Hospital Durant, OK

Alliance Health Durant

Alliance Health Durant in Durant, OK publishes cash prices for 416 common procedures listed here, from its own machine-readable price file updated Dec 21, 2024. Compared with other hospitals in the state, its outpatient cash prices are above the Oklahoma median for 311 of 408 procedures and below it for 86. By typical cash price it ranks #53 of 65 Oklahoma hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1800 University Blvd, Durant, OK 74701 Collected Nov 12, 2026 Source price file Check a bill from this hospital

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen WWO	$2,174.48	$15,532.00	$153.80–$13,978.80	65% above	86%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen WWO	$2,174.48	$15,532.00	$2,174.48–$13,978.80	—	86%
Abdominal X-ray, 2 views CPT 74019 XR Abd w Decub or Upright DR	$235.20	$1,680.00	$21.64–$1,512.00	12% above	86%
Abdominal X-ray, 2 views CPT 74019 XR Abd W Decub or Upright CR	$235.20	$1,680.00	$21.64–$1,512.00	12% above	86%
Abdominal X-ray, 2 views CPT 74019 XR Abd Flat Upright DR	$235.20	$1,680.00	$21.64–$1,512.00	12% above	86%
Abdominal X-ray, 2 views CPT 74019 XR Abd Flat Upright CR	$235.20	$1,680.00	$21.64–$1,512.00	12% above	86%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abd W Decub or Upright CR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abd w Decub or Upright DR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abd Flat Upright DR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abd Flat Upright CR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$374.36	$2,674.00	$23.58–$2,406.60	—	86%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$374.36	$2,674.00	$23.58–$2,406.60	112% above	86%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$374.36	$2,674.00	$23.58–$2,406.60	112% above	86%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$374.36	$2,674.00	$23.58–$2,406.60	112% above	86%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$374.36	$2,674.00	$23.58–$2,406.60	112% above	86%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete Min 3 V Bilateral DR	$374.36	$2,674.00	$374.36–$2,406.60	—	86%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$374.36	$2,674.00	$374.36–$2,406.60	—	86%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left CR	$374.36	$2,674.00	$374.36–$2,406.60	—	86%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$374.36	$2,674.00	$374.36–$2,406.60	—	86%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right CR	$374.36	$2,674.00	$374.36–$2,406.60	—	86%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US-EXT ARTERIAL LTD - Net Health - 207	$229.46	$1,639.00	$101.69–$1,475.10	10% below	86%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US LE Arterial Duplex W ABIP	$229.46	$1,639.00	$101.69–$1,475.10	10% below	86%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US-EXT ARTERIAL LTD - Net Health - 207	$229.46	$1,639.00	$229.46–$1,475.10	—	86%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US LE Arterial Duplex W ABIP	$229.46	$1,639.00	$229.46–$1,475.10	—	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Right WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Left WO	$1,263.92	$9,028.00	$92.03–$8,125.20	41% above	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Right WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Left WO	$1,263.92	$9,028.00	$1,263.92–$8,125.20	—	86%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$383.04	$2,736.00	$57.74–$2,462.40	33% above	86%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$383.04	$2,736.00	$57.74–$2,462.40	33% above	86%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$383.04	$2,736.00	$383.04–$2,462.40	—	86%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$383.04	$2,736.00	$383.04–$2,462.40	—	86%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,165.50	$8,325.00	$227.11–$7,492.50	24% above	86%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,165.50	$8,325.00	$1,165.50–$7,492.50	—	86%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left CM	$340.76	$2,434.00	$87.89–$2,190.60	2% below	86%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right CM	$340.76	$2,434.00	$87.89–$2,190.60	2% below	86%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left CM	$340.76	$2,434.00	$340.76–$2,190.60	—	86%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right CM	$340.76	$2,434.00	$340.76–$2,190.60	—	86%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right CM	$340.76	$2,434.00	$73.00–$2,190.60	2% above	86%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left CM	$340.76	$2,434.00	$73.00–$2,190.60	2% above	86%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right CM	$340.76	$2,434.00	$340.76–$2,190.60	—	86%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left CM	$340.76	$2,434.00	$340.76–$2,190.60	—	86%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen Pelvis	$1,744.12	$12,458.00	$321.91–$11,212.20	22% below	86%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abd Pelv Renal Transplant Evaluation	$1,744.12	$12,458.00	$321.91–$11,212.20	22% below	86%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen Pelvis	$1,744.12	$12,458.00	$1,744.12–$11,212.20	—	86%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abd Pelv Renal Transplant Evaluation	$1,744.12	$12,458.00	$1,744.12–$11,212.20	—	86%
CT angiography (CTA) of the head CPT 70496 CTA Head Neck Stroke	$1,060.64	$7,576.00	$153.80–$6,818.40	20% below	86%
CT angiography (CTA) of the head CPT 70496 CTA Head	$1,060.64	$7,576.00	$153.80–$6,818.40	20% below	86%
CT angiography (CTA) of the head CPT 70496 CTA Head Stroke	$1,060.64	$7,576.00	$153.80–$6,818.40	20% below	86%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head Neck Stroke	$1,060.64	$7,576.00	$1,060.64–$6,818.40	—	86%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head Stroke	$1,060.64	$7,576.00	$1,060.64–$6,818.40	—	86%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head	$1,060.64	$7,576.00	$1,060.64–$6,818.40	—	86%
CT angiography (CTA) of the neck CPT 70498 CTA Neck	$1,003.94	$7,171.00	$153.80–$6,453.90	24% below	86%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck	$1,003.94	$7,171.00	$1,003.94–$6,453.90	—	86%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$2,054.08	$14,672.00	$153.80–$13,204.80	37% above	86%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$2,054.08	$14,672.00	$153.80–$13,204.80	37% above	86%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$2,054.08	$14,672.00	$2,054.08–$13,204.80	—	86%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$2,054.08	$14,672.00	$2,054.08–$13,204.80	—	86%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart WO	$123.20	$880.00	$76.07–$792.00	17% above	86%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart WO	$123.20	$880.00	$123.20–$792.00	—	86%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$2,309.86	$16,499.00	$161.99–$14,849.10	73% above	86%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,309.86	$16,499.00	$161.99–$14,849.10	73% above	86%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Stone Protocol	$2,309.86	$16,499.00	$161.99–$14,849.10	73% above	86%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Trauma Abdomen Pelvis WO	$2,309.86	$16,499.00	$161.99–$14,849.10	73% above	86%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$2,309.86	$16,499.00	$2,309.86–$14,849.10	—	86%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,309.86	$16,499.00	$2,309.86–$14,849.10	—	86%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Stone Protocol	$2,309.86	$16,499.00	$2,309.86–$14,849.10	—	86%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Trauma Abdomen Pelvis WO	$2,309.86	$16,499.00	$2,309.86–$14,849.10	—	86%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$2,994.04	$21,386.00	$265.29–$19,247.40	72% above	86%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Trauma Abdomen Pelvis W	$2,994.04	$21,386.00	$265.29–$19,247.40	72% above	86%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis W Pancreatic Protocol	$2,994.04	$21,386.00	$265.29–$19,247.40	72% above	86%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$2,994.04	$21,386.00	$2,994.04–$19,247.40	—	86%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis W Pancreatic Protocol	$2,994.04	$21,386.00	$2,994.04–$19,247.40	—	86%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Trauma Abdomen Pelvis W	$2,994.04	$21,386.00	$2,994.04–$19,247.40	—	86%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis WWO Urology Protocol	$2,619.26	$18,709.00	$297.54–$16,838.10	27% above	86%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$2,619.26	$18,709.00	$297.54–$16,838.10	27% above	86%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$2,619.26	$18,709.00	$2,619.26–$16,838.10	—	86%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd Pelvis WWO Urology Protocol	$2,619.26	$18,709.00	$2,619.26–$16,838.10	—	86%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$2,051.70	$14,655.00	$146.26–$13,189.50	90% above	86%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$2,051.70	$14,655.00	$2,051.70–$13,189.50	—	86%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$1,293.88	$9,242.00	$92.03–$8,317.80	31% above	86%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$1,293.88	$9,242.00	$1,293.88–$8,317.80	—	86%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$1,379.84	$9,856.00	$92.03–$8,870.40	51% above	86%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$1,379.84	$9,856.00	$92.03–$8,870.40	51% above	86%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,379.84	$9,856.00	$1,379.84–$8,870.40	—	86%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,379.84	$9,856.00	$1,379.84–$8,870.40	—	86%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$1,499.96	$10,714.00	$92.03–$9,642.60	55% above	86%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$1,499.96	$10,714.00	$92.03–$9,642.60	55% above	86%
CT scan of the head or brain, no contrast dye CPT 70450 CT Trauma Head WO	$1,499.96	$10,714.00	$92.03–$9,642.60	55% above	86%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Trauma Head WO	$1,499.96	$10,714.00	$1,499.96–$9,642.60	—	86%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$1,499.96	$10,714.00	$1,499.96–$9,642.60	—	86%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$1,499.96	$10,714.00	$1,499.96–$9,642.60	—	86%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$1,570.94	$11,221.00	$130.30–$10,098.90	30% above	86%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$1,570.94	$11,221.00	$1,570.94–$10,098.90	—	86%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$1,990.80	$14,220.00	$152.39–$12,798.00	55% above	86%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$1,990.80	$14,220.00	$1,990.80–$12,798.00	—	86%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$2,112.60	$15,090.00	$87.53–$13,581.00	109% above	86%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$2,112.60	$15,090.00	$2,112.60–$13,581.00	—	86%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$2,211.30	$15,795.00	$92.03–$14,215.50	108% above	86%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$2,211.30	$15,795.00	$2,211.30–$14,215.50	—	86%
CT scan of the pelvis, with contrast dye CPT 72193 CT Trauma Pelvis W	$1,436.68	$10,262.00	$146.26–$9,235.80	33% above	86%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$1,436.68	$10,262.00	$146.26–$9,235.80	33% above	86%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$1,436.68	$10,262.00	$1,436.68–$9,235.80	—	86%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Trauma Pelvis W	$1,436.68	$10,262.00	$1,436.68–$9,235.80	—	86%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$545.86	$3,899.00	$195.06–$3,509.10	—	86%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$545.86	$3,899.00	$545.86–$3,509.10	—	86%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V CR	$74.34	$531.00	$28.75–$477.90	58% below	86%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$74.34	$531.00	$28.75–$477.90	58% below	86%
Chest X-ray, 2 views one side CPT 71046 XR Chest 1V w Decubitus Lt DR	$74.34	$531.00	$28.75–$477.90	58% below	86%
Chest X-ray, 2 views one side CPT 71046 XR Chest 1V w Decubitus Rt DR	$74.34	$531.00	$28.75–$477.90	58% below	86%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V CR	$74.34	$531.00	$74.34–$477.90	—	86%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$74.34	$531.00	$74.34–$477.90	—	86%
Chest X-ray, 2 views inpatient one side CPT 71046 XR Chest 1V w Decubitus Lt DR	$74.34	$531.00	$74.34–$477.90	—	86%
Chest X-ray, 2 views inpatient one side CPT 71046 XR Chest 1V w Decubitus Rt DR	$74.34	$531.00	$74.34–$477.90	—	86%
Chest X-ray, single view CPT 71045 XR Chest 1V DR	$194.04	$1,386.00	$21.95–$1,247.40	22% above	86%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$194.04	$1,386.00	$21.95–$1,247.40	22% above	86%
Chest X-ray, single view CPT 71045 XR Chest 1V CR	$194.04	$1,386.00	$21.95–$1,247.40	22% above	86%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable CR	$194.04	$1,386.00	$21.95–$1,247.40	22% above	86%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1V DR	$194.04	$1,386.00	$194.04–$1,247.40	—	86%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1V CR	$194.04	$1,386.00	$194.04–$1,247.40	—	86%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$194.04	$1,386.00	$194.04–$1,247.40	—	86%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable CR	$194.04	$1,386.00	$194.04–$1,247.40	—	86%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR Clavicle Bilateral DR	$205.80	$1,470.00	$20.53–$1,323.00	—	86%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left CR	$205.80	$1,470.00	$20.53–$1,323.00	17% above	86%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right CR	$205.80	$1,470.00	$20.53–$1,323.00	17% above	86%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right DR	$205.80	$1,470.00	$20.53–$1,323.00	17% above	86%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left DR	$205.80	$1,470.00	$20.53–$1,323.00	17% above	86%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR Clavicle Bilateral DR	$205.80	$1,470.00	$205.80–$1,323.00	—	86%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right CR	$205.80	$1,470.00	$205.80–$1,323.00	—	86%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left CR	$205.80	$1,470.00	$205.80–$1,323.00	—	86%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left DR	$205.80	$1,470.00	$205.80–$1,323.00	—	86%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right DR	$205.80	$1,470.00	$205.80–$1,323.00	—	86%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$578.06	$4,129.00	$92.03–$3,716.10	25% above	86%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$578.06	$4,129.00	$578.06–$3,716.10	—	86%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$247.94	$1,771.00	$87.53–$1,593.90	4% below	86%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$247.94	$1,771.00	$247.94–$1,593.90	—	86%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton	$99.40	$710.00	$18.58–$639.00	8% below	86%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton	$99.40	$710.00	$99.40–$639.00	—	86%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Trauma Chest WO	$1,377.46	$9,839.00	$92.03–$8,855.10	45% above	86%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT High Resolution Chest	$1,377.46	$9,839.00	$92.03–$8,855.10	45% above	86%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$1,377.46	$9,839.00	$92.03–$8,855.10	45% above	86%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT High Resolution Chest	$1,377.46	$9,839.00	$1,377.46–$8,855.10	—	86%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$1,377.46	$9,839.00	$1,377.46–$8,855.10	—	86%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Trauma Chest WO	$1,377.46	$9,839.00	$1,377.46–$8,855.10	—	86%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Trauma Chest W	$1,643.18	$11,737.00	$146.26–$10,563.30	45% above	86%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$1,643.18	$11,737.00	$146.26–$10,563.30	45% above	86%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$1,643.18	$11,737.00	$1,643.18–$10,563.30	—	86%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Trauma Chest W	$1,643.18	$11,737.00	$1,643.18–$10,563.30	—	86%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$207.20	$1,480.00	$94.63–$1,332.00	—	86%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD CM	$207.20	$1,480.00	$207.20–$1,332.00	—	86%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$163.94	$1,171.00	$73.80–$1,053.90	19% below	86%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$163.94	$1,171.00	$73.80–$1,053.90	19% below	86%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD CM	$163.94	$1,171.00	$163.94–$1,053.90	—	86%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD CM	$163.94	$1,171.00	$163.94–$1,053.90	—	86%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$554.26	$3,959.00	$202.67–$3,563.10	—	86%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$554.26	$3,959.00	$202.67–$3,563.10	—	86%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$554.26	$3,959.00	$554.26–$3,563.10	—	86%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$554.26	$3,959.00	$554.26–$3,563.10	—	86%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$561.26	$4,009.00	$157.95–$3,608.10	—	86%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$561.26	$4,009.00	$157.95–$3,608.10	—	86%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Lower Extremity Veins Limited Bilater - US Lowe	$561.26	$4,009.00	$157.95–$3,608.10	12% below	86%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$561.26	$4,009.00	$157.95–$3,608.10	12% below	86%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$561.26	$4,009.00	$561.26–$3,608.10	—	86%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$561.26	$4,009.00	$561.26–$3,608.10	—	86%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Upper Extremity Veins Limited Bilater - US Uppe	$561.26	$4,009.00	$561.26–$3,608.10	—	86%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Lower Extremity Veins Limited Bilater - US Lowe	$561.26	$4,009.00	$561.26–$3,608.10	—	86%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$896.14	$6,401.00	$168.33–$5,760.90	18% below	86%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Pediatric Echo Complete w Color Dop	$896.14	$6,401.00	$168.33–$5,760.90	18% below	86%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$896.14	$6,401.00	$896.14–$5,760.90	—	86%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Pediatric Echo Complete w Color Dop	$896.14	$6,401.00	$896.14–$5,760.90	—	86%
Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 V Bilateral DR	$254.66	$1,819.00	$17.75–$1,637.10	—	86%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Right DR	$254.66	$1,819.00	$17.75–$1,637.10	47% above	86%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Left DR	$254.66	$1,819.00	$17.75–$1,637.10	47% above	86%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Left CR	$254.66	$1,819.00	$17.75–$1,637.10	47% above	86%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Right CR	$254.66	$1,819.00	$17.75–$1,637.10	47% above	86%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 V Bilateral DR	$254.66	$1,819.00	$254.66–$1,637.10	—	86%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Left DR	$254.66	$1,819.00	$254.66–$1,637.10	—	86%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Right DR	$254.66	$1,819.00	$254.66–$1,637.10	—	86%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Left CR	$254.66	$1,819.00	$254.66–$1,637.10	—	86%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Right CR	$254.66	$1,819.00	$254.66–$1,637.10	—	86%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral CR	$251.16	$1,794.00	$20.53–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral DR	$251.16	$1,794.00	$20.53–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$251.16	$1,794.00	$20.53–$1,614.60	40% above	86%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$251.16	$1,794.00	$20.53–$1,614.60	40% above	86%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Left CR	$251.16	$1,794.00	$20.53–$1,614.60	40% above	86%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right CR - XR Elbow Com	$251.16	$1,794.00	$20.53–$1,614.60	40% above	86%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral CR	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete Min 3 V Bilateral DR	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right CR - XR Elbow Com	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Left CR	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$251.16	$1,794.00	$251.16–$1,614.60	—	86%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit WO	$1,270.92	$9,078.00	$92.03–$8,170.20	42% above	86%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Sella WO	$1,270.92	$9,078.00	$92.03–$8,170.20	42% above	86%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC Temporal WO	$1,270.92	$9,078.00	$92.03–$8,170.20	42% above	86%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC Temporal WO	$1,270.92	$9,078.00	$1,270.92–$8,170.20	—	86%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Sella WO	$1,270.92	$9,078.00	$1,270.92–$8,170.20	—	86%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit WO	$1,270.92	$9,078.00	$1,270.92–$8,170.20	—	86%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$235.20	$1,680.00	$29.13–$1,512.00	7% above	86%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 V Bilateral DR	$192.50	$1,375.00	$18.03–$1,237.50	—	86%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Right DR	$192.50	$1,375.00	$18.03–$1,237.50	8% above	86%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Left DR	$192.50	$1,375.00	$18.03–$1,237.50	8% above	86%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Left CR	$192.50	$1,375.00	$18.03–$1,237.50	8% above	86%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Right CR	$192.50	$1,375.00	$18.03–$1,237.50	8% above	86%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 V Bilateral DR	$192.50	$1,375.00	$192.50–$1,237.50	—	86%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Left CR	$192.50	$1,375.00	$192.50–$1,237.50	—	86%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Left DR	$192.50	$1,375.00	$192.50–$1,237.50	—	86%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Right DR	$192.50	$1,375.00	$192.50–$1,237.50	—	86%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Right CR	$192.50	$1,375.00	$192.50–$1,237.50	—	86%
Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 V Bilateral DR	$188.02	$1,343.00	$19.69–$1,208.70	—	86%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Left DR	$188.02	$1,343.00	$19.69–$1,208.70	at median	86%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Left CR	$188.02	$1,343.00	$19.69–$1,208.70	at median	86%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Right CR	$188.02	$1,343.00	$19.69–$1,208.70	at median	86%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Right DR	$188.02	$1,343.00	$19.69–$1,208.70	at median	86%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 2 V Bilateral DR	$188.02	$1,343.00	$188.02–$1,208.70	—	86%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Left CR	$188.02	$1,343.00	$188.02–$1,208.70	—	86%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Left DR	$188.02	$1,343.00	$188.02–$1,208.70	—	86%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Right CR	$188.02	$1,343.00	$188.02–$1,208.70	—	86%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Right DR	$188.02	$1,343.00	$188.02–$1,208.70	—	86%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneus Min 2 V Bilateral DR	$128.10	$915.00	$17.47–$823.50	—	86%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR XR Calcaneus 2 V Left DR	$128.10	$915.00	$17.47–$823.50	21% below	86%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 V Right DR	$128.10	$915.00	$17.47–$823.50	21% below	86%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneus Min 2 V Bilateral DR	$128.10	$915.00	$128.10–$823.50	—	86%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR XR Calcaneus 2 V Left DR	$128.10	$915.00	$128.10–$823.50	—	86%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 V Right DR	$128.10	$915.00	$128.10–$823.50	—	86%
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 V Bilateral DR	$270.20	$1,930.00	$26.63–$1,737.00	—	86%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left CR	$270.20	$1,930.00	$26.63–$1,737.00	45% above	86%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right CR	$270.20	$1,930.00	$26.63–$1,737.00	45% above	86%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$270.20	$1,930.00	$26.63–$1,737.00	45% above	86%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$270.20	$1,930.00	$26.63–$1,737.00	45% above	86%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 V Bilateral DR	$270.20	$1,930.00	$270.20–$1,737.00	—	86%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$270.20	$1,930.00	$270.20–$1,737.00	—	86%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$270.20	$1,930.00	$270.20–$1,737.00	—	86%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right CR	$270.20	$1,930.00	$270.20–$1,737.00	—	86%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left CR	$270.20	$1,930.00	$270.20–$1,737.00	—	86%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Complete 4 V Bilateral DR	$271.46	$1,939.00	$30.25–$1,745.10	—	86%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Right DR	$271.46	$1,939.00	$30.25–$1,745.10	3% below	86%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Left DR	$271.46	$1,939.00	$30.25–$1,745.10	3% below	86%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Left DR	$271.46	$1,939.00	$30.25–$1,745.10	3% below	86%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Right DR	$271.46	$1,939.00	$30.25–$1,745.10	3% below	86%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Complete 4 V Bilateral DR	$271.46	$1,939.00	$271.46–$1,745.10	—	86%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Right DR	$271.46	$1,939.00	$271.46–$1,745.10	—	86%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Left DR	$271.46	$1,939.00	$271.46–$1,745.10	—	86%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Right DR	$271.46	$1,939.00	$271.46–$1,745.10	—	86%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Left DR	$271.46	$1,939.00	$271.46–$1,745.10	—	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Left WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Right WO	$1,409.66	$10,069.00	$92.03–$9,062.10	58% above	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Right WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Left WO	$1,409.66	$10,069.00	$1,409.66–$9,062.10	—	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$582.68	$4,162.00	$74.39–$3,745.80	51% above	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$582.68	$4,162.00	$74.39–$3,745.80	51% above	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$582.68	$4,162.00	$74.39–$3,745.80	51% above	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus	$582.68	$4,162.00	$74.39–$3,745.80	51% above	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$582.68	$4,162.00	$74.39–$3,745.80	51% above	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$582.68	$4,162.00	$582.68–$3,745.80	—	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$582.68	$4,162.00	$582.68–$3,745.80	—	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$582.68	$4,162.00	$582.68–$3,745.80	—	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus	$582.68	$4,162.00	$582.68–$3,745.80	—	86%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$582.68	$4,162.00	$582.68–$3,745.80	—	86%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Left CM	$181.30	$1,295.00	$54.99–$1,165.50	30% below	86%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Rt	$181.30	$1,295.00	$54.99–$1,165.50	30% below	86%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Right CM	$181.30	$1,295.00	$54.99–$1,165.50	30% below	86%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Lt	$181.30	$1,295.00	$54.99–$1,165.50	30% below	86%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Rt	$181.30	$1,295.00	$181.30–$1,165.50	—	86%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Lt	$181.30	$1,295.00	$181.30–$1,165.50	—	86%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Right CM	$181.30	$1,295.00	$181.30–$1,165.50	—	86%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Left CM	$181.30	$1,295.00	$181.30–$1,165.50	—	86%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$47.60	$340.00	$47.60–$306.00	87% below	86%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$47.60	$340.00	$47.60–$306.00	87% below	86%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$47.60	$340.00	$47.60–$306.00	—	86%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$47.60	$340.00	$47.60–$306.00	—	86%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia Fibula Bilateral CR	$258.30	$1,845.00	$19.97–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia Fibula Bilateral DR	$258.30	$1,845.00	$19.97–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Left DR	$258.30	$1,845.00	$19.97–$1,660.50	57% above	86%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Right DR	$258.30	$1,845.00	$19.97–$1,660.50	57% above	86%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Right CR	$258.30	$1,845.00	$19.97–$1,660.50	57% above	86%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Left CR	$258.30	$1,845.00	$19.97–$1,660.50	57% above	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia Fibula Bilateral DR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia Fibula Bilateral CR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Right CR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Right DR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Left CR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Left DR	$258.30	$1,845.00	$258.30–$1,660.50	—	86%
MR angiography (MRA) of the head without contrast CPT 70544 MRV Head WO	$1,712.76	$12,234.00	$188.53–$11,010.60	59% above	86%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head WO	$1,712.76	$12,234.00	$188.53–$11,010.60	59% above	86%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head WO	$1,712.76	$12,234.00	$1,712.76–$11,010.60	—	86%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head WO	$1,712.76	$12,234.00	$1,712.76–$11,010.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$1,971.76	$14,084.00	$177.93–$12,675.60	49% above	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$1,971.76	$14,084.00	$1,971.76–$12,675.60	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$1,840.02	$13,143.00	$321.91–$11,828.70	8% above	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$1,840.02	$13,143.00	$1,840.02–$11,828.70	—	86%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$1,393.84	$9,956.00	$172.45–$8,960.40	21% above	86%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$1,393.84	$9,956.00	$1,393.84–$8,960.40	—	86%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$1,910.86	$13,649.00	$296.78–$12,284.10	at median	86%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$1,910.86	$13,649.00	$1,910.86–$12,284.10	—	86%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$1,517.60	$10,840.00	$172.79–$9,756.00	22% above	86%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Stroke Alert	$1,517.60	$10,840.00	$172.79–$9,756.00	22% above	86%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$1,517.60	$10,840.00	$1,517.60–$9,756.00	—	86%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO Stroke Alert	$1,517.60	$10,840.00	$1,517.60–$9,756.00	—	86%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$2,690.80	$19,220.00	$280.12–$17,298.00	81% above	86%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$2,690.80	$19,220.00	$2,690.80–$17,298.00	—	86%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$2,084.04	$14,886.00	$168.63–$13,397.40	65% above	86%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$2,084.04	$14,886.00	$2,084.04–$13,397.40	—	86%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$2,730.84	$19,506.00	$280.95–$17,555.40	69% above	86%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$2,730.84	$19,506.00	$2,730.84–$17,555.40	—	86%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$2,434.88	$17,392.00	$167.80–$15,652.80	117% above	86%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$2,434.88	$17,392.00	$2,434.88–$15,652.80	—	86%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$2,498.58	$17,847.00	$281.51–$16,062.30	52% above	86%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$2,498.58	$17,847.00	$2,498.58–$16,062.30	—	86%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$2,246.72	$16,048.00	$168.07–$14,443.20	89% above	86%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$2,246.72	$16,048.00	$2,246.72–$14,443.20	—	86%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WWO	$1,608.46	$11,489.00	$295.66–$10,340.10	at median	86%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WWO	$1,608.46	$11,489.00	$1,608.46–$10,340.10	—	86%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$1,644.86	$11,749.00	$201.05–$10,574.10	61% above	86%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$1,644.86	$11,749.00	$1,644.86–$10,574.10	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Elbow Bilateral WO	$2,142.70	$15,305.00	$178.21–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Wrist Bilateral WO	$2,142.70	$15,305.00	$178.21–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI Shoulder Bilateral WO	$2,142.70	$15,305.00	$178.21–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$2,142.70	$15,305.00	$178.21–$13,774.50	54% above	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Elbow Bilateral WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Wrist Bilateral WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI Shoulder Bilateral WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$2,142.70	$15,305.00	$2,142.70–$13,774.50	—	86%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 V DR	$737.38	$5,267.00	$34.13–$4,740.30	170% above	86%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 V DR	$737.38	$5,267.00	$737.38–$4,740.30	—	86%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck W	$1,262.38	$9,017.00	$153.80–$8,115.30	17% above	86%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck W	$1,262.38	$9,017.00	$1,262.38–$8,115.30	—	86%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck WO	$844.62	$6,033.00	$92.03–$5,429.70	at median	86%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck WO	$844.62	$6,033.00	$844.62–$5,429.70	—	86%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue DR	$184.66	$1,319.00	$18.86–$1,187.10	14% above	86%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue CR	$184.66	$1,319.00	$18.86–$1,187.10	14% above	86%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$3,059.84	$21,856.00	$365.90–$19,670.40	15% above	86%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$3,059.84	$21,856.00	$365.90–$19,670.40	15% above	86%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$3,059.84	$21,856.00	$365.90–$19,670.40	15% above	86%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$3,059.84	$21,856.00	$3,059.84–$19,670.40	—	86%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$3,059.84	$21,856.00	$3,059.84–$19,670.40	—	86%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion RestStr Mult Sc1 - NM Myoc	$3,059.84	$21,856.00	$3,059.84–$19,670.40	—	86%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO	$1,647.10	$11,765.00	$92.03–$10,588.50	70% above	86%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis WO	$1,647.10	$11,765.00	$1,647.10–$10,588.50	—	86%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$156.94	$1,121.00	$42.73–$1,008.90	48% below	86%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$156.94	$1,121.00	$156.94–$1,008.90	—	86%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$637.70	$4,555.00	$90.00–$4,099.50	31% above	86%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$637.70	$4,555.00	$637.70–$4,099.50	—	86%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$473.06	$3,379.00	$87.53–$3,041.10	2% above	86%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$473.06	$3,379.00	$473.06–$3,041.10	—	86%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$427.98	$3,057.00	$92.03–$2,751.30	11% above	86%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$427.98	$3,057.00	$427.98–$2,751.30	—	86%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$343.14	$2,451.00	$69.59–$2,205.90	1% above	86%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$343.14	$2,451.00	$343.14–$2,205.90	—	86%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Left DR	$307.86	$2,199.00	$21.91–$1,979.10	54% above	86%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Left CR	$307.86	$2,199.00	$21.91–$1,979.10	54% above	86%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Right CR	$307.86	$2,199.00	$21.91–$1,979.10	54% above	86%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Right DR	$307.86	$2,199.00	$21.91–$1,979.10	54% above	86%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Right DR	$307.86	$2,199.00	$307.86–$1,979.10	—	86%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Left CR	$307.86	$2,199.00	$307.86–$1,979.10	—	86%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Left DR	$307.86	$2,199.00	$307.86–$1,979.10	—	86%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Right CR	$307.86	$2,199.00	$307.86–$1,979.10	—	86%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Left Min 3 V CR	$235.20	$1,680.00	$24.69–$1,512.00	2% below	86%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$235.20	$1,680.00	$24.69–$1,512.00	2% below	86%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Right Min 3 V CR	$235.20	$1,680.00	$24.69–$1,512.00	2% below	86%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$235.20	$1,680.00	$24.69–$1,512.00	2% below	86%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Left Min 3 V CR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Right Min 3 V CR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$235.20	$1,680.00	$235.20–$1,512.00	—	86%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$180.18	$1,287.00	$78.02–$1,158.30	—	86%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$180.18	$1,287.00	$78.02–$1,158.30	1% below	86%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$180.18	$1,287.00	$78.02–$1,158.30	1% below	86%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD CM	$180.18	$1,287.00	$180.18–$1,158.30	—	86%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD CM	$180.18	$1,287.00	$180.18–$1,158.30	—	86%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD CM	$180.18	$1,287.00	$180.18–$1,158.30	—	86%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$311.22	$2,223.00	$21.64–$2,000.70	—	86%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$311.22	$2,223.00	$21.64–$2,000.70	66% above	86%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$311.22	$2,223.00	$21.64–$2,000.70	66% above	86%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$311.22	$2,223.00	$21.64–$2,000.70	66% above	86%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$311.22	$2,223.00	$21.64–$2,000.70	66% above	86%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Comp Min 2 V Bilateral DR	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right CR	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left CR	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete CR	$369.32	$2,638.00	$22.75–$2,374.20	79% above	86%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete DR	$369.32	$2,638.00	$22.75–$2,374.20	79% above	86%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete DR	$369.32	$2,638.00	$369.32–$2,374.20	—	86%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete CR	$369.32	$2,638.00	$369.32–$2,374.20	—	86%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 V DR	$238.98	$1,707.00	$22.75–$1,536.30	18% above	86%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 V CR	$238.98	$1,707.00	$22.75–$1,536.30	18% above	86%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 V CR	$238.98	$1,707.00	$238.98–$1,536.30	—	86%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 V DR	$238.98	$1,707.00	$238.98–$1,536.30	—	86%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$174.16	$1,244.00	$83.01–$1,119.60	47% below	86%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$174.16	$1,244.00	$174.16–$1,119.60	—	86%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur Minimum 2 Views Bilat DR	$254.10	$1,815.00	$22.47–$1,633.50	—	86%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Right DR	$254.10	$1,815.00	$22.47–$1,633.50	36% above	86%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Left CR	$254.10	$1,815.00	$22.47–$1,633.50	36% above	86%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Right CR	$254.10	$1,815.00	$22.47–$1,633.50	36% above	86%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Left DR	$254.10	$1,815.00	$22.47–$1,633.50	36% above	86%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur Minimum 2 Views Bilat DR	$254.10	$1,815.00	$254.10–$1,633.50	—	86%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Left CR	$254.10	$1,815.00	$254.10–$1,633.50	—	86%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Right CR	$254.10	$1,815.00	$254.10–$1,633.50	—	86%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Left DR	$254.10	$1,815.00	$254.10–$1,633.50	—	86%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Right DR	$254.10	$1,815.00	$254.10–$1,633.50	—	86%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic WO	$1,724.10	$12,315.00	$92.03–$11,083.50	70% above	86%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic WO	$1,724.10	$12,315.00	$1,724.10–$11,083.50	—	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Left CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Left CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Right CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Left CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Right CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Right CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Left CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Right CR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Left DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Right DR	$184.66	$1,319.00	$19.14–$1,187.10	14% above	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$197.40	$1,410.00	$92.03–$1,269.00	53% below	86%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$197.40	$1,410.00	$197.40–$1,269.00	—	86%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$198.66	$1,419.00	$79.65–$1,277.10	38% below	86%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$198.66	$1,419.00	$198.66–$1,277.10	—	86%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$614.18	$4,387.00	$92.03–$3,948.30	17% above	86%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$614.18	$4,387.00	$614.18–$3,948.30	—	86%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$519.68	$3,712.00	$85.39–$3,340.80	46% above	86%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$519.68	$3,712.00	$519.68–$3,340.80	—	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$395.78	$2,827.00	$92.03–$2,544.30	3% below	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parotid	