Hospital Rapid City, SD

Black Hills Surgical Hospital

Black Hills Surgical Hospital in Rapid City, SD publishes cash prices for 399 common procedures listed here, from its own machine-readable price file updated Jan 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the South Dakota median for 300 of 357 procedures and above it for 42. By typical cash price it ranks #1 of 24 South Dakota hospitals and #1 of 5 hospitals in the Rapid City, SD area, cheapest first. Select a procedure to compare it with other hospitals nearby.

216 Anamaria Drive, Rapid City, SD, 57701 Collected Sep 28, 2026 Source price file Check a bill from this hospital (605) 721-4700

Acute care hospital For-profit hospital No emergency department CCN 430091 · CMS hospital register

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 4 actions for a hospital named Black Hills Surgical Hospital in Rapid City, SD:

Dec 30, 2022 Warning notice
Apr 27, 2023 Case closed
Jul 9, 2025 Met requirements
Jul 31, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. 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 South Dakota	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO/W CONTRAST	$959.70	$1,599.50	$251.72–$1,439.55	70% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO/W CONTRAST	$959.70	$1,599.50	$251.72–$1,439.55	—	40%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN UPRIGHT/SUPINE	$160.09	$266.81	$34.92–$240.13	64% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN UPRIGHT/SUPINE	$160.09	$266.81	$34.92–$240.13	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW RIGHT,Right side	$84.11	$140.18	$87.13–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW RIGHT	$84.11	$140.18	$35.90–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW LEFT,Right side	$84.11	$140.18	$87.13–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW LEFT,Left side	$84.11	$140.18	$35.90–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW LEFT	$84.11	$140.18	$35.90–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEW RIGHT,Left side	$84.11	$140.18	$35.90–$126.16	71% below	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW RIGHT,Left side	$84.11	$140.18	$35.90–$126.16	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW RIGHT	$84.11	$140.18	$35.90–$126.16	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW LEFT	$84.11	$140.18	$35.90–$126.16	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW LEFT,Left side	$84.11	$140.18	$35.90–$126.16	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW LEFT,Right side	$84.11	$140.18	$87.13–$126.16	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEW RIGHT,Right side	$84.11	$140.18	$87.13–$126.16	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDEX (ABI ONLY)	$389.59	$649.32	$133.21–$584.39	24% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL INDEX (ABI ONLY)	$389.59	$649.32	$133.21–$584.39	—	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT CLAVICLE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SC JOINT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SC JOINT LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT CLAVICLE RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAPULA RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SCAPULA RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FINGER RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FINGER RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS/UPPER ARM RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS/UPPER ARM RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS/UPPER ARM LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT CLAVICLE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT CLAVICLE LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FINGER LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FINGER LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS/UPPER ARM LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	65% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SC JOINT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SC JOINT LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT CLAVICLE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT CLAVICLE RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SCAPULA RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SCAPULA RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS/UPPER ARM LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FINGER RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FINGER RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS/UPPER ARM LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT CLAVICLE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT CLAVICLE LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FINGER LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS/UPPER ARM RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS/UPPER ARM RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FINGER LEFT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT RIGHT W/O CONTRAST	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$155.70–$1,084.50	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN & PELVIS	$861.19	$1,435.32	$367.17–$1,291.79	79% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN & PELVIS	$861.19	$1,435.32	$367.17–$1,291.79	—	40%
CT angiography (CTA) of the head CPT 70496 CTA BRAIN WO/W CONTRAST	$771.72	$1,286.20	$265.81–$1,157.58	74% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA BRAIN WO/W CONTRAST	$771.72	$1,286.20	$265.81–$1,157.58	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/ CONTRAST	$705.84	$1,176.40	$265.81–$1,058.76	76% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/ CONTRAST	$705.84	$1,176.40	$265.81–$1,058.76	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST/THORACIC W/ CONTRAST	$873.24	$1,455.40	$271.91–$1,309.86	70% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PE W/ CONTRAST	$873.24	$1,455.40	$271.91–$1,309.86	70% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST PE W/ CONTRAST	$873.24	$1,455.40	$271.91–$1,309.86	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST/THORACIC W/ CONTRAST	$873.24	$1,455.40	$271.91–$1,309.86	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA CORONARY,Technical component	$633.18	$1,055.30	$349.30–$949.77	82% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA CORONARY,Technical component	$633.18	$1,055.30	$349.30–$949.77	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING	$185.22	$308.70	$96.46–$277.83	29% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING	$185.22	$308.70	$96.46–$277.83	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O CONTRAST	$870.26	$1,450.44	$176.99–$1,305.40	77% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS W/O CONTRAST	$870.26	$1,450.44	$176.99–$1,305.40	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W/ CONTRAST	$1,087.06	$1,811.76	$291.44–$1,630.58	77% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W/ CONTRAST	$1,087.06	$1,811.76	$291.44–$1,630.58	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM	$1,029.30	$1,715.50	$349.30–$1,543.95	79% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS WO/W CONTRAST	$1,355.18	$2,258.64	$328.00–$2,032.78	73% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM	$1,029.30	$1,715.50	$349.30–$1,543.95	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS WO/W CONTRAST	$1,355.18	$2,258.64	$328.00–$2,032.78	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST	$751.02	$1,251.70	$223.58–$1,126.53	74% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST	$751.02	$1,251.70	$223.58–$1,126.53	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$580.02	$966.70	$131.81–$870.03	71% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$580.02	$966.70	$131.81–$870.03	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST	$690.42	$1,150.70	$104.67–$1,035.63	65% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$690.42	$1,150.70	$124.39–$1,035.63	65% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$690.42	$1,150.70	$124.39–$1,035.63	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST	$690.42	$1,150.70	$104.67–$1,035.63	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN W/O CONTRAST	$524.52	$874.20	$103.12–$786.78	73% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN W/O CONTRAST	$524.52	$874.20	$103.12–$786.78	—	40%
CT scan of the head with contrast CPT 70460 CT BRAIN W/ CONTRAST,Technical component	$638.40	$1,064.00	$175.62–$957.60	71% below	40%
CT scan of the head with contrast CPT 70460 CT IAC W/ CONTRAST,Technical component	$638.40	$1,064.00	$175.62–$957.60	71% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN W/ CONTRAST,Technical component	$638.40	$1,064.00	$175.62–$957.60	—	40%
CT scan of the head with contrast inpatient CPT 70460 CT IAC W/ CONTRAST,Technical component	$638.40	$1,064.00	$175.62–$957.60	—	40%
CT scan of the head without and with contrast CPT 70470 CT IAC WO/W CONTRAST	$808.02	$1,346.70	$167.60–$1,212.03	71% below	40%
CT scan of the head without and with contrast CPT 70470 CT BRAIN WO/W CONTRAST	$808.02	$1,346.70	$167.60–$1,212.03	71% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN WO/W CONTRAST	$808.02	$1,346.70	$167.60–$1,212.03	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT IAC WO/W CONTRAST	$808.02	$1,346.70	$167.60–$1,212.03	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$775.62	$1,292.70	$125.81–$1,163.43	67% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$775.62	$1,292.70	$125.81–$1,163.43	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$714.12	$1,190.20	$126.47–$1,071.18	68% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$714.12	$1,190.20	$126.47–$1,071.18	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CONTRAST	$736.92	$1,228.20	$175.62–$1,105.38	67% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTRAST	$736.92	$1,228.20	$175.62–$1,105.38	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX	$389.59	$649.32	$238.89–$584.39	69% below	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX	$389.59	$649.32	$238.89–$584.39	—	40%
Chest CT scan without and with contrast CPT 71270 CT CHEST/THORAX WO/W CONTRAST	$939.90	$1,566.50	$189.86–$1,409.85	68% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST/THORAX WO/W CONTRAST	$939.90	$1,566.50	$189.86–$1,409.85	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST FRONT/LAT - 2 VIEW	$96.39	$160.65	$31.97–$144.58	74% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST FRONT/LAT - 2 VIEW	$96.39	$160.65	$31.97–$144.58	—	40%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW PICC/MIDLINE	$78.44	$130.73	$24.44–$117.66	74% below	40%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW	$78.44	$130.73	$24.44–$117.66	74% below	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW	$78.44	$130.73	$24.44–$117.66	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW PICC/MIDLINE	$78.44	$130.73	$24.44–$117.66	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LEFT	$80.08	$133.46	$32.30–$120.11	68% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LEFT,Left side	$80.08	$133.46	$87.13–$120.11	68% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RIGHT,Left side	$80.08	$133.46	$87.13–$120.11	68% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RIGHT	$80.08	$133.46	$32.30–$120.11	68% below	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LEFT	$80.08	$133.46	$32.30–$120.11	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RIGHT	$80.08	$133.46	$32.30–$120.11	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LEFT,Left side	$80.08	$133.46	$87.13–$120.11	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RIGHT,Left side	$80.08	$133.46	$87.13–$120.11	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL WITH BLADDER,Technical component	$389.59	$649.32	$104.67–$584.39	56% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL,Technical component	$389.59	$649.32	$104.67–$584.39	56% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL WITH BLADDER,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/THORAX W/O CONTRAST	$308.94	$514.90	$128.43–$463.41	85% below	40%
Diagnostic CT scan of the chest, no contrast dye one side CPT 71250 CT CHEST/THORAX W/O CONTRAST,Left side	$308.94	$514.90	$128.43–$463.41	85% below	40%
Diagnostic CT scan of the chest, no contrast dye one side CPT 71250 CT SCAPULA LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$128.43–$1,084.50	65% below	40%
Diagnostic CT scan of the chest, no contrast dye one side CPT 71250 CT SC JOINT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$128.43–$1,084.50	65% below	40%
Diagnostic CT scan of the chest, no contrast dye one side CPT 71250 CT SC JOINT RIGHT W/O CONTRAST	$723.00	$1,205.00	$128.43–$1,084.50	65% below	40%
Diagnostic CT scan of the chest, no contrast dye one side CPT 71250 CT SCAPULA LEFT W/O CONTRAST	$723.00	$1,205.00	$128.43–$1,084.50	65% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST/THORAX W/O CONTRAST	$308.94	$514.90	$128.43–$463.41	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient one side CPT 71250 CT CHEST/THORAX W/O CONTRAST,Left side	$308.94	$514.90	$128.43–$463.41	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient one side CPT 71250 CT SC JOINT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$128.43–$1,084.50	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient one side CPT 71250 CT SCAPULA LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$128.43–$1,084.50	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient one side CPT 71250 CT SC JOINT RIGHT W/O CONTRAST	$723.00	$1,205.00	$128.43–$1,084.50	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient one side CPT 71250 CT SCAPULA LEFT W/O CONTRAST	$723.00	$1,205.00	$128.43–$1,084.50	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/THORAX W/ CONTRAST	$759.12	$1,265.20	$161.38–$1,138.68	72% below	40%
Diagnostic CT scan of the chest, with contrast dye one side CPT 71260 CT SC JOINT RIGHT W/ CONTRAST	$803.58	$1,339.30	$161.38–$1,205.37	70% below	40%
Diagnostic CT scan of the chest, with contrast dye one side CPT 71260 CT SC JOINT LEFT W/ CONTRAST	$803.58	$1,339.30	$161.38–$1,205.37	70% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/THORAX W/ CONTRAST	$759.12	$1,265.20	$161.38–$1,138.68	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient one side CPT 71260 CT SC JOINT LEFT W/ CONTRAST	$803.58	$1,339.30	$161.38–$1,205.37	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient one side CPT 71260 CT SC JOINT RIGHT W/ CONTRAST	$803.58	$1,339.30	$161.38–$1,205.37	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL DUPLEX/GRAFT BILAT LOWER EXT	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL DUPLEX/GRAFT BILAT UPPER EXT	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL DUPLEX/GRAFT BILAT UPPER EXT	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL DUPLEX/GRAFT BILAT LOWER EXT	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DUPLEX UPPER EXT BILATERAL	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DUPLEX LOWER EXT BILATERAL	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DUPLEX LOWER EXT BILATERAL	$389.59	$649.32	$238.89–$584.39	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DUPLEX UPPER EXT BILATERAL	$389.59	$649.32	$238.89–$584.39	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM	$690.37	$1,150.62	$547.08–$1,035.56	71% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAM	$690.37	$1,150.62	$547.08–$1,035.56	—	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW RIGHT	$84.11	$140.18	$28.37–$126.16	69% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW LEFT,Left side	$84.11	$140.18	$28.37–$126.16	69% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW RIGHT,Left side	$84.11	$140.18	$28.37–$126.16	69% below	40%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW LEFT	$84.11	$140.18	$28.37–$126.16	69% below	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW RIGHT,Left side	$84.11	$140.18	$28.37–$126.16	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW LEFT,Left side	$84.11	$140.18	$28.37–$126.16	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW RIGHT	$84.11	$140.18	$28.37–$126.16	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW LEFT	$84.11	$140.18	$28.37–$126.16	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC W/O CONTRAST	$524.52	$874.20	$153.19–$786.78	75% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/PITUITARY W/O CONTRAST	$723.00	$1,205.00	$153.19–$1,084.50	66% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONE W/O CONTRAST	$723.00	$1,205.00	$153.19–$1,084.50	66% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC W/O CONTRAST	$524.52	$874.20	$153.19–$786.78	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONE W/O CONTRAST	$723.00	$1,205.00	$153.19–$1,084.50	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/PITUITARY W/O CONTRAST	$723.00	$1,205.00	$153.19–$1,084.50	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEW LEFT,Right side	$74.34	$123.90	$28.05–$111.51	76% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEW RIGHT,Right side	$74.34	$123.90	$28.05–$111.51	76% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEW RIGHT,Right side	$74.34	$123.90	$28.05–$111.51	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEW LEFT,Right side	$74.34	$123.90	$28.05–$111.51	—	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEW LEFT	$74.57	$124.28	$30.33–$111.85	72% below	40%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEW RIGHT	$74.57	$124.28	$30.33–$111.85	72% below	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEW LEFT	$74.57	$124.28	$30.33–$111.85	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEW RIGHT	$74.57	$124.28	$30.33–$111.85	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR CALCANEUS MIN TWO VIEWS,Technical component	$75.98	$126.63	$87.13–$113.97	64% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR CALCANEUS MIN TWO VIEWS,Technical component	$75.98	$126.63	$87.13–$113.97	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAM with CPAP	$2,628.00	$4,380.00	$859.79–$3,942.00	43% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAM with CPAP	$2,628.00	$4,380.00	$859.79–$3,942.00	—	40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEW LEFT,Left side	$100.49	$167.48	$41.14–$150.73	70% below	40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEW RIGHT,Left side	$100.49	$167.48	$41.14–$150.73	70% below	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEW LEFT,Left side	$100.49	$167.48	$41.14–$150.73	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEW RIGHT,Left side	$100.49	$167.48	$41.14–$150.73	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB/CALF RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB/CALF RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB/CALF LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT TIB/FIB/CALF LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR/THIGH LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR/THIGH LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR/THIGH RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FEMUR/THIGH RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	64% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR/THIGH LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR/THIGH LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB/CALF LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB/CALF LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT LEFT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT LEFT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR/THIGH RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FEMUR/THIGH RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB/CALF RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT TIB/FIB/CALF RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT RIGHT W/O CONTRAST	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT RIGHT W/O CONTRAST,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE LEFT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE LEFT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE RIGHT W/O CONTRAST STRYKER	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE RIGHT W/O CONTRAST STRYKER,Left side	$723.00	$1,205.00	$126.14–$1,084.50	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN; LIMITED	$389.59	$649.32	$83.58–$584.39	53% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN; LIMITED	$389.59	$649.32	$83.58–$584.39	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST/THORAX W/O CONTRAST LOW DOSE	$308.94	$514.90	$131.81–$463.41	65% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST/THORAX W/O CONTRAST LOW DOSE	$308.94	$514.90	$131.81–$463.41	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB RIGHT,Left side	$87.38	$145.64	$87.13–$131.08	74% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB LEFT,Right side	$87.38	$145.64	$87.13–$131.08	74% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB LEFT,Left side	$87.38	$145.64	$87.13–$131.08	74% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIB/FIB RIGHT,Right side	$87.38	$145.64	$87.13–$131.08	74% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB LEFT,Right side	$87.38	$145.64	$87.13–$131.08	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB RIGHT,Left side	$87.38	$145.64	$87.13–$131.08	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB RIGHT,Right side	$87.38	$145.64	$87.13–$131.08	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIB/FIB LEFT,Left side	$87.38	$145.64	$87.13–$131.08	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN W/O CONTRAST	$713.40	$1,189.00	$208.30–$1,070.10	76% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN W/O CONTRAST	$713.40	$1,189.00	$208.30–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	77% below	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RIGHT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LEFT W/O CONTRAST	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$198.37–$1,070.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP ARTHROGRAM RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP ARTHROGRAM LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP ARTHROGRAM LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP ARTHROGRAM RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	73% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP ARTHROGRAM LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP ARTHROGRAM RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP ARTHROGRAM RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP ARTHROGRAM LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE LEFT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP LEFT WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE RIGHT WO/W CONTRAST,Left side	$1,121.40	$1,869.00	$370.55–$1,682.10	—	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$713.40	$1,189.00	$187.90–$1,070.10	78% below	40%
