.50	756% above	76%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$6,667.44	$27,781.00	$250.00–$25,002.90	390% above	76%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$129.33	$538.88	$107.78–$701.16	44% below	76%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$5,141.04	$21,421.00	$212.26–$19,278.90	2112% above	76%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$129.33	$538.88	$129.33–$484.99	—	76%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$20,046.00	$83,525.00	$363.00–$75,172.50	195% above	76%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$18,618.00	$77,575.00	$363.00–$69,817.50	327% above	76%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$14,387.52	$59,948.00	$40.48–$53,953.20	3340% above	76%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$2,213.04	$9,221.00	$115.74–$8,298.90	683% above	76%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$15,606.96	$65,029.00	$363.00–$58,526.10	376% above	76%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$8,779.44	$36,581.00	$53.66–$32,922.90	2611% above	76%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$1,196.16	$4,984.00	$60.25–$4,485.60	311% above	76%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 S-JOINT ASP-INJ IM	$362.80	$1,511.65	$51.00–$1,360.48	7% above	76%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$4,590.24	$19,126.00	$51.00–$17,213.40	1255% above	76%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 S-JOINT ASP-INJ IM	$362.80	$1,511.65	$362.80–$1,360.48	—	76%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$14,633.04	$60,971.00	$49.76–$54,873.90	5251% above	76%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$25,199.04	$104,996.00	$297.00–$94,496.40	265% above	76%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$23,009.04	$95,871.00	$297.00–$86,283.90	233% above	76%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$26,701.20	$111,255.00	$363.00–$100,129.50	296% above	76%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS	$32,720.64	$136,336.00	$363.00–$122,702.40	109% above	76%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$32,726.40	$136,360.00	$363.00–$122,724.00	102% above	76%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$25,816.32	$107,568.00	$363.00–$96,811.20	454% above	76%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$20,728.56	$86,369.00	$363.00–$77,732.10	91% above	76%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$23,607.84	$98,366.00	$363.00–$88,529.40	124% above	76%
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/<	$8,410.80	$35,045.00	$236.52–$31,540.50	1837% above	76%
Left heart catheterization, diagnostic one side CPT 93452 IC-LEFT HRT CATH W/VENTRICLGRPHY [MOPB]	$6,987.76	$29,115.68	$134.65–$26,204.11	6% above	76%
Left heart catheterization, diagnostic inpatient one side CPT 93452 IC-LEFT HRT CATH W/VENTRICLGRPHY [MOPB]	$6,987.76	$29,115.68	$6,987.76–$26,204.11	—	76%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,120.08	$4,667.00	$231.03–$4,200.30	22% below	76%
Lower-back epidural injection, with imaging guidance CPT 62323 IR Inj Catheter Placement L-S w Imaging	$1,201.20	$5,005.02	$231.03–$4,504.52	16% below	76%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Inj Catheter Placement L-S w Imaging	$1,201.20	$5,005.02	$1,201.20–$4,504.52	—	76%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$974.88	$4,062.00	$124.02–$3,655.80	13% below	76%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,096.08	$4,567.00	$221.20–$4,110.30	27% below	76%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY	$48,495.12	$202,063.00	$297.00–$181,856.70	263% above	76%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAM FACETEC & FORAMOT LUMBAR	$44,481.84	$185,341.00	$297.00–$166,806.90	155% above	76%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$20,784.72	$86,603.00	$320.00–$77,942.70	471% above	76%
Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE	$34,993.20	$145,805.00	$320.00–$131,224.50	497% above	76%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$11,764.08	$49,017.00	$320.00–$44,115.30	151% above	76%
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<	$4,969.68	$20,707.00	$115.34–$18,636.30	800% above	76%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$12,340.56	$51,419.00	$129.16–$46,277.10	1849% above	76%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$5,523.60	$23,015.00	$104.21–$20,713.50	2132% above	76%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$1,093.68	$4,557.00	$70.16–$4,101.30	188% above	76%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$37,158.96	$154,829.00	$297.00–$139,346.10	125% above	76%
Paracentesis with imaging guidance CPT 49083 IR Abdominal Paracentesis w Imaging	$643.29	$2,680.39	$250.00–$2,412.35	36% below	76%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$3,246.48	$13,527.00	$250.00–$12,174.30	222% above	76%
Paracentesis with imaging guidance inpatient CPT 49083 IR Abdominal Paracentesis w Imaging	$643.29	$2,680.39	$643.29–$2,412.35	—	76%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$7,053.60	$29,390.00	$146.31–$26,451.00	1100% above	76%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$5,338.08	$22,242.00	$297.00–$20,017.80	196% above	76%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$13,550.88	$56,462.00	$320.00–$50,815.80	450% above	76%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$1,694.88	$7,062.00	$137.55–$6,355.80	245% above	76%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$5,046.24	$21,026.00	$308.61–$18,923.40	269% above	76%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$4,356.48	$18,152.00	$308.28–$16,336.80	224% above	76%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$31,529.52	$131,373.00	$363.00–$118,235.70	332% above	76%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Extracorporeal Shockwave Lithotripsy	$13,243.49	$55,181.22	$686.99–$49,663.10	66% above	76%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Extracorporeal Shockwave Lithotripsy	$13,243.49	$55,181.22	$13,243.49–$49,663.10	—	76%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST	$778.56	$3,244.00	$81.11–$2,919.60	191% above	76%
Short arm splint (forearm and hand) CPT 29125 SPLT SHRT ARM ST OT - REDOC 183	$177.76	$740.66	$61.31–$666.59	4% below	76%
Short arm splint (forearm and hand) CPT 29125 SPLT SHRT ARM ST 0T - REDOC 182	$177.76	$740.66	$61.31–$666.59	4% below	76%