$395.78	$2,827.00	$92.03–$2,544.30	3% below	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$395.78	$2,827.00	$92.03–$2,544.30	3% below	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parathyroid	$395.78	$2,827.00	$92.03–$2,544.30	3% below	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parotid	$395.78	$2,827.00	$395.78–$2,544.30	—	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parathyroid	$395.78	$2,827.00	$395.78–$2,544.30	—	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$395.78	$2,827.00	$395.78–$2,544.30	—	86%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$395.78	$2,827.00	$395.78–$2,544.30	—	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Barium	$430.92	$3,078.00	$70.79–$2,770.20	13% above	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Gastrografin	$430.92	$3,078.00	$70.79–$2,770.20	13% above	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Esophagus w Upper GI Barium	$430.92	$3,078.00	$70.79–$2,770.20	13% above	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Barium	$430.92	$3,078.00	$430.92–$2,770.20	—	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Esophagus w Upper GI Barium	$430.92	$3,078.00	$430.92–$2,770.20	—	86%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Gastrografin	$430.92	$3,078.00	$430.92–$2,770.20	—	86%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR Humerus Min 2 V Bilateral DR	$191.66	$1,369.00	$20.25–$1,232.10	—	86%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Right CR	$191.66	$1,369.00	$20.25–$1,232.10	10% above	86%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Right DR	$191.66	$1,369.00	$20.25–$1,232.10	10% above	86%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Left CR	$191.66	$1,369.00	$20.25–$1,232.10	10% above	86%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Left DR	$191.66	$1,369.00	$20.25–$1,232.10	10% above	86%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR Humerus Min 2 V Bilateral DR	$191.66	$1,369.00	$191.66–$1,232.10	—	86%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Left CR	$191.66	$1,369.00	$191.66–$1,232.10	—	86%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Right CR	$191.66	$1,369.00	$191.66–$1,232.10	—	86%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Right DR	$191.66	$1,369.00	$191.66–$1,232.10	—	86%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Left DR	$191.66	$1,369.00	$191.66–$1,232.10	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Limited Left	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Limited Left	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Limited Right	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Limited Right	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$565.32	$4,038.00	$87.53–$3,634.20	25% above	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Limited Right	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Limited Left	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Limited Left	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Limited Right	$565.32	$4,038.00	$565.32–$3,634.20	—	86%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Right CR	$184.66	$1,319.00	$21.64–$1,187.10	13% above	86%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Right DR	$184.66	$1,319.00	$21.64–$1,187.10	13% above	86%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Left DR	$184.66	$1,319.00	$21.64–$1,187.10	13% above	86%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Left CR	$184.66	$1,319.00	$21.64–$1,187.10	13% above	86%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$297.36	$2,124.00	$27.47–$1,911.60	—	86%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$297.36	$2,124.00	$27.47–$1,911.60	66% above	86%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$297.36	$2,124.00	$27.47–$1,911.60	66% above	86%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$297.36	$2,124.00	$27.47–$1,911.60	66% above	86%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$297.36	$2,124.00	$27.47–$1,911.60	66% above	86%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete Min 3 V Bilateral DR	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left CR	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right CR	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views DR	$184.66	$1,319.00	$30.80–$1,187.10	1% below	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views CR	$184.66	$1,319.00	$30.80–$1,187.10	1% below	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views DR	$184.66	$1,319.00	$30.80–$1,187.10	1% below	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views CR	$184.66	$1,319.00	$30.80–$1,187.10	1% below	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$224.84	$1,606.00	$18.03–$1,445.40	30% above	86%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB CR	$224.84	$1,606.00	$18.03–$1,445.40	30% above	86%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB CR	$224.84	$1,606.00	$224.84–$1,445.40	—	86%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$224.84	$1,606.00	$224.84–$1,445.40	—	86%
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 V Bilateral DR	$191.94	$1,371.00	$20.53–$1,233.90	—	86%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left CR	$191.94	$1,371.00	$20.53–$1,233.90	8% above	86%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right CR	$191.94	$1,371.00	$20.53–$1,233.90	8% above	86%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$191.94	$1,371.00	$20.53–$1,233.90	8% above	86%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$191.94	$1,371.00	$20.53–$1,233.90	8% above	86%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 V Bilateral DR	$191.94	$1,371.00	$191.94–$1,233.90	—	86%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right CR	$191.94	$1,371.00	$191.94–$1,233.90	—	86%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$191.94	$1,371.00	$191.94–$1,233.90	—	86%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left CR	$191.94	$1,371.00	$191.94–$1,233.90	—	86%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$191.94	$1,371.00	$191.94–$1,233.90	—	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$184.66	$1,319.00	$26.36–$1,187.10	14% above	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left CR	$184.66	$1,319.00	$184.66–$1,187.10	—	86%
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 V Bilateral DR	$193.76	$1,384.00	$17.75–$1,245.60	—	86%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left CR	$193.76	$1,384.00	$17.75–$1,245.60	12% above	86%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$193.76	$1,384.00	$17.75–$1,245.60	12% above	86%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right CR	$193.76	$1,384.00	$17.75–$1,245.60	12% above	86%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$193.76	$1,384.00	$17.75–$1,245.60	12% above	86%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 V Bilateral DR	$193.76	$1,384.00	$193.76–$1,245.60	—	86%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left CR	$193.76	$1,384.00	$193.76–$1,245.60	—	86%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right CR	$193.76	$1,384.00	$193.76–$1,245.60	—	86%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$193.76	$1,384.00	$193.76–$1,245.60	—	86%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$193.76	$1,384.00	$193.76–$1,245.60	—	86%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$297.78	$2,127.00	$21.91–$1,914.30	—	86%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$297.78	$2,127.00	$21.91–$1,914.30	53% above	86%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$297.78	$2,127.00	$21.91–$1,914.30	53% above	86%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right CR	$297.78	$2,127.00	$21.91–$1,914.30	53% above	86%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left CR	$297.78	$2,127.00	$21.91–$1,914.30	53% above	86%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete Min 3 V Bilateral DR	$297.78	$2,127.00	$297.78–$1,914.30	—	86%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left CR	$297.78	$2,127.00	$297.78–$1,914.30	—	86%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$297.78	$2,127.00	$297.78–$1,914.30	—	86%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right CR	$297.78	$2,127.00	$297.78–$1,914.30	—	86%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$297.78	$2,127.00	$297.78–$1,914.30	—	86%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$258.16	$1,844.00	$24.14–$1,659.60	—	86%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$258.16	$1,844.00	$24.14–$1,659.60	35% above	86%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$258.16	$1,844.00	$24.14–$1,659.60	35% above	86%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left CR	$258.16	$1,844.00	$24.14–$1,659.60	35% above	86%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right CR	$258.16	$1,844.00	$24.14–$1,659.60	35% above	86%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete Min 3 V Bilateral DR	$258.16	$1,844.00	$258.16–$1,659.60	—	86%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$258.16	$1,844.00	$258.16–$1,659.60	—	86%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right CR	$258.16	$1,844.00	$258.16–$1,659.60	—	86%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left CR	$258.16	$1,844.00	$258.16–$1,659.60	—	86%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$258.16	$1,844.00	$258.16–$1,659.60	—	86%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral CR	$258.44	$1,846.00	$21.91–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$258.44	$1,846.00	$21.91–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right CR	$258.44	$1,846.00	$21.91–$1,661.40	54% above	86%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left CR	$258.44	$1,846.00	$21.91–$1,661.40	54% above	86%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$258.44	$1,846.00	$21.91–$1,661.40	54% above	86%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$258.44	$1,846.00	$21.91–$1,661.40	54% above	86%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral CR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 V Bilateral DR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left CR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right CR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$258.44	$1,846.00	$258.44–$1,661.40	—	86%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$352.94	$2,521.00	$24.41–$2,268.90	67% above	86%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$352.94	$2,521.00	$24.41–$2,268.90	67% above	86%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V CR	$352.94	$2,521.00	$352.94–$2,268.90	—	86%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$352.94	$2,521.00	$352.94–$2,268.90	—	86%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V CR	$625.38	$4,467.00	$33.02–$4,020.30	99% above	86%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$625.38	$4,467.00	$33.02–$4,020.30	99% above	86%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$625.38	$4,467.00	$625.38–$4,020.30	—	86%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V CR	$625.38	$4,467.00	$625.38–$4,020.30	—	86%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V DR	$352.94	$2,521.00	$19.41–$2,268.90	68% above	86%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 V CR	$352.94	$2,521.00	$19.41–$2,268.90	68% above	86%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V CR	$352.94	$2,521.00	$352.94–$2,268.90	—	86%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 V DR	$352.94	$2,521.00	$352.94–$2,268.90	—	86%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V CR	$246.12	$1,758.00	$24.69–$1,582.20	51% above	86%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$246.12	$1,758.00	$24.69–$1,582.20	51% above	86%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$246.12	$1,758.00	$246.12–$1,582.20	—	86%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V CR	$246.12	$1,758.00	$246.12–$1,582.20	—	86%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$246.12	$1,758.00	$24.14–$1,582.20	20% above	86%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V CR	$246.12	$1,758.00	$24.14–$1,582.20	20% above	86%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$246.12	$1,758.00	$246.12–$1,582.20	—	86%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V CR	$246.12	$1,758.00	$246.12–$1,582.20	—	86%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$216.02	$1,543.00	$16.36–$1,388.70	12% above	86%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V CR	$216.02	$1,543.00	$16.36–$1,388.70	12% above	86%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$216.02	$1,543.00	$216.02–$1,388.70	—	86%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V CR	$216.02	$1,543.00	$216.02–$1,388.70	—	86%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$246.12	$1,758.00	$20.25–$1,582.20	38% above	86%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$246.12	$1,758.00	$246.12–$1,582.20	—	86%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone Plasma (LC)	$378.28	$2,702.00	$34.35–$2,431.80	190% above	86%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone Plasma (LC)	$378.28	$2,702.00	$378.28–$2,431.80	—	86%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase Body Fluid	$109.48	$782.00	$4.71–$703.80	238% above	86%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$109.48	$782.00	$4.71–$703.80	238% above	86%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 TRANSFERASE ALT	$109.48	$782.00	$4.71–$703.80	238% above	86%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 TRANSFERASE ALT	$109.48	$782.00	$109.48–$703.80	—	86%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase Body Fluid	$109.48	$782.00	$109.48–$703.80	—	86%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$109.48	$782.00	$109.48–$703.80	—	86%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$109.76	$784.00	$4.61–$705.60	196% above	86%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase Body Fluid	$109.76	$784.00	$4.61–$705.60	196% above	86%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase Body Fluid	$109.76	$784.00	$109.76–$705.60	—	86%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$109.76	$784.00	$109.76–$705.60	—	86%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Viral Hepatitis (HAV,HBV,HCV) LC	$263.90	$1,885.00	$42.37–$1,696.50	43% above	86%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Viral Hepatitis (HAV,HBV,HCV) LC	$263.90	$1,885.00	$263.90–$1,696.50	—	86%
Albumin blood test CPT 82040 Albumin Level	$100.24	$716.00	$4.40–$644.40	230% above	86%
Albumin blood test CPT 82040 82040 ALBUMIN SERUM	$100.24	$716.00	$4.40–$644.40	230% above	86%
Albumin blood test CPT 82040 82040 L123390 ALB SER	$100.24	$716.00	$4.40–$644.40	230% above	86%
Albumin blood test inpatient CPT 82040 Albumin Level	$100.24	$716.00	$100.24–$644.40	—	86%
Albumin blood test inpatient CPT 82040 82040 L123390 ALB SER	$100.24	$716.00	$100.24–$644.40	—	86%
Albumin blood test inpatient CPT 82040 82040 ALBUMIN SERUM	$100.24	$716.00	$100.24–$644.40	—	86%
Aldosterone blood test CPT 82088 Aldosterone LCMS Level LC	$139.86	$999.00	$36.25–$899.10	at median	86%
Aldosterone blood test CPT 82088 Aldosterone Urine LC	$139.86	$999.00	$36.25–$899.10	at median	86%
Aldosterone blood test CPT 82088 82088 L4354 ALDOSTERONE	$139.86	$999.00	$36.25–$899.10	at median	86%
Aldosterone blood test inpatient CPT 82088 Aldosterone Urine LC	$139.86	$999.00	$139.86–$899.10	—	86%
Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS Level LC	$139.86	$999.00	$139.86–$899.10	—	86%
Aldosterone blood test inpatient CPT 82088 82088 L4354 ALDOSTERONE	$139.86	$999.00	$139.86–$899.10	—	86%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$133.56	$954.00	$4.61–$858.60	354% above	86%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 PHOSPHATASE ALKALINE	$133.56	$954.00	$4.61–$858.60	354% above	86%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 L1612 PHOSPHATASE,ALKALINE	$133.56	$954.00	$4.61–$858.60	354% above	86%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$133.56	$954.00	$133.56–$858.60	—	86%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 L1612 PHOSPHATASE,ALKALINE	$133.56	$954.00	$133.56–$858.60	—	86%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 PHOSPHATASE ALKALINE	$133.56	$954.00	$133.56–$858.60	—	86%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L648014 ALG IGE QT	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 K087-IgE Alpha-Amylase (LC)	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F095-IgE Peach Sendout to LabCorp	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F010-IgE Sesame Seed LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F152 IgE Green Bell Pepper LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Rice LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F279-IgE Chili Pepper LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mucor racemosus IgE Quant	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L660423ALLERGEN IGE	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F083-IgE Chicken LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 F025-IgE Tomato LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen CPT 86003 M004-IgE Mucor racemosus LC	$11.62	$83.00	$4.64–$74.70	45% below	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk (Cow) LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mucor racemosus IgE Quant	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F083-IgE Chicken LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F095-IgE Peach Sendout to LabCorp	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L648014 ALG IGE QT	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F279-IgE Chili Pepper LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F152 IgE Green Bell Pepper LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F010-IgE Sesame Seed LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M004-IgE Mucor racemosus LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L660423ALLERGEN IGE	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F025-IgE Tomato LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009-IgE Rice LC	$11.62	$83.00	$11.62–$74.70	—	86%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K087-IgE Alpha-Amylase (LC)	$11.62	$83.00	$11.62–$74.70	—	86%
Alpha-fetoprotein (AFP) blood test CPT 82105 82105 L17319 AFP SERUM	$146.30	$1,045.00	$14.92–$940.50	171% above	86%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker (LC)	$146.30	$1,045.00	$14.92–$940.50	171% above	86%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker (LC)	$146.30	$1,045.00	$146.30–$940.50	—	86%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 82105 L17319 AFP SERUM	$146.30	$1,045.00	$146.30–$940.50	—	86%
Ammonia blood test CPT 82140 Ammonia Level	$153.16	$1,094.00	$12.96–$984.60	122% above	86%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$153.16	$1,094.00	$153.16–$984.60	—	86%
Amylase blood test CPT 82150 Amylase Body Fluid	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Amylase, Body Fluid (LC)	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Amylase Urine	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Amylase Urine Timed	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Amylase Blood	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Amylase 24 Hour Urine	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test CPT 82150 Pancreatic Amylase Blood	$147.00	$1,050.00	$5.76–$945.00	238% above	86%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Amylase 24 Hour Urine	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Amylase, Body Fluid (LC)	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Amylase Blood	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Amylase Urine Timed	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Amylase Urine	$147.00	$1,050.00	$147.00–$945.00	—	86%