MRI of the abdomen without contrast CPT 74181 MRE ABDOMEN W/O CONTRAST	$713.40	$1,189.00	$187.90–$1,070.10	78% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$713.40	$1,189.00	$187.90–$1,070.10	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRE ABDOMEN W/O CONTRAST	$713.40	$1,189.00	$187.90–$1,070.10	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO/W CONTRAST	$1,121.40	$1,869.00	$325.81–$1,682.10	74% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO/W CONTRAST	$1,121.40	$1,869.00	$325.81–$1,682.10	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$713.40	$1,189.00	$189.32–$1,070.10	77% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$713.40	$1,189.00	$189.32–$1,070.10	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/W CONTRAST	$1,121.40	$1,869.00	$307.16–$1,682.10	74% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/W CONTRAST	$1,121.40	$1,869.00	$307.16–$1,682.10	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$713.40	$1,189.00	$185.71–$1,070.10	78% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST	$713.40	$1,189.00	$185.71–$1,070.10	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WO/W CONTRAST	$1,121.40	$1,869.00	$308.46–$1,682.10	75% below	40%
MRI of the lower back, without and then with contrast dye one side CPT 72158 MRI LUMBAR SPINE WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$308.46–$1,682.10	75% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WO/W CONTRAST	$1,121.40	$1,869.00	$308.46–$1,682.10	—	40%
MRI of the lower back, without and then with contrast dye inpatient one side CPT 72158 MRI LUMBAR SPINE WO/W CONTRAST,Right side	$1,121.40	$1,869.00	$308.46–$1,682.10	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE W/O CONTRAST	$713.40	$1,189.00	$184.41–$1,070.10	78% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O CONTRAST	$713.40	$1,189.00	$184.41–$1,070.10	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WO/W CONTRAST	$1,121.40	$1,869.00	$308.14–$1,682.10	74% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WO/W CONTRAST	$1,121.40	$1,869.00	$308.14–$1,682.10	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE W/O CONTRAST	$713.40	$1,189.00	$184.73–$1,070.10	78% below	40%
MRI of the neck (cervical spine), no contrast dye one side CPT 72141 MRI CERVICAL SPINE W/O CONTRAST,Left side	$713.40	$1,189.00	$184.73–$1,070.10	78% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O CONTRAST	$713.40	$1,189.00	$184.73–$1,070.10	—	40%
MRI of the neck (cervical spine), no contrast dye inpatient one side CPT 72141 MRI CERVICAL SPINE W/O CONTRAST,Left side	$713.40	$1,189.00	$184.73–$1,070.10	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/W CONTRAST	$1,121.40	$1,869.00	$324.17–$1,682.10	74% below	40%
MRI of the pelvis without and with contrast CPT 72197 MRI SACRUM WO/W CONTRAST	$1,121.40	$1,869.00	$324.17–$1,682.10	74% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI SACRUM WO/W CONTRAST	$1,121.40	$1,869.00	$324.17–$1,682.10	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/W CONTRAST	$1,121.40	$1,869.00	$324.17–$1,682.10	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	80% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI SI JOINTS W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	80% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI SACRUM W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	80% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI SI JOINTS W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI SACRUM W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$713.40	$1,189.00	$220.95–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	78% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RIGHT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RIGHT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LEFT W/O CONTRAST,Left side	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LEFT W/O CONTRAST	$713.40	$1,189.00	$199.03–$1,070.10	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4+ VIEW	$147.33	$245.55	$104.67–$221.00	72% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR C-SPINE 4+ VIEW	$147.33	$245.55	$104.67–$221.00	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/ CONTRAST	$831.72	$1,386.20	$177.74–$1,247.58	67% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/ CONTRAST	$831.72	$1,386.20	$177.74–$1,247.58	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST	$692.64	$1,154.40	$104.67–$1,038.96	66% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTRAST	$692.64	$1,154.40	$104.67–$1,038.96	—	40%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE,Technical component	$108.61	$181.02	$87.13–$162.92	66% below	40%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE,Technical component	$108.61	$181.02	$87.13–$162.92	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$628.20	$1,047.00	$128.43–$942.30	67% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$628.20	$1,047.00	$128.43–$942.30	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED,Technical component	$389.59	$649.32	$104.67–$584.39	15% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1st Trimester,Technical component	$389.59	$649.32	$104.67–$584.39	38% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1st Trimester,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited one or more,Technical component	$389.59	$649.32	$104.67–$584.39	22% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited one or more,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEW RIGHT	$84.92	$141.54	$34.92–$127.39	75% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEW LEFT	$84.92	$141.54	$34.92–$127.39	75% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEW RIGHT	$84.92	$141.54	$34.92–$127.39	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEW LEFT	$84.92	$141.54	$34.92–$127.39	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS LEFT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION LEFT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW (Placement),Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-VIEW RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW (Placement),Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW LEFT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION LEFT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW LEFT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-VIEW LEFT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-VIEW RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3-VIEW RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2-VIEW LEFT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS LEFT,Left side	$105.34	$175.56	$34.59–$158.00	69% below	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-VIEW LEFT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION LEFT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION LEFT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS LEFT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP/AXILLARY VIEWS LEFT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW (Placement),Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW (Placement),Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW LEFT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW LEFT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3-VIEW RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-VIEW RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-VIEW RIGHT,Right side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER AP INT/EXT ROTATION RIGHT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2-VIEW LEFT,Left side	$105.34	$175.56	$34.59–$158.00	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LESS THAN 4 VIEWS	$114.61	$191.02	$34.59–$171.92	72% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LESS THAN 4 VIEWS	$114.61	$191.02	$34.59–$171.92	—	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAM	$2,568.00	$4,280.00	$859.79–$3,852.00	41% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAM	$2,568.00	$4,280.00	$859.79–$3,852.00	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR COMPLETE LEFT,Right side	$87.38	$145.64	$87.13–$131.08	72% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR COMPLETE LEFT,Left side	$87.38	$145.64	$87.13–$131.08	72% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR COMPLETE RIGHT,Right side	$87.38	$145.64	$87.13–$131.08	72% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR COMPLETE RIGHT,Left side	$87.38	$145.64	$87.13–$131.08	72% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR COMPLETE LEFT,Right side	$87.38	$145.64	$87.13–$131.08	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR COMPLETE RIGHT,Right side	$87.38	$145.64	$87.13–$131.08	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR COMPLETE RIGHT,Left side	$87.38	$145.64	$87.13–$131.08	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR COMPLETE LEFT,Left side	$87.38	$145.64	$87.13–$131.08	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$806.76	$1,344.60	$126.14–$1,210.14	65% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$806.76	$1,344.60	$126.14–$1,210.14	—	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOES LEFT	$62.06	$103.43	$27.71–$93.09	75% below	40%
Toe X-ray, 2 or more views one side CPT 73660 XR TOES RIGHT	$62.06	$103.43	$27.71–$93.09	75% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES LEFT	$62.06	$103.43	$27.71–$93.09	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOES RIGHT	$62.06	$103.43	$27.71–$93.09	—	40%
Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANSVAGINAL,Technical component	$389.59	$649.32	$104.67–$584.39	33% below	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANSVAGINAL,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN; COMPLETE,Technical component	$389.59	$649.32	$104.67–$584.39	65% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN; COMPLETE,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTAL,Technical component	$389.59	$649.32	$104.67–$584.39	53% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTAL,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID/SOFT TISSUE NECK,Technical component	$389.59	$649.32	$104.67–$584.39	52% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID/SOFT TISSUE NECK,Technical component	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX LOWER EXT RIGHT,Right side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX UPPER EXT LEFT,Left side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX LOWER EXT LEFT,Right side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX UPPER EXT RIGHT,Right side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX LOWER EXT LEFT,Left side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX UPPER EXT LEFT,Right side	$389.59	$649.32	$104.67–$584.39	60% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX LOWER EXT LEFT,Right side	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX UPPER EXT LEFT,Right side	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX LOWER EXT LEFT,Left side	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX UPPER EXT RIGHT,Right side	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX LOWER EXT RIGHT,Right side	$389.59	$649.32	$104.67–$584.39	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS DUPLEX UPPER EXT LEFT,Left side	$389.59	$649.32	$104.67–$584.39	—	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEW LEFT	$71.06	$118.44	$33.28–$106.60	70% below	40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEW RIGHT	$71.06	$118.44	$33.28–$106.60	70% below	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEW RIGHT	$71.06	$118.44	$33.28–$106.60	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEW LEFT	$71.06	$118.44	$33.28–$106.60	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW RIGHT,Left side	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW LEFT,Left side	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW LEFT	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW RIGHT,Right side	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW RIGHT	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEW LEFT,Right side	$78.17	$130.28	$41.46–$117.25	74% below	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW LEFT,Right side	$78.17	$130.28	$41.46–$117.25	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW RIGHT	$78.17	$130.28	$41.46–$117.25	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW RIGHT,Left side	$78.17	$130.28	$41.46–$117.25	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW RIGHT,Right side	$78.17	$130.28	$41.46–$117.25	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW LEFT	$78.17	$130.28	$41.46–$117.25	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW LEFT,Left side	$78.17	$130.28	$41.46–$117.25	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP AP/LAT W/ PELVIS - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP AP/LAT - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - LEFT,Left side	$96.12	$160.20	$87.13–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP AP/LAT - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP AP/LAT W/ PELVIS - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	69% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP AP/LAT W/ PELVIS - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP AP/LAT - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP AP/LAT W/ PELVIS - RIGHT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP AP/LAT - LEFT,Right side	$96.12	$160.20	$47.35–$144.18	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LAT 1 VIEW W/ PELVIS - LEFT,Left side	$96.12	$160.20	$87.13–$144.18	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN SINGLE AP - KUB	$160.09	$266.81	$28.69–$240.13	50% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN SINGLE AP - KUB	$160.09	$266.81	$28.69–$240.13	—	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEW RIGHT	$74.34	$123.90	$31.32–$111.51	73% below	40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEW LEFT	$74.34	$123.90	$31.32–$111.51	73% below	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEW RIGHT	$74.34	$123.90	$31.32–$111.51	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEW LEFT	$74.34	$123.90	$31.32–$111.51	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LEFT,Left side	$62.90	$104.84	$87.13–$94.36	74% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RIGHT	$62.90	$104.84	$38.19–$94.36	74% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RIGHT,Left side	$62.90	$104.84	$87.13–$94.36	74% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LEFT	$62.90	$104.84	$38.19–$94.36	74% below	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RIGHT,Left side	$62.90	$104.84	$87.13–$94.36	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LEFT	$62.90	$104.84	$38.19–$94.36	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RIGHT	$62.90	$104.84	$38.19–$94.36	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LEFT,Left side	$62.90	$104.84	$87.13–$94.36	—	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEW LEFT	$57.20	$95.34	$27.71–$85.81	80% below	40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEW RIGHT	$75.98	$126.63	$27.71–$113.97	73% below	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW LEFT	$57.20	$95.34	$27.71–$85.81	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW RIGHT	$75.98	$126.63	$27.71–$113.97	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW LEFT,Right side	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW RIGHT	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW RIGHT,Left side	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW RIGHT,Right side	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW LEFT	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEW LEFT,Left side	$87.38	$145.64	$32.96–$131.08	70% below	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW RIGHT,Right side	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW LEFT,Left side	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW RIGHT	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW LEFT,Right side	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW RIGHT,Left side	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW LEFT	$87.38	$145.64	$32.96–$131.08	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW RIGHT	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW RIGHT,Left side	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW RIGHT,Right side	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW LEFT	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW LEFT,Left side	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEW LEFT,Right side	$78.17	$130.28	$36.88–$117.25	74% below	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW RIGHT	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW LEFT,Right side	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW RIGHT,Left side	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW LEFT	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW LEFT,Left side	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW RIGHT,Right side	$78.17	$130.28	$36.88–$117.25	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEW RIGHT,Left side	$75.98	$126.63	$33.28–$113.97	73% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEW LEFT	$75.98	$126.63	$87.13–$113.97	73% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEW LEFT,Left side	$75.98	$126.63	$33.28–$113.97	73% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEW RIGHT	$75.98	$126.63	