Sky Lakes Medical Center
Sky Lakes Medical Center in Klamath Falls, OR publishes cash prices for 428 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Oregon median for 256 of 423 procedures and below it for 162. By typical cash price it ranks #33 of 47 Oregon hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
2865 Daggett Ave, Klamath Falls, OR 97601-1106 Collected Sep 22, 2026 Source price file (541) 882-6311
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 380050 · CMS hospital register NPI 1659340370
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Sky Lakes Medical Center in Klamath Falls, OR:
- Jan 14, 2026 Warning notice
- Apr 17, 2026 Corrective action plan requested
- May 4, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/WO Contrast | $2,412.32 | $3,216.43 | $197.74–$3,216.43 | 48% above | 25% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen W/WO Contrast | $2,412.32 | $3,216.43 | $197.74–$3,216.43 | — | 25% |
| Abdominal X-ray, 2 views CPT 74019 HC Abd 2 View | $321.67 | $428.89 | $118.12–$428.89 | 8% above | 25% |
| Abdominal X-ray, 2 views CPT 74019 HC Abd,2 Views | $321.67 | $428.89 | $118.12–$428.89 | 8% above | 25% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC Abd,2 Views | $321.67 | $428.89 | $118.12–$428.89 | — | 25% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC Abd 2 View | $321.67 | $428.89 | $118.12–$428.89 | — | 25% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 24% above | 25% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 24% above | 25% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Ankle Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | 24% above | 25% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Ankle,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Ankle/Brachial Indices | $146.04 | $194.72 | $143.18–$444.05 | 71% below | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Duplex Art Ankle/Arm Index | $893.29 | $1,191.05 | $143.18–$1,191.05 | 77% above | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Ankle/Brachial Indices | $146.04 | $194.72 | $143.18–$444.05 | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Duplex Art Ankle/Arm Index | $893.29 | $1,191.05 | $143.18–$1,191.05 | — | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Extremity Lt Upper W/O Contrast | $1,524.39 | $2,032.52 | $118.12–$2,032.52 | 44% above | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Extremity Rt Upper W/O Contrast | $1,524.39 | $2,032.52 | $118.12–$2,032.52 | 44% above | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Extremity Rt Upper W/O Contrast | $1,524.39 | $2,032.52 | $118.12–$2,032.52 | — | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Extremity Lt Upper W/O Contrast | $1,524.39 | $2,032.52 | $118.12–$2,032.52 | — | 25% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram | $552.44 | $736.58 | $197.74–$736.58 | 1% below | 25% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esophagram | $552.44 | $736.58 | $197.74–$736.58 | — | 25% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Scan Whole Body | $1,425.89 | $1,901.19 | $446.34–$1,901.19 | 7% above | 25% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone Scan Whole Body | $1,425.89 | $1,901.19 | $446.34–$1,901.19 | — | 25% |
| Breast ultrasound, complete, one breast both sides CPT 76641 HC US Breast Bilateral Complete | $408.14 | $544.18 | $118.12–$544.18 | — | 25% |
| Breast ultrasound, complete, one breast CPT 76641 HC Breast Ultrasound | $408.14 | $544.18 | $118.12–$544.18 | 13% above | 25% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Complete Rt | $408.14 | $544.18 | $118.12–$544.18 | 13% above | 25% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Complete Lt | $408.14 | $544.18 | $118.12–$544.18 | 13% above | 25% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US Breast Bilateral Complete | $408.14 | $544.18 | $118.12–$544.18 | — | 25% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC Breast Ultrasound | $408.14 | $544.18 | $118.12–$544.18 | — | 25% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Complete Rt | $408.14 | $544.18 | $118.12–$544.18 | — | 25% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Complete Lt | $408.14 | $544.18 | $118.12–$544.18 | — | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC Ultrasound Breast Limited | $80.97 | $107.96 | $89.07–$107.96 | 73% below | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US Breast Uni Real Time W Img Lmtd | $138.56 | $184.74 | $97.80–$184.74 | 54% below | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC Ultrasound Breast Limited | $80.97 | $107.96 | $89.07–$107.96 | — | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US Breast Uni Real Time W Img Lmtd | $138.56 | $184.74 | $97.80–$184.74 | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd/Pelv W/WO Contrast | $2,489.39 | $3,319.19 | $396.69–$3,319.19 | 1% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT Angio Abd/Pelv W/WO Contrast | $2,489.39 | $3,319.19 | $396.69–$3,319.19 | — | 25% |
| CT angiography (CTA) of the head CPT 70496 HC CT Angiography, Head | $2,081.86 | $2,775.81 | $197.74–$2,775.81 | 12% above | 25% |
| CT angiography (CTA) of the head CPT 70496 HC CT Angio Head W/WO Contrast | $2,081.86 | $2,775.81 | $197.74–$2,775.81 | 12% above | 25% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angiography, Head | $2,081.86 | $2,775.81 | $197.74–$2,775.81 | — | 25% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angio Head W/WO Contrast | $2,081.86 | $2,775.81 | $197.74–$2,775.81 | — | 25% |