Short arm splint (forearm and hand) CPT 29125 SPLT SHRT ARM ST 0T - REDOC 184	$177.76	$740.66	$61.31–$666.59	4% below	76%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$1,125.36	$4,689.00	$61.31–$4,220.10	506% above	76%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLT SHRT ARM ST 0T - REDOC 182	$177.76	$740.66	$177.76–$666.59	—	76%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLT SHRT ARM ST 0T - REDOC 184	$177.76	$740.66	$177.76–$666.59	—	76%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLT SHRT ARM ST OT - REDOC 183	$177.76	$740.66	$177.76–$666.59	—	76%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$1,703.52	$7,098.00	$67.04–$6,388.20	758% above	76%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC	$50,395.20	$209,980.00	$297.00–$188,982.00	311% above	76%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$37,801.20	$157,505.00	$162.13–$141,754.50	177% above	76%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$1,148.40	$4,785.00	$85.76–$4,306.50	345% above	76%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$12,299.04	$51,246.00	$111.79–$46,121.40	3599% above	76%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM/<	$21,378.48	$89,077.00	$178.63–$80,169.30	3277% above	76%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15	$24,882.72	$103,678.00	$83.97–$93,310.20	14680% above	76%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$520.96	$2,170.67	$132.29–$1,953.60	22% below	76%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Punctures w/o imaging	$520.96	$2,170.67	$132.29–$1,953.60	22% below	76%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$3,879.36	$16,164.00	$132.29–$14,547.60	481% above	76%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$520.96	$2,170.67	$520.96–$1,953.60	—	76%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Punctures w/o imaging	$520.96	$2,170.67	$520.96–$1,953.60	—	76%
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	$1,271.76	$5,299.00	$104.56–$4,769.10	295% above	76%
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/<	$1,635.12	$6,813.00	$102.47–$6,131.70	541% above	76%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$4,805.76	$20,024.00	$89.72–$18,021.60	1815% above	76%
Thoracentesis with imaging guidance CPT 32555 IR Thoracentesis w Imging Guidance	$2,441.88	$10,174.51	$250.00–$9,157.06	139% above	76%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$3,283.20	$13,680.00	$250.00–$12,312.00	221% above	76%
Thoracentesis with imaging guidance inpatient CPT 32555 IR Thoracentesis w Imging Guidance	$2,441.88	$10,174.51	$2,441.88–$9,157.06	—	76%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$17,236.56	$71,819.00	$287.08–$64,637.10	197% above	76%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$15,907.44	$66,281.00	$275.20–$59,652.90	199% above	76%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$69,169.44	$288,206.00	$297.00–$259,385.40	1801% above	76%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$59,277.12	$246,988.00	$297.00–$222,289.20	315% above	76%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$78,537.84	$327,241.00	$297.00–$294,516.90	486% above	76%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$79,560.00	$331,500.00	$320.00–$298,350.00	462% above	76%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$15,009.60	$62,540.00	$250.00–$56,286.00	657% above	76%
Trigger point injections, 1 or 2 muscles CPT 20552 S-INJ TRIG 1-2 MSCL	$205.47	$856.14	$48.58–$770.53	33% below	76%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$658.80	$2,745.00	$48.58–$2,470.50	114% above	76%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 S-INJ TRIG 1-2 MSCL	$205.47	$856.14	$205.47–$770.53	—	76%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$18,717.36	$77,989.00	$353.29–$70,190.10	721% above	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$946.80	$3,945.00	$250.00–$3,550.50	46% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 IR US Breast Biopsy w Loc 1 Lesion Right	$843.73	$3,515.53	$250.00–$3,163.98	52% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt CM	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt CM	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$1,384.00	$5,766.68	$250.00–$5,190.01	21% below	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 IR US Breast Biopsy w Loc 1 Lesion Right	$843.73	$3,515.53	$843.73–$3,163.98	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt CM	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Rt CM	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$1,384.00	$5,766.68	$1,384.00–$5,190.01	—	76%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$6,647.52	$27,698.00	$363.00–$24,928.20	267% above	76%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$6,538.08	$27,242.00	$297.00–$24,517.80	375% above	76%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ	$7,367.76	$30,699.00	$250.00–$27,629.10	261% above	76%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$7,623.84	$31,766.00	$250.00–$28,589.40	336% above	76%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$4,377.84	$18,241.00	$250.00–$16,416.90	191% above	76%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$26,013.60	$108,390.00	$363.00–$97,551.00	161% above	76%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OBSTETRICAL CARE	$20,838.72	$86,828.00	$297.00–$78,145.20	642% above	76%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$10,181.28	$42,422.00	$297.00–$38,179.80	141% above	76%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$690.24	$2,876.00	$101.63–$2,588.40	283% above	76%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$3,343.68	$13,932.00	$116.75–$12,538.80	494% above	76%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP	$26,493.84	$110,391.00	$297.00–$99,351.90	538% above	76%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$429.14	$1,788.09	$36.43–$1,609.28	35% below	76%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$4,920.72	$20,503.00	$36.43–$18,452.70	650% above	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$429.14	$1,788.09	$429.14–$1,609.28	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$222.55	$927.29	$6.00–$834.56	59% above	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$222.55	$927.29	$222.55–$834.56	—	76%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$222.55	$927.29	$222.55–$834.56	—	76%
Chemotherapy IV infusion, first hour CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$385.19	$1,604.97	$112.53–$1,444.47	11% below	76%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$385.19	$1,604.97	$385.19–$1,444.47	—	76%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$906.15	$3,775.64	$52.02–$3,398.08	56% below	76%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$906.15	$3,775.64	$906.15–$3,398.08	—	76%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Including Recording Awake and Drowsy	$1,114.70	$4,644.60	$25.00–$4,180.14	49% above	76%
EEG (brain wave test), awake and drowsy, routine CPT 95816 CHRG - EEG AWAKE DROWSY	$1,114.70	$4,644.60	$25.00–$4,180.14	49% above	76%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Including Recording Awake and Drowsy	$1,114.70	$4,644.60	$1,114.70–$4,180.14	—	76%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 CHRG - EEG AWAKE DROWSY	$1,114.70	$4,644.60	$1,114.70–$4,180.14	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG BCE	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$240.47	$1,001.94	$17.00–$901.75	30% above	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG BCE	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$240.47	$1,001.94	$240.47–$901.75	—	76%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT 90870	$676.05	$2,816.86	$40.00–$2,535.17	48% below	76%