$87.13–$113.97	73% below	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEW RIGHT	$75.98	$126.63	$87.13–$113.97	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEW LEFT,Left side	$75.98	$126.63	$33.28–$113.97	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEW RIGHT,Left side	$75.98	$126.63	$33.28–$113.97	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEW LEFT	$75.98	$126.63	$87.13–$113.97	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE LAT FLEXTION & EXTENTION	$108.61	$181.02	$39.17–$162.92	73% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE AP/LAT - 2 VIEW	$108.61	$181.02	$39.17–$162.92	73% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE AP/LAT - 2 VIEW (Placement)	$160.09	$266.81	$39.17–$240.13	60% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE LAT FLEXTION & EXTENTION	$108.61	$181.02	$39.17–$162.92	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE AP/LAT - 2 VIEW	$108.61	$181.02	$39.17–$162.92	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE AP/LAT - 2 VIEW (Placement)	$160.09	$266.81	$39.17–$240.13	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEW	$108.61	$181.02	$31.97–$162.92	71% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T-SPINE 2 VIEW	$108.61	$181.02	$31.97–$162.92	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE LAT FLEXION & EXTENTION	$109.43	$182.39	$38.51–$164.15	70% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE AP/LAT - 2/3 VIEW	$109.43	$182.39	$38.51–$164.15	70% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE AP/LAT - 2/3 VIEW (Placement)	$160.09	$266.81	$38.51–$240.13	57% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE AP/LAT - 2/3 VIEW	$109.43	$182.39	$38.51–$164.15	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE LAT FLEXION & EXTENTION	$109.43	$182.39	$38.51–$164.15	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE AP/LAT - 2/3 VIEW (Placement)	$160.09	$266.81	$38.51–$240.13	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP	$160.09	$266.81	$27.06–$240.13	49% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP and LATERAL	$160.09	$266.81	$27.06–$240.13	49% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP (FOR PLACEMENT POST-OP)	$160.09	$266.81	$27.06–$240.13	49% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP (PLACEMENT)	$160.09	$266.81	$27.06–$240.13	49% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP (FOR PLACEMENT POST-OP)	$160.09	$266.81	$27.06–$240.13	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP	$160.09	$266.81	$27.06–$240.13	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP (PLACEMENT)	$160.09	$266.81	$27.06–$240.13	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP and LATERAL	$160.09	$266.81	$27.06–$240.13	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs South Dakota	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone (ACTH)-	$45.42	$75.70	$37.85–$68.13	74% below	40%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone (ACTH)-	$45.42	$75.70	$37.85–$68.13	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SPGT-	$27.00	$45.00	$5.19–$40.50	63% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SPGT (Send Out)-	$27.00	$45.00	$5.19–$40.50	63% below	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SPGT (Send Out)-	$27.00	$45.00	$5.19–$40.50	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SPGT-	$27.00	$45.00	$5.19–$40.50	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT-	$27.00	$45.00	$5.08–$40.50	64% below	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT (Send Out)-	$27.00	$45.00	$5.08–$40.50	64% below	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT-	$27.00	$45.00	$5.08–$40.50	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT (Send Out)-	$27.00	$45.00	$5.08–$40.50	—	40%
Albumin blood test CPT 82040 ALBUMIN-	$27.00	$45.00	$4.85–$40.50	56% below	40%
Albumin blood test CPT 82040 ALBUMIN (Send Out)-	$27.00	$45.00	$4.85–$40.50	56% below	40%
Albumin blood test inpatient CPT 82040 ALBUMIN-	$27.00	$45.00	$4.85–$40.50	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN (Send Out)-	$27.00	$45.00	$4.85–$40.50	—	40%
Aldosterone blood test CPT 82088 Aldosterone-	$52.75	$87.92	$39.94–$79.13	51% below	40%
Aldosterone blood test inpatient CPT 82088 Aldosterone-	$52.75	$87.92	$39.94–$79.13	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE-	$27.00	$45.00	$5.08–$40.50	63% below	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE (Send Out)-	$27.00	$45.00	$5.08–$40.50	63% below	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE (Send Out)-	$27.00	$45.00	$5.08–$40.50	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE-	$27.00	$45.00	$5.08–$40.50	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Quantitative or Semiquanitativ-	$35.33	$58.88	$5.12–$52.99	3% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Quantitative or Semiquanitativ-	$35.33	$58.88	$5.12–$52.99	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (Tumor Marker)-	$128.59	$214.32	$16.43–$192.89	4% below	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (Maternal)-	$128.59	$214.32	$16.43–$192.89	4% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (Maternal)-	$128.59	$214.32	$16.43–$192.89	—	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (Tumor Marker)-	$128.59	$214.32	$16.43–$192.89	—	40%
Ammonia blood test CPT 82140 AMMONIA LEVEL-	$35.34	$58.90	$14.28–$53.01	79% below	40%
Ammonia blood test inpatient CPT 82140 AMMONIA LEVEL-	$35.34	$58.90	$14.28–$53.01	—	40%
Amylase blood test CPT 82150 AMYLASE-	$35.34	$58.90	$6.35–$53.01	65% below	40%
Amylase blood test CPT 82150 AMYLASE (Send Out)-	$35.34	$58.90	$6.35–$53.01	65% below	40%
Amylase blood test inpatient CPT 82150 AMYLASE (Send Out)-	$35.34	$58.90	$6.35–$53.01	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE-	$35.34	$58.90	$6.35–$53.01	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Anti-Citrulline (CCP) Abs, IgG-	$40.12	$66.86	$12.69–$60.17	72% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Anti-Citrulline (CCP) Abs, IgG-	$40.12	$66.86	$12.69–$60.17	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY with REFLEX-	$35.34	$58.90	$11.85–$53.01	52% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY with REFLEX-	$35.34	$58.90	$11.85–$53.01	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE B-TYPE-	$128.59	$214.32	$38.47–$192.89	40% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE B-TYPE-	$128.59	$214.32	$38.47–$192.89	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory with Gram Stain-	$26.51	$44.18	$8.45–$39.76	69% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory-	$26.51	$44.18	$8.45–$39.76	69% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ID OF ORGANISM AEROBIC-	$26.51	$44.19	$8.45–$39.77	69% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC (Send Out)-	$26.51	$44.18	$8.45–$39.76	69% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC-	$39.19	$65.31	$8.45–$58.78	54% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC EXT-	$39.19	$65.31	$8.45–$58.78	54% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ID OF ORGANISM AEROBIC-	$26.51	$44.19	$8.45–$39.77	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory-	$26.51	$44.18	$8.45–$39.76	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory with Gram Stain-	$26.51	$44.18	$8.45–$39.76	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC (Send Out)-	$26.51	$44.18	$8.45–$39.76	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC EXT-	$39.19	$65.31	$8.45–$58.78	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC-	$39.19	$65.31	$8.45–$58.78	—	40%
Basic metabolic panel (blood test) CPT 80048 BMP (Send Out)-	$62.33	$103.88	$8.29–$93.49	56% below	40%
Basic metabolic panel (blood test) CPT 80048 BMP-	$62.33	$103.88	$8.29–$93.49	56% below	40%
Basic metabolic panel (blood test) CPT 80048 BMP with Reflex-	$62.33	$103.88	$8.29–$93.49	56% below	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with Reflex-	$62.33	$103.88	$8.29–$93.49	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP (Send Out)-	$62.33	$103.88	$8.29–$93.49	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP-	$62.33	$103.88	$8.29–$93.49	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL-	$35.34	$58.90	$4.92–$53.01	58% below	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL (Send Out)-	$35.34	$58.90	$4.92–$53.01	58% below	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL-	$35.34	$58.90	$4.92–$53.01	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL (Send Out)-	$35.34	$58.90	$4.92–$53.01	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURG PATH GROSS & MICRO	$56.51	$94.19	$0.01–$84.77	65% below	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURG PATH GROSS & MICRO	$56.51	$94.19	$0.01–$84.77	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD-	$68.71	$114.52	$10.11–$103.07	58% below	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD-	$68.71	$114.52	$10.11–$103.07	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAW VENIPUNCTURE OVER AGE 3-	$11.78	$19.63	$0.01–$9.24	58% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAW VENIPUNCTURE OVER AGE 3-	$11.78	$19.63	$0.01–$9.24	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOMETER	$12.95	$21.58	$3.85–$19.42	78% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE-	$27.00	$45.00	$3.85–$40.50	54% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE (Confirmation)-	$27.00	$45.00	$3.85–$40.50	54% below	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE (Send Out)-	$27.00	$45.00	$3.85–$40.50	54% below	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOMETER	$12.95	$21.58	$3.85–$19.42	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE (Send Out)-	$27.00	$45.00	$3.85–$40.50	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE-	$27.00	$45.00	$3.85–$40.50	—	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE (Confirmation)-	$27.00	$45.00	$3.85–$40.50	—	40%
Blood lead test CPT 83655 Lead-	$55.57	$92.62	$11.87–$83.36	at median	40%
Blood lead test inpatient CPT 83655 Lead-	$55.57	$92.62	$11.87–$83.36	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG (Screen) Qualitative, Total-	$37.24	$62.06	$7.37–$55.85	68% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG (Screen) Qualitative, Total-	$37.24	$62.06	$7.37–$55.85	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 XBB BLOOD TYPING ABO-	$105.04	$175.06	$133.21–$157.55	88% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 XBB BLOOD TYPING ABO-	$105.04	$175.06	$133.21–$157.55	—	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN (Send Out)-	$27.00	$45.00	$3.87–$40.50	57% below	40%
Blood urea nitrogen (BUN) test CPT 84520 BUN-	$27.00	$45.00	$3.87–$40.50	57% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN-	$27.00	$45.00	$3.87–$40.50	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (Send Out)-	$27.00	$45.00	$3.87–$40.50	—	40%
C-peptide blood test CPT 84681 C PEPTIDE-	$48.06	$80.10	$20.39–$72.09	68% below	40%
C-peptide blood test inpatient CPT 84681 C PEPTIDE-	$48.06	$80.10	$20.39–$72.09	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 EXECUTIVE HEALTH CRP	$19.42	$32.37	$5.08–$29.13	77% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP - Extended-	$27.00	$45.00	$5.08–$40.50	68% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP - Inflammation-	$27.00	$45.00	$5.08–$40.50	68% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTIEN (INFLAMATION)-	$29.15	$48.59	$5.08–$43.73	65% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 EXECUTIVE HEALTH CRP	$19.42	$32.37	$5.08–$29.13	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP - Extended-	$27.00	$45.00	$5.08–$40.50	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP - Inflammation-	$27.00	$45.00	$5.08–$40.50	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTIEN (INFLAMATION)-	$29.15	$48.59	$5.08–$43.73	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile - NAAT with Reflex to Toxin-	$48.59	$80.98	$36.52–$72.88	77% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile - NAAT with Reflex to Toxin-	$48.59	$80.98	$36.52–$72.88	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19, NAAT, POC-	$45.90	$76.50	$50.28–$68.85	63% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 (co)-	$45.90	$76.50	$50.28–$68.85	63% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19, PCR-	$45.90	$76.50	$50.28–$68.85	63% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19-	$90.00	$150.00	$50.28–$135.00	28% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19, PCR-	$45.90	$76.50	$50.28–$68.85	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19, NAAT, POC-	$45.90	$76.50	$50.28–$68.85	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 (co)-	$45.90	$76.50	$50.28–$68.85	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19-	$90.00	$150.00	$50.28–$135.00	—	40%
Calcium blood test, total CPT 82310 CALCIUM-	$27.00	$45.00	$5.06–$40.50	64% below	40%
Calcium blood test, total CPT 82310 Calcium Corrected-	$27.00	$45.00	$5.06–$40.50	64% below	40%
Calcium blood test, total CPT 82310 CALCIUM (confirmation)-	$27.00	$45.00	$5.06–$40.50	64% below	40%
Calcium blood test, total CPT 82310 CALCIUM (Send Out)-	$27.00	$45.00	$5.06–$40.50	64% below	40%
Calcium blood test, total inpatient CPT 82310 Calcium Corrected-	$27.00	$45.00	$5.06–$40.50	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM-	$27.00	$45.00	$5.06–$40.50	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (Send Out)-	$27.00	$45.00	$5.06–$40.50	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (confirmation)-	$27.00	$45.00	$5.06–$40.50	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster, IgG Ab-	$42.02	$70.04	$12.62–$63.04	23% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster, IgG Ab-	$42.02	$70.04	$12.62–$63.04	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS PCR-	$130.66	$217.77	$34.39–$195.99	14% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS-	$130.66	$217.77	$34.39–$195.99	14% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS NAA-	$130.66	$217.77	$34.39–$195.99	14% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMATIS PCR (co)-	$130.66	$217.77	$34.39–$195.99	14% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS PCR (co)-	$130.66	$217.77	$34.39–$195.99	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMATIS PCR-	$130.66	$217.77	$34.39–$195.99	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS NAA-	$130.66	$217.77	$34.39–$195.99	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS-	$130.66	$217.77	$34.39–$195.99	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL (Send Out)-	$62.33	$103.88	$13.12–$93.49	42% below	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL-	$62.33	$103.88	$13.12–$93.49	42% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL (Send Out)-	$62.33	$103.88	$13.12–$93.49	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL-	$62.33	$103.88	$13.12–$93.49	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/ DIFFERENTIAL (confirmation)-	$32.88	$54.80	$7.61–$49.32	69% below	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/ DIFFERENTIAL (Send Out)-	$32.88	$54.80	$7.61–$49.32	69% below	40%
Complete blood count (CBC) with differential CPT 85025 CBC W/ DIFFERENTIAL (co)-	$32.88	$54.80	$7.61–$49.32	69% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ DIFFERENTIAL (co)-	$32.88	$54.80	$7.61–$49.32	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ DIFFERENTIAL (confirmation)-	$32.88	$54.80	$7.61–$49.32	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ DIFFERENTIAL (Send Out)-	$32.88	$54.80	$7.61–$49.32	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFFERENTIAL-	$32.88	$54.80	$6.34–$49.32	62% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFFERENTIAL (confirmation)-	$32.88	$54.80	$6.34–$49.32	62% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFFERENTIAL (co)-	$32.88	$54.80	$6.34–$49.32	62% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFFERENTIAL (Send Out)-	$32.88	$54.80	$6.34–$49.32	62% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFFERENTIAL-	$32.88	$54.80	$6.34–$49.32	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFFERENTIAL (confirmation)-	$32.88	$54.80	$6.34–$49.32	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFFERENTIAL (co)-	$32.88	$54.80	$6.34–$49.32	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFFERENTIAL (Send Out)-	$32.88	$54.80	$6.34–$49.32	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL-	$62.33	$103.88	$10.35–$93.49	62% below	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL (SendOut)-	$62.33	$103.88	$10.35–$93.49	62% below	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL w/ Reflex-	$62.33	$103.88	$10.35–$93.49	62% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL w/ Reflex-	$62.33	$103.88	$10.35–$93.49	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL-	$62.33	$103.88	$10.35–$93.49	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL (SendOut)-	$62.33	$103.88	$10.35–$93.49	—	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL (8am)-	$59.88	$99.80	$15.97–$89.82	35% below	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL (8am)-	$59.88	$99.80	$15.97–$89.82	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL only-	$35.35	$58.92	$6.38–$53.03	53% below	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL only-	$35.35	$58.92	$6.38–$53.03	—	40%
Creatinine blood test CPT 82565 CREATININE (Send Out)-	$35.34	$58.90	$5.02–$53.01	48% below	40%
Creatinine blood test CPT 82565 CREATININE-	$35.34	$58.90	$5.02–$53.01	48% below	40%
Creatinine blood test inpatient CPT 82565 CREATININE (Send Out)-	$35.34	$58.90	$5.02–$53.01	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE-	$35.34	$58.90	$5.02–$53.01	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV (Cytomegalovirus) Antibody IgG-	$51.24	$85.40	$14.10–$76.86	27% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV (Cytomegalovirus) Antibody IgG-	$51.24	$85.40	$14.10–$76.86	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER-	$54.48	$90.80	$9.98–$81.72	61% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER-	$54.48	$90.80	$9.98–$81.72	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate-	$47.42	$79.04	$21.79–$71.14	70% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate-	$47.42	$79.04	$21.79–$71.14	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetaminophen-	$118.33	$197.22	$60.90–$177.50	21% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BLOOD ALCOHOL-	$118.33	$197.22	$60.90–$177.50	21% below	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BLOOD ALCOHOL-	$118.33	$197.22	$60.90–$177.50	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Acetaminophen-	$118.33	$197.22	$60.90–$177.50	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL (confirmation)--	$35.34	$58.90	$6.87–$53.01	67% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL-	$35.34	$58.90	$6.87–$53.01	67% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL (Send Out)-	$35.34	$58.90	$6.87–$53.01	67% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL-	$35.34	$58.90	$6.87–$53.01	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL (Send Out)-	$35.34	$58.90	$6.87–$53.01	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL (confirmation)--	$35.34	$58.90	$6.87–$53.01	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus-	$51.24	$85.40	$17.78–$76.86	26% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus IgM Antibody-	$60.18	$100.30	$17.78–$90.27	13% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus IgG Antibody-	$60.18	$100.30	$17.78–$90.27	13% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus-	$51.24	$85.40	$17.78–$76.86	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus IgM Antibody-	$60.18	$100.30	$17.78–$90.27	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus IgG Antibody-	$60.18	$100.30	$17.78–$90.27	—	40%
Estradiol blood test CPT 82670 Estradiol (E2) Serum-	$59.44	$99.06	$27.38–$89.15	60% below	40%