| CT angiography (CTA) of the neck CPT 70498 HC CT Angiography, Neck | $2,084.15 | $2,778.87 | $197.74–$2,778.87 | 12% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 HC CT Angio Neck W/WO Contrast | $2,084.15 | $2,778.87 | $197.74–$2,778.87 | 12% above | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angio Neck W/WO Contrast | $2,084.15 | $2,778.87 | $197.74–$2,778.87 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angiography, Neck | $2,084.15 | $2,778.87 | $197.74–$2,778.87 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Chest W/WO Con | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | 35% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angiography, Chest With Dye | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | 35% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Pulmonary Angio W/Cont Only | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | 35% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Chest W/WO Con | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angiography, Chest With Dye | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Pulmonary Angio W/Cont Only | $2,382.75 | $3,177.00 | $197.74–$3,177.00 | — | 25% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Ccta W/WO Struct/Calc Eval | $933.40 | $1,244.53 | $197.74–$1,244.53 | 33% below | 25% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Ccta W/WO Struct/Calc Eval | $933.40 | $1,244.53 | $197.74–$1,244.53 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Kub Abd/Pel W/O Con | $2,468.42 | $3,291.22 | $268.50–$3,291.22 | 17% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Kub Abd/Pel W/O Con | $2,468.42 | $3,291.22 | $268.50–$3,291.22 | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd/Pelv W/Con | $3,485.96 | $4,647.94 | $396.69–$4,647.94 | 44% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd/Pelv W/Con | $3,485.96 | $4,647.94 | $396.69–$4,647.94 | — | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd/Pelv W/WO Con | $4,341.01 | $5,788.01 | $396.69–$5,788.01 | 46% above | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abd/Pelv W/WO Con | $4,341.01 | $5,788.01 | $396.69–$5,788.01 | — | 25% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Contrast | $1,742.99 | $2,323.98 | $197.74–$2,323.98 | 21% above | 25% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen Lmtd W/Contrast | $1,742.99 | $2,323.98 | $197.74–$2,323.98 | 21% above | 25% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen Lmtd W/Contrast | $1,742.99 | $2,323.98 | $197.74–$2,323.98 | — | 25% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/Contrast | $1,742.99 | $2,323.98 | $197.74–$2,323.98 | — | 25% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen WO/Contrast | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | 12% above | 25% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen Lmtd | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | 12% above | 25% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen WO/Contrast | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | — | 25% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen Lmtd | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | — | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Sinus,Facial WO/Contrast | $1,325.90 | $1,767.87 | $118.12–$1,767.87 | 23% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Dental Implant W/O Con | $1,325.90 | $1,767.87 | $118.12–$1,767.87 | 23% above | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Dental Implant W/O Con | $1,325.90 | $1,767.87 | $118.12–$1,767.87 | — | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Sinus,Facial WO/Contrast | $1,325.90 | $1,767.87 | $118.12–$1,767.87 | — | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head WO/Contrast | $1,073.51 | $1,431.35 | $118.12–$1,431.35 | 7% above | 25% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head WO/Contrast | $1,073.51 | $1,431.35 | $118.12–$1,431.35 | — | 25% |
| CT scan of the head with contrast CPT 70460 HC CT Head W/Contrast | $1,600.17 | $2,133.56 | $197.74–$2,133.56 | 24% above | 25% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT Head W/Contrast | $1,600.17 | $2,133.56 | $197.74–$2,133.56 | — | 25% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head/Brain W/O & W/Dye | $1,816.38 | $2,421.84 | $197.74–$2,421.84 | 18% above | 25% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head W/WO Contrast | $1,816.38 | $2,421.84 | $197.74–$2,421.84 | 18% above | 25% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head/Brain W/O & W/Dye | $1,816.38 | $2,421.84 | $197.74–$2,421.84 | — | 25% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head W/WO Contrast | $1,816.38 | $2,421.84 | $197.74–$2,421.84 | — | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Spine Lumbar WO/Contrast | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | 27% above | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Post Lumbar Myelography | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | 27% above | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine W/O Dye | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | 27% above | 25% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Post Lumbar Myelography | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | — | 25% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Spine Lumbar WO/Contrast | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | — | 25% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar Spine W/O Dye | $1,597.92 | $2,130.56 | $118.12–$2,130.56 | — | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Spine Cervical WO/Contrast | $1,500.89 | $2,001.19 | $118.12–$2,001.19 | 24% above | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Neck Spine W/O Dye | $1,500.89 | $2,001.19 | $118.12–$2,001.19 | 24% above | 25% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Neck Spine W/O Dye | $1,500.89 | $2,001.19 | $118.12–$2,001.19 | — | 25% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Spine Cervical WO/Contrast | $1,500.89 | $2,001.19 | $118.12–$2,001.19 | — | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/Contrast | $1,830.09 | $2,440.12 | $197.74–$2,440.12 | 24% above | 25% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/Contrast | $1,830.09 | $2,440.12 | $197.74–$2,440.12 | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Duplex,Carotid Ultrasound,Bilat | $951.47 | $1,268.63 | $268.50–$1,268.63 | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Duplex,Carotid Ultrasound,Bilat | $951.47 | $1,268.63 | $268.50–$1,268.63 | — | 25% |
| Chest CT scan without and with contrast CPT 71270 HC CT Thorax W/WO Contrast | $1,928.69 | $2,571.58 | $197.74–$2,571.58 | 10% above | 25% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT Thorax W/WO Contrast | $1,928.69 | $2,571.58 | $197.74–$2,571.58 | — | 25% |
| Chest X-ray, 2 views CPT 71046 HC Chest,2 Views | $304.46 | $405.94 | $97.80–$405.94 | 13% above | 25% |