Electroconvulsive therapy (ECT), one session CPT 90870 Electroconvulsive Therapy Procedure	$676.05	$2,816.86	$40.00–$2,535.17	48% below	76%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Electroconvulsive Therapy Procedure	$676.05	$2,816.86	$676.05–$2,535.17	—	76%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT 90870	$676.05	$2,816.86	$676.05–$2,535.17	—	76%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$148.09	$617.03	$11.01–$1,000.00	38% below	76%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$148.09	$617.03	$148.09–$555.33	—	76%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$209.39	$872.47	$40.20–$1,000.00	43% below	76%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$209.39	$872.47	$209.39–$785.22	—	76%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$312.13	$1,300.54	$52.02–$1,230.11	63% below	76%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 $ED Cricothyrotomy	$710.76	$2,961.49	$52.02–$2,665.34	16% below	76%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$312.13	$1,300.54	$312.13–$1,170.49	—	76%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 $ED Cricothyrotomy	$710.76	$2,961.49	$710.76–$2,665.34	—	76%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$469.45	$1,956.05	$52.02–$1,760.44	48% below	76%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$469.45	$1,956.05	$469.45–$1,760.44	—	76%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$684.16	$2,850.68	$52.02–$2,565.61	56% below	76%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$684.16	$2,850.68	$684.16–$2,565.61	—	76%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$490.17	$2,042.37	$32.39–$1,838.13	36% below	76%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI Stress Test	$490.17	$2,042.37	$32.39–$1,838.13	36% below	76%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI Stress Test	$490.17	$2,042.37	$490.17–$1,838.13	—	76%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$490.17	$2,042.37	$490.17–$1,838.13	—	76%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$182.52	$760.49	$28.57–$684.44	24% below	76%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$182.52	$760.49	$28.57–$684.44	24% below	76%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$182.52	$760.49	$28.57–$684.44	24% below	76%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$182.52	$760.49	$28.57–$1,000.00	24% below	76%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$182.52	$760.49	$182.52–$684.44	—	76%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$182.52	$760.49	$182.52–$684.44	—	76%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$182.52	$760.49	$182.52–$684.44	—	76%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$182.52	$760.49	$182.52–$684.44	—	76%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$214.99	$895.80	$54.90–$806.22	25% below	76%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$214.99	$895.80	$54.90–$806.22	25% below	76%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$214.99	$895.80	$54.90–$1,000.00	25% below	76%
IV infusion of a medicine, first hour CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$214.99	$895.80	$54.90–$806.22	25% below	76%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$214.99	$895.80	$214.99–$806.22	—	76%
IV infusion of a medicine, first hour inpatient CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$214.99	$895.80	$214.99–$806.22	—	76%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$214.99	$895.80	$214.99–$806.22	—	76%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$214.99	$895.80	$214.99–$806.22	—	76%
IV push of a medicine, first drug CPT 96374 IV push initial	$180.00	$750.00	$32.37–$675.00	at median	76%
IV push of a medicine, first drug CPT 96374 96374 - IV Injection, single/initial	$180.00	$750.00	$32.37–$1,000.00	at median	76%
IV push of a medicine, first drug CPT 96374 CHRG - THER/PROPH/DIAG INJ, IVPUSH	$180.00	$750.00	$32.37–$675.00	at median	76%
IV push of a medicine, first drug CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$180.00	$750.00	$32.37–$675.00	at median	76%
IV push of a medicine, first drug CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$180.00	$750.00	$32.37–$675.00	at median	76%
IV push of a medicine, first drug inpatient CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$180.00	$750.00	$180.00–$675.00	—	76%
IV push of a medicine, first drug inpatient CPT 96374 IV push initial	$180.00	$750.00	$180.00–$675.00	—	76%
IV push of a medicine, first drug inpatient CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$180.00	$750.00	$180.00–$675.00	—	76%
IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Injection, single/initial	$180.00	$750.00	$180.00–$675.00	—	76%
IV push of a medicine, first drug inpatient CPT 96374 CHRG - THER/PROPH/DIAG INJ, IVPUSH	$180.00	$750.00	$180.00–$675.00	—	76%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$135.21	$563.37	$13.13–$507.03	45% above	76%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$135.21	$563.37	$13.13–$1,000.00	45% above	76%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$135.21	$563.37	$13.13–$507.03	45% above	76%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$135.21	$563.37	$13.13–$507.03	45% above	76%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$135.21	$563.37	$135.21–$507.03	—	76%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$135.21	$563.37	$135.21–$507.03	—	76%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$135.21	$563.37	$135.21–$507.03	—	76%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$135.21	$563.37	$135.21–$507.03	—	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 182	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PT - REDOC 183	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN PT - REDOC 182	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN PT - REDOC 184	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 183	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 184	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 257	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromusclr Reeducation Assist Charge	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 2	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN OT -REDOC 182	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MN COTA -REDOC 182	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN OT - REDOC 184	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MN COTA - REDOC 184	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PT - REDOC 257	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MN COTA - REDOC 183	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PTA - REDOC 257	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PTA - REDOC 183	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN OT - REDOC 183	