Estradiol blood test inpatient CPT 82670 Estradiol (E2) Serum-	$59.44	$99.06	$27.38–$89.15	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICILE STIMULATING HORMONE (FSH)-	$59.88	$99.80	$18.21–$89.82	45% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICILE STIMULATING HORMONE (FSH)-	$59.88	$99.80	$18.21–$89.82	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal-	$33.74	$56.24	$19.24–$50.62	86% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal-	$33.74	$56.24	$19.24–$50.62	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN-	$24.73	$41.21	$13.36–$37.09	80% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN-	$24.73	$41.21	$13.36–$37.09	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY-	$24.54	$40.90	$9.53–$36.81	78% below	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY-	$24.54	$40.90	$9.53–$36.81	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID-	$35.34	$58.90	$14.41–$53.01	68% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID-	$35.34	$58.90	$14.41–$53.01	—	40%
Free T3 thyroid hormone test CPT 84481 T3 FREE-	$46.14	$76.90	$16.60–$69.21	72% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE-	$46.14	$76.90	$16.60–$69.21	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE T4-	$46.14	$76.90	$8.84–$69.21	51% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE T4-	$46.14	$76.90	$8.84–$69.21	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE-	$47.42	$79.04	$24.96–$71.14	21% below	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE-	$47.42	$79.04	$24.96–$71.14	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT (Gamma Glutamyl Transpeptidase)-	$24.36	$40.60	$7.06–$36.54	65% below	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT (Gamma Glutamyl Transpeptidase)-	$24.36	$40.60	$7.06–$36.54	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Gestational Diabetic Screen 1hr-	$24.36	$40.60	$4.66–$36.54	70% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Gestational Diabetic Screen 1hr-	$24.36	$40.60	$4.66–$36.54	—	40%
Glucose tolerance test, 3 samples CPT 82951 Glucose Gestational Diabetic hr 1-2-	$15.07	$25.11	$12.61–$22.60	90% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Gestational Diabetic hr 1-2-	$15.07	$25.11	$12.61–$22.60	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA NEISSERIA-	$130.66	$217.77	$34.39–$195.99	51% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE PCR (co)-	$130.66	$217.77	$34.39–$195.99	51% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE PCR-	$130.66	$217.77	$34.39–$195.99	51% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA NEISSERIA NAA-	$130.66	$217.77	$34.39–$195.99	51% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA NEISSERIA NAA-	$130.66	$217.77	$34.39–$195.99	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE PCR-	$130.66	$217.77	$34.39–$195.99	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA NEISSERIA-	$130.66	$217.77	$34.39–$195.99	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE PCR (co)-	$130.66	$217.77	$34.39–$195.99	—	40%
H. pylori antibody blood test CPT 86677 H PYLORI IgG ANTIBODY-	$69.70	$116.16	$16.51–$104.54	50% below	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IgG ANTIBODY-	$69.70	$116.16	$16.51–$104.54	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quantification Real-Time PCR-	$136.32	$227.20	$83.40–$204.48	67% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quantification Real-Time PCR-	$136.32	$227.20	$83.40–$204.48	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 EXECUTIVE HEALTH HIV	$19.42	$32.37	$13.44–$29.13	82% below	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 EXECUTIVE HEALTH HIV	$19.42	$32.37	$13.44–$29.13	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Screen with Confirmation-	$48.59	$80.98	$23.60–$72.88	54% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Rapid HIV-	$48.59	$80.98	$23.60–$72.88	54% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Screen with Confirmation-	$48.59	$80.98	$23.60–$72.88	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Rapid HIV-	$48.59	$80.98	$23.60–$72.88	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 EXECUTIVE HEALTH HBGA1C	$12.95	$21.58	$9.52–$19.42	84% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED (A1C) (SEND OUT)-	$35.34	$58.90	$9.52–$53.01	56% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1C-	$42.00	$70.00	$9.52–$63.00	48% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 EXECUTIVE HEALTH HBGA1C	$12.95	$21.58	$9.52–$19.42	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED (A1C) (SEND OUT)-	$35.34	$58.90	$9.52–$53.01	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1C-	$42.00	$70.00	$9.52–$63.00	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN-	$32.88	$54.80	$2.32–$49.32	30% below	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN (Send Out)-	$32.88	$54.80	$2.32–$49.32	30% below	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN (confirmation)-	$32.88	$54.80	$2.32–$49.32	30% below	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN - Body Fluid-	$32.88	$54.80	$2.32–$49.32	30% below	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN - Body Fluid-	$32.88	$54.80	$2.32–$49.32	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (Send Out)-	$32.88	$54.80	$2.32–$49.32	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (confirmation)-	$32.88	$54.80	$2.32–$49.32	—	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN-	$32.88	$54.80	$2.32–$49.32	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE Total ANTIBODIES-	$36.31	$60.52	$11.81–$54.47	60% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE Total ANTIBODIES-	$36.31	$60.52	$11.81–$54.47	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY IMMUNE STA-	$35.34	$58.90	$10.53–$53.01	68% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY IMMUNE STA-	$35.34	$58.90	$10.53–$53.01	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN-	$42.46	$70.77	$10.12–$63.69	49% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN-	$42.46	$70.77	$10.12–$63.69	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANITBODY-	$35.34	$58.90	$13.98–$53.01	72% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C with Reflex to HCV RNA Quat-	$35.34	$58.90	$13.98–$53.01	72% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C with Reflex to HCV RNA Quat-	$35.34	$58.90	$13.98–$53.01	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANITBODY-	$35.34	$58.90	$13.98–$53.01	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUATNT PCR MONITOR-	$62.54	$104.24	$41.98–$93.82	75% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (HCV) RNA and Quant-	$62.54	$104.24	$41.98–$93.82	75% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUATNT PCR MONITOR-	$62.54	$104.24	$41.98–$93.82	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus (HCV) RNA and Quant-	$62.54	$104.24	$41.98–$93.82	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 IgG Antibody-	$66.58	$110.96	$12.93–$99.86	24% below	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type 1 IgG Antibody-	$66.58	$110.96	$12.93–$99.86	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 IgG Antibody-	$40.13	$66.88	$18.96–$60.19	57% below	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2 IgG Antibody-	$40.13	$66.88	$18.96–$60.19	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN (HIGH SENS CARDIAC)-	$35.34	$58.90	$12.69–$53.01	65% below	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN (HIGH SENS CARDIAC)-	$35.34	$58.90	$12.69–$53.01	—	40%
Homocysteine blood test CPT 83090 EXECUTIVE HEALTH HOMOCYSTEIN LEVEL	$22.37	$37.28	$17.56–$33.55	77% below	40%
Homocysteine blood test CPT 83090 Homocystiene-	$42.49	$70.82	$17.56–$63.74	56% below	40%
Homocysteine blood test inpatient CPT 83090 EXECUTIVE HEALTH HOMOCYSTEIN LEVEL	$22.37	$37.28	$17.56–$33.55	—	40%
Homocysteine blood test inpatient CPT 83090 Homocystiene-	$42.49	$70.82	$17.56–$63.74	—	40%
Insulin blood test CPT 83525 Insulin Total-	$41.12	$68.54	$11.20–$61.69	61% below	40%
Insulin blood test CPT 83525 Insulin Level-	$52.75	$87.92	$11.20–$79.13	50% below	40%
Insulin blood test inpatient CPT 83525 Insulin Total-	$41.12	$68.54	$11.20–$61.69	—	40%
Insulin blood test inpatient CPT 83525 Insulin Level-	$52.75	$87.92	$11.20–$79.13	—	40%
Iron blood test (serum iron) CPT 83540 IRON-	$35.35	$58.92	$6.34–$53.03	51% below	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON-	$35.35	$58.92	$6.34–$53.03	—	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIY (UIBC)-	$29.42	$49.04	$8.57–$44.14	66% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIY (UIBC)-	$29.42	$49.04	$8.57–$44.14	—	40%
Kidney function blood test panel CPT 80069 Renal Function Panel-	$60.46	$100.76	$8.51–$90.68	57% below	40%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel-	$60.46	$100.76	$8.51–$90.68	—	40%
LH (luteinizing hormone) test CPT 83002 LH (LUTEINIZING HORMONE)-	$59.88	$99.80	$18.15–$89.82	66% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 LH (LUTEINIZING HORMONE)-	$59.88	$99.80	$18.15–$89.82	—	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Lactate) (Arterial)-	$128.59	$214.32	$11.34–$192.89	24% above	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID (LACTATE) (send out)-	$128.59	$214.32	$11.34–$192.89	24% above	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Lactate)-	$128.59	$214.32	$11.34–$192.89	24% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid (Lactate) (Arterial)-	$128.59	$214.32	$11.34–$192.89	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID (LACTATE) (send out)-	$128.59	$214.32	$11.34–$192.89	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid (Lactate)-	$128.59	$214.32	$11.34–$192.89	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-	$27.00	$45.00	$5.92–$40.50	63% below	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-	$27.00	$45.00	$5.92–$40.50	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-	$35.34	$58.90	$6.75–$53.01	71% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-	$35.34	$58.90	$6.75–$53.01	—	40%
Liver function blood test panel CPT 80076 LIVER PANEL (Send Out)-	$62.33	$103.88	$8.01–$93.49	55% below	40%
Liver function blood test panel CPT 80076 LIVER PANEL-	$62.33	$103.88	$8.01–$93.49	55% below	40%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL (Send Out)-	$62.33	$103.88	$8.01–$93.49	—	40%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL-	$62.33	$103.88	$8.01–$93.49	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY-	$59.48	$99.14	$16.69–$89.23	47% below	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB CSF-	$69.70	$116.16	$16.69–$104.54	38% below	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY-	$59.48	$99.14	$16.69–$89.23	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB CSF-	$69.70	$116.16	$16.69–$104.54	—	40%
Magnesium blood test CPT 83735 Magnesium RBC-	$24.36	$40.60	$6.57–$36.54	65% below	40%
Magnesium blood test CPT 83735 MAGNESIUM-	$35.34	$58.90	$6.57–$53.01	49% below	40%
Magnesium blood test CPT 83735 MAGNESIUM (Send Out)-	$35.34	$58.90	$6.57–$53.01	49% below	40%
Magnesium blood test inpatient CPT 83735 Magnesium RBC-	$24.36	$40.60	$6.57–$36.54	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM-	$35.34	$58.90	$6.57–$53.01	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM (Send Out)-	$35.34	$58.90	$6.57–$53.01	—	40%
Measles (rubeola) antibody test CPT 86765 Rubeola IgG-	$44.45	$74.08	$12.62–$66.67	44% below	40%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG-	$44.45	$74.08	$12.62–$66.67	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Monoucleosis Infectious Screen-	$47.65	$79.42	$5.08–$71.48	31% below	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monoucleosis Infectious Screen-	$47.65	$79.42	$5.08–$71.48	—	40%
Mumps immunity blood test CPT 86735 Mumps IgG-	$44.45	$74.08	$12.79–$66.67	64% below	40%
Mumps immunity blood test CPT 86735 Mumps IgM-	$44.45	$74.08	$12.79–$66.67	64% below	40%
Mumps immunity blood test inpatient CPT 86735 Mumps IgM-	$44.45	$74.08	$12.79–$66.67	—	40%
Mumps immunity blood test inpatient CPT 86735 Mumps IgG-	$44.45	$74.08	$12.79–$66.67	—	40%
Obstetric blood test panel CPT 80055 OB Panel 1-	$60.46	$100.76	$46.85–$90.68	73% below	40%
Obstetric blood test panel inpatient CPT 80055 OB Panel 1-	$60.46	$100.76	$46.85–$90.68	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total-	$35.34	$58.90	$18.02–$53.01	70% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total-	$35.34	$58.90	$18.02–$53.01	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-	$35.34	$58.90	$18.02–$53.01	73% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA-	$35.34	$58.90	$18.02–$53.01	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH CER/VAG THIN PREP	$75.16	$125.27	$19.85–$112.74	8% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH CER/VAG THIN PREP	$75.16	$125.27	$19.85–$112.74	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE-	$59.88	$99.80	$40.45–$89.82	73% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE-	$59.88	$99.80	$40.45–$89.82	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (Send Out)-	$24.54	$40.90	$5.89–$36.81	73% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT-	$24.54	$40.90	$5.89–$36.81	73% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT-	$24.54	$40.90	$5.89–$36.81	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (Send Out)-	$24.54	$40.90	$5.89–$36.81	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS-	$27.00	$45.00	$4.65–$40.50	54% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS-	$27.00	$45.00	$4.65–$40.50	—	40%
Potassium blood test CPT 84132 POTASSIUM (confirmation)-	$27.00	$45.00	$4.66–$40.50	53% below	40%
Potassium blood test CPT 84132 POTASSIUM (Send Out)-	$27.00	$45.00	$4.66–$40.50	53% below	40%
Potassium blood test CPT 84132 POTASSIUM-	$27.00	$45.00	$4.66–$40.50	53% below	40%
Potassium blood test inpatient CPT 84132 POTASSIUM (Send Out)-	$27.00	$45.00	$4.66–$40.50	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM-	$27.00	$45.00	$4.66–$40.50	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM (confirmation)-	$27.00	$45.00	$4.66–$40.50	—	40%
Progesterone blood test CPT 84144 Progesterone-	$46.12	$76.86	$20.44–$69.17	68% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone-	$46.12	$76.86	$20.44–$69.17	—	40%
Prolactin blood test CPT 84146 Prolactin-	$52.75	$87.92	$18.99–$79.13	62% below	40%
Prolactin blood test inpatient CPT 84146 Prolactin-	$52.75	$87.92	$18.99–$79.13	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN / INR-	$24.54	$40.90	$4.20–$36.81	34% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN / INR (Send Out)-	$24.54	$40.90	$4.20–$36.81	34% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN / INR (confirmation)-	$24.54	$40.90	$4.20–$36.81	34% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN / INR-	$24.54	$40.90	$4.20–$36.81	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN / INR (Send Out)-	$24.54	$40.90	$4.20–$36.81	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN / INR (confirmation)-	$24.54	$40.90	$4.20–$36.81	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Nicotine Screen Urine-	$44.95	$74.92	$12.35–$67.43	23% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Nicotine Screen Urine-	$44.95	$74.92	$12.35–$67.43	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B-	$26.51	$44.18	$16.22–$39.76	67% below	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A-	$26.51	$44.18	$16.22–$39.76	67% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A-	$26.51	$44.18	$16.22–$39.76	—	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B-	$26.51	$44.18	$16.22–$39.76	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS A SCREEN-	$26.51	$44.18	$16.20–$39.76	65% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS A SCREEN-	$26.51	$44.18	$16.20–$39.76	—	40%
Renin blood test CPT 84244 Renin Activity-	$52.75	$87.92	$21.55–$79.13	38% below	40%
Renin blood test inpatient CPT 84244 Renin Activity-	$52.75	$87.92	$21.55–$79.13	—	40%
Rh blood typing CPT 86901 XBB BLOOD TYPING RH-	$105.04	$175.06	$2.93–$157.55	148% above	40%
Rh blood typing inpatient CPT 86901 XBB BLOOD TYPING RH-	$105.04	$175.06	$2.93–$157.55	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE-	$48.59	$80.98	$5.56–$72.88	41% below	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT SYNOVIAL FLUID-	$48.59	$80.98	$5.56–$72.88	41% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE-	$48.59	$80.98	$5.56–$72.88	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT SYNOVIAL FLUID-	$48.59	$80.98	$5.56–$72.88	—	40%
Rubella antibody test (immunity check) CPT 86762 Rubella IgM-	$44.45	$74.08	$14.10–$66.67	37% below	40%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG-	$44.45	$74.08	$14.10–$66.67	37% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG-	$44.45	$74.08	$14.10–$66.67	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgM-	$44.45	$74.08	$14.10–$66.67	—	40%
Sodium blood test CPT 84295 SODIUM-	$27.00	$45.00	$4.71–$40.50	54% below	40%
Sodium blood test CPT 84295 SODIUM (Send Out)-	$27.00	$45.00	$4.71–$40.50	54% below	40%
Sodium blood test inpatient CPT 84295 SODIUM-	$27.00	$45.00	$4.71–$40.50	—	40%
Sodium blood test inpatient CPT 84295 SODIUM (Send Out)-	$27.00	$45.00	$4.71–$40.50	—	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITES OF STOOL-	$26.02	$43.36	$8.72–$39.02	70% below	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES OF STOOL-	$26.02	$43.36	$8.72–$39.02	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphllis IgG and IgM with reflex-	$51.24	$85.40	$12.98–$76.86	26% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibodies (FTA)-	$51.24	$85.40	$12.98–$76.86	26% below	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphllis IgG and IgM with reflex-	$51.24	$85.40	$12.98–$76.86	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibodies (FTA)-	$51.24	$85.40	$12.98–$76.86	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Lab Only- SYPHILIS TEST QUALITATIVE-	$27.79	$46.31	$4.18–$41.68	54% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF-	$47.65	$79.42	$4.18–$71.48	21% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Lab Only- SYPHILIS TEST QUALITATIVE-	$27.79	$46.31	$4.18–$41.68	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF-	$47.65	$79.42	$4.18–$71.48	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD QUANTIFERON-	$69.70	$116.16	$60.74–$104.54	75% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD QUANTIFERON-	$69.70	$116.16	$60.74–$104.54	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, AM DRAW MALES-	$63.38	$105.64	$25.29–$95.08	52% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, RANDOM DRAW FEMALES-	$63.38	$105.64	$25.29–$95.08	52% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL-	$63.38	$105.64	$25.29–$95.08	52% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL-	$63.38	$105.64	$25.29–$95.08	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, AM DRAW MALES-	$63.38	$105.64	$25.29–$95.08	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, RANDOM DRAW FEMALES-	$63.38	$105.64	$25.29–$95.08	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Antibodies-	$59.88	$99.80	$14.26–$89.82	54% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Antibodies-	$59.88	$99.80	$14.26–$89.82	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (Send Out)-	$46.14	$76.90	$16.46–$69.21	58% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE with Reflex-	$46.14	$76.90	$16.46–$69.21	58% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE w/ Reflex-	$46.14	$76.90	$16.46–$69.21	58% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE-	$46.14	$76.90	$16.46–$69.21	58% below	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE with Reflex-	$46.14	$76.90	$16.46–$69.21	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (Send Out)-	$46.14	$76.90	$16.46–$69.21	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE w/ Reflex-	$46.14	$76.90	$16.46–$69.21	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE-	$46.14	$76.90	$16.46–$69.21	—	40%
Total IgE blood test CPT 82785 Immunoglobulin IgE-	$128.62	$214.36	$16.13–$192.92	52% above	40%