| Chest X-ray, 2 views CPT 71046 HC Chest 2 View | $304.46 | $405.94 | $97.80–$405.94 | 13% above | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 HC Chest,2 Views | $304.46 | $405.94 | $97.80–$405.94 | — | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 HC Chest 2 View | $304.46 | $405.94 | $97.80–$405.94 | — | 25% |
| Chest X-ray, single view CPT 71045 HC Chest 1 View | $281.08 | $374.77 | $97.80–$374.77 | 11% above | 25% |
| Chest X-ray, single view inpatient CPT 71045 HC Chest 1 View | $281.08 | $374.77 | $97.80–$374.77 | — | 25% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Clavicle,Left | $309.98 | $413.30 | $97.80–$413.30 | 44% above | 25% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Clavicle Lt | $309.98 | $413.30 | $97.80–$413.30 | 44% above | 25% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Clavicle,Right | $309.98 | $413.30 | $97.80–$413.30 | 44% above | 25% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Clavicle,Left | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Clavicle Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Clavicle,Right | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC Renal Ult | $904.19 | $1,205.59 | $118.12–$1,205.59 | 64% above | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC Aorta Ult | $904.19 | $1,205.59 | $118.12–$1,205.59 | 64% above | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC Aorta Ult | $904.19 | $1,205.59 | $118.12–$1,205.59 | — | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC Renal Ult | $904.19 | $1,205.59 | $118.12–$1,205.59 | — | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Axial Skeleton | $387.83 | $517.10 | $118.12–$517.10 | 1% above | 25% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Bone Density Axial Skeleton | $387.83 | $517.10 | $118.12–$517.10 | — | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC Bone Density Appendicular Skelt Nc | $163.58 | $218.10 | $97.80–$296.10 | 33% below | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC Bone Density Appendicular Skelt Nc | $163.58 | $218.10 | $97.80–$296.10 | — | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB Ult W/Fetal Exam 1st Gest | $1,153.32 | $1,537.76 | $268.50–$1,537.76 | 82% above | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC F-Ult Fetal Exam 1st Gest | $1,202.48 | $1,603.30 | $268.50–$1,603.30 | 90% above | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB Ult W/Fetal Exam 1st Gest | $1,153.32 | $1,537.76 | $268.50–$1,537.76 | — | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC F-Ult Fetal Exam 1st Gest | $1,202.48 | $1,603.30 | $268.50–$1,603.30 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax W/O Cont Lmtd | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | 2% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax WO/Contrast | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | 2% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax W/O Cont Lmtd | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax WO/Contrast | $1,234.21 | $1,645.61 | $118.12–$1,645.61 | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax W/Cont Lmtd | $1,848.32 | $2,464.42 | $197.74–$2,464.42 | 24% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax W/Contrast | $1,848.32 | $2,464.42 | $197.74–$2,464.42 | 24% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax W/Cont Lmtd | $1,848.32 | $2,464.42 | $197.74–$2,464.42 | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax W/Contrast | $1,848.32 | $2,464.42 | $197.74–$2,464.42 | — | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammo Diag Bilat Digital | $323.55 | $431.40 | $106.62–$515.32 | — | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammo Bilat W/Scrn Sm Day Dgtl | $323.55 | $431.40 | $106.62–$515.32 | — | 25% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammo Bilat W/Scrn Sm Day Dgtl | $323.55 | $431.40 | $106.62–$515.32 | — | 25% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammo Diag Bilat Digital | $323.55 | $431.40 | $106.62–$515.32 | — | 25% |
| Diagnostic mammogram, one breast CPT 77065 HC Mammo Uni W/Scrn Sm Day Dgtl | $249.59 | $332.79 | $83.66–$402.12 | 20% below | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammo Lt Digital | $249.59 | $332.79 | $83.66–$402.12 | 20% below | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammo Rt Digital | $249.59 | $332.79 | $83.66–$402.12 | 20% below | 25% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC Mammo Uni W/Scrn Sm Day Dgtl | $249.59 | $332.79 | $83.66–$402.12 | — | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammo Rt Digital | $249.59 | $332.79 | $83.66–$402.12 | — | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammo Lt Digital | $249.59 | $332.79 | $83.66–$402.12 | — | 25% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Arterial Leg Image,Bilat | $1,457.36 | $1,943.15 | $268.50–$1,943.15 | — | 25% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Duplex Arterial Leg Image,Bilat | $1,457.36 | $1,943.15 | $268.50–$1,943.15 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Doppler Ven Ext Bilat Upr/Lwr | $1,397.81 | $1,863.75 | $268.50–$1,863.75 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Venous Extremity,Bilat | $1,457.36 | $1,943.15 | $268.50–$1,943.15 | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Doppler Ven Ext Bilat Upr/Lwr | $1,397.81 | $1,863.75 | $268.50–$1,863.75 | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Venous Extremity,Bilat | $1,457.36 | $1,943.15 | $268.50–$1,943.15 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2d W/Dopp/Color Flow/Cont | $1,849.59 | $2,466.12 | $877.58–$3,267.58 | 21% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echo 2d W/Dopp/Color Flow | $1,928.38 | $2,571.17 | $609.04–$2,571.17 | 26% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Abrtd Echo Heart 2d Complete | $1,928.38 | $2,571.17 | $609.04–$2,571.17 | 26% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo 2d W/Dopp/Color Flow/Cont | $1,849.59 | $2,466.12 | $877.58–$3,267.58 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Abrtd Echo Heart 2d Complete | $1,928.38 | $2,571.17 | $609.04–$2,571.17 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echo 2d W/Dopp/Color Flow | $1,928.38 | $2,571.17 | $609.04–$2,571.17 | — | 25% |