Amylase blood test inpatient CPT 82150 Pancreatic Amylase Blood	$147.00	$1,050.00	$147.00–$945.00	—	86%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$29.12	$208.00	$11.52–$187.20	56% below	86%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG IgA (LC)	$29.12	$208.00	$29.12–$187.20	—	86%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Antibody IFA (LC)	$93.94	$671.00	$10.75–$603.90	68% above	86%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 L52373 ANA	$93.94	$671.00	$10.75–$603.90	68% above	86%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Antibody IFA (LC)	$93.94	$671.00	$93.94–$603.90	—	86%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 L52373 ANA	$93.94	$671.00	$93.94–$603.90	—	86%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$83.30	$595.00	$34.92–$535.50	28% below	86%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$83.30	$595.00	$34.92–$535.50	28% below	86%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$83.30	$595.00	$83.30–$535.50	—	86%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$83.30	$595.00	$83.30–$535.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Alveolar Lavage Quantitative Culture wit	$65.66	$469.00	$7.67–$422.10	52% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 CULTURE BACTERIA OTH	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Medical Device Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bone Marrow Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Skin Culture without Gram Stain Panel	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Strep Culture QA NC	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sinus Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Feeding Tube Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Aspirate Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Trachea Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bone Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Wash Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Brush Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Alveolar Lavage Culture without Gram Sta	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Foreign Body Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Gastric Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Transfusion Reaction Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aspirate Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Abscess Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasopharyngeal Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Miscellaneous Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 zzEnvironmental Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture without Gram stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture without Gram Stain	$140.70	$1,005.00	$7.67–$904.50	225% above	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Alveolar Lavage Quantitative Culture wit	$65.66	$469.00	$65.66–$422.10	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 87070 CULTURE BACTERIA OTH	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 zzEnvironmental Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Miscellaneous Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasopharyngeal Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Abscess Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aspirate Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Transfusion Reaction Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Gastric Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Foreign Body Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Alveolar Lavage Culture without Gram Sta	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Brush Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Wash Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bone Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Trachea Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bronchial Aspirate Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Feeding Tube Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sinus Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Strep Culture QA NC	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Skin Culture without Gram Stain Panel	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Bone Marrow Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Medical Device Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture without Gram Stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$140.70	$1,005.00	$140.70–$904.50	—	86%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture without Gram stain	$140.70	$1,005.00	$140.70–$904.50	—	86%
Basic metabolic panel (blood test) CPT 80048 BMPWTCA	$192.64	$1,376.00	$7.53–$1,238.40	283% above	86%
Basic metabolic panel (blood test) inpatient CPT 80048 BMPWTCA	$192.64	$1,376.00	$192.64–$1,238.40	—	86%
Bilirubin blood test, total CPT 82247 Bilirubin Total Cord Blood	$12.32	$88.00	$4.47–$79.20	68% below	86%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$12.32	$88.00	$4.47–$79.20	68% below	86%
Bilirubin blood test, total CPT 82247 Bilirubin Total Neo	$12.32	$88.00	$4.47–$79.20	68% below	86%
Bilirubin blood test, total CPT 82247 Bilirubin Total Body Fluid	$12.32	$88.00	$4.47–$79.20	68% below	86%
Bilirubin blood test, total CPT 82247 82247 BILIRUBIN TOTAL	$12.32	$88.00	$4.47–$79.20	68% below	86%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Cord Blood	$12.32	$88.00	$12.32–$79.20	—	86%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Neo	$12.32	$88.00	$12.32–$79.20	—	86%
Bilirubin blood test, total inpatient CPT 82247 82247 BILIRUBIN TOTAL	$12.32	$88.00	$12.32–$79.20	—	86%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$12.32	$88.00	$12.32–$79.20	—	86%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Body Fluid	$12.32	$88.00	$12.32–$79.20	—	86%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$57.29	$409.24	$31.71–$368.32	57% below	86%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 $APRL 88305 Bill Surg Path Gross Lvl4	$57.29	$409.24	$57.29–$368.32	—	86%
Blood culture for bacteria CPT 87040 Blood Culture	$171.22	$1,223.00	$9.18–$1,100.70	153% above	86%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$171.22	$1,223.00	$171.22–$1,100.70	—	86%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg BCE	$24.50	$175.00	$7.85–$157.50	125% above	86%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$24.50	$175.00	$7.85–$157.50	125% above	86%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$2,449.30	$17,495.00	$8.39–$15,745.50	22371% above	86%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg BCE	$24.50	$175.00	$24.50–$157.50	—	86%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$24.50	$175.00	$24.50–$157.50	—	86%
Blood glucose (sugar) test CPT 82947 82947 GLUCOSE,SER PL OR WB	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 .Glucose Fasting	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 .Glucose POC	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 .GTT 3rd Hr OB	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 Glucose 4 Hour Postprandial	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 Glucose 3 Hour Postprandial	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hr OB	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test CPT 82947 Glucose Level	$110.04	$786.00	$3.50–$707.40	334% above	86%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose Fasting	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 3rd Hr OB	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 4 Hour Postprandial	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 3 Hour Postprandial	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hr OB	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE,SER PL OR WB	$110.04	$786.00	$110.04–$707.40	—	86%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose POC	$110.04	$786.00	$110.04–$707.40	—	86%
Blood lead test CPT 83655 83655 L42580 LEAD	$72.52	$518.00	$10.77–$466.20	53% above	86%
Blood lead test CPT 83655 Lead Blood Pediatric (LC)	$72.52	$518.00	$10.77–$466.20	53% above	86%
Blood lead test CPT 83655 83655 LEAD	$72.52	$518.00	$10.77–$466.20	53% above	86%
Blood lead test CPT 83655 83655 L7046 LEAD	$72.52	$518.00	$10.77–$466.20	53% above	86%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric (LC)	$72.52	$518.00	$72.52–$466.20	—	86%
Blood lead test inpatient CPT 83655 83655 L42580 LEAD	$72.52	$518.00	$72.52–$466.20	—	86%
Blood lead test inpatient CPT 83655 83655 L7046 LEAD	$72.52	$518.00	$72.52–$466.20	—	86%
Blood lead test inpatient CPT 83655 83655 LEAD	$72.52	$518.00	$72.52–$466.20	—	86%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Chorionic Gonadotropin Qual	$245.98	$1,757.00	$6.69–$1,581.30	441% above	86%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qual, Urine CQ	$245.98	$1,757.00	$6.69–$1,581.30	441% above	86%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qual, Urine CQ	$245.98	$1,757.00	$245.98–$1,581.30	—	86%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Human Chorionic Gonadotropin Qual	$245.98	$1,757.00	$245.98–$1,581.30	—	86%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Ref Lab ABO/Rh	$165.48	$1,182.00	$2.66–$1,063.80	169% above	86%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$165.48	$1,182.00	$2.66–$1,063.80	169% above	86%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$165.48	$1,182.00	$2.66–$1,063.80	169% above	86%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$165.48	$1,182.00	$2.66–$1,063.80	169% above	86%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Ref Lab ABO/Rh	$165.48	$1,182.00	$165.48–$1,063.80	—	86%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$165.48	$1,182.00	$165.48–$1,063.80	—	86%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$165.48	$1,182.00	$165.48–$1,063.80	—	86%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$165.48	$1,182.00	$165.48–$1,063.80	—	86%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Body Fluid	$72.38	$517.00	$3.51–$465.30	194% above	86%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$72.38	$517.00	$3.51–$465.30	194% above	86%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Body Fluid	$72.38	$517.00	$72.38–$465.30	—	86%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$72.38	$517.00	$72.38–$465.30	—	86%
C-peptide blood test CPT 84681 C-Peptide Level LC	$140.56	$1,004.00	$18.51–$903.60	54% above	86%
C-peptide blood test inpatient CPT 84681 C-Peptide Level LC	$140.56	$1,004.00	$140.56–$903.60	—	86%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin PCR	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 Verigene C difficile Panel	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile by DNA Amp	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile DNA Amp w/reflex Toxin Confirmation	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin A B Amp Probe	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) CPT 87493 C diff AB PCR	$85.82	$613.00	$33.15–$551.70	6% below	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin PCR	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Verigene C difficile Panel	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile by DNA Amp	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile DNA Amp w/reflex Toxin Confirmation	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile PCR w/reflex Toxin Confirmation	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin A B Amp Probe	$85.82	$613.00	$85.82–$551.70	—	86%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diff AB PCR	$85.82	$613.00	$85.82–$551.70	—	86%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 LC	$159.88	$1,142.00	$18.51–$1,027.80	75% above	86%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 LC	$159.88	$1,142.00	$159.88–$1,027.80	—	86%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC	$154.56	$1,104.00	$18.51–$993.60	72% above	86%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125	$154.56	$1,104.00	$18.51–$993.60	72% above	86%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125	$154.56	$1,104.00	$154.56–$993.60	—	86%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC	$154.56	$1,104.00	$154.56–$993.60	—	86%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 NAA (LC)	$28.00	$200.00	$28.00–$180.00	65% below	86%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 NAA (LC)	$28.00	$200.00	$28.00–$180.00	—	86%
Calcium blood test, total CPT 82310 Calcium Level	$125.86	$899.00	$4.59–$809.10	246% above	86%
Calcium blood test, total CPT 82310 Calcium, Random Urine (CQ)	$125.86	$899.00	$4.59–$809.10	246% above	86%
Calcium blood test, total CPT 82310 Calcium Urine	$125.86	$899.00	$4.59–$809.10	246% above	86%
Calcium blood test, total CPT 82310 Calcium BF	$125.86	$899.00	$4.59–$809.10	246% above	86%
Calcium blood test, total inpatient CPT 82310 Calcium, Random Urine (CQ)	$125.86	$899.00	$125.86–$809.10	—	86%
Calcium blood test, total inpatient CPT 82310 Calcium Urine	$125.86	$899.00	$125.86–$809.10	—	86%
Calcium blood test, total inpatient CPT 82310 Calcium BF	$125.86	$899.00	$125.86–$809.10	—	86%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$125.86	$899.00	$125.86–$809.10	—	86%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$218.12	$1,558.00	$16.86–$1,402.20	113% above	86%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (LC)	$218.12	$1,558.00	$16.86–$1,402.20	113% above	86%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA CQ	$218.12	$1,558.00	$16.86–$1,402.20	113% above	86%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA Pericardial Fluid CQ	$218.12	$1,558.00	$16.86–$1,402.20	113% above	86%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA CQ	$218.12	$1,558.00	$218.12–$1,402.20	—	86%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Pericardial Fluid CQ	$218.12	$1,558.00	$218.12–$1,402.20	—	86%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen (LC)	$218.12	$1,558.00	$218.12–$1,402.20	—	86%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$218.12	$1,558.00	$218.12–$1,402.20	—	86%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab IgM (LC)	$43.54	$311.00	$11.46–$279.90	24% below	86%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab IgG (LC)	$43.54	$311.00	$11.46–$279.90	24% below	86%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab IgM (LC)	$43.54	$311.00	$43.54–$279.90	—	86%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab IgG (LC)	$43.54	$311.00	$43.54–$279.90	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHLMYD TRACH DNA AMP	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183160 C TRACH AMP	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis NAA LC	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183194CHLMYD TRACH	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ChlamydiaNAALC	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Probe 2	$85.82	$613.00	$31.21–$551.70	8% above	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Probe 2	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ChlamydiaNAALC	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183160 C TRACH AMP	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHLMYD TRACH DNA AMP	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183194CHLMYD TRACH	$85.82	$613.00	$85.82–$551.70	—	86%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis NAA LC	$85.82	$613.00	$85.82–$551.70	—	86%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$193.06	$1,379.00	$11.91–$1,241.10	185% above	86%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with LDL/HDL Ratio	$193.06	$1,379.00	$11.91–$1,241.10	185% above	86%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$193.06	$1,379.00	$193.06–$1,241.10	—	86%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with LDL/HDL Ratio	$193.06	$1,379.00	$193.06–$1,241.10	—	86%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/ 3 Part Diff Auto	$102.20	$730.00	$6.91–$657.00	125% above	86%
Complete blood count (CBC) with differential CPT 85025 CBCADIFF	$102.20	$730.00	$6.91–$657.00	125% above	86%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/ 3 Part Diff Auto	$102.20	$730.00	$102.20–$657.00	—	86%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCADIFF	$102.20	$730.00	$102.20–$657.00	—	86%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$47.18	$337.00	$5.75–$303.30	11% above	86%
Complete blood count (CBC), no differential CPT 85027 CBC	$47.18	$337.00	$5.75–$303.30	11% above	86%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$47.18	$337.00	$47.18–$303.30	—	86%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$47.18	$337.00	$47.18–$303.30	—	86%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$245.14	$1,751.00	$9.39–$1,575.90	241% above	86%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$245.14	$1,751.00	$245.14–$1,575.90	—	86%
Cortisol blood test, total CPT 82533 Cortisol AM	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol 30 Minute	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol 60 Minute	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol Baseline	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol 90 Minute	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol PM	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol - AM Sendout to LabCorp	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol Sendout to LabCorp	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol Level	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total CPT 82533 Cortisol PM (LC)	$41.44	$296.00	$14.50–$266.40	44% below	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol Level	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol AM	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol PM	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol 30 Minute	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol - AM Sendout to LabCorp	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol PM (LC)	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol Sendout to LabCorp	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol 90 Minute	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline	$41.44	$296.00	$41.44–$266.40	—	86%
Cortisol blood test, total inpatient CPT 82533 Cortisol 60 Minute	$41.44	$296.00	$41.44–$266.40	—	86%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$103.88	$742.00	$5.79–$667.80	172% above	86%
Creatine kinase (CK) blood test, total CPT 82550 82550 L2154 CREATINE KINASE TOTAL	$103.88	$742.00	$5.79–$667.80	172% above	86%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase w/Reflex CKMB/Relative Index	$103.88	$742.00	$5.79–$667.80	172% above	86%
Creatine kinase (CK) blood test, total CPT 82550 82550 CREATINE KINASE TOTAL	$103.88	$742.00	$5.79–$667.80	172% above	86%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase w/Reflex CKMB/Relative Index	$103.88	$742.00	$103.88–$667.80	—	86%
Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 CREATINE KINASE TOTAL	$103.88	$742.00	$103.88–$667.80	—	86%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$103.88	$742.00	$103.88–$667.80	—	86%
Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 L2154 CREATINE KINASE TOTAL	$103.88	$742.00	$103.88–$667.80	—	86%
Creatinine blood test CPT 82565 ISCREA	$78.54	$561.00	$4.55–$504.90	175% above	86%
Creatinine blood test CPT 82565 CREA	$78.54	$561.00	$4.55–$504.90	175% above	86%
Creatinine blood test inpatient CPT 82565 CREA	$78.54	$561.00	$78.54–$504.90	—	86%
Creatinine blood test inpatient CPT 82565 ISCREA	$78.54	$561.00	$78.54–$504.90	—	86%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibody IgG (LC)	$61.18	$437.00	$12.80–$393.30	21% below	86%
Cytomegalovirus (CMV) antibody test CPT 86644 86644 CMV AB	$61.18	$437.00	$12.80–$393.30	21% below	86%
Cytomegalovirus (CMV) antibody test CPT 86644 86644 L221085 CMV AB	$61.18	$437.00	$12.80–$393.30	21% below	86%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 CMV AB	$61.18	$437.00	$61.18–$393.30	—	86%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 L221085 CMV AB	$61.18	$437.00	$61.18–$393.30	—	86%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibody IgG (LC)	$61.18	$437.00	$61.18–$393.30	—	86%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$139.61	$997.24	$9.05–$897.52	41% above	86%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$139.61	$997.24	$139.61–$897.52	—	86%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$54.46	$389.00	$19.77–$350.10	28% below	86%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (LC)	$54.46	$389.00	$54.46–$350.10	—	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10BQualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10AQualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS10QualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS13QualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Screen, Urine (LC)	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamine Screen, Urine (LC)	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone Qual Urine	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Hydrocodone Qual Urine	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UBarbQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite, Serum LC	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UAmpQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Panel 8 MedTox RLNI	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS9AQualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UTHCQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UPCPQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UOpiQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UCocQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS8AQualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen (9) Umbilical Cord Blood (LC)	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Urine LC	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS7QualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Qual	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 8 w/Conf WB (LC)	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UBenzQl	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS11QA	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Umbil. Cord Tissue LC	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS12QualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS6QualAuto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS 8C Qual Auto	$281.54	$2,011.00	$55.27–$1,809.90	187% above	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10AQualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UCocQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UBenzQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UBarbQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UAmpQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS8AQualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite Urine LC	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Qual	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 8 w/Conf WB (LC)	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS11QA	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS12QualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS6QualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS 8C Qual Auto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10BQualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS10QualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UOpiQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UPCPQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UTHCQl	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS9AQualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Hydrocodone Qual Urine	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone Qual Urine	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamine Screen, Urine (LC)	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen, Urine (LC)	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS13QualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS7QualAuto	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen (9) Umbilical Cord Blood (LC)	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Panel 8 MedTox RLNI	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite, Serum LC	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Umbil. Cord Tissue LC	$281.54	$2,011.00	$281.54–$1,809.90	—	86%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Urine Panel	$165.76	$1,184.00	$6.24–$1,065.60	188% above	86%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Panel	$165.76	$1,184.00	$6.24–$1,065.60	188% above	86%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Urine Panel	$165.76	$1,184.00	$165.76–$1,065.60	—	86%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Panel	$165.76	$1,184.00	$165.76–$1,065.60	—	86%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 L240610 EBV VCA	$49.98	$357.00	$16.14–$321.30	27% below	86%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus VCA IgG (LC)	$49.98	$357.00	$16.14–$321.30	27% below	86%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus VCA IgM (LC)	$49.98	$357.00	$16.14–$321.30	27% below	86%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 L240610 EBV VCA	$49.98	$357.00	$49.98–$321.30	—	86%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus VCA IgG (LC)	$49.98	$357.00	$49.98–$321.30	—	86%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Virus VCA IgM (LC)	$49.98	$357.00	$49.98–$321.30	—	86%