Total IgE blood test inpatient CPT 82785 Immunoglobulin IgE-	$128.62	$214.36	$16.13–$192.92	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL (Send Out)-	$15.00	$25.00	$4.26–$22.50	71% below	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL-	$15.00	$25.00	$4.26–$22.50	71% below	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL-	$15.00	$25.00	$4.26–$22.50	—	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL (Send Out)-	$15.00	$25.00	$4.26–$22.50	—	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL-	$46.14	$76.90	$6.73–$69.21	21% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL-	$46.14	$76.90	$6.73–$69.21	—	40%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine, Total (T3)-	$22.37	$37.28	$13.90–$33.55	82% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine, Total (T3)-	$22.37	$37.28	$13.90–$33.55	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE (Send Out)-	$27.00	$45.00	$5.63–$40.50	61% below	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDE-	$27.00	$45.00	$5.63–$40.50	61% below	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE-	$27.00	$45.00	$5.63–$40.50	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE (Send Out)-	$27.00	$45.00	$5.63–$40.50	—	40%
Troponin test, quantitative CPT 84484 TROPONIN I (HIGH SENSITIVITY)-	$128.59	$214.32	$12.22–$192.89	14% below	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUANTITATIVE (Send Out)-	$128.59	$214.32	$12.22–$192.89	14% below	40%
Troponin test, quantitative CPT 84484 TROPONIN I QUANTITATIVE-	$128.59	$214.32	$12.22–$192.89	14% below	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANTITATIVE-	$128.59	$214.32	$12.22–$192.89	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANTITATIVE (Send Out)-	$128.59	$214.32	$12.22–$192.89	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I (HIGH SENSITIVITY)-	$128.59	$214.32	$12.22–$192.89	—	40%
Uric acid blood test CPT 84550 URIC ACID-	$27.00	$45.00	$4.43–$40.50	54% below	40%
Uric acid blood test inpatient CPT 84550 URIC ACID-	$27.00	$45.00	$4.43–$40.50	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE-	$24.05	$40.08	$3.11–$36.07	58% below	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE (co)-	$24.05	$40.08	$3.11–$36.07	58% below	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/ REFLEX TO CULTURE-	$24.05	$40.08	$3.11–$36.07	58% below	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/ REFLEX TO CULTURE (Send)-	$24.05	$40.08	$3.11–$36.07	58% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE-	$24.05	$40.08	$3.11–$36.07	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE (co)-	$24.05	$40.08	$3.11–$36.07	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/ REFLEX TO CULTURE (Send)-	$24.05	$40.08	$3.11–$36.07	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/ REFLEX TO CULTURE-	$24.05	$40.08	$3.11–$36.07	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO (co)-	$19.63	$32.72	$2.20–$29.45	50% below	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO-	$19.63	$32.72	$2.20–$29.45	50% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO-	$19.63	$32.72	$2.20–$29.45	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO (co)-	$19.63	$32.72	$2.20–$29.45	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE-	$26.51	$44.18	$7.91–$39.76	67% below	40%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE (Send Out)-	$26.51	$44.18	$7.91–$39.76	67% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE (Send Out)-	$26.51	$44.18	$7.91–$39.76	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE-	$26.51	$44.18	$7.91–$39.76	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROABLUMIN URINE-QUANTATIVE	$25.15	$41.92	$5.66–$37.73	77% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROABLUMIN URINE-QUANTATIVE	$25.15	$41.92	$5.66–$37.73	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE HCG-	$24.05	$40.08	$8.44–$36.07	71% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE HCG-	$24.05	$40.08	$8.44–$36.07	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12-	$46.14	$76.90	$14.78–$69.21	60% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B 12-	$46.14	$76.90	$14.78–$69.21	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 EXECUTIVE HEALTH VITAMIN D	$32.89	$54.81	$29.01–$49.33	79% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 and D3, 25 HYDROXY-	$128.59	$214.32	$29.01–$192.89	17% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY-	$128.59	$214.32	$29.01–$192.89	17% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 EXECUTIVE HEALTH VITAMIN D	$32.89	$54.81	$29.01–$49.33	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY-	$128.59	$214.32	$29.01–$192.89	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 and D3, 25 HYDROXY-	$128.59	$214.32	$29.01–$192.89	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1, 25 DIHYDROXY-	$123.19	$205.32	$37.73–$184.79	7% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1, 25 DIHYDROXY-	$123.19	$205.32	$37.73–$184.79	—	40%
Zinc blood test CPT 84630 Zinc-	$28.18	$46.96	$11.16–$42.26	32% below	40%
Zinc blood test inpatient CPT 84630 Zinc-	$28.18	$46.96	$11.16–$42.26	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE-	$56.39	$93.98	$14.75–$84.58	58% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER QUANTITATIVE-	$56.39	$93.98	$14.75–$84.58	58% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER QUANTITATIVE-	$56.39	$93.98	$14.75–$84.58	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE-	$56.39	$93.98	$14.75–$84.58	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs South Dakota	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMYPRIMARY: UNDER AGE 12	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMYPRIMARY: UNDER AGE 12	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRODESIS ANT CERVICAL ASSIST SUR	$1,424.47	$2,374.12	$2,136.71–$12,982.97	—	40%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRODESIS ANTERIOR INTERBODY TECH	$13,496.88	$22,494.80	$12,854.42–$20,245.32	—	40%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRODESIS ANT CERVICAL ASSIST SUR	$1,424.47	$2,374.12	$2,136.71–$12,982.97	—	40%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRODESIS ANTERIOR INTERBODY TECH	$13,496.88	$22,494.80	$12,854.42–$20,245.32	—	40%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPY FOR RUPTURED APPY/PERITONITIS	$3,659.23	$6,098.72	$5,488.85	—	40%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPY FOR RUPTURED APPY/PERITONITIS	$3,659.23	$6,098.72	$5,488.85	—	40%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$3,659.23	$6,098.72	$5,488.85–$6,546.58	—	40%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$3,659.23	$6,098.72	$5,488.85–$6,546.58	—	40%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC	$7,316.38	$12,193.96	$7,265.11–$10,974.56	at median	40%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC,Right side	$7,316.38	$12,193.96	$812.13–$10,974.56	at median	40%
Arthroscopic ACL reconstruction or repair of the knee one side CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC,Left side	$7,316.38	$12,193.96	$812.13–$10,974.56	at median	40%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC	$7,316.38	$12,193.96	$7,265.11–$10,974.56	—	40%
Arthroscopic ACL reconstruction or repair of the knee inpatient one side CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC,Left side	$7,316.38	$12,193.96	$812.13–$10,974.56	—	40%
Arthroscopic ACL reconstruction or repair of the knee inpatient one side CPT 29888 ARTHROSCOPIC ASSISTED ACL RECONSTRUC,Right side	$7,316.38	$12,193.96	$812.13–$10,974.56	—	40%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR	$5,434.49	$9,057.48	$7,265.11–$8,151.73	at median	40%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR,Right side	$5,434.49	$9,057.48	$890.49–$8,151.73	at median	40%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR,Left side	$5,434.49	$9,057.48	$890.49–$8,151.73	at median	40%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR	$5,434.49	$9,057.48	$7,265.11–$8,151.73	—	40%
Arthroscopic rotator cuff repair of the shoulder inpatient one side CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR,Right side	$5,434.49	$9,057.48	$890.49–$8,151.73	—	40%
Arthroscopic rotator cuff repair of the shoulder inpatient one side CPT 29827 SHOULDER ARTH W/ ROTATOR CUFF REPAIR,Left side	$5,434.49	$9,057.48	$890.49–$8,151.73	—	40%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL/SINUS ENDOS SURGICAL W/ MAX AN	$4,001.80	$6,669.67	$6,002.70–$7,136.77	49% below	40%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL/SINUS ENDOS SURGICAL W/ MAX AN	$4,001.80	$6,669.67	$6,002.70–$7,136.77	—	40%
Botox injections for chronic migraine CPT 64615 CHEMODENERVATION OF MUSCLE BY FACIAL NER	$573.37	$955.61	$307.33–$860.05	16% below	40%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION OF MUSCLE BY FACIAL NER	$573.37	$955.61	$307.33–$860.05	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TRTMNT DISTAL FIBULA FX W/OUT	$1,356.53	$2,260.88	$246.97–$2,034.79	107% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TRTMNT DISTAL FIBULA FX W/OUT	$1,356.53	$2,260.88	$246.97–$2,034.79	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX OF METATARSAL FX	$1,356.53	$2,260.88	$246.97–$2,034.79	136% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TX OF METATARSAL FX	$1,356.53	$2,260.88	$246.97–$2,034.79	—	40%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL,Left side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with a bone cut near the head of the first metatarsal one side CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL,Right side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Bunion correction with a bone cut near the head of the first metatarsal inpatient one side CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL,Right side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Bunion correction with a bone cut near the head of the first metatarsal inpatient one side CPT 28296 HALLUX VALGUS(BUNION) W/METATARSAL,Left side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Bunion correction with removal of part of the big toe joint CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with removal of part of the big toe joint one side CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO,Right side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with removal of part of the big toe joint one side CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO,Left side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	11% above	40%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Bunion correction with removal of part of the big toe joint inpatient one side CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO,Left side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Bunion correction with removal of part of the big toe joint inpatient one side CPT 28292 CORR HALLUX VALGUS BUNION W SESAMOIDECTO,Right side	$4,739.20	$7,898.66	$3,276.01–$7,108.79	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSIONELECTIVEELECTRICAL	$699.04	$1,165.06	$661.75–$1,048.55	52% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSIONELECTIVEELECTRICAL	$699.04	$1,165.06	$661.75–$1,048.55	—	40%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION	$2,585.75	$4,309.58	$1,955.12–$3,878.62	45% below	40%
Carpal tunnel release, open surgery one side CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION,Right side	$2,585.75	$4,309.58	$451.48–$3,878.62	45% below	40%
Carpal tunnel release, open surgery one side CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION,Left side	$2,585.75	$4,309.58	$1,955.12–$3,878.62	45% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION	$2,585.75	$4,309.58	$1,955.12–$3,878.62	—	40%
Carpal tunnel release, open surgery inpatient one side CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION,Left side	$2,585.75	$4,309.58	$1,955.12–$3,878.62	—	40%
Carpal tunnel release, open surgery inpatient one side CPT 64721 NEUROPLASTY AND/OR DECOMPRESSION,Right side	$2,585.75	$4,309.58	$451.48–$3,878.62	—	40%
Cataract surgery with lens implant CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE	$2,758.00	$4,596.66	$2,310.65–$4,136.99	37% below	40%
Cataract surgery with lens implant one side CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE,Left side	$2,758.00	$4,596.66	$441.62–$4,136.99	37% below	40%
Cataract surgery with lens implant one side CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE,Right side	$2,758.00	$4,596.66	$441.62–$4,136.99	37% below	40%
Cataract surgery with lens implant inpatient CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE	$2,758.00	$4,596.66	$2,310.65–$4,136.99	—	40%
Cataract surgery with lens implant inpatient one side CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE,Right side	$2,758.00	$4,596.66	$441.62–$4,136.99	—	40%
Cataract surgery with lens implant inpatient one side CPT 66984 CATARACT REMOVAL INSERTION OF IOL LE,Left side	$2,758.00	$4,596.66	$441.62–$4,136.99	—	40%
Cervical biopsy CPT 57500 BX LESIONS OF CERVIX	$1,562.92	$2,604.86	$922.18–$2,344.37	at median	40%
Cervical biopsy inpatient CPT 57500 BX LESIONS OF CERVIX	$1,562.92	$2,604.86	$922.18–$2,344.37	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMSION OLDER THAN 28 DAYS OF AGE	$2,117.66	$3,529.43	$2,092.95–$3,176.49	20% above	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMSION OLDER THAN 28 DAYS OF AGE	$2,117.66	$3,529.43	$2,092.95–$3,176.49	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION CLAMP/DEVICE W/ RING BLOCK	$2,117.66	$3,529.43	$2,092.95–$3,176.49	20% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION CLAMP/DEVICE W/ RING BLOCK	$2,117.66	$3,529.43	$2,092.95–$3,176.49	—	40%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION SURGICAL EXCISION OTHE	$2,117.66	$3,529.43	$698.15–$3,176.49	209% above	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION SURGICAL EXCISION OTHE	$2,117.66	$3,529.43	$698.15–$3,176.49	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISTL RADIAL FX NO MANIPULAT	$1,271.72	$2,119.54	$246.97–$1,907.59	113% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISTL RADIAL FX NO MANIPULAT	$1,271.72	$2,119.54	$246.97–$1,907.59	—	40%
Colonoscopy with polyp removal CPT 45385 COLONSCOPY WITH REMOVAL OF POLYPS	$1,472.04	$2,453.40	$1,198.11–$2,208.06	49% below	40%
Colonoscopy with polyp removal CPT 45385 GI Colonoscopy flexible with removal	$1,472.04	$2,453.40	$1,198.11–$2,208.06	49% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 GI Colonoscopy flexible with removal	$1,472.04	$2,453.40	$1,198.11–$2,208.06	—	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONSCOPY WITH REMOVAL OF POLYPS	$1,472.04	$2,453.40	$1,198.11–$2,208.06	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPYFLEXIBLEWITH BIOPSY	$1,472.04	$2,453.40	$1,198.11–$2,208.06	17% below	40%
Colonoscopy with tissue sample CPT 45380 GI Colonoscopy and biopsy	$1,472.04	$2,453.40	$1,198.11–$2,208.06	17% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 GI Colonoscopy and biopsy	$1,472.04	$2,453.40	$1,198.11–$2,208.06	—	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPYFLEXIBLEWITH BIOPSY	$1,472.04	$2,453.40	$1,198.11–$2,208.06	—	40%
Colonoscopy, diagnostic CPT 45378 COLONSCOPY, DIAGNOSTIC	$1,278.93	$2,131.55	$931.10–$1,918.40	40% below	40%
Colonoscopy, diagnostic CPT 45378 GI Colonoscopy Diagnostic	$1,356.53	$2,260.88	$931.10–$2,034.79	37% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONSCOPY, DIAGNOSTIC	$1,278.93	$2,131.55	$931.10–$1,918.40	—	40%
Colonoscopy, diagnostic inpatient CPT 45378 GI Colonoscopy Diagnostic	$1,356.53	$2,260.88	$931.10–$2,034.79	—	40%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPYWITH LOOP EXC PROD OF C	$2,247.74	$3,746.23	$3,241.10–$3,371.61	63% below	40%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPYWITH LOOP EXC PROD OF C	$2,247.74	$3,746.23	$3,241.10–$3,371.61	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY W/ BIOPSY OF THE CERVIX	$923.31	$1,538.85	$305.10–$1,384.96	24% above	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY W/ BIOPSY OF THE CERVIX	$923.31	$1,538.85	$305.10–$1,384.96	—	40%
Complex cataract surgery with lens implant CPT 66982 EXTRACAP CATAR REM W/IOL	$2,925.34	$4,875.56	$2,310.65–$4,388.00	at median	40%
Complex cataract surgery with lens implant one side CPT 66982 EXTRACAP CATAR REM W/IOL,Left side	$2,925.34	$4,875.56	$600.83–$4,388.00	at median	40%
Complex cataract surgery with lens implant inpatient CPT 66982 EXTRACAP CATAR REM W/IOL	$2,925.34	$4,875.56	$2,310.65–$4,388.00	—	40%
Complex cataract surgery with lens implant inpatient one side CPT 66982 EXTRACAP CATAR REM W/IOL,Left side	$2,925.34	$4,875.56	$600.83–$4,388.00	—	40%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO WITH INSERTION OF STENT	$2,382.26	$3,970.43	$3,529.30–$3,573.39	45% below	40%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO WITH INSERTION OF STENT	$2,382.26	$3,970.43	$3,529.30–$3,573.39	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY(SEPERATE PROCEDURE	$1,127.14	$1,878.57	$698.15–$1,690.71	28% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY(SEPERATE PROCEDURE	$1,127.14	$1,878.57	$698.15–$1,690.71	—	40%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURRETTAGE	$2,247.74	$3,746.23	$3,241.10–$3,371.61	66% below	40%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURRETTAGE	$2,247.74	$3,746.23	$3,241.10–$3,371.61	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMAL LESIONS 1ST LESIO	$1,356.53	$2,260.88	$200.88–$2,034.79	460% above	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMAL LESIONS 1ST LESIO	$1,356.53	$2,260.88	$200.88–$2,034.79	—	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INSERTION PE TUBES (ONE OR BOTH EAR)	$2,342.88	$3,904.80	$1,553.49–$3,514.32	37% below	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear one side CPT 69436 INSERTION PE TUBES (ONE OR BOTH EAR),Left side	$2,342.88	$3,904.80	$1,553.49–$3,514.32	37% below	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 INSERTION PE TUBES (ONE OR BOTH EAR)	$2,342.88	$3,904.80	$1,553.49–$3,514.32	—	40%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient one side CPT 69436 INSERTION PE TUBES (ONE OR BOTH EAR),Left side	$2,342.88	$3,904.80	$1,553.49–$3,514.32	—	40%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN	$970.88	$1,618.13	$59.06–$1,456.32	481% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN	$970.88	$1,618.13	$59.06–$1,456.32	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY W/O DILATION	$1,356.53	$2,260.88	$202.42–$2,034.79	219% above	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY W/O DILATION	$1,356.53	$2,260.88	$202.42–$2,034.79	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL,Right side	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening one side CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL,Left side	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient one side CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL,Left side	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient one side CPT 31255 NASAL/SINUS ENDO W/ETHMOIDECTOMY TOTAL,Right side	$5,800.61	$9,667.68	$7,066.11–$8,700.91	—	40%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NASAL/SINUS ENDOSCOPY SURG FRONTAL	$4,001.80	$6,669.67	$6,002.70–$7,136.77	—	40%
Endoscopic sinus surgery: opening the frontal sinus one side CPT 31276 NASAL/SINUS ENDOSCOPY SURG FRONTAL,Left side	$4,001.80	$6,669.67	$6,002.70–$7,136.77	—	40%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NASAL/SINUS ENDOSCOPY SURG FRONTAL	$4,001.80	$6,669.67	$6,002.70–$7,136.77	—	40%