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Charges	$103.02	$429.24	$29.05–$386.32	14% above	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PTA - REDOC 183	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN OT - REDOC 184	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MN COTA - REDOC 184	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MN COTA -REDOC 182	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN OT -REDOC 182	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN PT - REDOC 184	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 2	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromusclr Reeducation Assist Charge	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 257	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 184	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN PT - REDOC 182	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PT - REDOC 183	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PTA - REDOC 257	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 183	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 182	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Charges	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN OT - REDOC 183	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MN COTA - REDOC 183	$103.02	$429.24	$103.02–$386.32	—	76%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PT - REDOC 257	$103.02	$429.24	$103.02–$386.32	—	76%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$21.00	$87.48	$17.50–$78.73	48% below	76%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$21.00	$87.48	$21.00–$78.73	—	76%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - REDOC 185	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW CMP OT - REDOC 183	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW CMP OT - REDOC 182	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity CPT 97165 IRF OT EVAL LOW	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW CMP OT - REDOC 184	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW Unit - Yes	$146.97	$612.36	$87.52–$551.12	11% above	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW Unit - Yes	$146.97	$612.36	$146.97–$551.12	—	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - REDOC 185	$146.97	$612.36	$146.97–$551.12	—	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW CMP OT - REDOC 182	$146.97	$612.36	$146.97–$551.12	—	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW CMP OT - REDOC 184	$146.97	$612.36	$146.97–$551.12	—	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 IRF OT EVAL LOW	$146.97	$612.36	$146.97–$551.12	—	76%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW CMP OT - REDOC 183	$146.97	$612.36	$146.97–$551.12	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 183	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH CMP PT - REDOC 183	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH CMP PT - REDOC 257	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 IRF PT EVAL HIGH	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 182	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 184	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 257	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$131.29	$547.04	$86.67–$492.34	26% below	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 184	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 182	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH CMP PT - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 IRF PT EVAL HIGH	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH CMP PT - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW CMP PT - REDOC 257	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 184	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW CMP PT - REDOC 183	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 257	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 182	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 183	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 IRF PT EVAL LOW	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$131.29	$547.04	$86.67–$492.34	2% above	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW CMP PT - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 182	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 IRF PT EVAL LOW	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW CMP PT - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 184	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD CMP PT - REDOC 183	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 184	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD CMP PT - REDOC 257	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 183	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 IRF PT EVAL MOD	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 182	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 257	$131.29	$547.04	$86.67–$492.34	16% below	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD CMP PT - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 184	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 182	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 IRF PT EVAL MOD	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD CMP PT - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 257	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 183	$131.29	$547.04	$131.29–$492.34	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 184	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 257	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 182	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Charges	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Charges	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 257	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 184	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 182	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Charges	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charges	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PT - REDOC 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 GAIT TRNNG-15MIN PTA - REDOC 257	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN OT - REDOC 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PT - REDOC 257	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15MIN COTA - REDOC 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PTA - REDOC 183	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15MIN COTA -REDOC 182	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15MIN COTA - REDOC 184	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN OT - REDOC 182	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN PT - REDOC 184	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN OT - REDOC 184	$36.95	$153.96	$23.35–$138.56	55% below	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charges	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 184	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PT - REDOC 