Estradiol blood test CPT 82670 Estradiol Level	$65.38	$467.00	$24.85–$420.30	28% below	86%
Estradiol blood test CPT 82670 Estradiol Sendout to LabCorp	$65.38	$467.00	$24.85–$420.30	28% below	86%
Estradiol blood test inpatient CPT 82670 Estradiol Sendout to LabCorp	$65.38	$467.00	$65.38–$420.30	—	86%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$65.38	$467.00	$65.38–$420.30	—	86%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone (LC)	$302.26	$2,159.00	$16.53–$1,943.10	340% above	86%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$302.26	$2,159.00	$16.53–$1,943.10	340% above	86%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$302.26	$2,159.00	$302.26–$1,943.10	—	86%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone (LC)	$302.26	$2,159.00	$302.26–$1,943.10	—	86%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Feces (LC)	$213.64	$1,526.00	$17.46–$1,373.40	48% above	86%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Feces (LC)	$213.64	$1,526.00	$213.64–$1,373.40	—	86%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$84.70	$605.00	$12.12–$544.50	32% above	86%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$84.70	$605.00	$84.70–$544.50	—	86%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$156.10	$1,115.00	$8.65–$1,003.50	133% above	86%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$156.10	$1,115.00	$156.10–$1,003.50	—	86%
Folate (folic acid) blood test CPT 82746 Folate Level	$12.64	$90.31	$12.64–$81.28	80% below	86%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$12.64	$90.31	$12.64–$81.28	—	86%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free Serum (LC)	$41.44	$296.00	$15.07–$266.40	54% below	86%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free	$41.44	$296.00	$15.07–$266.40	54% below	86%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free Serum (LC)	$41.44	$296.00	$41.44–$266.40	—	86%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free	$41.44	$296.00	$41.44–$266.40	—	86%
Free T4 (free thyroxine) thyroid blood test CPT 84439 .Thyroxine (T4) Free, Direct, S LC	$82.60	$590.00	$8.02–$531.00	35% above	86%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$82.60	$590.00	$8.02–$531.00	35% above	86%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$82.60	$590.00	$8.02–$531.00	35% above	86%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .Thyroxine (T4) Free, Direct, S LC	$82.60	$590.00	$82.60–$531.00	—	86%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$82.60	$590.00	$82.60–$531.00	—	86%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$82.60	$590.00	$82.60–$531.00	—	86%
Free testosterone test CPT 84402 84402 L140103 TESTOST FREE	$41.16	$294.00	$22.66–$264.60	52% below	86%
Free testosterone test CPT 84402 Testosterone Free Direct LC	$41.16	$294.00	$22.66–$264.60	52% below	86%
Free testosterone test inpatient CPT 84402 Testosterone Free Direct LC	$41.16	$294.00	$41.16–$264.60	—	86%
Free testosterone test inpatient CPT 84402 84402 L140103 TESTOST FREE	$41.16	$294.00	$41.16–$264.60	—	86%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 82977 GGT	$140.42	$1,003.00	$6.40–$902.70	186% above	86%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$140.42	$1,003.00	$6.40–$902.70	186% above	86%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase (LC)	$140.42	$1,003.00	$6.40–$902.70	186% above	86%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase Body Fluid	$140.42	$1,003.00	$6.40–$902.70	186% above	86%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase Body Fluid	$140.42	$1,003.00	$140.42–$902.70	—	86%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 82977 GGT	$140.42	$1,003.00	$140.42–$902.70	—	86%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$140.42	$1,003.00	$140.42–$902.70	—	86%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase (LC)	$140.42	$1,003.00	$140.42–$902.70	—	86%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 $ General Health Panel	$513.24	$3,666.00	$31.24–$3,299.40	162% above	86%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 $ General Health Panel	$513.24	$3,666.00	$513.24–$3,299.40	—	86%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Postprandial	$96.60	$690.00	$4.23–$621.00	216% above	86%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 1st Hr OB	$96.60	$690.00	$4.23–$621.00	216% above	86%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Postprandial	$96.60	$690.00	$4.23–$621.00	216% above	86%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Postprandial	$96.60	$690.00	$96.60–$621.00	—	86%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Postprandial	$96.60	$690.00	$96.60–$621.00	—	86%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 1st Hr OB	$96.60	$690.00	$96.60–$621.00	—	86%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$149.38	$1,067.00	$11.45–$960.30	106% above	86%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$149.38	$1,067.00	$149.38–$960.30	—	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus by NAA LC	$71.54	$511.00	$31.21–$459.90	14% below	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183160 N GONO AMP	$71.54	$511.00	$31.21–$459.90	14% below	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183194N.GONORRHO,DN	$78.82	$563.00	$31.21–$506.70	5% below	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183160 N GONO AMP	$71.54	$511.00	$71.54–$459.90	—	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonococcus by NAA LC	$71.54	$511.00	$71.54–$459.90	—	86%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183194N.GONORRHO,DN	$78.82	$563.00	$78.82–$506.70	—	86%
H. pylori antibody blood test CPT 86677 86677 L163683H PYLOR AB QL	$48.72	$348.00	$14.99–$313.20	35% below	86%
H. pylori antibody blood test CPT 86677 Heliobacter pylori Ab IgG	$48.72	$348.00	$14.99–$313.20	35% below	86%
H. pylori antibody blood test inpatient CPT 86677 Heliobacter pylori Ab IgG	$48.72	$348.00	$48.72–$313.20	—	86%
H. pylori antibody blood test inpatient CPT 86677 86677 L163683H PYLOR AB QL	$48.72	$348.00	$48.72–$313.20	—	86%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Fecal IA	$104.58	$747.00	$12.79–$672.30	7% below	86%
H. pylori stool antigen test CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$104.58	$747.00	$12.79–$672.30	7% below	86%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Fecal IA	$104.58	$747.00	$104.58–$672.30	—	86%
H. pylori stool antigen test inpatient CPT 87338 Heliobacter pylori Stool Ag EIA (LC)	$104.58	$747.00	$104.58–$672.30	—	86%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, PCR (NonGraph) Rfx Geno LC	$290.64	$2,076.00	$75.70–$1,868.40	43% above	86%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, PCR (NonGraph) Rfx Geno LC	$290.64	$2,076.00	$290.64–$1,868.40	—	86%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 2 Ab Ag 4th Generation Auto w/Rfx	$23.80	$170.00	$21.42–$153.00	50% below	86%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 2 Ab Ag 4th Generation Auto w/Rfx	$23.80	$170.00	$23.80–$153.00	—	86%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$107.66	$769.00	$8.64–$692.10	159% above	86%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (LC)	$107.66	$769.00	$8.64–$692.10	159% above	86%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (LC)	$107.66	$769.00	$107.66–$692.10	—	86%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$107.66	$769.00	$107.66–$692.10	—	86%
Hemoglobin blood test CPT 85018 Hemoglobin	$63.98	$457.00	$2.11–$411.30	223% above	86%
Hemoglobin blood test CPT 85018 85018 HEMOGLOBIN 131	$63.98	$457.00	$2.11–$411.30	223% above	86%
Hemoglobin blood test inpatient CPT 85018 85018 HEMOGLOBIN 131	$63.98	$457.00	$63.98–$411.30	—	86%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$63.98	$457.00	$63.98–$411.30	—	86%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total	$122.08	$872.00	$10.72–$784.80	154% above	86%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab Total (LC)	$122.08	$872.00	$10.72–$784.80	154% above	86%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody Total	$122.08	$872.00	$122.08–$784.80	—	86%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Ab Total (LC)	$122.08	$872.00	$122.08–$784.80	—	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab w/Interp	$145.04	$1,036.00	$9.55–$932.40	186% above	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab (LC)	$145.04	$1,036.00	$9.55–$932.40	186% above	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody w/Interp	$145.04	$1,036.00	$9.55–$932.40	186% above	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody w/Interp	$145.04	$1,036.00	$145.04–$932.40	—	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab w/Interp	$145.04	$1,036.00	$145.04–$932.40	—	86%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab (LC)	$145.04	$1,036.00	$145.04–$932.40	—	86%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Screen (LC)	$78.26	$559.00	$9.19–$503.10	72% above	86%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$78.26	$559.00	$9.19–$503.10	72% above	86%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag w/Interp	$78.26	$559.00	$9.19–$503.10	72% above	86%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag w/Interp	$78.26	$559.00	$78.26–$503.10	—	86%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$78.26	$559.00	$78.26–$503.10	—	86%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag Screen (LC)	$78.26	$559.00	$78.26–$503.10	—	86%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody (LC)	$137.76	$984.00	$12.69–$885.60	157% above	86%
Hepatitis C antibody blood test (screening) CPT 86803 HCAB2	$137.76	$984.00	$12.69–$885.60	157% above	86%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C IgG Antibody	$137.76	$984.00	$12.69–$885.60	157% above	86%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR (LC)	$137.76	$984.00	$12.69–$885.60	157% above	86%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody (LC)	$137.76	$984.00	$137.76–$885.60	—	86%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCAB2	$137.76	$984.00	$137.76–$885.60	—	86%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody RFX to Quant PCR (LC)	$137.76	$984.00	$137.76–$885.60	—	86%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C IgG Antibody	$137.76	$984.00	$137.76–$885.60	—	86%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Diagnosis LC	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test CPT 87522 Allergen M006 IgE Alternaria alternata (LC)	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA, Quantitative Real Time PCR (CQ)	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$212.52	$1,518.00	$38.11–$1,366.20	4% below	86%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Allergen M006 IgE Alternaria alternata (LC)	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Diagnosis LC	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV RNA, Quantitative Real Time PCR (CQ)	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno. (LC)	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Non-Graph (LC)	$212.52	$1,518.00	$212.52–$1,366.20	—	86%
Herpes blood test, HSV-1 antibody CPT 86695 86695 HERPES SIMP TYPE 1	$98.14	$701.00	$11.73–$630.90	68% above	86%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG, Type Spec LC	$98.14	$701.00	$11.73–$630.90	68% above	86%
Herpes blood test, HSV-1 antibody CPT 86695 86695 L164099 HSV1	$98.14	$701.00	$11.73–$630.90	68% above	86%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus 1 Ab IgG	$98.14	$701.00	$11.73–$630.90	68% above	86%
Herpes blood test, HSV-1 antibody CPT 86695 86695 L164922 HSV1	$98.14	$701.00	$11.73–$630.90	68% above	86%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG, Type Spec LC	$98.14	$701.00	$98.14–$630.90	—	86%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 L164099 HSV1	$98.14	$701.00	$98.14–$630.90	—	86%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 L164922 HSV1	$98.14	$701.00	$98.14–$630.90	—	86%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus 1 Ab IgG	$98.14	$701.00	$98.14–$630.90	—	86%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 HERPES SIMP TYPE 1	$98.14	$701.00	$98.14–$630.90	—	86%
Herpes blood test, HSV-2 antibody CPT 86696 86696 L164922 HSV2	$43.40	$310.00	$17.21–$279.00	27% below	86%
Herpes blood test, HSV-2 antibody CPT 86696 86696 L164099 HSV2	$61.18	$437.00	$17.21–$393.30	3% above	86%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 L164922 HSV2	$43.40	$310.00	$43.40–$279.00	—	86%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 L164099 HSV2	$61.18	$437.00	$61.18–$393.30	—	86%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein Cardiac (LC)	$93.52	$668.00	$11.52–$601.20	72% above	86%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitivity	$93.52	$668.00	$11.52–$601.20	72% above	86%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein Cardiac (LC)	$93.52	$668.00	$93.52–$601.20	—	86%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein High Sensitivity	$93.52	$668.00	$93.52–$601.20	—	86%
Homocysteine blood test CPT 83090 Homocyst(e)ine Plasma LC	$164.22	$1,173.00	$15.94–$1,055.70	42% above	86%
Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine Plasma LC	$164.22	$1,173.00	$164.22–$1,055.70	—	86%
Insulin blood test CPT 83525 83525 L501561 INSULIN TOT	$100.94	$721.00	$10.17–$648.90	92% above	86%
Insulin blood test CPT 83525 83525 INSULIN, TOTAL	$100.94	$721.00	$10.17–$648.90	92% above	86%
Insulin blood test inpatient CPT 83525 83525 L501561 INSULIN TOT	$100.94	$721.00	$100.94–$648.90	—	86%
Insulin blood test inpatient CPT 83525 83525 INSULIN, TOTAL	$100.94	$721.00	$100.94–$648.90	—	86%
Iron blood test (serum iron) CPT 83540 83540 IRON	$92.54	$661.00	$5.75–$594.90	157% above	86%
Iron blood test (serum iron) CPT 83540 IRON	$92.54	$661.00	$5.75–$594.90	157% above	86%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$92.54	$661.00	$92.54–$594.90	—	86%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$92.54	$661.00	$92.54–$594.90	—	86%
Kidney function blood test panel CPT 80069 RFP	$203.70	$1,455.00	$7.72–$1,309.50	181% above	86%
Kidney function blood test panel inpatient CPT 80069 RFP	$203.70	$1,455.00	$203.70–$1,309.50	—	86%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$278.46	$1,989.00	$16.47–$1,790.10	282% above	86%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone S (LC)	$278.46	$1,989.00	$16.47–$1,790.10	282% above	86%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone S (LC)	$278.46	$1,989.00	$278.46–$1,790.10	—	86%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$278.46	$1,989.00	$278.46–$1,790.10	—	86%
Lactate (lactic acid) blood test CPT 83605 .ISTAT Lactate POC	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex 2	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid w/ Reflex LA	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test CPT 83605 .Lactate POC	$122.36	$874.00	$10.29–$786.60	130% above	86%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate (lactic acid) blood test inpatient CPT 83605 .ISTAT Lactate POC	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactate POC	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex 2	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid w/ Reflex LA	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex	$122.36	$874.00	$122.36–$786.60	—	86%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$99.40	$710.00	$5.37–$639.00	189% above	86%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid (LC)	$99.40	$710.00	$5.37–$639.00	189% above	86%
Lactate dehydrogenase (LDH) blood test CPT 83615 83615 LACTATE DEHYDROLDH	$99.40	$710.00	$5.37–$639.00	189% above	86%
Lactate dehydrogenase (LDH) blood test CPT 83615 83615 L1842 LACTATE DEHYDR	$99.40	$710.00	$5.37–$639.00	189% above	86%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$99.40	$710.00	$5.37–$639.00	189% above	86%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$99.40	$710.00	$99.40–$639.00	—	86%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid (LC)	$99.40	$710.00	$99.40–$639.00	—	86%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$99.40	$710.00	$99.40–$639.00	—	86%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 83615 L1842 LACTATE DEHYDR	$99.40	$710.00	$99.40–$639.00	—	86%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 83615 LACTATE DEHYDROLDH	$99.40	$710.00	$99.40–$639.00	—	86%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Peritoneal Fluid Sendout to CQ	$122.22	$873.00	$6.13–$785.70	134% above	86%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$122.22	$873.00	$6.13–$785.70	134% above	86%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid	$122.22	$873.00	$6.13–$785.70	134% above	86%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Pleural Fluid (CQ)	$122.22	$873.00	$6.13–$785.70	134% above	86%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Pleural Fluid (CQ)	$122.22	$873.00	$122.22–$785.70	—	86%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid	$122.22	$873.00	$122.22–$785.70	—	86%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Peritoneal Fluid Sendout to CQ	$122.22	$873.00	$122.22–$785.70	—	86%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$122.22	$873.00	$122.22–$785.70	—	86%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$49.56	$354.00	$7.27–$318.60	9% below	86%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$49.56	$354.00	$49.56–$318.60	—	86%
Lyme disease antibody test CPT 86618 86618 L139825 LYME DIS AB	$110.88	$792.00	$15.15–$712.80	48% above	86%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$110.88	$792.00	$15.15–$712.80	48% above	86%
Lyme disease antibody test CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$110.88	$792.00	$15.15–$712.80	48% above	86%
Lyme disease antibody test CPT 86618 86618 LYME DISEASE AB	$110.88	$792.00	$15.15–$712.80	48% above	86%
Lyme disease antibody test inpatient CPT 86618 C6 B burgdorferi w/Reflex WB (LC)	$110.88	$792.00	$110.88–$712.80	—	86%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$110.88	$792.00	$110.88–$712.80	—	86%
Lyme disease antibody test inpatient CPT 86618 86618 L139825 LYME DIS AB	$110.88	$792.00	$110.88–$712.80	—	86%
Lyme disease antibody test inpatient CPT 86618 86618 LYME DISEASE AB	$110.88	$792.00	$110.88–$712.80	—	86%
Magnesium blood test CPT 83735 Magnesium Urine	$62.58	$447.00	$5.96–$402.30	99% above	86%
Magnesium blood test CPT 83735 Magnesium Serum Obstetric	$62.58	$447.00	$5.96–$402.30	99% above	86%
Magnesium blood test CPT 83735 Magnesium Urine Sendout to LabCorp	$62.58	$447.00	$5.96–$402.30	99% above	86%
Magnesium blood test CPT 83735 Magnesium Serum	$62.58	$447.00	$5.96–$402.30	99% above	86%
Magnesium blood test inpatient CPT 83735 Magnesium Urine	$62.58	$447.00	$62.58–$402.30	—	86%
Magnesium blood test inpatient CPT 83735 Magnesium Serum Obstetric	$62.58	$447.00	$62.58–$402.30	—	86%
Magnesium blood test inpatient CPT 83735 Magnesium Urine Sendout to LabCorp	$62.58	$447.00	$62.58–$402.30	—	86%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$62.58	$447.00	$62.58–$402.30	—	86%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$35.98	$257.00	$11.46–$231.30	18% below	86%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibodies, IgG (LC)	$35.98	$257.00	$35.98–$231.30	—	86%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$150.08	$1,072.00	$4.61–$964.80	264% above	86%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$150.08	$1,072.00	$150.08–$964.80	—	86%
Mumps immunity blood test CPT 86735 Mumps Antibodies IgM Sendout to LabCorp	$35.70	$255.00	$11.61–$229.50	39% below	86%