Endoscopic sinus surgery: opening the frontal sinus inpatient one side CPT 31276 NASAL/SINUS ENDOSCOPY SURG FRONTAL,Left side	$4,001.80	$6,669.67	$6,002.70–$7,136.77	—	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NASAL/SINUS ENDOS SURGICAL W/ MAX AN	$2,529.47	$4,215.79	$3,732.92–$3,794.21	71% below	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus one side CPT 31256 NASAL/SINUS ENDOS SURGICAL W/ MAX AN,Left side	$2,529.47	$4,215.79	$3,732.92–$3,794.21	71% below	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NASAL/SINUS ENDOS SURGICAL W/ MAX AN	$2,529.47	$4,215.79	$3,732.92–$3,794.21	—	40%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient one side CPT 31256 NASAL/SINUS ENDOS SURGICAL W/ MAX AN,Left side	$2,529.47	$4,215.79	$3,732.92–$3,794.21	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH	$5,240.48	$8,734.14	$7,066.11–$7,860.73	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH,Left side	$5,240.48	$8,734.14	$205.29–$7,860.73	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue one side CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH,Right side	$5,240.48	$8,734.14	$7,066.11–$7,860.73	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH	$5,240.48	$8,734.14	$7,066.11–$7,860.73	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient one side CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH,Left side	$5,240.48	$8,734.14	$205.29–$7,860.73	—	40%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient one side CPT 31267 NASAL ENDOSCOPY WITH ANTROSTOMY WITH,Right side	$5,240.48	$8,734.14	$7,066.11–$7,860.73	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ASA CERVICAL/THORACIC EPIDURAL W/IMG GUI	$684.00	$1,140.00	$267.12–$1,026.00	64% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL/THORACIC EPIDURAL W/US GUIDANCE	$1,206.60	$2,011.00	$706.75–$1,809.90	37% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL/THORACIC EPIDURAL W/FLUOROSCOPY	$1,311.50	$2,185.83	$706.75–$1,967.25	31% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 ASA CERVICAL/THORACIC EPIDURAL W/IMG GUI	$684.00	$1,140.00	$267.12–$1,026.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL/THORACIC EPIDURAL W/US GUIDANCE	$1,206.60	$2,011.00	$706.75–$1,809.90	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL/THORACIC EPIDURAL W/FLUOROSCOPY	$1,311.50	$2,185.83	$706.75–$1,967.25	—	40%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJEC PHARMACO AGE	$313.45	$522.41	$330.71–$470.17	—	40%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJEC PHARMACO AGE	$313.45	$522.41	$330.71–$470.17	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION FACET LUMBAR OR SACRAL-SIN	$1,980.79	$3,301.31	$885.56–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC BIL,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC LT,Left side	$1,980.79	$3,301.31	$885.56–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC RT,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC LT DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC RT,Right side	$1,980.79	$3,301.31	$885.56–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJECTION FACET LUMBAR OR SACRAL-SIN,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC BIL DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ FACET LUMB/SAC RT DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	at median	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJECTION FACET LUMBAR OR SACRAL-SIN	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC RT DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC BIL DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC LT DIAGNOSTIC,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC BIL,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC LT,Left side	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC RT,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ FACET LUMB/SAC RT,Right side	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJECTION FACET LUMBAR OR SACRAL-SIN,Left side	$1,980.79	$3,301.31	$183.53–$2,971.18	—	40%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR AB HERNIA 3 CM TO 10 CM REDUCIBLE	$4,215.39	$7,025.65	$6,323.08–$6,546.58	—	40%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR AB HERNIA 3 CM TO 10 CM REDUCIBLE	$4,215.39	$7,025.65	$6,323.08–$6,546.58	—	40%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR AB HERNIA < 10 CM REDUCIBLE	$4,215.39	$7,025.65	$6,323.08–$6,546.58	—	40%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 REPAIR AB HERNIA < 10 CM REDUCIBLE	$4,215.39	$7,025.65	$6,323.08–$6,546.58	—	40%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANTERIOR AB >3 CM REDUCIBLE	$4,215.39	$7,025.65	$3,584.79–$6,323.08	46% below	40%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANTERIOR AB >3 CM REDUCIBLE	$4,215.39	$7,025.65	$3,584.79–$6,323.08	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,087.96	$1,813.26	$931.10–$1,631.93	5% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 GI Sigmoidoscopy diag specimen	$1,120.28	$1,867.14	$931.10–$1,680.43	2% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXIBLE SIGMOIDOSCOPY	$1,087.96	$1,813.26	$931.10–$1,631.93	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 GI Sigmoidoscopy diag specimen	$1,120.28	$1,867.14	$931.10–$1,680.43	—	40%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLECYSTECTOMY	$5,892.34	$9,820.57	$6,052.94–$8,838.51	at median	40%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLECYSTECTOMY	$5,892.34	$9,820.57	$6,052.94–$8,838.51	—	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W/ GRAMS	$5,892.34	$9,820.57	$6,052.94–$8,838.51	31% below	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W/ GRAMS	$5,892.34	$9,820.57	$6,052.94–$8,838.51	—	40%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY	$5,564.28	$9,273.80	$8,346.42	—	40%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY	$5,564.28	$9,273.80	$8,346.42	—	40%
Hammertoe correction surgery CPT 28285 HAMMER TOE REPAIR	$2,174.44	$3,624.06	$3,261.65–$3,308.77	49% below	40%
Hammertoe correction surgery one side CPT 28285 HAMMER TOE REPAIR,Right side	$2,174.44	$3,624.06	$3,261.65–$3,308.77	49% below	40%
Hammertoe correction surgery one side CPT 28285 HAMMER TOE REPAIR,Left side	$2,174.44	$3,624.06	$3,261.65–$3,308.77	49% below	40%
Hammertoe correction surgery inpatient CPT 28285 HAMMER TOE REPAIR	$2,174.44	$3,624.06	$3,261.65–$3,308.77	—	40%
Hammertoe correction surgery inpatient one side CPT 28285 HAMMER TOE REPAIR,Right side	$2,174.44	$3,624.06	$3,261.65–$3,308.77	—	40%
Hammertoe correction surgery inpatient one side CPT 28285 HAMMER TOE REPAIR,Left side	$2,174.44	$3,624.06	$3,261.65–$3,308.77	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY BY SIMPLE LIGATURE	$1,600.70	$2,667.84	$931.10–$2,401.06	35% above	40%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY BY SIMPLE LIGATURE	$1,600.70	$2,667.84	$931.10–$2,401.06	—	40%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTER	$2,283.13	$3,805.21	$2,779.06–$3,424.69	63% below	40%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY INTERNAL AND EXTER	$2,283.13	$3,805.21	$2,779.06–$3,424.69	—	40%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 CONVERSION PREV HIP SX TO TOTAL HIP	$10,216.60	$17,027.67	$12,854.42–$15,324.90	—	40%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 CONVERSION PREV HIP SX TO TOTAL HIP	$10,216.60	$17,027.67	$12,854.42–$15,324.90	—	40%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMYWITH OR	$9,365.56	$15,609.27	$14,048.34	98% above	40%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMYWITH OR	$9,365.56	$15,609.27	$14,048.34	—	40%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY W/ ENDOMETRIAL ABLATION	$3,339.75	$5,566.25	$5,008.58–$5,058.67	50% below	40%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY W/ ENDOMETRIAL ABLATION	$3,339.75	$5,566.25	$5,008.58–$5,058.67	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY W/ OR W/O D&C	$2,309.12	$3,848.53	$3,241.10–$3,463.68	37% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY WITH D&C/POLYPECTOMY	$3,181.03	$5,301.72	$3,241.10–$4,771.55	13% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY W/ OR W/O D&C	$2,309.12	$3,848.53	$3,241.10–$3,463.68	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY WITH D&C/POLYPECTOMY	$3,181.03	$5,301.72	$3,241.10–$4,771.55	—	40%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IU	$1,494.97	$2,491.62	$2,242.46	294% above	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF INTRAUTERINE DEVICE (IU	$1,494.97	$2,491.62	$2,242.46	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS	$1,562.92	$2,604.86	$200.88–$2,344.37	240% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE OF ABSCESS	$1,562.92	$2,604.86	$200.88–$2,344.37	—	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INITIAL INGUINAL HERNIA	$3,031.53	$5,052.55	$3,584.79–$4,547.30	4% below	40%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505 REPAIR INITIAL INGUINAL HERNIA,Left side	$3,031.53	$5,052.55	$3,584.79–$4,547.30	4% below	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL INGUINAL HERNIA	$3,031.53	$5,052.55	$3,584.79–$4,547.30	—	40%
Inguinal (groin) hernia repair, age 5 or older inpatient one side CPT 49505 REPAIR INITIAL INGUINAL HERNIA,Left side	$3,031.53	$5,052.55	$3,584.79–$4,547.30	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER POINT INJECTION	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH 50	$431.68	$719.46	$57.29–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 TRIGGER POINT INJECTION,Right side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH LT	$431.68	$719.46	$57.29–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 TRIGGER POINT INJECTION,Left side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH RT,Right side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH 50,Left side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH LT,Left side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH RT	$431.68	$719.46	$57.29–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH LT,Right side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH 50,Right side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJ TENDON SHEATH RT,Left side	$431.68	$719.46	$307.33–$647.51	13% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH 50	$431.68	$719.46	$57.29–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER POINT INJECTION	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH RT,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH 50,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH 50,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH LT,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH LT	$431.68	$719.46	$57.29–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 TRIGGER POINT INJECTION,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH LT,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 TRIGGER POINT INJECTION,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH RT,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJ TENDON SHEATH RT	$431.68	$719.46	$57.29–$647.51	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ/ASPIR LG JNT/BUR BIL	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION	$591.19	$985.32	$307.33–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR LT,Right side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR RT,Right side	$591.19	$985.32	$307.33–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION,Left side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR BIL,Left side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION,Right side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR LT,Left side	$591.19	$985.32	$307.33–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR RT,Left side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR BIL,Right side	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR LT	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ/ASPIR LG JNT/BUR RT	$591.19	$985.32	$64.60–$886.79	14% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION	$591.19	$985.32	$307.33–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ/ASPIR LG JNT/BUR BIL	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR RT,Right side	$591.19	$985.32	$307.33–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION,Left side	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR LT,Right side	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR LT	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR LT,Left side	$591.19	$985.32	$307.33–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR RT,Left side	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR RT	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION,Right side	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR BIL,Right side	$591.19	$985.32	$64.60–$886.79	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ/ASPIR LG JNT/BUR BIL,Left side	$591.19	$985.32	$64.60–$886.79	—	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NONBIODEGRADABLE DRUG DELIV	$525.80	$876.34	$133.21–$788.71	71% above	40%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NONBIODEGRADABLE DRUG DELIV	$525.80	$876.34	$133.21–$788.71	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESISASPIRATION/INJECTION	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL,Right side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL,Left side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESISASPIRATION/INJECTION,Right side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT,Left side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT,Left side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESISASPIRATION/INJECTION,Left side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT,Right side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT,Right side	$431.68	$719.46	$307.33–$647.51	11% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESISASPIRATION/INJECTION	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHROCENTESISASPIRATION/INJECTION,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR BIL,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR LT,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT,Left side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ/ASPIR INTMD JNT/BUR RT,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHROCENTESISASPIRATION/INJECTION,Right side	$431.68	$719.46	$307.33–$647.51	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT,Left side	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT,Right side	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN,Right side	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT,Left side	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL,Left side	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT,Right side	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN,Left side	$486.17	$810.29	$307.33–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL,Right side	$486.17	$810.29	$53.25–$729.26	2% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL	$486.17	$810.29	$53.25–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT,Right side	$486.17	$810.29	$53.25–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT,Right side	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN,Right side	$486.17	$810.29	$53.25–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL,Left side	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR BIL,Right side	$486.17	$810.29	$53.25–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT,Left side	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHROCENTESISASPIRATION AND /OR IN,Left side	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT,Left side	$486.17	$810.29	$307.33–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR LT	$486.17	$810.29	$53.25–$729.26	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 INJ/ASPIR SMALL JNT/BUR RT	$486.17	$810.29	$53.25–$729.26	—	40%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI	$3,671.74	$6,119.57	$3,276.01–$5,507.61	26% below	40%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI,Right side	$3,671.74	$6,119.57	$3,276.01–$5,507.61	26% below	40%
Knee arthroscopy with meniscus repair (one side of the knee) one side CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI,Left side	$3,671.74	$6,119.57	$588.70–$5,507.61	26% below	40%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI	$3,671.74	$6,119.57	$3,276.01–$5,507.61	—	40%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient one side CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI,Left side	$3,671.74	$6,119.57	$588.70–$5,507.61	—	40%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient one side CPT 29882 ARTHROSCOPYKNEE WITH REPAIR OF MENI,Right side	$3,671.74	$6,119.57	$3,276.01–$5,507.61	—	40%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC	$4,551.55	$7,585.92	$3,276.01–$6,827.33	27% below	40%
Knee arthroscopy with meniscus trim one side CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC,Left side	$4,551.55	$7,585.92	$474.97–$6,827.33	27% below	40%
Knee arthroscopy with meniscus trim one side CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC,Right side	$4,551.55	$7,585.92	$474.97–$6,827.33	27% below	40%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC	$4,551.55	$7,585.92	$3,276.01–$6,827.33	—	40%
Knee arthroscopy with meniscus trim inpatient one side CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC,Right side	$4,551.55	$7,585.92	$474.97–$6,827.33	—	40%
Knee arthroscopy with meniscus trim inpatient one side CPT 29881 ARTHROSCOPY KNEE MED OR LAT MENISEC,Left side	$4,551.55	$7,585.92	$474.97–$6,827.33	—	40%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT	$4,729.96	$7,883.26	$3,276.01–$7,094.93	24% below	40%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT,Right side	$4,729.96	$7,883.26	$490.47–$7,094.93	24% below	40%
Knee arthroscopy with removal of both torn meniscus parts one side CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT,Left side	$4,729.96	$7,883.26	$3,276.01–$7,094.93	24% below	40%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT	$4,729.96	$7,883.26	$3,276.01–$7,094.93	—	40%
Knee arthroscopy with removal of both torn meniscus parts inpatient one side CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT,Right side	$4,729.96	$7,883.26	$490.47–$7,094.93	—	40%
Knee arthroscopy with removal of both torn meniscus parts inpatient one side CPT 29880 ARTHROSCOPIC MENISECTOMY MED AND LAT,Left side	$4,729.96	$7,883.26	$3,276.01–$7,094.93	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT,Left side	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) one side CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT,Right side	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient one side CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT,Left side	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient one side CPT 29877 KNEE ARTHROSCOPY WITH DEBRIDEMENT,Right side	$2,722.36	$4,537.26	$3,276.01–$4,083.53	—	40%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 LAP GASTRIC RESTRICTIVE PROC ROUX-EN-Y	$15,230.65	$25,384.41	$22,845.97	—	40%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 LAP GASTRIC RESTRICTIVE PROC ROUX-EN-Y	$15,230.65	$25,384.41	$22,845.97	—	40%
Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 LAPAROSCOPIC GASTRIC RESTRICTIVE BAND	$8,233.31	$13,722.19	$10,642.87–$12,349.97	—	40%
Laparoscopic adjustable gastric band placement (Lap-Band) inpatient CPT 43770 LAPAROSCOPIC GASTRIC RESTRICTIVE BAND	$8,233.31	$13,722.19	$10,642.87–$12,349.97	—	40%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$4,351.96	$7,253.27	$6,052.94–$6,527.94	66% below	40%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAP NISSEN FUNDOPLICATION	$6,391.49	$10,652.49	$9,587.24–$10,749.30	72% below	40%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAP NISSEN FUNDOPLICATION	$6,391.49	$10,652.49	$9,587.24–$10,749.30	—	40%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 LAPAROSCOPYTOTAL HYSTERECT UTERUS	$8,968.90	$14,948.17	$10,642.87–$13,453.35	—	40%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 LAPAROSCOPYTOTAL HYSTERECT UTERUS	$8,968.90	$14,948.17	$10,642.87–$13,453.35	—	40%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAPAROSCOPYTOTAL HYSTERECT UTERUS	$8,968.90	$14,948.17	$10,642.87–$13,453.35	—	40%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAPAROSCOPYTOTAL HYSTERECT UTERUS	$8,968.90	$14,948.17	$10,642.87–$13,453.35	—	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN	$4,895.99	$8,159.98	$6,052.94–$7,343.98	at median	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN,Left side	$4,895.99	$8,159.98	$6,052.94–$7,343.98	at median	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN,Right side	$4,895.99	$8,159.98	$6,052.94–$7,343.98	at median	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN	$4,895.99	$8,159.98	$6,052.94–$7,343.98	—	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient one side CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN,Left side	$4,895.99	$8,159.98	$6,052.94–$7,343.98	—	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient one side CPT 49650 LAP SURGICAL REPAIR INITIAL INGUIN,Right side	$4,895.99	$8,159.98	$6,052.94–$7,343.98	—	40%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAPAROSCOPYREPAIR RECURRENT ING HER	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAPAROSCOPYREPAIR RECURRENT ING HER	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 REMOVAL LAP GASTRIC RESTRICTIVE BAND	$8,233.31	$13,722.19	$3,860.20–$12,349.97	—	40%