257	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN OT - REDOC 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GAIT TRNNG-15MIN PTA - REDOC 257	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PT - REDOC 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Charges	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Charges	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 182	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 257	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Charges	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 257	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15MIN COTA -REDOC 182	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PTA - REDOC 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN OT - REDOC 184	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 182	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN PT - REDOC 184	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15MIN COTA - REDOC 183	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN OT - REDOC 182	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 184	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15MIN COTA - REDOC 184	$36.95	$153.96	$36.95–$138.56	—	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MN COTA -REDOC 182	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN OT -REDOC 182	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 257	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 184	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 257	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 184	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 182	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PT - REDOC 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PTA - REDOC 257	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PT - REDOC 257	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MN COTA - REDOC 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN OT - REDOC 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PTA - REDOC 183	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN PT - REDOC 184	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MN COTA - REDOC 184	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN OT - REDOC 184	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN PT - REDOC 182	$39.75	$165.63	$21.76–$149.07	49% below	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN OT -REDOC 182	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MN COTA -REDOC 182	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN PT - REDOC 182	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN OT - REDOC 184	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MN COTA - REDOC 184	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN PT - REDOC 184	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PTA - REDOC 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN OT - REDOC 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MN COTA - REDOC 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PT - REDOC 257	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PTA - REDOC 257	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PT - REDOC 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 182	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 184	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 257	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 184	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 183	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 257	$39.75	$165.63	$39.75–$149.07	—	76%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$39.75	$165.63	$39.75–$149.07	—	76%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$35.27	$146.97	$13.78–$132.27	32% above	76%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco counseling Charge - 3-10 minutes	$35.27	$146.97	$13.78–$132.27	32% above	76%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$35.27	$146.97	$35.27–$132.27	—	76%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco counseling Charge - 3-10 minutes	$35.27	$146.97	$35.27–$132.27	—	76%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$811.20	$3,380.00	$74.12–$3,042.00	499% above	76%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Outpatient EM Charges - Level 4 EP	$220.31	$917.96	$108.00–$826.16	22% above	76%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Outpatient EM Charges - Level 4 EP	$220.31	$917.96	$220.31–$826.16	—	76%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Outpatient EM Charges - Level 2 EP	$50.67	$211.12	$42.22–$190.01	51% below	76%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Outpatient EM Charges - Level 2 EP	$50.67	$211.12	$50.67–$190.01	—	76%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 188	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 EVAL SP SND PROD CMP - REDOC 177	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge - Yes	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 178	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 177	$334.52	$1,393.85	$49.44–$1,254.46	30% above	76%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 188	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 EVAL SP SND PROD CMP - REDOC 177	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge - Yes	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 178	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 177	$334.52	$1,393.85	$334.52–$1,254.46	—	76%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 188	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 177	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI - REDOC 177	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 178	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$178.88	$745.33	$21.76–$670.80	6% above	76%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 188	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 178	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI - REDOC 177	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 177	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$178.88	$745.33	$178.88–$670.80	—	76%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$178.88	$745.33	$178.88–$670.80	—	76%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$218.07	$908.63	$24.00–$817.77	6% below	76%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$218.07	$908.63	$218.07–$817.77	—	76%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$416.82	$1,736.77	$39.00–$1,563.09	5% below	76%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$416.82	$1,736.77	$416.82–$1,563.09	—	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTV-15MIN COTA - REDOC 183	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTV-15MIN COTA - REDOC 184	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN OT - REDOC 183	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN OT - REDOC 184	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PT - REDOC 183	