| Elbow X-ray, 2 views CPT 73070 HC Elbow,Lt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | 28% above | 25% |
| Elbow X-ray, 2 views CPT 73070 HC Elbow,Rt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | 28% above | 25% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC Elbow,Lt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC Elbow,Rt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow,Rt 4 Vw | $309.98 | $413.30 | $97.80–$413.30 | 27% above | 25% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC Elbow,Lt 4 Vw | $309.98 | $413.30 | $97.80–$413.30 | 27% above | 25% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Elbow Lt 4 View | $309.98 | $413.30 | $97.80–$413.30 | 27% above | 25% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Elbow,Lt 4 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Elbow,Rt 4 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Elbow Lt 4 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbits,Iacs WO/Contrast | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | 28% above | 25% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Orbits,Iacs WO/Contrast | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | — | 25% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC Facial Bones,3-4 Views | $309.98 | $413.30 | $118.12–$490.36 | 7% below | 25% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC Facial Bones,3-4 Views | $309.98 | $413.30 | $118.12–$490.36 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Forearm,Rt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Forearm,Lt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Forearm Lt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Forearm Rt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Forearm,Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Forearm,Rt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Forearm Rt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Forearm Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Hand X-ray, 2 views one side CPT 73120 HC Hand,Left 2 Views | $331.58 | $442.10 | $118.12–$490.36 | 36% above | 25% |
| Hand X-ray, 2 views one side CPT 73120 HC Hand,Right 2 Views | $331.58 | $442.10 | $118.12–$490.36 | 36% above | 25% |
| Hand X-ray, 2 views one side CPT 73120 HC Hand Lt 1 or 2 Views | $331.58 | $442.10 | $118.12–$490.36 | 36% above | 25% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC Hand,Left 2 Views | $331.58 | $442.10 | $118.12–$490.36 | — | 25% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC Hand Lt 1 or 2 Views | $331.58 | $442.10 | $118.12–$490.36 | — | 25% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HC Hand,Right 2 Views | $331.58 | $442.10 | $118.12–$490.36 | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Calcaneus,Right | $309.98 | $413.30 | $97.80–$413.30 | 50% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Calcaneus Lt | $309.98 | $413.30 | $97.80–$413.30 | 50% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Calcaneus,Left | $309.98 | $413.30 | $97.80–$413.30 | 50% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Calcaneus,Left | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Calcaneus,Right | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Calcaneus Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Knee X-ray, 3 views one side CPT 73562 HC Knee,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 10% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 HC Knee,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 10% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 HC Knee Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | 10% above | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC Knee,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC Knee,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC Knee Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC Knee,Right 4 Views | $458.30 | $611.06 | $118.12–$611.06 | 29% above | 25% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HC Knee Lt 4 View | $458.30 | $611.06 | $118.12–$611.06 | 29% above | 25% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Knee Lt 4 View | $458.30 | $611.06 | $118.12–$611.06 | — | 25% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Knee,Right 4 Views | $458.30 | $611.06 | $118.12–$611.06 | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Ext Lwr Lt WO Cont Lmtd | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | 44% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Extremity Rt Lower W/O Contrast | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | 44% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Extremity Lt Lower W/O Contrast | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | 44% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Extremity Rt Lower W/O Contrast | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Extremity Lt Lower W/O Contrast | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Ext Lwr Lt WO Cont Lmtd | $1,450.88 | $1,934.50 | $118.12–$1,934.50 | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC Abd Single Organ,Lmtd | $705.83 | $941.10 | $118.12–$941.10 | 47% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC Abd Single Organ,Lmtd | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Extremity Non-Vasc Lmtd | $146.36 | $195.14 | $118.12–$448.38 | 50% below | 25% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremity Non Vasc Lmtd Rt | $393.48 | $524.64 | $118.12–$524.64 | 34% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremity Non Vasc Lmtd Lt | $393.48 | $524.64 | $118.12–$524.64 | 34% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US Extremity Non-Vasc Lmtd | $146.36 | $195.14 | $118.12–$448.38 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US Extremity Non Vasc Lmtd Rt | $393.48 | $524.64 | $118.12–$524.64 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US Extremity Non Vasc Lmtd Lt | $393.48 | $524.64 | $118.12–$524.64 | — | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Lung Screen | $247.50 | $330.00 | $118.12–$330.00 | 9% below | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Lung Screen | $247.50 | $330.00 | $118.12–$330.00 | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Leg,Right Lower | $309.98 | $413.30 | $97.80–$413.30 | 24% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Leg,Left Lower | $309.98 | $413.30 | $97.80–$413.30 | 24% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Leg Lt | $309.98 | $413.30 | $97.80–$413.30 | 24% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Leg,Right Lower | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Leg,Left Lower | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Leg Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Lmtd MR Head W/O Cont | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | 38% above | 25% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head Lmtd W/O Contrast | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | 38% above | 25% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Lmtd MR Head W/O Cont | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | — | 25% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Mra Head Lmtd W/O Contrast | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | — | 25% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MR Breast Bilateral W & W/O Cont | $3,189.91 | $4,253.21 | $396.69–$4,253.21 | — | 25% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MR Breast Bilateral W & W/O Cont | $3,189.91 | $4,253.21 | $396.69–$4,253.21 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Jnt Lwr Extre W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Extremity Rt Lower Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Joint Low Ext Lt W/O Cont Lmt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Joint Low Ext Rt W/O Cont Lmt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MR Extremity Lt Lower Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Jnt Lwr Extre W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MR Extremity Lt Lower Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MR Joint Low Ext Rt W/O Cont Lmt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MR Extremity Rt Lower Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MR Joint Low Ext Lt W/O Cont Lmt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Joint Lwr Extr W/O&W/Dye | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | 32% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MR Joint Le W/WO Cont Lt | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | 32% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MR Joint Le W/WO Cont Rt | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | 32% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Joint Lwr Extr W/O&W/Dye | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MR Joint Le W/WO Cont Lt | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MR Joint Le W/WO Cont Rt | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | — | 25% |
| MRI of the abdomen without contrast CPT 74181 HC MR Abdomen | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 40% above | 25% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MR Abdomen | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W/O & W/Dye | $3,858.98 | $5,145.31 | $396.69–$5,145.31 | 35% above | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MR Abdomen W/WO Contrast | $3,858.98 | $5,145.31 | $396.69–$5,145.31 | 35% above | 25% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MR Abdomen W/WO Contrast | $3,858.98 | $5,145.31 | $396.69–$5,145.31 | — | 25% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abdomen W/O & W/Dye | $3,858.98 | $5,145.31 | $396.69–$5,145.31 | — | 25% |
| MRI of the brain, no contrast dye CPT 70551 HC MR Brain WO/Contrast | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | 42% above | 25% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Dye | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | 42% above | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MR Brain WO/Contrast | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | — | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Dye | $2,578.61 | $3,438.14 | $268.50–$3,438.14 | — | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MR Brain W/WO Cont Lmtd | $3,374.55 | $4,499.40 | $396.69–$4,499.40 | 9% above | 25% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MR Brain W/WO Cont Lmtd | $3,374.55 | $4,499.40 | $396.69–$4,499.40 | — | 25% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine W/O Dye | $2,647.40 | $3,529.87 | $268.50–$3,529.87 | 46% above | 25% |
| MRI of the lower back, no contrast dye CPT 72148 HC MR Spine Lumbar WO/Contrast | $2,647.40 | $3,529.87 | $268.50–$3,529.87 | 46% above | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine W/O Dye | $2,647.40 | $3,529.87 | $268.50–$3,529.87 | — | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MR Spine Lumbar WO/Contrast | $2,647.40 | $3,529.87 | $268.50–$3,529.87 | — | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MR Spine Lumbar W/WO Contrast | $3,869.35 | $5,159.13 | $396.69–$5,159.13 | 28% above | 25% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MR Spine Lumbar W/WO Contrast | $3,869.35 | $5,159.13 | $396.69–$5,159.13 | — | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MR Spine Thoracic WO/Contrast | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 38% above | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Chest Spine W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 38% above | 25% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Chest Spine W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MR Spine Thoracic WO/Contrast | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Neck Spine W/O & W/Dye | $3,034.60 | $4,046.13 | $396.69–$4,046.13 | 6% above | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MR Spine Cervical W/WO Contrast | $3,034.60 | $4,046.13 | $396.69–$4,046.13 | 6% above | 25% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI Neck Spine W/O & W/Dye | $3,034.60 | $4,046.13 | $396.69–$4,046.13 | — | 25% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MR Spine Cervical W/WO Contrast | $3,034.60 | $4,046.13 | $396.69–$4,046.13 | — | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MR Spine Cervical WO/Contrast | $2,172.41 | $2,896.54 | $268.50–$2,896.54 | 22% above | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Neck Spine W/O Dye | $2,172.41 | $2,896.54 | $268.50–$2,896.54 | 22% above | 25% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Neck Spine W/O Dye | $2,172.41 | $2,896.54 | $268.50–$2,896.54 | — | 25% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MR Spine Cervical WO/Contrast | $2,172.41 | $2,896.54 | $268.50–$2,896.54 | — | 25% |