Mumps immunity blood test CPT 86735 Mumps Antibodies IgG LC	$35.70	$255.00	$11.61–$229.50	39% below	86%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies IgM Sendout to LabCorp	$35.70	$255.00	$35.70–$229.50	—	86%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies IgG LC	$35.70	$255.00	$35.70–$229.50	—	86%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$124.74	$891.00	$16.36–$801.90	62% above	86%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Ag, Serum (RL)	$124.74	$891.00	$16.36–$801.90	62% above	86%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Ag, Serum (RL)	$124.74	$891.00	$124.74–$801.90	—	86%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$124.74	$891.00	$124.74–$801.90	—	86%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact (LC)	$442.40	$3,160.00	$36.72–$2,844.00	217% above	86%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Surgical	$442.40	$3,160.00	$36.72–$2,844.00	217% above	86%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$442.40	$3,160.00	$36.72–$2,844.00	217% above	86%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Intraop	$442.40	$3,160.00	$36.72–$2,844.00	217% above	86%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact (LC)	$442.40	$3,160.00	$442.40–$2,844.00	—	86%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Intraop	$442.40	$3,160.00	$442.40–$2,844.00	—	86%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Surgical	$442.40	$3,160.00	$442.40–$2,844.00	—	86%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$442.40	$3,160.00	$442.40–$2,844.00	—	86%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLAST TIMEPTT	$103.46	$739.00	$5.35–$665.10	221% above	86%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L117199 THROMBO TIME	$103.46	$739.00	$5.35–$665.10	221% above	86%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$103.46	$739.00	$5.35–$665.10	221% above	86%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLAST TIMEPTT	$103.46	$739.00	$103.46–$665.10	—	86%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$103.46	$739.00	$103.46–$665.10	—	86%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L117199 THROMBO TIME	$103.46	$739.00	$103.46–$665.10	—	86%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum	$126.56	$904.00	$4.22–$813.60	291% above	86%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum	$126.56	$904.00	$126.56–$813.60	—	86%
Potassium blood test CPT 84132 Potassium Serum	$90.44	$646.00	$4.23–$581.40	171% above	86%
Potassium blood test CPT 84132 84132 POTASSIUM SER PL WB	$90.44	$646.00	$4.23–$581.40	171% above	86%
Potassium blood test inpatient CPT 84132 Potassium Serum	$90.44	$646.00	$90.44–$581.40	—	86%
Potassium blood test inpatient CPT 84132 84132 POTASSIUM SER PL WB	$90.44	$646.00	$90.44–$581.40	—	86%
Progesterone blood test CPT 84144 Progesterone Sendout to LabCorp	$238.42	$1,703.00	$18.55–$1,532.70	218% above	86%
Progesterone blood test CPT 84144 Progesterone Level	$238.42	$1,703.00	$18.55–$1,532.70	218% above	86%
Progesterone blood test inpatient CPT 84144 Progesterone Sendout to LabCorp	$238.42	$1,703.00	$238.42–$1,532.70	—	86%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$238.42	$1,703.00	$238.42–$1,532.70	—	86%
Prolactin blood test CPT 84146 Prolactin Level	$237.44	$1,696.00	$17.24–$1,526.40	153% above	86%
Prolactin blood test CPT 84146 Prolactin LC	$237.44	$1,696.00	$17.24–$1,526.40	153% above	86%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$237.44	$1,696.00	$237.44–$1,526.40	—	86%
Prolactin blood test inpatient CPT 84146 Prolactin LC	$237.44	$1,696.00	$237.44–$1,526.40	—	86%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME	$100.52	$718.00	$3.82–$646.20	208% above	86%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$100.52	$718.00	$3.82–$646.20	208% above	86%
Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC	$100.52	$718.00	$3.82–$646.20	208% above	86%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC	$100.52	$718.00	$100.52–$646.20	—	86%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$100.52	$718.00	$100.52–$646.20	—	86%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME	$100.52	$718.00	$100.52–$646.20	—	86%
Rapid flu test (influenza antigen) CPT 87804 Influenza A Antigen Result	$32.90	$235.00	$14.72–$211.50	39% below	86%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen Result	$32.90	$235.00	$14.72–$211.50	39% below	86%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$32.90	$235.00	$14.72–$211.50	39% below	86%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$32.90	$235.00	$32.90–$211.50	—	86%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A Antigen Result	$32.90	$235.00	$32.90–$211.50	—	86%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen Result	$32.90	$235.00	$32.90–$211.50	—	86%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 .Rapid Strep A POC	$59.22	$423.00	$14.70–$380.70	22% above	86%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A FIA	$59.22	$423.00	$14.70–$380.70	22% above	86%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Streptococcus A Antigen IA1	$59.22	$423.00	$14.70–$380.70	22% above	86%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A FIA	$59.22	$423.00	$59.22–$380.70	—	86%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Streptococcus A Antigen IA1	$59.22	$423.00	$59.22–$380.70	—	86%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 .Rapid Strep A POC	$59.22	$423.00	$59.22–$380.70	—	86%
Renin blood test CPT 84244 Renin Activity Plasma LC	$74.34	$531.00	$19.56–$477.90	28% below	86%
Renin blood test CPT 84244 84244 L4354 RENIN	$74.34	$531.00	$19.56–$477.90	28% below	86%
Renin blood test inpatient CPT 84244 Renin Activity Plasma LC	$74.34	$531.00	$74.34–$477.90	—	86%
Renin blood test inpatient CPT 84244 84244 L4354 RENIN	$74.34	$531.00	$74.34–$477.90	—	86%
Rh blood typing CPT 86901 BB Bill Rh Test	$89.88	$642.00	$2.66–$577.80	92% above	86%
Rh blood typing inpatient CPT 86901 BB Bill Rh Test	$89.88	$642.00	$89.88–$577.80	—	86%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor (LC)	$12.74	$91.00	$5.04–$81.90	54% below	86%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor (LC)	$12.74	$91.00	$12.74–$81.90	—	86%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$94.64	$676.00	$12.80–$608.40	80% above	86%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody	$94.64	$676.00	$12.80–$608.40	80% above	86%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgG LC	$94.64	$676.00	$12.80–$608.40	80% above	86%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$94.64	$676.00	$94.64–$608.40	—	86%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgG LC	$94.64	$676.00	$94.64–$608.40	—	86%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody	$94.64	$676.00	$94.64–$608.40	—	86%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESRA	$35.70	$255.00	$2.40–$229.50	57% above	86%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESRA	$35.70	$255.00	$35.70–$229.50	—	86%
Sodium blood test CPT 84295 Sodium Serum	$55.30	$395.00	$4.28–$355.50	82% above	86%
Sodium blood test CPT 84295 84295 SODIUM,SER PL OR WB	$55.30	$395.00	$4.28–$355.50	82% above	86%
Sodium blood test inpatient CPT 84295 84295 SODIUM,SER PL OR WB	$55.30	$395.00	$55.30–$355.50	—	86%
Sodium blood test inpatient CPT 84295 Sodium Serum	$55.30	$395.00	$55.30–$355.50	—	86%
Stool ova and parasites exam CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$121.52	$868.00	$7.92–$781.20	111% above	86%
Stool ova and parasites exam inpatient CPT 87177 87177 L8623 OVA-PARASITES SMEARS	$121.52	$868.00	$121.52–$781.20	—	86%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$63.98	$457.00	$14.16–$411.30	14% above	86%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Feces Diagnostic 1-3 D	$63.98	$457.00	$14.16–$411.30	14% above	86%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$63.98	$457.00	$63.98–$411.30	—	86%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Feces Diagnostic 1-3 D	$63.98	$457.00	$63.98–$411.30	—	86%
Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Screening cascade LC	$52.78	$377.00	$11.78–$339.30	30% above	86%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibodies (LC)	$52.78	$377.00	$11.78–$339.30	30% above	86%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody w Rfx to RPR	$52.78	$377.00	$11.78–$339.30	30% above	86%
Syphilis antibody test (Treponema pallidum) CPT 86780 zzTreponema pallidum Ab FTA (LC)	$52.78	$377.00	$11.78–$339.30	30% above	86%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 zzTreponema pallidum Ab FTA (LC)	$52.78	$377.00	$52.78–$339.30	—	86%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Screening cascade LC	$52.78	$377.00	$52.78–$339.30	—	86%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibodies (LC)	$52.78	$377.00	$52.78–$339.30	—	86%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Antibody w Rfx to RPR	$52.78	$377.00	$52.78–$339.30	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .Rapid Plasma Reagin Qual w/Reflex Quant	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF LC	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Reflex Titer + TP-PA (LC)	$4.48	$32.00	$3.80–$28.80	84% below	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 .Rapid Plasma Reagin Qual w/Reflex Quant	$4.48	$32.00	$4.48–$28.80	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual	$4.48	$32.00	$4.48–$28.80	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual w/Reflex Quant	$4.48	$32.00	$4.48–$28.80	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF LC	$4.48	$32.00	$4.48–$28.80	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Reflex Titer + TP-PA (LC)	$4.48	$32.00	$4.48–$28.80	—	86%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$4.48	$32.00	$4.48–$28.80	—	86%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$151.62	$1,083.00	$55.13–$974.70	14% below	86%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC	$151.62	$1,083.00	$151.62–$974.70	—	86%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level LC	$311.22	$2,223.00	$22.96–$2,000.70	237% above	86%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$311.22	$2,223.00	$22.96–$2,000.70	237% above	86%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 TESTOSTERONE, TOTAL	$311.22	$2,223.00	$22.96–$2,000.70	237% above	86%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 L140103 TESTOST TOTA	$311.22	$2,223.00	$22.96–$2,000.70	237% above	86%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 L140103 TESTOST TOTA	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level LC	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 TESTOSTERONE, TOTAL	$311.22	$2,223.00	$311.22–$2,000.70	—	86%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 L6684 MICROSOMAL AB	$36.96	$264.00	$12.94–$237.60	38% below	86%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 MICROSOMAL AB	$36.96	$264.00	$12.94–$237.60	38% below	86%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (LC)	$36.96	$264.00	$12.94–$237.60	38% below	86%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (LC)	$36.96	$264.00	$36.96–$237.60	—	86%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 L6684 MICROSOMAL AB	$36.96	$264.00	$36.96–$237.60	—	86%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 MICROSOMAL AB	$36.96	$264.00	$36.96–$237.60	—	86%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$157.92	$1,128.00	$14.94–$1,015.20	194% above	86%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex to T4 Total	$157.92	$1,128.00	$14.94–$1,015.20	194% above	86%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$157.92	$1,128.00	$14.94–$1,015.20	194% above	86%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex to T4 Total	$157.92	$1,128.00	$157.92–$1,015.20	—	86%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$157.92	$1,128.00	$157.92–$1,015.20	—	86%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$157.92	$1,128.00	$157.92–$1,015.20	—	86%
Total IgE blood test CPT 82785 Immunoglobulin E Total (LC)	$85.54	$611.00	$14.64–$549.90	65% above	86%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E Total (LC)	$85.54	$611.00	$85.54–$549.90	—	86%
Total cholesterol blood test CPT 82465 Cholesterol Body Fluid	$115.64	$826.00	$3.87–$743.40	250% above	86%
Total cholesterol blood test CPT 82465 Cholesterol	$115.64	$826.00	$3.87–$743.40	250% above	86%
Total cholesterol blood test inpatient CPT 82465 Cholesterol	$115.64	$826.00	$115.64–$743.40	—	86%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Body Fluid	$115.64	$826.00	$115.64–$743.40	—	86%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 Total	$90.02	$643.00	$6.11–$578.70	113% above	86%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 (LC)	$90.02	$643.00	$6.11–$578.70	113% above	86%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 (LC)	$90.02	$643.00	$90.02–$578.70	—	86%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 Total	$90.02	$643.00	$90.02–$578.70	—	86%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (LC)	$175.42	$1,253.00	$12.61–$1,127.70	197% above	86%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (LC)	$175.42	$1,253.00	$175.42–$1,127.70	—	86%
Transferrin blood test CPT 84466 TRANSF	$91.84	$656.00	$11.35–$590.40	60% above	86%
Transferrin blood test CPT 84466 84466 TRANSFERRIN	$91.84	$656.00	$11.35–$590.40	60% above	86%
Transferrin blood test inpatient CPT 84466 TRANSF	$91.84	$656.00	$91.84–$590.40	—	86%
Transferrin blood test inpatient CPT 84466 84466 TRANSFERRIN	$91.84	$656.00	$91.84–$590.40	—	86%
Trichomonas test (NAAT) CPT 87661 87661 L183160 T VAG AMP	$36.40	$260.00	$31.21–$234.00	59% below	86%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (LC)	$78.82	$563.00	$31.21–$506.70	10% below	86%
Trichomonas test (NAAT) inpatient CPT 87661 87661 L183160 T VAG AMP	$36.40	$260.00	$36.40–$234.00	—	86%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (LC)	$78.82	$563.00	$78.82–$506.70	—	86%
Triglycerides blood test CPT 84478 Triglycerides Body Fluid	$168.42	$1,203.00	$5.11–$1,082.70	400% above	86%
Triglycerides blood test CPT 84478 Triglycerides	$168.42	$1,203.00	$5.11–$1,082.70	400% above	86%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$168.42	$1,203.00	$168.42–$1,082.70	—	86%
Triglycerides blood test inpatient CPT 84478 Triglycerides Body Fluid	$168.42	$1,203.00	$168.42–$1,082.70	—	86%
Troponin test, quantitative CPT 84484 .Troponin T Quant 1 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin T Quant x 3 Series	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin I HS x 3 Series	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I HS 2 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I HS 4 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin I Quant x 3 Series	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin T Quant 4 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I Quant 4 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin T Quant 3 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I Quant 1 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin T HS 3 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin T HS x 3 Series	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .ISTAT cTroponin I POC	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin T HS 1 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I Quant POC	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin I Quant	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin T HS	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin T Quant	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I HS 3 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I Quant 3 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin I HS	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I Quant 2 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 Troponin I (LC)	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative CPT 84484 .Troponin I HS 1 Hour	$120.82	$863.00	$11.09–$776.70	74% above	86%
Troponin test, quantitative inpatient CPT 84484 Troponin T Quant x 3 Series	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin I HS	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin I HS x 3 Series	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 4 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin T Quant 4 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 2 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin I (LC)	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin T Quant	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin I Quant	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant POC	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .ISTAT cTroponin I POC	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin T HS 1 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin T HS x 3 Series	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin T HS 3 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 1 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin T Quant 3 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin T Quant 1 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 1 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 3 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 3 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin T HS	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 4 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 Troponin I Quant x 3 Series	$120.82	$863.00	$120.82–$776.70	—	86%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 2 Hour	$120.82	$863.00	$120.82–$776.70	—	86%
Uric acid blood test CPT 84550 Uric Acid Level	$100.10	$715.00	$4.02–$643.50	279% above	86%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$100.10	$715.00	$100.10–$643.50	—	86%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Microscopic Automated	$76.58	$547.00	$2.82–$492.30	140% above	86%
Urinalysis with microscope exam, automated CPT 81001 Perform Microscopic - Yes	$76.58	$547.00	$2.82–$492.30	140% above	86%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$76.58	$547.00	$2.82–$492.30	140% above	86%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Microscopic Automated	$76.58	$547.00	$76.58–$492.30	—	86%
Urinalysis with microscope exam, automated inpatient CPT 81001 Perform Microscopic - Yes	$76.58	$547.00	$76.58–$492.30	—	86%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$76.58	$547.00	$76.58–$492.30	—	86%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Auto	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic Automated	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Perform Microscopic - No	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Ketones Urine Dipstk Qual Automated	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated CPT 81003 Reflex Microscopic Type? - Not Required	$53.48	$382.00	$2.00–$343.80	282% above	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Auto	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Perform Microscopic - No	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones Urine Dipstk Qual Automated	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic Automated	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 Reflex Microscopic Type? - Not Required	$53.48	$382.00	$53.48–$343.80	—	86%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$53.48	$382.00	$53.48–$343.80	—	86%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$141.82	$1,013.00	$7.18–$911.70	195% above	86%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$141.82	$1,013.00	$141.82–$911.70	—	86%
Urine microalbumin (albumin) test CPT 82043 82043 L140285 MICROALB QT	$74.48	$532.00	$5.14–$478.80	94% above	86%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine 24 Hour	$74.48	$532.00	$5.14–$478.80	94% above	86%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Quant	$74.48	$532.00	$5.14–$478.80	94% above	86%
Urine microalbumin (albumin) test CPT 82043 MicroAlb QNT Random	$74.48	$532.00	$5.14–$478.80	94% above	86%
Urine microalbumin (albumin) test CPT 82043 82043 MICROALB QNT	$74.48	$532.00	$5.14–$478.80	94% above	86%
Urine microalbumin (albumin) test inpatient CPT 82043 82043 L140285 MICROALB QT	$74.48	$532.00	$74.48–$478.80	—	86%
Urine microalbumin (albumin) test inpatient CPT 82043 MicroAlb QNT Random	$74.48	$532.00	$74.48–$478.80	—	86%
Urine microalbumin (albumin) test inpatient CPT 82043 82043 MICROALB QNT	$74.48	$532.00	$74.48–$478.80	—	86%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 24 Hour	$74.48	$532.00	$74.48–$478.80	—	86%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Quant	$74.48	$532.00	$74.48–$478.80	—	86%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Positive	$62.86	$449.00	$7.66–$404.10	130% above	86%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result - Negative	$62.86	$449.00	$7.66–$404.10	130% above	86%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$62.86	$449.00	$7.66–$404.10	130% above	86%
Urine pregnancy test, read by color change CPT 81025 .HCG Urine Ql POC	$62.86	$449.00	$7.66–$404.10	130% above	86%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$62.86	$449.00	$7.66–$404.10	130% above	86%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$62.86	$449.00	$62.86–$404.10	—	86%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$62.86	$449.00	$62.86–$404.10	—	86%
Urine pregnancy test, read by color change inpatient CPT 81025 .HCG Urine Ql POC	$62.86	$449.00	$62.86–$404.10	—	86%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Negative	$62.86	$449.00	$62.86–$404.10	—	86%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result - Positive	$62.86	$449.00	$62.86–$404.10	—	86%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$106.40	$760.00	$13.41–$684.00	66% above	86%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$106.40	$760.00	$106.40–$684.00	—	86%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$92.96	$664.00	$26.33–$597.60	24% below	86%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$92.96	$664.00	$92.96–$597.60	—	86%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol Level (LC)	$86.52	$618.00	$34.25–$556.20	44% below	86%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol Level (LC)	$86.52	$618.00	$86.52–$556.20	—	86%