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN OT - REDOC 182	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PT - REDOC 257	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PTA - REDOC 257	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN PT - REDOC 182	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 2	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assist Charges	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Assist Charge	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 257	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 184	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 183	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Charge	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTV-15MIN COTA - REDOC 182	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 182	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PTA - REDOC 183	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN PT - REDOC 184	$42.83	$178.46	$21.76–$160.61	47% below	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PTA - REDOC 257	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PT - REDOC 257	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTV-15MIN COTA - REDOC 183	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PTA - REDOC 183	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PT - REDOC 183	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN PT - REDOC 182	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTV-15MIN COTA - REDOC 182	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN PT - REDOC 184	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTV-15MIN COTA - REDOC 184	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN OT - REDOC 184	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN OT - REDOC 182	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Charge	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 182	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 183	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 184	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 257	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Assist Charge	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assist Charges	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 2	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN OT - REDOC 183	$42.83	$178.46	$42.83–$160.61	—	76%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$162.08	$675.35	$82.29–$607.82	7% below	76%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therap Phlebotomy	$162.08	$675.35	$82.29–$607.82	7% below	76%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$162.08	$675.35	$82.29–$607.82	7% below	76%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$162.08	$675.35	$162.08–$607.82	—	76%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$162.08	$675.35	$162.08–$607.82	—	76%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therap Phlebotomy	$162.08	$675.35	$162.08–$607.82	—	76%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$267.75	$1,115.64	$124.55–$1,004.08	at median	76%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$267.75	$1,115.64	$124.55–$1,004.08	at median	76%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$267.75	$1,115.64	$267.75–$1,004.08	—	76%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$267.75	$1,115.64	$267.75–$1,004.08	—	76%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$347.77	$1,449.05	$51.53–$1,304.15	110% above	76%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$347.77	$0.01	$0.01–$121.65	110% above	-3477600%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$347.77	$1,449.05	$51.53–$1,304.15	110% above	76%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$347.77	$1,449.05	$51.53–$1,304.15	110% above	76%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$347.77	$1,449.05	$347.77–$1,304.14	—	76%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$347.77	$1,449.05	$347.77–$1,304.14	—	76%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$347.77	$0.01	$0.01	—	-3477600%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$347.77	$1,449.05	$347.77–$1,304.14	—	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$13.14–$787.32	304% above	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$13.14–$787.32	304% above	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0562-10 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$13.14–$787.32	304% above	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$13.14–$787.32	304% above	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0562-10 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$21.47–$787.32	159% above	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$21.47–$787.32	159% above	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$21.47–$787.32	159% above	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$21.47–$787.32	159% above	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 58160-0811-52 - diphtheria/hepB/pertussis,acel/pol	$209.95	$874.80	$13.14–$787.32	65% above	76%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 58160-0811-52 - diphtheria/hepB/pertussis,acel/pol	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$209.95	$874.80	$15.45–$787.32	67% above	76%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 49281-0511-05 - diphth/haemophilus/pertussis/tetan	$209.95	$874.80	$15.45–$787.32	67% above	76%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$209.95	$874.80	$209.95–$787.32	—	76%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 49281-0511-05 - diphth/haemophilus/pertussis/tetan	$209.95	$874.80	$209.95–$787.32	—	76%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$37.19–$787.32	53% above	76%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$209.95–$787.32	—	76%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$209.95	$874.80	$13.12–$787.32	348% above	76%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$13.12–$787.32	348% above	76%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$209.95	$874.80	$209.95–$787.32	—	76%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$209.95–$787.32	—	76%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$540.01	$2,250.03	$13.14–$2,025.03	64% above	76%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$540.01	$2,250.03	$540.01–$2,025.03	—	76%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$244.58	$1,019.08	$91.28–$917.17	145% above	76%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$244.58	$1,019.08	$244.58–$917.17	—	76%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$209.95	$874.80	$61.05–$787.32	138% above	76%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$61.05–$787.32	138% above	76%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$209.95	$874.80	$61.05–$787.32	138% above	76%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$61.05–$787.32	138% above	76%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$61.05–$787.32	138% above	