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 REMOVAL LAP GASTRIC RESTRICTIVE BAND	$8,233.31	$13,722.19	$3,860.20–$12,349.97	—	40%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP REMOVAL OF ADNEXAL STRUCTURES	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP REMOVAL OF ADNEXAL STRUCTURES	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAPAROSCOPIC SLEEVE GASTRECTOMY	$8,233.31	$13,722.19	$12,349.97	—	40%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAPAROSCOPIC SLEEVE GASTRECTOMY	$8,233.31	$13,722.19	$12,349.97	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUNDS OFTRUNK	$1,356.53	$2,260.88	$407.01–$2,034.79	96% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUNDS OFTRUNK	$1,356.53	$2,260.88	$407.01–$2,034.79	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 ASA CAUDAL EPIDURAL W/IMAGING GUIDANCE	$684.00	$1,140.00	$264.06–$1,026.00	60% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CAUDAL EPIDURAL W/US GUIDANCE	$1,083.95	$1,806.58	$706.75–$1,625.92	37% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CAUDAL EPIDURAL W/FLUOROSCOPY	$1,497.35	$2,495.58	$706.75–$2,246.02	13% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ASA CAUDAL EPIDURAL W/IMAGING GUIDANCE	$684.00	$1,140.00	$264.06–$1,026.00	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CAUDAL EPIDURAL W/US GUIDANCE	$1,083.95	$1,806.58	$706.75–$1,625.92	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CAUDAL EPIDURAL W/FLUOROSCOPY	$1,497.35	$2,495.58	$706.75–$2,246.02	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 ASA INJECTION LUMBAR SACRAL(CAUDAL)	$659.07	$1,098.45	$139.45–$988.60	50% below	40%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION LUMBAR SACRAL(CAUDAL)	$969.95	$1,616.58	$885.56–$1,454.92	26% below	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ASA INJECTION LUMBAR SACRAL(CAUDAL)	$659.07	$1,098.45	$139.45–$988.60	—	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION LUMBAR SACRAL(CAUDAL)	$969.95	$1,616.58	$885.56–$1,454.92	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFORAM LUMB/SAC BIL	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANESTHETIC AND OR STER LUM	$1,980.79	$3,301.31	$885.56–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT,Left side	$1,980.79	$3,301.31	$885.56–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC BIL,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC BIL,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT,Right side	$1,980.79	$3,301.31	$885.56–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION ANESTHETIC AND OR STER LUM,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 INJECTION ANESTHETIC AND OR STER LUM,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	5% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSFORAM LUMB/SAC BIL	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANESTHETIC AND OR STER LUM	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJECTION ANESTHETIC AND OR STER LUM,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJECTION ANESTHETIC AND OR STER LUM,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT,Right side	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC BIL,Left side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC RT	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT,Left side	$1,980.79	$3,301.31	$885.56–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC BIL,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 INJ TRANSFORAM LUMB/SAC LT,Right side	$1,980.79	$3,301.31	$255.88–$2,971.18	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER	$8,576.17	$14,293.62	$7,265.11–$12,864.26	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER,Left side	$8,576.17	$14,293.62	$796.73–$12,864.26	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level one side CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER,Right side	$8,576.17	$14,293.62	$796.73–$12,864.26	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER	$8,576.17	$14,293.62	$7,265.11–$12,864.26	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient one side CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER,Right side	$8,576.17	$14,293.62	$796.73–$12,864.26	—	40%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient one side CPT 63030 LAMINOTOMY WITH DECOMPRESSION OF NER,Left side	$8,576.17	$14,293.62	$796.73–$12,864.26	—	40%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRODESIS COMBINED A/P LUMB ASSIST SUR	$1,424.47	$2,374.12	$1,482.23–$2,374.12	—	40%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 ARTHRODESIS COMBINED POST OR POSTLAT	$17,358.48	$28,930.80	$26,037.72–$27,438.97	—	40%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRODESIS COMBINED A/P LUMB ASSIST SUR	$1,424.47	$2,374.12	$1,482.23–$2,374.12	—	40%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 ARTHRODESIS COMBINED POST OR POSTLAT	$17,358.48	$28,930.80	$26,037.72–$27,438.97	—	40%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 ARTHRODESIS POSTERIOR INTERBODY TECH	$14,163.38	$23,605.63	$21,245.07–$27,438.97	—	40%
Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630 ARTHRODESIS POSTERIOR INTERBODY TECH	$14,163.38	$23,605.63	$21,245.07–$27,438.97	—	40%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAMINECTOMYFACETECTOMY AND FORAMINO	$7,774.01	$12,956.69	$7,265.11–$11,661.02	—	40%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAMINECTOMYFACETECTOMY AND FORAMINO	$7,774.01	$12,956.69	$7,265.11–$11,661.02	—	40%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR LUMB ASSIST SURG	$1,424.47	$2,374.12	$2,136.71–$17,730.88	—	40%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS POSTERIOR TECHNIQUE LUM	$14,163.38	$23,605.63	$17,555.32–$21,245.07	—	40%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POSTERIOR LUMB ASSIST SURG	$1,424.47	$2,374.12	$2,136.71–$17,730.88	—	40%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS POSTERIOR TECHNIQUE LUM	$14,163.38	$23,605.63	$17,555.32–$21,245.07	—	40%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY)	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Lumpectomy (partial mastectomy) one side CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY),Right side	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Lumpectomy (partial mastectomy) one side CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY),Left side	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY)	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Lumpectomy (partial mastectomy) inpatient one side CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY),Right side	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Lumpectomy (partial mastectomy) inpatient one side CPT 19301 MASTECTOMY PARTIAL (LUMPECTOMY),Left side	$3,265.59	$5,442.65	$3,920.24–$4,898.38	—	40%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Mastectomy (total removal of the breast) one side CPT 19303 MASTECTOMY SIMPLE COMPLETE,Right side	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Mastectomy (total removal of the breast) one side CPT 19303 MASTECTOMY SIMPLE COMPLETE,Left side	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Mastectomy (total removal of the breast) inpatient one side CPT 19303 MASTECTOMY SIMPLE COMPLETE,Left side	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Mastectomy (total removal of the breast) inpatient one side CPT 19303 MASTECTOMY SIMPLE COMPLETE,Right side	$3,906.28	$6,510.47	$5,859.42–$6,714.79	—	40%
Miscarriage treatment with D&C, first trimester CPT 59820 TX OF MISSED MISCARRIAGE COMPLETE	$2,162.62	$3,604.37	$3,241.10–$3,273.50	41% below	40%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX OF MISSED MISCARRIAGE COMPLETE	$2,162.62	$3,604.37	$3,241.10–$3,273.50	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF LESION TRUNKARMSLEGS	$813.76	$1,356.26	$709.00–$1,220.63	21% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm one side CPT 11400 EXCISION OF LESION TRUNKARMSLEGS,Right side	$813.76	$1,356.26	$709.00–$1,220.63	21% above	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF LESION TRUNKARMSLEGS	$813.76	$1,356.26	$709.00–$1,220.63	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient one side CPT 11400 EXCISION OF LESION TRUNKARMSLEGS,Right side	$813.76	$1,356.26	$709.00–$1,220.63	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION	$813.76	$1,356.26	$709.00–$1,220.63	at median	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION BENIGN LESION	$813.76	$1,356.26	$709.00–$1,220.63	—	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE SIMPLE SING	$692.29	$1,153.81	$200.88–$1,038.43	127% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE SIMPLE SING	$692.29	$1,153.81	$200.88–$1,038.43	—	40%
Occipital nerve block (injection for headaches) CPT 64405 INJ GREATER OCCIPITAL NERVE BIL	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION GREATER OCCIPITAL NERVE	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT,Left side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION GREATER OCCIPITAL NERVE,Left side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJECTION GREATER OCCIPITAL NERVE,Right side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT,Left side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE BIL,Right side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE BIL,Left side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT,Right side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT,Right side	$691.24	$1,152.06	$307.33–$1,036.85	9% below	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREATER OCCIPITAL NERVE BIL	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION GREATER OCCIPITAL NERVE	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT,Left side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE BIL,Right side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJECTION GREATER OCCIPITAL NERVE,Right side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE BIL,Left side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT,Right side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE LT,Right side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJECTION GREATER OCCIPITAL NERVE,Left side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 INJ GREATER OCCIPITAL NERVE RT,Left side	$691.24	$1,152.06	$307.33–$1,036.85	—	40%
Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 GASTRIC RESTRICTIVE PROC ROUX-EN-Y	$15,230.65	$25,384.41	$22,845.97	—	40%
Open Roux-en-Y gastric bypass through an abdominal incision inpatient CPT 43846 GASTRIC RESTRICTIVE PROC ROUX-EN-Y	$15,230.65	$25,384.41	$22,845.97	—	40%
Pacemaker implant (dual chamber) CPT 33208 INSERTION/REPLACEMENT DUAL CHAMBER PACEM	$12,712.85	$21,188.09	$10,464.81–$19,069.28	55% below	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERTION/REPLACEMENT DUAL CHAMBER PACEM	$12,712.85	$21,188.09	$10,464.81–$19,069.28	—	40%
Partial knee replacement (one compartment) CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU	$13,181.46	$21,969.10	$12,854.42–$19,772.19	16% below	40%
Partial knee replacement (one compartment) one side CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU,Left side	$13,181.46	$21,969.10	$12,854.42–$19,772.19	16% below	40%
Partial knee replacement (one compartment) one side CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU,Right side	$13,181.46	$21,969.10	$12,854.42–$19,772.19	16% below	40%
Partial knee replacement (one compartment) inpatient CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU	$13,181.46	$21,969.10	$12,854.42–$19,772.19	—	40%
Partial knee replacement (one compartment) inpatient one side CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU,Left side	$13,181.46	$21,969.10	$12,854.42–$19,772.19	—	40%
Partial knee replacement (one compartment) inpatient one side CPT 27446 KNEE ARTHROPLASTY CONDYLE & PLATEAU,Right side	$13,181.46	$21,969.10	$12,854.42–$19,772.19	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL PARTIAL/COMPLETE INGROWN NAI	$1,005.73	$1,676.22	$407.01–$1,508.60	18% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL PARTIAL/COMPLETE INGROWN NAI	$1,005.73	$1,676.22	$407.01–$1,508.60	—	40%
Prostate biopsy CPT 55700 BIOPSY PROSTATE NEEDLE	$1,355.68	$2,259.46	$2,033.51	73% below	40%
Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE NEEDLE	$1,355.68	$2,259.46	$2,033.51	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 NEUROLYTIC DESTRUCTION NERVE LUMBAR	$1,530.00	$2,550.00	$1,955.12–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 INJ DESTR NV LUMB/SAC BIL	$1,683.00	$2,805.00	$1,955.12–$2,524.50	56% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC RT,Left side	$1,530.00	$2,550.00	$449.34–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 NEUROLYTIC DESTRUCTION NERVE LUMBAR,Left side	$1,530.00	$2,550.00	$449.34–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC RT,Right side	$1,530.00	$2,550.00	$1,955.12–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC RT	$1,530.00	$2,550.00	$1,955.12–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC LT,Left side	$1,530.00	$2,550.00	$1,955.12–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC LT	$1,530.00	$2,550.00	$1,955.12–$2,295.00	60% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 INJ DESTR NV LUMB/SAC BIL,Left side	$1,683.00	$2,805.00	$449.34–$2,524.50	56% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 NEUROLYTIC DESTRUCTION NERVE LUMBAR	$1,530.00	$2,550.00	$1,955.12–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 INJ DESTR NV LUMB/SAC BIL	$1,683.00	$2,805.00	$1,955.12–$2,524.50	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC LT,Left side	$1,530.00	$2,550.00	$1,955.12–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC LT	$1,530.00	$2,550.00	$1,955.12–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 NEUROLYTIC DESTRUCTION NERVE LUMBAR,Left side	$1,530.00	$2,550.00	$449.34–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC RT,Right side	$1,530.00	$2,550.00	$1,955.12–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC RT,Left side	$1,530.00	$2,550.00	$449.34–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC RT	$1,530.00	$2,550.00	$1,955.12–$2,295.00	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 INJ DESTR NV LUMB/SAC BIL,Left side	$1,683.00	$2,805.00	$449.34–$2,524.50	—	40%
Removal of a breast lump, open surgery CPT 19120 EXCISION OF BREAST TISSUELESION	$2,324.74	$3,874.56	$3,487.10–$3,959.44	47% below	40%
Removal of a breast lump, open surgery one side CPT 19120 EXCISION OF BREAST TISSUELESION,Left side	$2,324.74	$3,874.56	$3,487.10–$3,959.44	47% below	40%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF BREAST TISSUELESION	$2,324.74	$3,874.56	$3,487.10–$3,959.44	—	40%
Removal of a breast lump, open surgery inpatient one side CPT 19120 EXCISION OF BREAST TISSUELESION,Left side	$2,324.74	$3,874.56	$3,487.10–$3,959.44	—	40%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY	$1,388.76	$2,314.60	$407.01–$2,083.14	116% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY	$1,388.76	$2,314.60	$407.01–$2,083.14	—	40%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL,Right side	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL,Left side	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL,Left side	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 TOTAL THYROID LOBECTOMYUNILATERAL,Right side	$4,581.59	$7,635.99	$6,052.94–$6,872.39	—	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONSCOPY NOT HIGH RISK IND	$1,356.53	$2,260.88	$931.10–$2,034.79	11% below	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 GI Colorectal Screen Colonoscopy notHRis	$1,356.53	$2,260.88	$931.10–$2,034.79	11% below	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 GI Colorectal Screen Colonoscopy notHRis	$1,356.53	$2,260.88	$931.10–$2,034.79	—	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONSCOPY NOT HIGH RISK IND	$1,356.53	$2,260.88	$931.10–$2,034.79	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY HIGH RISK SCREENING	$1,356.53	$2,260.88	$931.10–$2,034.79	30% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 GI Colorectal Screen Colonoscopy HRisk	$1,356.53	$2,260.88	$931.10–$2,034.79	30% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY HIGH RISK SCREENING	$1,356.53	$2,260.88	$931.10–$2,034.79	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 GI Colorectal Screen Colonoscopy HRisk	$1,356.53	$2,260.88	$931.10–$2,034.79	—	40%
Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY	$2,758.48	$4,597.46	$3,319.52–$4,137.71	64% below	40%
Septoplasty to straighten the nasal septum inpatient CPT 30520 SEPTOPLASTY	$2,758.48	$4,597.46	$3,319.52–$4,137.71	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$6,982.93	$11,638.21	$3,529.30–$10,474.39	45% below	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$6,982.93	$11,638.21	$3,529.30–$10,474.39	—	40%
Short arm cast (elbow to hand) CPT 29075 CASTING; ELBOW TO FINGER	$307.49	$512.48	$280.04–$461.23	at median	40%
Short arm cast (elbow to hand) inpatient CPT 29075 CASTING; ELBOW TO FINGER	$307.49	$512.48	$280.04–$461.23	—	40%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT ARM SPLINT	$307.49	$512.48	$133.21–$461.23	19% above	40%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF SHORT ARM SPLINT,Left side	$307.49	$512.48	$75.62–$461.23	19% above	40%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION OF SHORT ARM SPLINT,Right side	$307.49	$512.48	$75.62–$461.23	19% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT ARM SPLINT	$307.49	$512.48	$133.21–$461.23	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLICATION OF SHORT ARM SPLINT,Left side	$307.49	$512.48	$75.62–$461.23	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLICATION OF SHORT ARM SPLINT,Right side	$307.49	$512.48	$75.62–$461.23	—	40%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$307.49	$512.48	$280.04–$461.23	1% below	40%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST	$307.49	$512.48	$280.04–$461.23	—	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHROSCOPY SHOULDER MUMFORD	$3,986.62	$6,644.37	$3,276.01–$5,979.93	at median	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 ARTHROSCOPY SHOULDER MUMFORD,Left side	$3,986.62	$6,644.37	$587.93–$5,979.93	at median	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) one side CPT 29824 ARTHROSCOPY SHOULDER MUMFORD,Right side	$3,986.62	$6,644.37	$587.93–$5,979.93	at median	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY SHOULDER MUMFORD	$3,986.62	$6,644.37	$3,276.01–$5,979.93	—	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient one side CPT 29824 ARTHROSCOPY SHOULDER MUMFORD,Left side	$3,986.62	$6,644.37	$587.93–$5,979.93	—	40%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient one side CPT 29824 ARTHROSCOPY SHOULDER MUMFORD,Right side	$3,986.62	$6,644.37	$587.93–$5,979.93	—	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER	$2,196.50	$3,660.84	$3,294.76	at median	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 ARTHROSCOPY SHOULDER,Left side	$2,196.50	$3,660.84	$132.07–$3,294.76	at median	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) one side CPT 29826 ARTHROSCOPY SHOULDER,Right side	$2,196.50	$3,660.84	$132.07–$3,294.76	at median	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHOULDER	$2,196.50	$3,660.84	$3,294.76	—	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient one side CPT 29826 ARTHROSCOPY SHOULDER,Left side	$2,196.50	$3,660.84	$132.07–$3,294.76	—	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient one side CPT 29826 ARTHROSCOPY SHOULDER,Right side	$2,196.50	$3,660.84	$132.07–$3,294.76	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 25CM OR LESS SKIN	$1,018.44	$1,697.40	$200.88–$1,527.66	121% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 25CM OR LESS SKIN	$1,018.44	$1,697.40	$200.88–$1,527.66	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN (SINGLE LESION)	$467.99	$779.98	$407.01–$701.98	at median	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN (SINGLE LESION)	$467.99	$779.98	$407.01–$701.98	—	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO 15 LESIO	$525.80	$876.34	$200.88–$788.71	33% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UP TO 15 LESIO	$525.80	$876.34	$200.88–$788.71	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURELUMBAR DIAGNOSTIC	$1,018.44	$1,697.40	$706.75–$1,527.66	at median	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURELUMBAR DIAGNOSTIC	$1,018.44	$1,697.40	$706.75–$1,527.66	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 26 TO 75CM	$1,018.44	$1,697.40	$200.88–$1,527.66	105% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 26 TO 75CM	$1,018.44	$1,697.40	$200.88–$1,527.66	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SUPERFICIAL FACE	$1,018.44	$1,697.40	$200.88–$1,527.66	123% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR OF SUPERFICIAL FACE	$1,018.44	$1,697.40	$200.88–$1,527.66	—	40%