Zinc blood test CPT 84630 Zinc Plasma or Serum (LC)	$36.54	$261.00	$10.13–$234.90	37% below	86%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (LC)	$36.54	$261.00	$36.54–$234.90	—	86%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 HCG QUANT	$357.84	$2,556.00	$13.39–$2,300.40	483% above	86%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$357.84	$2,556.00	$13.39–$2,300.40	483% above	86%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 L17319 HCG QUANT	$357.84	$2,556.00	$13.39–$2,300.40	483% above	86%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 L17319 HCG QUANT	$357.84	$2,556.00	$357.84–$2,300.40	—	86%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 HCG QUANT	$357.84	$2,556.00	$357.84–$2,300.40	—	86%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$357.84	$2,556.00	$357.84–$2,300.40	—	86%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$4,696.58	$33,547.00	$201.09–$30,192.30	2% above	86%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY	$17,344.18	$123,887.00	$917.27–$111,498.30	at median	86%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR	$18,282.74	$130,591.00	$1,005.40–$117,531.90	29% above	86%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$4,840.78	$34,577.00	$142.70–$31,119.30	1816% above	86%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 COR HLX VLGS DSTL MTAR OSTEO	$9,484.86	$67,749.00	$814.50–$60,974.10	108% above	86%
Bunion correction with removal of part of the big toe joint CPT 28292 COR HLX VLGS RSC PRX PHLX BS	$9,155.44	$65,396.00	$648.51–$58,856.40	38% above	86%
Cardiac catheterization with coronary angiogram CPT 93458 CC-L HRT ARTERY-VENT[OKAH]	$6,845.72	$48,898.00	$657.41–$44,008.20	5% above	86%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$15,142.96	$108,164.00	$657.41–$97,347.60	132% above	86%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CC-L HRT ARTERY-VENT[OKAH]	$6,845.72	$48,898.00	$6,845.72–$44,008.20	—	86%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION[OKAH]	$658.70	$4,705.00	$143.00–$4,234.50	29% below	86%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion	$658.70	$4,705.00	$143.00–$4,234.50	29% below	86%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$658.70	$4,705.00	$143.00–$4,234.50	29% below	86%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$658.70	$4,705.00	$143.00–$4,234.50	29% below	86%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$4,190.20	$29,930.00	$143.00–$26,937.00	351% above	86%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion	$658.70	$4,705.00	$658.70–$4,234.50	—	86%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$658.70	$4,705.00	$658.70–$4,234.50	—	86%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$658.70	$4,705.00	$658.70–$4,234.50	—	86%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION[OKAH]	$658.70	$4,705.00	$658.70–$4,234.50	—	86%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$6,660.08	$47,572.00	$418.78–$42,814.80	159% above	86%
Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP	$4,629.66	$33,069.00	$503.94–$29,762.10	35% above	86%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$7,016.66	$50,119.00	$141.16–$45,107.10	556% above	86%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$9,926.98	$70,907.00	$186.59–$63,816.30	241% above	86%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$1,704.92	$12,178.00	$138.55–$10,960.20	211% above	86%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$1,857.10	$13,265.00	$205.90–$11,938.50	251% above	86%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL	$3,700.76	$26,434.00	$418.49–$23,790.60	122% above	86%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$3,511.34	$25,081.00	$397.05–$22,572.90	121% above	86%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$3,335.36	$23,824.00	$312.96–$21,441.60	129% above	86%
Coronary stent placement, one artery CPT 92928 IC-PRQ CRD STN W-ANG[OKAH]	$10,414.88	$74,392.00	$543.17–$66,952.80	at median	86%
Coronary stent placement, one artery inpatient CPT 92928 IC-PRQ CRD STN W-ANG[OKAH]	$10,414.88	$74,392.00	$10,414.88–$66,952.80	—	86%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$15,831.76	$113,084.00	$364.94–$101,775.60	161% above	86%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$7,311.22	$52,223.00	$218.31–$47,000.70	951% above	86%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$7,702.80	$55,020.00	$278.99–$49,518.00	72% above	86%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$3,318.70	$23,705.00	$150.09–$21,334.50	10% above	86%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$652.54	$4,661.00	$14.21–$4,194.90	956% above	86%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$5,160.12	$36,858.00	$44.71–$33,172.20	6606% above	86%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$7,216.02	$51,543.00	$94.63–$46,388.70	2441% above	86%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CT Inj Catheter Placement C-T w Imaging	$1,076.74	$7,691.00	$240.59–$6,921.90	63% above	86%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$2,619.96	$18,714.00	$240.59–$16,842.60	297% above	86%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CT Inj Catheter Placement C-T w Imaging	$1,076.74	$7,691.00	$1,076.74–$6,921.90	—	86%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$2,571.38	$18,367.00	$163.21–$16,530.30	125% above	86%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$18,067.70	$129,055.00	$539.23–$116,149.50	163% above	86%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$8,152.34	$58,231.00	$321.76–$52,407.90	68% above	86%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$2,642.08	$18,872.00	$168.53–$16,984.80	147% above	86%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$17,269.00	$123,350.00	$621.94–$111,015.00	174% above	86%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$18,055.24	$128,966.00	$676.23–$116,069.40	119% above	86%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$15,529.78	$110,927.00	$500.23–$99,834.30	260% above	86%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$7,908.32	$56,488.00	$260.65–$50,839.20	588% above	86%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$7,058.24	$50,416.00	$479.75–$45,374.40	49% above	86%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$159.74	$1,141.00	$159.74–$1,026.90	17% below	86%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$669.34	$4,781.00	$218.15–$4,302.90	249% above	86%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$159.74	$1,141.00	$159.74–$1,026.90	—	86%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$8,954.54	$63,961.00	$1,872.71–$57,564.90	12% above	86%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$6,779.78	$48,427.00	$1,186.31–$43,584.30	34% above	86%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$2,104.48	$15,032.00	$117.68–$13,528.80	700% above	86%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$11,904.76	$85,034.00	$492.87–$76,530.60	145% above	86%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$3,053.96	$21,814.00	$54.07–$19,632.60	1158% above	86%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 S-JNT ASP INJ MAJ UN	$1,265.32	$9,038.00	$60.66–$8,134.20	231% above	86%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$4,409.30	$31,495.00	$60.66–$28,345.50	1053% above	86%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 S-JNT ASP INJ MAJ UN	$1,265.32	$9,038.00	$1,265.32–$8,134.20	—	86%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$4,544.96	$32,464.00	$51.47–$29,217.60	1584% above	86%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$7,273.70	$51,955.00	$50.21–$46,759.50	2733% above	86%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY	$9,688.14	$69,201.00	$649.88–$62,280.90	25% above	86%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$10,002.02	$71,443.00	$511.25–$64,298.70	40% above	86%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$8,575.14	$61,251.00	$530.74–$55,125.90	27% above	86%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY	$10,028.06	$71,629.00	$586.07–$64,466.10	48% above	86%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$15,844.64	$113,176.00	$567.42–$101,858.40	223% above	86%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY	$22,501.36	$160,724.00	$1,012.44–$144,651.60	52% above	86%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS	$18,968.88	$135,492.00	$765.16–$121,942.80	35% above	86%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$20,696.20	$147,830.00	$861.38–$133,047.00	33% above	86%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$21,695.24	$154,966.00	$408.02–$139,469.40	195% above	86%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$10,788.68	$77,062.00	$619.00–$69,355.80	3% below	86%
Left heart catheterization, diagnostic CPT 93452 CC-LHC VENT PUNC[OKAH]	$4,303.04	$30,736.00	$582.08–$27,662.40	9% below	86%
Left heart catheterization, diagnostic inpatient CPT 93452 CC-LHC VENT PUNC[OKAH]	$4,303.04	$30,736.00	$4,303.04–$27,662.40	—	86%
Lower-back epidural injection, with imaging guidance CPT 62323 CT Inj Catheter Placement L-S w Imaging	$1,076.74	$7,691.00	$236.22–$6,921.90	37% above	86%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$2,638.72	$18,848.00	$236.22–$16,963.20	235% above	86%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT Inj Catheter Placement L-S w Imaging	$1,076.74	$7,691.00	$1,076.74–$6,921.90	—	86%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$1,775.20	$12,680.00	$125.60–$11,412.00	181% above	86%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$2,229.22	$15,923.00	$225.90–$14,330.70	129% above	86%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$15,061.90	$107,585.00	$621.22–$96,826.50	257% above	86%
Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE	$15,411.48	$110,082.00	$901.19–$99,073.80	66% above	86%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$5,517.82	$39,413.00	$410.29–$35,471.70	26% above	86%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$521.08	$3,722.00	$106.20–$3,349.80	136% above	86%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$2,947.00	$21,050.00	$70.17–$18,945.00	654% above	86%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$30,298.80	$216,420.00	$478.20–$194,778.00	164% above	86%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image	$884.10	$6,315.00	$265.07–$5,683.50	5% below	86%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,137.64	$8,126.00	$265.07–$7,313.40	22% above	86%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image	$884.10	$6,315.00	$884.10–$5,683.50	—	86%
Partial knee replacement (one compartment) CPT 27446 REVISION OF KNEE JOINT	$30,193.80	$215,670.00	$1,078.95–$194,103.00	37% above	86%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$5,537.28	$39,552.00	$148.95–$35,596.80	1162% above	86%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$7,209.44	$51,496.00	$222.70–$46,346.40	121% above	86%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$3,140.76	$22,434.00	$404.50–$20,190.60	77% above	86%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$6,597.78	$47,127.00	$484.20–$42,414.30	250% above	86%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$903.70	$6,455.00	$140.17–$5,809.50	128% above	86%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$3,451.00	$24,650.00	$313.24–$22,185.00	163% above	86%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$3,328.08	$23,772.00	$312.96–$21,394.80	151% above	86%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$12,676.86	$90,549.00	$628.67–$81,494.10	138% above	86%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Extracorporeal Shockwave Lithotripsy	$14,144.90	$101,035.00	$692.52–$90,931.50	53% above	86%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$19,611.20	$140,080.00	$692.52–$126,072.00	112% above	86%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Extracorporeal Shockwave Lithotripsy	$14,144.90	$101,035.00	$14,144.90–$90,931.50	—	86%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$1,297.52	$9,268.00	$62.38–$8,341.20	832% above	86%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$1,767.50	$12,625.00	$67.91–$11,362.50	735% above	86%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$12,595.66	$89,969.00	$160.64–$80,972.10	28% above	86%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$1,173.62	$8,383.00	$86.86–$7,544.70	493% above	86%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$2,964.92	$21,178.00	$133.93–$19,060.20	358% above	86%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$1,576.54	$11,261.00	$105.59–$10,134.90	626% above	86%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$1,941.10	$13,865.00	$103.59–$12,478.50	913% above	86%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$12,532.24	$89,516.00	$688.06–$80,564.40	106% above	86%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis w Imaging Guidance	$728.28	$5,202.00	$266.83–$4,681.80	6% above	86%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis w Imaging Guidance	$728.28	$5,202.00	$728.28–$4,681.80	—	86%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$6,011.32	$42,938.00	$288.23–$38,644.20	26% above	86%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$5,611.90	$40,085.00	$276.21–$36,076.50	4% above	86%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS	$8,342.60	$59,590.00	$241.97–$53,631.00	80% above	86%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$31,194.80	$222,820.00	$1,206.39–$200,538.00	74% above	86%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT	$34,868.40	$249,060.00	$1,357.02–$224,154.00	23% above	86%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$8,045.80	$57,470.00	$537.98–$51,723.00	343% above	86%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$2,115.40	$15,110.00	$49.05–$13,599.00	656% above	86%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$8,654.80	$61,820.00	$352.49–$55,638.00	7% above	86%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$1,517.88	$10,842.00	$449.35–$9,757.80	16% below	86%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$1,603.00	$11,450.00	$420.73–$10,305.00	11% below	86%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$1,603.00	$11,450.00	$420.73–$10,305.00	11% below	86%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$1,603.00	$11,450.00	$1,603.00–$10,305.00	—	86%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$1,603.00	$11,450.00	$1,603.00–$10,305.00	—	86%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$2,767.66	$19,769.00	$959.08–$17,792.10	46% above	86%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$3,142.16	$22,444.00	$342.45–$20,199.60	178% above	86%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$3,218.74	$22,991.00	$450.16–$20,691.90	30% above	86%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$3,087.14	$22,051.00	$262.87–$19,845.90	170% above	86%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$12,188.96	$87,064.00	$389.51–$78,357.60	at median	86%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$7,681.66	$54,869.00	$310.45–$49,382.10	219% above	86%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$5,633.18	$40,237.00	$956.74–$36,213.30	14% below	86%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$4,880.54	$34,861.00	$104.09–$31,374.90	2791% above	86%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$868.14	$6,201.00	$119.00–$5,580.90	72% above	86%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 OPTX DST RD XARTC FX/EPI SEP	$17,518.48	$125,132.00	$700.13–$112,618.80	42% above	86%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$297.36	$2,124.00	$37.59–$1,911.60	57% below	86%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$6,804.98	$48,607.00	$37.59–$43,746.30	887% above	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$297.36	$2,124.00	$297.36–$1,911.60	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$136.22	$973.00	$6.64–$875.70	2% above	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$136.22	$973.00	$136.22–$875.70	—	86%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$136.22	$973.00	$136.22–$875.70	—	86%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$674.24	$4,816.00	$257.85–$4,334.40	44% below	86%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$674.24	$4,816.00	$674.24–$4,334.40	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$102.76	$734.00	$5.25–$660.60	19% below	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$102.76	$734.00	$102.76–$660.60	—	86%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$102.76	$734.00	$102.76–$660.60	—	86%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$105.00	$750.00	$10.91–$675.00	34% below	86%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$105.00	$750.00	$105.00–$675.00	—	86%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$177.52	$1,268.00	$39.89–$1,141.20	44% below	86%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$177.52	$1,268.00	$177.52–$1,141.20	—	86%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$264.74	$1,891.00	$67.94–$1,701.90	50% below	86%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 $ED Cricothyrotomy	$510.58	$3,647.00	$67.94–$3,282.30	3% below	86%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$264.74	$1,891.00	$264.74–$1,701.90	—	86%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 $ED Cricothyrotomy	$510.58	$3,647.00	$510.58–$3,282.30	—	86%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$400.82	$2,863.00	$115.67–$2,576.70	47% below	86%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$400.82	$2,863.00	$400.82–$2,576.70	—	86%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$556.92	$3,978.00	$167.65–$3,580.20	52% below	86%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Trauma Notification Level - No Prior Notification	$612.92	$4,378.00	$167.65–$3,940.20	47% below	86%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$556.92	$3,978.00	$556.92–$3,580.20	—	86%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Trauma Notification Level - No Prior Notification	$612.92	$4,378.00	$612.92–$3,940.20	—	86%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI Stress Test	$952.42	$6,803.00	$31.33–$6,122.70	146% above	86%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$952.42	$6,803.00	$31.33–$6,122.70	146% above	86%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI Stress Test	$952.42	$6,803.00	$952.42–$6,122.70	—	86%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$952.42	$6,803.00	$952.42–$6,122.70	—	86%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$256.48	$1,832.00	$29.36–$1,648.80	34% above	86%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$256.48	$1,832.00	$29.36–$1,648.80	34% above	86%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$256.48	$1,832.00	$29.36–$1,648.80	34% above	86%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$256.48	$1,832.00	$29.36–$1,648.80	34% above	86%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$256.48	$1,832.00	$256.48–$1,648.80	—	86%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$256.48	$1,832.00	$256.48–$1,648.80	—	86%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$256.48	$1,832.00	$256.48–$1,648.80	—	86%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$256.48	$1,832.00	$256.48–$1,648.80	—	86%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$247.24	$1,766.00	$56.42–$1,589.40	4% above	86%
IV infusion of a medicine, first hour CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$247.24	$1,766.00	$56.42–$1,589.40	4% above	86%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$247.24	$1,766.00	$56.42–$1,589.40	4% above	86%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$247.24	$1,766.00	$56.42–$1,589.40	4% above	86%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$247.24	$1,766.00	$247.24–$1,589.40	—	86%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$247.24	$1,766.00	$247.24–$1,589.40	—	86%
IV infusion of a medicine, first hour inpatient CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$247.24	$1,766.00	$247.24–$1,589.40	—	86%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$247.24	$1,766.00	$247.24–$1,589.40	—	86%
IV push of a medicine, first drug CPT 96374 IV push initial	$184.10	$1,315.00	$33.23–$1,183.50	22% above	86%
IV push of a medicine, first drug CPT 96374 96374 - IV Injection, single/initial	$184.10	$1,315.00	$33.23–$1,183.50	22% above	86%
IV push of a medicine, first drug CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$184.10	$1,315.00	$33.23–$1,183.50	22% above	86%
IV push of a medicine, first drug CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$184.10	$1,315.00	$33.23–$1,183.50	22% above	86%
IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Injection, single/initial	$184.10	$1,315.00	$184.10–$1,183.50	—	86%
IV push of a medicine, first drug inpatient CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$184.10	$1,315.00	$184.10–$1,183.50	—	86%
IV push of a medicine, first drug inpatient CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$184.10	$1,315.00	$184.10–$1,183.50	—	86%