76%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$209.95	$874.80	$31.35–$787.32	437% above	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$209.95	$874.80	$56.70–$787.32	168% above	76%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$209.95	$874.80	$56.70–$787.32	168% above	76%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$209.95	$874.80	$56.70–$787.32	168% above	76%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$209.95	$874.80	$56.70–$787.32	168% above	76%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$209.95	$874.80	$25.80–$787.32	180% above	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$209.95	$874.80	$209.95–$787.32	—	76%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$209.95	$874.80	$209.95–$787.32	—	76%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$209.95	$874.80	$14.08–$787.32	500% above	76%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$209.95	$874.80	$14.08–$787.32	500% above	76%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$209.95	$874.80	$209.95–$787.32	—	76%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$209.95	$874.80	$209.95–$787.32	—	76%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$13.80–$787.32	130% above	76%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$209.95	$874.80	$13.80–$787.32	130% above	76%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$209.95	$874.80	$13.80–$787.32	130% above	76%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$209.95	$874.80	$209.95–$787.32	—	76%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$209.95	$874.80	$209.95–$787.32	—	76%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$209.95	$874.80	$209.95–$787.32	—	76%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$209.95	$874.80	$34.64–$787.32	32% above	76%
MMR vaccine (measles, mumps and rubella), live CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$209.95	$0.01	$0.01–$81.79	32% above	-2099400%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$209.95	$0.01	$0.01	—	-2099400%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$209.95	$874.80	$209.95–$787.32	—	76%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$527.92	$2,199.67	$24.51–$1,979.70	107% above	76%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$527.92	$2,199.67	$24.51–$1,979.70	107% above	76%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$527.92	$2,199.67	$527.92–$1,979.70	—	76%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$527.92	$2,199.67	$527.92–$1,979.70	—	76%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$211.14	$879.73	$61.58–$791.76	66% above	76%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$287.62	$1,198.41	$65.60–$1,078.57	126% above	76%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$211.14	$879.73	$211.14–$791.76	—	76%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$287.62	$1,198.41	$287.62–$1,078.57	—	76%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$224.01	$933.39	$65.34–$840.05	37% below	76%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$224.01	$933.39	$224.01–$840.05	—	76%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$415.88	$1,732.85	$121.30–$1,559.57	35% above	76%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$415.88	$1,732.85	$415.88–$1,559.56	—	76%
Nasal spray flu vaccine, live (FluMist) CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$36.71	$152.95	$18.40–$137.66	19% below	76%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$36.71	$152.95	$36.71–$137.66	—	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$170.28–$1,695.89	84% above	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$170.28–$1,695.89	84% above	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$170.28–$1,695.89	84% above	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$452.24–$1,695.89	—	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$452.24–$1,695.89	—	76%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$452.24	$1,884.32	$452.24–$1,695.89	—	76%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$422.33	$1,759.70	$240.88–$1,583.73	73% above	76%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$422.33	$1,759.70	$240.88–$1,583.73	73% above	76%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$422.33	$1,759.70	$422.33–$1,583.73	—	76%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$422.33	$1,759.70	$422.33–$1,583.73	—	76%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$499.38	$2,080.75	$283.14–$1,872.68	at median	76%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$499.38	$2,080.75	$283.14–$1,872.68	at median	76%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$499.38	$2,080.75	$499.38–$1,872.68	—	76%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$499.38	$2,080.75	$499.38–$1,872.68	—	76%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$469.96	$1,958.18	$383.81–$1,762.36	12% below	76%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$469.96	$1,958.18	$469.96–$1,762.36	—	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$217.53	$906.36	$12.34–$815.72	25% above	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$12.34–$815.72	25% above	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$12.34–$815.72	25% above	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$12.34–$815.72	25% above	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$217.53–$815.72	—	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$217.53	$906.36	$217.53–$815.72	—	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$217.53–$815.72	—	76%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$217.53	$906.36	$217.53–$815.72	—	76%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$209.95	$874.80	$19.43–$787.32	386% above	76%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$209.95	$874.80	$19.43–$787.32	386% above	76%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$209.95	$874.80	$209.95–$787.32	—	76%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$209.95	$874.80	$209.95–$787.32	—	76%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$832.54	$3,468.93	$242.83–$3,122.04	25% below	76%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$832.54	$3,468.93	$832.54–$3,122.04	—	76%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$832.54	$3,468.93	$242.83–$3,122.04	25% below	76%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$832.54	$3,468.93	$242.83–$3,122.04	25% below	76%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$832.54	$3,468.93	$832.54–$3,122.04	—	76%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$832.54	$3,468.93	$832.54–$3,122.04	—	76%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$534.64	$2,227.68	$155.94–$2,004.91	14% above	76%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$534.64	$2,227.68	$155.94–$2,004.91	14% above	76%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$534.64	$2,227.68	$534.64–$2,004.91	—	76%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$534.64	$2,227.68	$534.64–$2,004.91	—	76%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$534.75	$2,228.12	$155.97–$2,005.31	20% above	76%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$534.75	$2,228.12	$534.75–$2,005.31	—	76%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$262.98–$2,544.46	20% below	76%