TURP (transurethral resection of the prostate) CPT 52601 TRANSURETHRAL ELECTROSURGICAL	$4,973.51	$8,289.18	$5,368.37–$7,460.26	—	40%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRANSURETHRAL ELECTROSURGICAL	$4,973.51	$8,289.18	$5,368.37–$7,460.26	—	40%
Tonsil and adenoid removal, age 12 or older CPT 42821 T&A OVER AGE 12	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T&A OVER AGE 12	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Tonsil and adenoid removal, child under 12 CPT 42820 T&A UNDER AGE 12	$4,577.45	$7,629.08	$5,927.09–$6,866.17	at median	40%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 T&A UNDER AGE 12	$4,577.45	$7,629.08	$5,927.09–$6,866.17	—	40%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY	$2,246.12	$3,743.54	$3,319.52–$3,369.19	—	40%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY UNDER AGE 12	$4,365.48	$7,275.80	$5,927.09–$6,548.22	—	40%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY UNDER AGE 12	$4,365.48	$7,275.80	$5,927.09–$6,548.22	—	40%
Total hip replacement CPT 27130 HIP JOINT ARTHROPLASTY TOTAL	$13,732.15	$22,886.91	$12,854.42–$20,598.22	—	40%
Total hip replacement one side CPT 27130 HIP JOINT ARTHROPLASTY TOTAL,Right side	$13,732.15	$22,886.91	$1,050.76–$20,598.22	—	40%
Total hip replacement one side CPT 27130 HIP JOINT ARTHROPLASTY TOTAL,Left side	$13,732.15	$22,886.91	$1,050.76–$20,598.22	—	40%
Total hip replacement inpatient CPT 27130 HIP JOINT ARTHROPLASTY TOTAL	$13,732.15	$22,886.91	$12,854.42–$20,598.22	—	40%
Total hip replacement inpatient one side CPT 27130 HIP JOINT ARTHROPLASTY TOTAL,Left side	$13,732.15	$22,886.91	$1,050.76–$20,598.22	—	40%
Total hip replacement inpatient one side CPT 27130 HIP JOINT ARTHROPLASTY TOTAL,Right side	$13,732.15	$22,886.91	$1,050.76–$20,598.22	—	40%
Total knee replacement CPT 27447 TOTAL KNEE	$12,279.76	$20,466.27	$12,854.42–$18,419.64	26% below	40%
Total knee replacement one side CPT 27447 TOTAL KNEE,Left side	$12,279.76	$20,466.27	$1,048.79–$18,419.64	26% below	40%
Total knee replacement one side CPT 27447 TOTAL KNEE,Right side	$12,279.76	$20,466.27	$1,048.79–$18,419.64	26% below	40%
Total knee replacement inpatient CPT 27447 TOTAL KNEE	$12,279.76	$20,466.27	$12,854.42–$18,419.64	—	40%
Total knee replacement inpatient one side CPT 27447 TOTAL KNEE,Right side	$12,279.76	$20,466.27	$1,048.79–$18,419.64	—	40%
Total knee replacement inpatient one side CPT 27447 TOTAL KNEE,Left side	$12,279.76	$20,466.27	$1,048.79–$18,419.64	—	40%
Total shoulder replacement CPT 23472 TOTAL SHOULDER ARTHROPLASTY	$11,194.09	$18,656.82	$16,791.14–$17,730.88	at median	40%
Total shoulder replacement one side CPT 23472 TOTAL SHOULDER ARTHROPLASTY,Left side	$11,194.09	$18,656.82	$16,791.14–$17,730.88	at median	40%
Total shoulder replacement inpatient CPT 23472 TOTAL SHOULDER ARTHROPLASTY	$11,194.09	$18,656.82	$16,791.14–$17,730.88	—	40%
Total shoulder replacement inpatient one side CPT 23472 TOTAL SHOULDER ARTHROPLASTY,Left side	$11,194.09	$18,656.82	$16,791.14–$17,730.88	—	40%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMYTOTAL OR COMPLETE	$5,753.90	$9,589.84	$6,052.94–$8,630.86	—	40%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMYTOTAL OR COMPLETE	$5,753.90	$9,589.84	$6,052.94–$8,630.86	—	40%
Trigger finger release surgery CPT 26055 TRIGGER FINGER RELEASE	$1,585.85	$2,643.08	$1,609.96–$2,378.77	60% below	40%
Trigger finger release surgery one side CPT 26055 TRIGGER FINGER RELEASE,Left side	$1,585.85	$2,643.08	$1,609.96–$2,378.77	60% below	40%
Trigger finger release surgery inpatient CPT 26055 TRIGGER FINGER RELEASE	$1,585.85	$2,643.08	$1,609.96–$2,378.77	—	40%
Trigger finger release surgery inpatient one side CPT 26055 TRIGGER FINGER RELEASE,Left side	$1,585.85	$2,643.08	$1,609.96–$2,378.77	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGERT POINT TENDON INSERT	$573.37	$955.61	$307.33–$860.05	14% above	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES,Left side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT,Right side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL,Right side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES,Right side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL,Left side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT,Left side	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT,Left side	$486.17	$810.29	$49.22–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT,Right side	$486.17	$810.29	$307.33–$729.26	3% below	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGERT POINT TENDON INSERT,Left side	$573.37	$955.61	$49.22–$860.05	14% above	40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 INJ TRIGGERT POINT TENDON INSERT,Right side	$573.37	$955.61	$49.22–$860.05	14% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGERT POINT TENDON INSERT	$573.37	$955.61	$307.33–$860.05	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT,Left side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT,Right side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL,Left side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC BIL,Right side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES,Right side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 TRIGGER POINT INJ 1 OR MORE MUSCLES,Left side	$486.17	$810.29	$49.22–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT,Left side	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC RT,Right side	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGER PNT 1/2 MUSC LT	$486.17	$810.29	$307.33–$729.26	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGERT POINT TENDON INSERT,Left side	$573.37	$955.61	$49.22–$860.05	—	40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 INJ TRIGGERT POINT TENDON INSERT,Right side	$573.37	$955.61	$49.22–$860.05	—	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY-SURGICAL -FULGARTION OR	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY-SURGICAL -FULGARTION OR	$4,351.96	$7,253.27	$6,052.94–$6,527.94	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ENDOSCOPY WITH BALLOON DILATION	$1,356.53	$2,260.88	$1,921.26–$2,034.79	46% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 GI EGD esoph dilation <30 mm	$1,356.53	$2,260.88	$1,921.26–$2,034.79	46% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ENDOSCOPY WITH BALLOON DILATION	$1,356.53	$2,260.88	$1,921.26–$2,034.79	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 GI EGD esoph dilation <30 mm	$1,356.53	$2,260.88	$1,921.26–$2,034.79	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,356.53	$2,260.88	$908.10–$2,034.79	8% below	40%
Upper endoscopy (EGD) with biopsy CPT 43239 GI EGD biopsy single/multiple	$1,356.53	$2,260.88	$908.10–$2,034.79	8% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,356.53	$2,260.88	$908.10–$2,034.79	—	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GI EGD biopsy single/multiple	$1,356.53	$2,260.88	$908.10–$2,034.79	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 GI EGD w/submuc inj	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 GI EGD w/submuc inj	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPPER GI ENDO WITH GASTRIC POLYP	$1,356.53	$2,260.88	$1,921.26–$2,034.79	28% below	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 GI EGD remove lesion snare	$1,356.53	$2,260.88	$1,921.26–$2,034.79	28% below	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPPER GI ENDO WITH GASTRIC POLYP	$1,356.53	$2,260.88	$1,921.26–$2,034.79	—	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 GI EGD remove lesion snare	$1,356.53	$2,260.88	$1,921.26–$2,034.79	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 GI EGD guide wire insertion	$1,356.53	$2,260.88	$908.10–$2,034.79	24% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 GI EGD guide wire insertion	$1,356.53	$2,260.88	$908.10–$2,034.79	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,145.88	$1,909.80	$908.10–$1,718.82	8% below	40%
Upper endoscopy (EGD), diagnostic CPT 43235 GI EGD	$1,145.88	$1,909.80	$908.10–$1,718.82	8% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GASTROINTESTINAL ENDOSCOPY INC	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 GI EGD	$1,145.88	$1,909.80	$908.10–$1,718.82	—	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$2,685.80	$4,476.33	$2,092.95–$4,028.70	2% below	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$2,685.80	$4,476.33	$2,092.95–$4,028.70	—	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESION O/T SKIN TAGS	$1,356.53	$2,260.88	$200.88–$2,034.79	485% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT BENIGN LESION O/T SKIN TAGS	$1,356.53	$2,260.88	$200.88–$2,034.79	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKINAND SUBCUTANEOUS	$1,356.53	$2,260.88	$407.01–$2,034.79	29% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKINAND SUBCUTANEOUS	$1,356.53	$2,260.88	$407.01–$2,034.79	—	40%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 ORIF RADIAL EXTRA-ARTICULAR FX W/ IN	$6,290.29	$10,483.82	$7,265.11–$9,435.44	—	40%
Wrist fracture surgery (plate and screws), distal radius one side CPT 25607 ORIF RADIAL EXTRA-ARTICULAR FX W/ IN,Left side	$6,290.29	$10,483.82	$7,265.11–$9,435.44	—	40%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 ORIF RADIAL EXTRA-ARTICULAR FX W/ IN	$6,290.29	$10,483.82	$7,265.11–$9,435.44	—	40%
Wrist fracture surgery (plate and screws), distal radius inpatient one side CPT 25607 ORIF RADIAL EXTRA-ARTICULAR FX W/ IN,Left side	$6,290.29	$10,483.82	$7,265.11–$9,435.44	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs South Dakota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 XBB TRANSFUSION OF BLOOD-	$718.04	$1,196.74	$441.72–$1,077.07	26% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 XBB TRANSFUSION OF BLOOD-	$718.04	$1,196.74	$441.72–$1,077.07	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER	$123.86	$206.44	$185.80–$221.44	43% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER	$123.86	$206.44	$185.80–$221.44	—	40%
Critical care, first 30 to 74 minutes CPT 99291 SUB HOSP CRITICAL CARE	$698.84	$1,164.73	$292.78–$1,048.26	72% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 SUB HOSP CRITICAL CARE	$698.84	$1,164.73	$292.78–$1,048.26	—	40%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG - TRAC & INT	$36.00	$60.00	$54.00	56% below	40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG - TRAC & INT	$36.00	$60.00	$54.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EXECUTIVE HEALTH RESTING EKG	$37.15	$61.91	$55.72–$59.65	85% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$39.46	$65.77	$59.06–$59.65	84% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EXECUTIVE HEALTH RESTING EKG	$37.15	$61.91	$55.72–$59.65	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$39.46	$65.77	$59.06–$59.65	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT E/M MOD SEVE	$178.91	$298.19	$268.37–$276.05	74% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT E/M MOD SEVE	$178.91	$298.19	$268.37–$276.05	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAVENOUS INFUSION THERAPY UP TO 1 HOU	$242.82	$404.70	$212.96–$364.23	44% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAVENOUS INFUSION THERAPY UP TO 1 HOU	$242.82	$404.70	$212.96–$364.23	—	40%
IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUSION THERAPY UP TO 1 HOU	$242.82	$404.70	$212.96–$364.23	45% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 INTRAVENOUS INFUSION THERAPY UP TO 1 HOU	$242.82	$404.70	$212.96–$364.23	—	40%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE OR INITIAL SUBSTANCE	$158.45	$264.08	$212.96–$237.67	55% below	40%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE OR INITIAL SUBSTANCE	$158.45	$264.08	$212.96–$237.67	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOS	$155.17	$258.62	$72.09–$232.76	74% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC OR DIAGNOS	$155.17	$258.62	$72.09–$232.76	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES	$508.43	$847.38	$373.62–$762.64	11% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES	$508.43	$847.38	$373.62–$762.64	—	40%
New patient office visit, about 30 minutes CPT 99203 New Pt Low 30-44min	$103.80	$173.00	$155.70	46% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 New Pt Low 30-44min	$103.80	$173.00	$155.70	—	40%
New patient office visit, about 45 minutes CPT 99204 New Pt Moderate 45-59min	$157.80	$263.00	$236.70	38% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 New Pt Moderate 45-59min	$157.80	$263.00	$236.70	—	40%
New patient office visit, about 60 minutes CPT 99205 New Pt High 60-73min	$210.00	$350.00	$315.00	33% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 New Pt High 60-73min	$210.00	$350.00	$315.00	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Straightforward 15-29min	$90.00	$150.00	$135.00	38% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt Straightforward 15-29min	$90.00	$150.00	$135.00	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 EXECUTIVE HEALTH NUTRITION ANALYSIS	$54.42	$90.70	$81.63	at median	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 WELNESS NUTRITIAL CONSULTATION/ANALY	$63.63	$106.05	$95.44	17% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 EXECUTIVE HEALTH NUTRITION ANALYSIS	$54.42	$90.70	$81.63	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 WELNESS NUTRITIAL CONSULTATION/ANALY	$63.63	$106.05	$95.44	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PROMOTION PHYSICAL THERAPY EVAL LOW	$94.63	$157.72	$95.69–$157.72	57% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 BHO PHYSICAL THERAPY EVALUATION LOW	$94.63	$157.72	$95.69–$157.72	57% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 BHO PHYSICAL THERAPY EVALUATION LOW	$94.63	$157.72	$95.69–$157.72	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PROMOTION PHYSICAL THERAPY EVAL LOW	$94.63	$157.72	$95.69–$157.72	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PROMOTION PHYSICAL THERAPY EVAL MOD	$118.29	$197.15	$95.69–$177.44	55% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 BHO PHYSICAL THERAPY EVALUATION MOD	$118.29	$197.15	$95.69–$177.44	55% below	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 BHO PHYSICAL THERAPY EVALUATION MOD	$118.29	$197.15	$95.69–$177.44	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PROMOTION PHYSICAL THERAPY EVAL MOD	$118.29	$197.15	$95.69–$177.44	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$77.62	$129.36	$116.42	34% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY	$77.62	$129.36	$116.42	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PROMOTION THERAPEUTIC EXERCISE	$58.78	$97.97	$28.26–$88.17	50% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 BHO THERAPEUTIC EXERCISE	$73.14	$121.90	$28.26–$109.71	38% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PROMOTION THERAPEUTIC EXERCISE	$58.78	$97.97	$28.26–$88.17	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 BHO THERAPEUTIC EXERCISE	$73.14	$121.90	$28.26–$109.71	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est Pt High 60-73min	$103.80	$173.00	$155.70	59% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Est Pt High 60-73min	$103.80	$173.00	$155.70	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est Pt Low 30-44min	$78.60	$131.00	$117.90	43% below	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Est Pt Low 30-44min	$78.60	$131.00	$117.90	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est Pt Moderate 45-59min	$90.00	$150.00	$135.00	51% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Est Pt Moderate 45-59min	$90.00	$150.00	$135.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Pt Straightforward 15-29min	$45.00	$75.00	$67.50	59% below	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Est Pt Straightforward 15-29min	$45.00	$75.00	$67.50	—	40%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION DETAIL	$78.60	$131.00	$117.90	69% below	40%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION DETAIL	$78.60	$131.00	$117.90	—	40%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION COMP/M	$103.80	$173.00	$155.70	77% below	40%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATION COMP/M	$103.80	$173.00	$155.70	—	40%
Spirometry (breathing test) CPT 94010 EXECUTIVE HEALTH SPIROMETRY	$94.02	$156.70	$141.03–$218.35	70% below	40%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMETRY	$106.49	$177.48	$159.73–$218.35	67% below	40%
Spirometry (breathing test) inpatient CPT 94010 EXECUTIVE HEALTH SPIROMETRY	$94.02	$156.70	$141.03–$218.35	—	40%
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIROMETRY	$106.49	$177.48	$159.73–$218.35	—	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY TEST (PULMONARY FUNCTION TEST	$185.35	$308.91	$278.02–$377.35	66% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY TEST (PULMONARY FUNCTION TEST	$185.35	$308.91	$278.02–$377.35	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PROMOTION THERAPEUTIC ACTIVITIES	$74.34	$123.90	$111.51	38% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 BHO THERAPEUTIC ACTIVITIES	$74.34	$123.90	$111.51	38% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PROMOTION THERAPEUTIC ACTIVITIES	$74.34	$123.90	$111.51	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 BHO THERAPEUTIC ACTIVITIES	$74.34	$123.90	$111.51	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMYTHERAPEUTIC	$174.26	$290.43	$133.21–$261.39	28% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMYTHERAPEUTIC	$174.26	$290.43	$133.21–$261.39	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs South Dakota	Off list
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal 13-valent 0.5 ml SYR	$105.38	$175.63	$158.07	61% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal 13-valent 0.5 ml SYR	$105.38	$175.63	$158.07	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Polyvalent 0.5 ml VIAL	$34.14	$56.90	$51.21	76% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Polyvalent 0.5 ml VIAL	$34.14	$56.90	$51.21	—	40%
Rabies vaccine, one dose CPT 90675 rabies vaccine	$308.84	$514.73	$307.41–$463.26	40% below	40%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine	$308.84	$514.73	$307.41–$463.26	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus/diphtheria toxoids adsorbed VIAL	$48.29	$80.49	$72.44	26% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus/diphtheria toxoids adsorbed	$61.20	$102.00	$91.80	6% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus/diphtheria toxoids adsorbed VIAL	$48.29	$80.49	$72.44	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus/diphtheria toxoids adsorbed	$61.20	$102.00	$91.80	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphtheria toxoids adsorbed	$61.20	$102.00	$91.80	28% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphtheria toxoids adsorbed	$61.20	$102.00	$91.80	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM INJECTION VACCINE	$46.96	$78.26	$70.43–$72.81	9% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM INJECTION VACCINE	$46.96	$78.26	$70.43–$72.81	—	40%

Dental

Procedure	Cash price	List price	Insurers pay	vs South Dakota	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH	$249.60	$416.00	$374.40–$653.75	—	40%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH	$249.60	$416.00	$374.40–$653.75	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://bhsh.com/wp-content/uploads/2023/03/460440466_black-hills-surgical-hospital_standardcharges.csv