| MRI of the pelvis without and with contrast CPT 72197 HC MR Pelvis W/WO Contrast | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | 32% above | 25% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/O & W/Dye | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | 32% above | 25% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MR Pelvis W/WO Contrast | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | — | 25% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis W/O & W/Dye | $3,518.06 | $4,690.74 | $396.69–$4,690.74 | — | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MR Pelvis,Complete | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MR Pelvis W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR Pelvis,Complete | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MR Pelvis W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Joint Upr Extrem W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Extremity Rt Upper Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Joint Up Ext Lt W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Joint Up Ext Rt W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MR Extremity Lt Upper Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | 42% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI Joint Upr Extrem W/O Dye | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MR Joint Up Ext Lt W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MR Extremity Rt Upper Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MR Joint Up Ext Rt W/O Cont Lmtd | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MR Extremity Lt Upper Jt | $2,518.52 | $3,358.02 | $268.50–$3,358.02 | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine,Cervical 5 Views | $462.93 | $617.24 | $118.12–$617.24 | 23% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine Cervical 5 View | $462.93 | $617.24 | $118.12–$617.24 | 23% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Spine Cervical 5 View | $462.93 | $617.24 | $118.12–$617.24 | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Spine,Cervical 5 Views | $462.93 | $617.24 | $118.12–$617.24 | — | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck W/Contrast | $1,847.25 | $2,463.00 | $197.74–$2,463.00 | 28% above | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Soft Tissue Neck W/Dye | $1,847.25 | $2,463.00 | $197.74–$2,463.00 | 28% above | 25% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck W/Contrast | $1,847.25 | $2,463.00 | $197.74–$2,463.00 | — | 25% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Soft Tissue Neck W/Dye | $1,847.25 | $2,463.00 | $197.74–$2,463.00 | — | 25% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Neck WO Contrast | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | 24% above | 25% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Soft Tissue Neck W/O Dye | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | 24% above | 25% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Soft Tissue Neck W/O Dye | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | — | 25% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Neck WO Contrast | $1,288.22 | $1,717.62 | $118.12–$1,717.62 | — | 25% |
| Neck soft tissue X-ray CPT 70360 HC Neck,Soft Tissue | $276.22 | $368.29 | $97.80–$368.29 | 14% above | 25% |
| Neck soft tissue X-ray inpatient CPT 70360 HC Neck,Soft Tissue | $276.22 | $368.29 | $97.80–$368.29 | — | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM Myocard Img Multi W/Ef Wm | $4,178.92 | $5,571.89 | $1,450.10–$5,571.89 | 22% above | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM Myocard Img Multi W/Ef Wm | $4,178.92 | $5,571.89 | $1,450.10–$5,571.89 | — | 25% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull to Thigh Restaging Treatment Strategy | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | 2% above | 25% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull to Thigh | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | 2% above | 25% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet/CT Skull to Thigh Initial Treatment Strategy | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | 2% above | 25% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull to Thigh Restaging Treatment Strategy | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | — | 25% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull to Thigh | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | — | 25% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet/CT Skull to Thigh Initial Treatment Strategy | $4,813.90 | $6,418.53 | $1,620.17–$6,418.53 | — | 25% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O Cont Lmtd | $1,241.27 | $1,655.02 | $118.12–$1,655.02 | 9% above | 25% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis WO/Contrast | $1,241.27 | $1,655.02 | $118.12–$1,655.02 | 9% above | 25% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis W/O Cont Lmtd | $1,241.27 | $1,655.02 | $118.12–$1,655.02 | — | 25% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis WO/Contrast | $1,241.27 | $1,655.02 | $118.12–$1,655.02 | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC F-Ult Nonob Pelvic Lmtd | $393.48 | $524.64 | $118.12–$524.64 | 24% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC Ult Pelvic,F/U Lmtd | $393.48 | $524.64 | $118.12–$524.64 | 24% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC Ult Pelvic,F/U Lmtd | $393.48 | $524.64 | $118.12–$524.64 | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC F-Ult Nonob Pelvic Lmtd | $393.48 | $524.64 | $118.12–$524.64 | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC Pelvic Ult,Non OB | $782.24 | $1,042.98 | $118.12–$1,042.98 | 49% above | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC F-Ult Nonob Pelvic | $815.57 | $1,087.43 | $118.12–$1,087.43 | 56% above | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC Pelvic Ult,Non OB | $782.24 | $1,042.98 | $118.12–$1,042.98 | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC F-Ult Nonob Pelvic | $815.57 | $1,087.43 | $118.12–$1,087.43 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC Phy Complete OB US | $142.82 | $190.43 | $118.12–$747.93 | 72% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB Ult>14wk 1st Gest | $676.97 | $902.63 | $118.12–$902.63 | 31% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC F-Ult >14wk 1st Gest | $705.83 | $941.10 | $118.12–$941.10 | 36% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC Phy Complete OB US | $142.82 | $190.43 | $118.12–$747.93 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB Ult>14wk 1st Gest | $676.97 | $902.63 | $118.12–$902.63 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC F-Ult >14wk 1st Gest | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US, OB < 14 Wks, Single Fetus | $133.07 | $177.42 | $118.12–$747.93 | 71% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC Phy US OB/1st Gest, 1st Trimester | $180.68 | $240.90 | $118.12–$747.93 | 60% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB Ult<14wk 1st Gest | $676.97 | $902.63 | $118.12–$902.63 | 48% above | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC F-Ult <14wk 1st Gest | $705.83 | $941.10 | $118.12–$941.10 | 54% above | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US, OB < 14 Wks, Single Fetus | $133.07 | $177.42 | $118.12–$747.93 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC Phy US OB/1st Gest, 1st Trimester | $180.68 | $240.90 | $118.12–$747.93 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB Ult<14wk 1st Gest | $676.97 | $902.63 | $118.12–$902.63 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC F-Ult <14wk 1st Gest | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US Limited Fetus(S) | $146.36 | $195.14 | $118.12–$747.93 | 59% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC Fetal Assessment US | $425.53 | $567.37 | $118.12–$747.93 | 20% above | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US Limited Fetus(S) | $146.36 | $195.14 | $118.12–$747.93 | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC Fetal Assessment US | $425.53 | $567.37 | $118.12–$747.93 | — | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs,Right | $309.98 | $413.30 | $97.80–$413.30 | 17% above | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs,Left | $309.98 | $413.30 | $97.80–$413.30 | 17% above | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC Ribs Lt | $309.98 | $413.30 | $97.80–$413.30 | 17% above | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs,Right | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs,Left | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Ribs Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Screening mammogram, both breasts CPT 77067 HC Mammo Screen Digital | $277.34 | $369.78 | $88.23–$425.16 | 17% below | 25% |
| Screening mammogram, both breasts one side CPT 77067 HC Mammo Scr Unilat Digital | $277.34 | $369.78 | $88.23–$425.16 | 17% below | 25% |
| Screening mammogram, both breasts inpatient CPT 77067 HC Mammo Screen Digital | $277.34 | $369.78 | $88.23–$425.16 | — | 25% |
| Screening mammogram, both breasts inpatient one side CPT 77067 HC Mammo Scr Unilat Digital | $277.34 | $369.78 | $88.23–$425.16 | — | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder,Lt 2+ Views | $309.98 | $413.30 | $97.80–$413.30 | 11% above | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder,Rt 2+ Views | $309.98 | $413.30 | $97.80–$413.30 | 11% above | 25% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Shoulder Lt 2 or More Views | $309.98 | $413.30 | $97.80–$413.30 | 11% above | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder,Lt 2+ Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder,Rt 2+ Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Shoulder Lt 2 or More Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinuses, Min 3-Views | $309.98 | $413.30 | $97.80–$413.30 | 8% above | 25% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Sinuses, Min 3-Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 HC Skull,3 Views or Less | $309.98 | $413.30 | $118.12–$490.36 | 11% above | 25% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Skull,3 Views or Less | $309.98 | $413.30 | $118.12–$490.36 | — | 25% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echo 2d W/Stress W/O Con | $986.18 | $1,314.90 | $609.04–$2,029.82 | 34% below | 25% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Stress Echo, Inc. Performance of Cont. Ecg Moni. | $1,230.75 | $1,641.00 | $609.04–$2,029.82 | 17% below | 25% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Echo 2d W/Stress W/O Con | $986.18 | $1,314.90 | $609.04–$2,029.82 | — | 25% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Stress Echo, Inc. Performance of Cont. Ecg Moni. | $1,230.75 | $1,641.00 | $609.04–$2,029.82 | — | 25% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Esophagus,Video | $489.14 | $652.18 | $197.74–$652.18 | 10% below | 25% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Esophagus,Video | $489.14 | $652.18 | $197.74–$652.18 | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur 2 Vw Lt | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur 2 Vw Rt | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur 2 Vw Rt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur 2 Vw Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine W/O Dye | $1,481.04 | $1,974.72 | $118.12–$1,974.72 | 23% above | 25% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Spine Thoracic WO/Contrast | $1,481.04 | $1,974.72 | $118.12–$1,974.72 | 23% above | 25% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Spine Thoracic WO/Contrast | $1,481.04 | $1,974.72 | $118.12–$1,974.72 | — | 25% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Thoracic Spine W/O Dye | $1,481.04 | $1,974.72 | $118.12–$1,974.72 | — | 25% |
| Toe X-ray, 2 or more views one side CPT 73660 HC Toe Lt | $309.98 | $413.30 | $97.80–$413.30 | 54% above | 25% |
| Toe X-ray, 2 or more views one side CPT 73660 HC Toe,Left | $309.98 | $413.30 | $97.80–$413.30 | 54% above | 25% |