Rabies vaccine, one dose CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$262.98–$2,544.46	20% below	76%
Rabies vaccine, one dose CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$262.98–$2,544.46	20% below	76%
Rabies vaccine, one dose CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$262.98–$3,035.59	5% below	76%
Rabies vaccine, one dose CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$262.98–$3,035.59	5% below	76%
Rabies vaccine, one dose CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$262.98–$3,035.59	5% below	76%
Rabies vaccine, one dose CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$262.98–$3,035.59	5% below	76%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$678.52–$2,544.46	—	76%
Rabies vaccine, one dose inpatient CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$678.52–$2,544.46	—	76%
Rabies vaccine, one dose inpatient CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$678.52	$2,827.18	$678.52–$2,544.46	—	76%
Rabies vaccine, one dose inpatient CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$809.49–$3,035.59	—	76%
Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$809.49–$3,035.59	—	76%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$809.49–$3,035.59	—	76%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$809.49	$3,372.88	$809.49–$3,035.59	—	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$119.79	$499.11	$13.14–$449.20	6% above	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$119.79	$499.11	$13.14–$449.20	6% above	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$119.79	$499.11	$13.14–$449.20	6% above	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$119.79	$499.11	$119.79–$449.20	—	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$119.79	$499.11	$119.79–$449.20	—	76%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$119.79	$499.11	$119.79–$449.20	—	76%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$386.64	$1,610.99	$112.00–$1,449.89	61% above	76%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$386.64	$1,610.99	$112.00–$1,449.89	61% above	76%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$386.64	$1,610.99	$386.64–$1,449.89	—	76%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$386.64	$1,610.99	$386.64–$1,449.89	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$209.95	$874.80	$14.00–$787.32	186% above	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$209.95	$874.80	$209.95–$787.32	—	76%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$28.80–$787.32	113% above	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$209.95	$874.80	$209.95–$787.32	—	76%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$209.95	$874.80	$209.95–$787.32	—	76%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$154.52	$643.85	$9.71–$579.46	—	76%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$154.52	$643.85	$9.71–$579.46	—	76%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$154.52	$643.85	$154.52–$579.46	—	76%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$154.52	$643.85	$154.52–$579.46	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$49.83	$207.62	$13.14–$186.86	13% below	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE	$104.42	$435.07	$13.14–$391.56	82% above	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$104.42	$435.07	$13.14–$391.56	82% above	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$104.42	$435.07	$13.14–$391.56	82% above	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 $ED Admin Vaccine	$104.42	$435.07	$13.14–$391.56	82% above	76%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$104.42	$435.07	$13.14–$391.56	82% above	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$49.83	$207.62	$49.83–$186.86	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$104.42	$435.07	$104.42–$391.56	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE	$104.42	$435.07	$104.42–$391.56	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 $ED Admin Vaccine	$104.42	$435.07	$104.42–$391.56	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$104.42	$435.07	$104.42–$391.56	—	76%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$104.42	$435.07	$104.42–$391.56	—	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - OB Obs/OP Addition	$49.83	$207.62	$13.14–$186.86	11% above	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 OB CHRG - VACCINE ADM EA AD	$49.83	$207.62	$13.14–$186.86	11% above	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$119.81	$499.22	$13.14–$449.30	167% above	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CHRG - VACCINE ADM EA AD	$119.81	$499.22	$13.14–$449.30	167% above	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$119.81	$499.22	$13.14–$449.30	167% above	76%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 $ED Admin Vaccine Ea Add'l	$119.81	$499.22	$13.14–$449.30	167% above	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 OB CHRG - VACCINE ADM EA AD	$49.83	$207.62	$49.83–$186.86	—	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - OB Obs/OP Addition	$49.83	$207.62	$49.83–$186.86	—	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$119.81	$499.22	$119.81–$449.30	—	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CHRG - VACCINE ADM EA AD	$119.81	$499.22	$119.81–$449.30	—	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$119.81	$499.22	$119.81–$449.30	—	76%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 $ED Admin Vaccine Ea Add'l	$119.81	$499.22	$119.81–$449.30	—	76%
Yellow fever vaccine, live CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$1,241.38	$5,172.43	$154.73–$4,655.19	535% above	76%
Yellow fever vaccine, live CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$1,241.38	$5,172.43	$154.73–$4,655.19	535% above	76%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$1,241.38	$5,172.43	$1,241.38–$4,655.19	—	76%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$1,241.38	$5,172.43	$1,241.38–$4,655.19	—	76%

Dental

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH/EXR	$21,484.08	$89,517.00	$93.56–$80,565.30	331% above	76%

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

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

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

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

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

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

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

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

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

Source file: https://www.pbrmc.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/431238701_poplar-bluff-regional-medical-center_standardcharges.csv