IV push of a medicine, first drug inpatient CPT 96374 IV push initial	$184.10	$1,315.00	$184.10–$1,183.50	—	86%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$115.36	$824.00	$13.34–$741.60	72% above	86%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$115.36	$824.00	$13.34–$741.60	72% above	86%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$115.36	$824.00	$13.34–$741.60	72% above	86%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$115.36	$824.00	$13.34–$741.60	72% above	86%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$115.36	$824.00	$115.36–$741.60	—	86%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$115.36	$824.00	$115.36–$741.60	—	86%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$115.36	$824.00	$115.36–$741.60	—	86%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$115.36	$824.00	$115.36–$741.60	—	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 IRF PT EVAL HIGH	$110.46	$789.00	$61.16–$710.10	31% below	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$110.46	$789.00	$61.16–$710.10	31% below	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$110.46	$789.00	$61.16–$710.10	31% below	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$110.46	$789.00	$110.46–$710.10	—	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 IRF PT EVAL HIGH	$110.46	$789.00	$110.46–$710.10	—	86%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$110.46	$789.00	$110.46–$710.10	—	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$78.12	$558.00	$61.16–$502.20	30% below	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 IRF PT EVAL LOW	$78.12	$558.00	$61.16–$502.20	30% below	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$78.12	$558.00	$61.16–$502.20	30% below	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$78.12	$558.00	$78.12–$502.20	—	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 IRF PT EVAL LOW	$78.12	$558.00	$78.12–$502.20	—	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$78.12	$558.00	$78.12–$502.20	—	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 IRF PT EVAL MOD	$93.38	$667.00	$61.16–$600.30	30% below	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$93.38	$667.00	$61.16–$600.30	30% below	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$93.38	$667.00	$61.16–$600.30	30% below	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$93.38	$667.00	$93.38–$600.30	—	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 IRF PT EVAL MOD	$93.38	$667.00	$93.38–$600.30	—	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$93.38	$667.00	$93.38–$600.30	—	86%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$37.24	$266.00	$26.32–$239.40	45% below	86%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$37.24	$266.00	$26.32–$239.40	45% below	86%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$62.02	$443.00	$26.32–$398.70	8% below	86%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$62.02	$443.00	$26.32–$398.70	8% below	86%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$62.02	$443.00	$26.32–$398.70	8% below	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$37.24	$266.00	$37.24–$239.40	—	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$37.24	$266.00	$37.24–$239.40	—	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$62.02	$443.00	$62.02–$398.70	—	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$62.02	$443.00	$62.02–$398.70	—	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$62.02	$443.00	$62.02–$398.70	—	86%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$739.62	$5,283.00	$85.43–$4,754.70	455% above	86%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$399.56	$2,854.00	$111.15–$2,568.60	118% above	86%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$399.56	$2,854.00	$111.15–$2,568.60	118% above	86%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$399.56	$2,854.00	$111.15–$2,568.60	118% above	86%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge - Yes	$399.56	$2,854.00	$111.15–$2,568.60	118% above	86%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge - Yes	$399.56	$2,854.00	$399.56–$2,568.60	—	86%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$399.56	$2,854.00	$399.56–$2,568.60	—	86%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$399.56	$2,854.00	$399.56–$2,568.60	—	86%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$399.56	$2,854.00	$399.56–$2,568.60	—	86%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$103.46	$739.00	$68.93–$665.10	17% below	86%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$103.46	$739.00	$68.93–$665.10	17% below	86%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$103.46	$739.00	$68.93–$665.10	17% below	86%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$103.46	$739.00	$68.93–$665.10	17% below	86%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$103.46	$739.00	$103.46–$665.10	—	86%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$103.46	$739.00	$103.46–$665.10	—	86%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$103.46	$739.00	$103.46–$665.10	—	86%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$103.46	$739.00	$103.46–$665.10	—	86%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$103.88	$742.00	$23.30–$667.80	52% below	86%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$103.88	$742.00	$103.88–$667.80	—	86%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$372.40	$2,660.00	$33.19–$2,394.00	5% below	86%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$372.40	$2,660.00	$372.40–$2,394.00	—	86%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therap Phlebotomy	$72.24	$516.00	$72.24–$464.40	41% below	86%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$72.24	$516.00	$72.24–$464.40	41% below	86%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$72.24	$516.00	$72.24–$464.40	41% below	86%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therap Phlebotomy	$72.24	$516.00	$72.24–$464.40	—	86%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$72.24	$516.00	$72.24–$464.40	—	86%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$72.24	$516.00	$72.24–$464.40	—	86%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$258.89	$1,849.20	$124.55–$1,664.28	141% above	86%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$258.89	$1,849.20	$124.55–$1,664.28	141% above	86%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$258.89	$1,849.20	$258.89–$1,664.28	—	86%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$258.89	$1,849.20	$258.89–$1,664.28	—	86%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$336.26	$2,401.84	$175.54–$2,161.66	19% above	86%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$336.26	$2,401.84	$175.54–$2,161.66	19% above	86%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$336.26	$2,401.84	$175.54–$2,161.66	19% above	86%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$336.26	$2,401.84	$175.54–$2,161.66	19% above	86%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4055-00 - varicella virus vaccine - Powder	$336.26	$2,401.84	$336.26–$2,161.66	—	86%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$336.26	$2,401.84	$336.26–$2,161.66	—	86%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$336.26	$2,401.84	$336.26–$2,161.66	—	86%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$336.26	$2,401.84	$336.26–$2,161.66	—	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0562-10 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$55.43–$1,305.00	185% above	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$55.43–$1,305.00	185% above	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$55.43–$1,305.00	185% above	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$55.43–$1,305.00	185% above	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0562-10 - diphtheria/pertussis,acel/tetanus/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$30.24–$1,305.00	199% above	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$30.24–$1,305.00	199% above	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$30.24–$1,305.00	199% above	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$30.24–$1,305.00	199% above	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 58160-0811-52 - diphtheria/hepB/pertussis,acel/pol	$203.00	$1,450.00	$88.22–$1,305.00	58% above	86%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 58160-0811-52 - diphtheria/hepB/pertussis,acel/pol	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$203.00	$1,450.00	$116.87–$1,305.00	165% above	86%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 49281-0511-05 - diphth/haemophilus/pertussis/tetan	$203.00	$1,450.00	$116.87–$1,305.00	165% above	86%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 49281-0511-05 - diphth/haemophilus/pertussis/tetan	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$78.17–$1,450.00	—	86%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$20.93–$1,305.00	299% above	86%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$203.00	$1,450.00	$20.93–$1,305.00	299% above	86%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$522.13	$3,729.47	$287.31–$3,356.52	118% above	86%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$522.13	$3,729.47	$522.13–$3,356.52	—	86%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$236.48	$1,689.15	$127.08–$1,520.24	42% above	86%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$236.48	$1,689.15	$236.48–$1,520.24	—	86%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$87.40–$1,305.00	16% above	86%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$203.00	$1,450.00	$87.40–$1,305.00	16% above	86%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$87.40–$1,305.00	16% above	86%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$87.40–$1,305.00	16% above	86%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$203.00	$1,450.00	$87.40–$1,305.00	16% above	86%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$203.00	$1,450.00	$26.86–$1,305.00	139% above	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$203.00	$1,450.00	$65.89–$1,305.00	112% above	86%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$203.00	$1,450.00	$65.89–$1,305.00	112% above	86%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$203.00	$1,450.00	$65.89–$1,305.00	112% above	86%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$203.00	$1,450.00	$65.89–$1,305.00	112% above	86%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$28.81–$1,305.00	238% above	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$203.00	$1,450.00	$12.65–$1,305.00	340% above	86%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$203.00	$1,450.00	$12.65–$1,305.00	340% above	86%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$203.00	$1,450.00	$69.73–$1,305.00	19% above	86%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$69.73–$1,305.00	19% above	86%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$203.00	$1,450.00	$69.73–$1,305.00	19% above	86%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0405-65 - 2019-2020 influenza virus vaccine,	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$203.00	$1,450.00	$97.11–$1,305.00	24% above	86%
MMR vaccine (measles, mumps and rubella), live CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$203.00	$1,450.00	$97.11–$1,305.00	24% above	86%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 49999-0422-01 - measles/mumps/rubella virus vaccin	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$510.44	$3,646.00	$133.54–$3,281.40	175% above	86%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$510.44	$3,646.00	$133.54–$3,281.40	175% above	86%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$510.44	$3,646.00	$510.44–$3,281.40	—	86%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$510.44	$3,646.00	$510.44–$3,281.40	—	86%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$204.15	$1,458.18	$138.57–$1,312.36	27% above	86%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$278.09	$1,986.38	$138.57–$1,787.74	73% above	86%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$204.15	$1,458.18	$204.15–$1,312.36	—	86%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 46028-0208-01 - meningococcal conjugate vaccine RE	$278.09	$1,986.38	$278.09–$1,787.74	—	86%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$216.60	$1,547.12	$155.65–$1,547.12	at median	86%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$216.60	$1,547.12	$216.60–$1,392.41	—	86%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$402.11	$2,872.23	$208.45–$2,585.01	26% above	86%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$402.11	$2,872.23	$402.11–$2,585.01	—	86%
Nasal spray flu vaccine, live (FluMist) CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$45.32	$323.71	$27.03–$323.71	—	86%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$45.32	$323.71	$45.32–$291.34	—	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$241.56–$2,810.97	62% above	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$241.56–$2,810.97	62% above	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$241.56–$2,810.97	62% above	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$437.26–$2,810.97	—	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$437.26–$2,810.97	—	86%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$437.26	$3,123.30	$437.26–$2,810.97	—	86%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$408.35	$2,916.75	$237.41–$2,625.08	155% above	86%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$408.35	$2,916.75	$237.41–$2,625.08	155% above	86%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$408.35	$2,916.75	$408.34–$2,625.08	—	86%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$408.35	$2,916.75	$408.34–$2,625.08	—	86%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$482.84	$3,448.89	$279.05–$3,104.00	36% below	86%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$482.84	$3,448.89	$279.05–$3,104.00	36% below	86%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$482.84	$3,448.89	$482.84–$3,104.00	—	86%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$482.84	$3,448.89	$482.84–$3,104.00	—	86%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$454.40	$3,245.72	$307.01–$3,245.72	at median	86%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$454.40	$3,245.72	$454.40–$2,921.15	—	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$124.97–$1,352.09	27% above	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$124.97–$1,352.09	27% above	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$210.32	$1,502.32	$124.97–$1,352.09	27% above	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$124.97–$1,352.09	27% above	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$210.32–$1,352.09	—	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$210.32	$1,502.32	$210.32–$1,352.09	—	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$210.32–$1,352.09	—	86%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$210.32	$1,502.32	$210.32–$1,352.09	—	86%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$203.00	$1,450.00	$34.50–$1,305.00	218% above	86%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$203.00	$1,450.00	$34.50–$1,305.00	218% above	86%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$804.98	$5,749.83	$463.47–$5,174.85	30% below	86%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$804.98	$5,749.83	$804.98–$5,174.85	—	86%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$804.98	$5,749.83	$463.47–$5,174.85	at median	86%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$804.98	$5,749.83	$463.47–$5,174.85	at median	86%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$804.98	$5,749.83	$804.98–$5,174.85	—	86%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$804.98	$5,749.83	$804.98–$5,174.85	—	86%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$516.94	$3,692.43	$276.21–$3,323.19	at median	86%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$516.94	$3,692.43	$276.21–$3,323.19	at median	86%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$516.94	$3,692.43	$516.94–$3,323.19	—	86%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$516.94	$3,692.43	$516.94–$3,323.19	—	86%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$517.04	$3,693.15	$275.27–$3,323.84	—	86%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$517.04	$3,693.15	$517.04–$3,323.84	—	86%
Rabies vaccine, one dose CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$327.84–$4,217.50	at median	86%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$327.84–$4,217.50	at median	86%
Rabies vaccine, one dose CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$327.84–$4,217.50	at median	86%
Rabies vaccine, one dose CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$327.84–$5,031.56	19% above	86%
Rabies vaccine, one dose CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$327.84–$5,031.56	19% above	86%
Rabies vaccine, one dose CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$327.84–$5,031.56	19% above	86%
Rabies vaccine, one dose CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$327.84–$5,031.56	19% above	86%
Rabies vaccine, one dose inpatient CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$656.06–$4,217.50	—	86%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$656.06–$4,217.50	—	86%
Rabies vaccine, one dose inpatient CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell	$656.06	$4,686.11	$656.06–$4,217.50	—	86%
Rabies vaccine, one dose inpatient CPT 90675 50632-0010-01 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$782.69–$5,031.56	—	86%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$782.69–$5,031.56	—	86%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$782.69–$5,031.56	—	86%
Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$782.69	$5,590.62	$782.69–$5,031.56	—	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$91.66	$654.70	$91.66–$589.23	13% below	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$91.66	$654.70	$91.66–$589.23	13% below	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$91.66	$654.70	$91.66–$589.23	13% below	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$91.66	$654.70	$91.66–$589.23	—	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$91.66	$654.70	$91.66–$589.23	—	86%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$91.66	$654.70	$91.66–$589.23	—	86%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$373.84	$2,670.25	$185.29–$2,403.22	4% below	86%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$373.84	$2,670.25	$185.29–$2,403.22	4% below	86%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$373.84	$2,670.25	$373.84–$2,403.22	—	86%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$373.84	$2,670.25	$373.84–$2,403.22	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$26.43–$1,305.00	134% above	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$203.00	$1,450.00	$47.76–$1,305.00	137% above	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$203.00	$1,450.00	$203.00–$1,305.00	—	86%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$118.24	$844.56	$112.00–$760.10	—	86%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$118.24	$844.56	$112.00–$760.10	—	86%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$118.24	$844.56	$118.24–$760.10	—	86%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$118.24	$844.56	$118.24–$760.10	—	86%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 $ED Admin Vaccine	$68.04	$486.00	$18.98–$437.40	20% above	86%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$68.04	$486.00	$18.98–$437.40	20% above	86%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$68.04	$486.00	$18.98–$437.40	20% above	86%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$68.04	$486.00	$18.98–$437.40	20% above	86%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$68.04	$486.00	$18.98–$437.40	20% above	86%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 $ED Admin Vaccine	$68.04	$486.00	$68.04–$437.40	—	86%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$68.04	$486.00	$68.04–$437.40	—	86%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$68.04	$486.00	$68.04–$437.40	—	86%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$68.04	$486.00	$68.04–$437.40	—	86%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$68.04	$486.00	$68.04–$437.40	—	86%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$63.84	$456.00	$13.57–$410.40	114% above	86%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$63.84	$456.00	$13.57–$410.40	114% above	86%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 $ED Admin Vaccine Ea Add'l	$63.84	$456.00	$13.57–$410.40	114% above	86%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$63.84	$456.00	$63.84–$410.40	—	86%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 $ED Admin Vaccine Ea Add'l	$63.84	$456.00	$63.84–$410.40	—	86%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$63.84	$456.00	$63.84–$410.40	—	86%
Yellow fever vaccine, live CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$1,034.72	$7,390.88	$215.74–$7,390.88	—	86%
Yellow fever vaccine, live CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$1,034.72	$7,390.88	$215.74–$7,390.88	—	86%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$1,034.72	$7,390.88	$1,034.72–$6,651.79	—	86%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$1,034.72	$7,390.88	$1,034.72–$6,651.79	—	86%

Dental

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION ERUPTED TOOTH/EXR	$12,145.84	$86,756.00	$7,015.26–$78,080.40	258% above	86%

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

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

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

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

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

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

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

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

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

Source file: https://www.alliancehealthdurant.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/581725656_alliancehealth-durant_standardcharges.csv