| Toe X-ray, 2 or more views one side CPT 73660 HC Toe,Right | $309.98 | $413.30 | $97.80–$413.30 | 54% above | 25% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Toe Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Toe,Left | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Toe,Right | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Transvaginal pelvic ultrasound CPT 76830 HC Transvaginal US Non-OB | $146.36 | $195.14 | $118.12–$747.93 | 69% below | 25% |
| Transvaginal pelvic ultrasound CPT 76830 HC F-Ult Nonob Transvag | $705.83 | $941.10 | $118.12–$941.10 | 51% above | 25% |
| Transvaginal pelvic ultrasound CPT 76830 HC Transvaginal Ult | $705.83 | $941.10 | $118.12–$941.10 | 51% above | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC Transvaginal US Non-OB | $146.36 | $195.14 | $118.12–$747.93 | — | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC F-Ult Nonob Transvag | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC Transvaginal Ult | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC Transvaginal US Obstetric | $146.36 | $195.14 | $118.12–$747.93 | 60% below | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC F-Ult OB Transvag | $640.23 | $853.64 | $118.12–$853.64 | 77% above | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC OB Ult,Transvaginal | $667.51 | $890.01 | $118.12–$890.01 | 85% above | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC Transvaginal US Obstetric | $146.36 | $195.14 | $118.12–$747.93 | — | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC F-Ult OB Transvag | $640.23 | $853.64 | $118.12–$853.64 | — | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC OB Ult,Transvaginal | $667.51 | $890.01 | $118.12–$890.01 | — | 25% |
| Ultrasound of the abdomen, complete CPT 76700 HC Abd Ult,Complete | $904.19 | $1,205.59 | $118.12–$1,205.59 | 50% above | 25% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC Abd Ult,Complete | $904.19 | $1,205.59 | $118.12–$1,205.59 | — | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 HC Testicular Ult | $705.83 | $941.10 | $118.12–$941.10 | 33% above | 25% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC Testicular Ult | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Exam of Head and Neck | $146.36 | $195.14 | $118.12–$747.93 | 69% below | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Head and Neck, Soft Tissues | $705.83 | $941.10 | $118.12–$941.10 | 47% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Exam of Head and Neck | $146.36 | $195.14 | $118.12–$747.93 | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Head and Neck, Soft Tissues | $705.83 | $941.10 | $118.12–$941.10 | — | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Upper GI Single Contrast | $552.44 | $736.58 | $197.74–$736.58 | 3% below | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Upper GI Tract Xray | $552.44 | $736.58 | $197.74–$736.58 | 3% below | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Upper GI Single Contrast | $552.44 | $736.58 | $197.74–$736.58 | — | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Upper GI Tract Xray | $552.44 | $736.58 | $197.74–$736.58 | — | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC Humerus,Lt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC Humerus,Rt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Humerus Lt | $309.98 | $413.30 | $97.80–$413.30 | 30% above | 25% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Humerus,Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Humerus,Rt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Humerus Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Doppler Venous Ext Lt | $934.34 | $1,245.79 | $118.12–$1,245.79 | 47% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Doppler Venous Ext Rt | $934.34 | $1,245.79 | $118.12–$1,245.79 | 47% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Doppler Venous Ext Lt | $934.34 | $1,245.79 | $118.12–$1,245.79 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Doppler Venous Ext Rt | $934.34 | $1,245.79 | $118.12–$1,245.79 | — | 25% |
| Wrist X-ray, 2 views CPT 73100 HC Wrist,Rt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | 37% above | 25% |
| Wrist X-ray, 2 views CPT 73100 HC Wrist,Lt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | 37% above | 25% |
| Wrist X-ray, 2 views one side CPT 73100 HC Wrist Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | 37% above | 25% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC Wrist,Rt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC Wrist,Lt 2 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HC Wrist Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist,Rt 3-4 Vws | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist,Lt 3-4 Vws | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Wrist Lt 3-4 View | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Wrist,Rt 3-4 Vws | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Wrist,Lt 3-4 Vws | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Wrist Lt 3-4 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip Lt 2 View | $282.83 | $377.10 | $97.80–$377.10 | 4% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip,Left 2 Views | $282.83 | $377.10 | $97.80–$377.10 | 4% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Hip,Right 2 Views | $282.83 | $377.10 | $97.80–$377.10 | 4% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip 2-3 Vw Lt | $458.30 | $611.06 | $97.80–$611.06 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip 2-3 Vw Rt | $458.30 | $611.06 | $97.80–$611.06 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip,Right 2 Views | $282.83 | $377.10 | $97.80–$377.10 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip Lt 2 View | $282.83 | $377.10 | $97.80–$377.10 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Hip,Left 2 Views | $282.83 | $377.10 | $97.80–$377.10 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip 2-3 Vw Rt | $458.30 | $611.06 | $97.80–$611.06 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip 2-3 Vw Lt | $458.30 | $611.06 | $97.80–$611.06 | — | 25% |
| X-ray of the abdomen, 1 view CPT 74018 HC Abd 1 View | $291.44 | $388.58 | $97.80–$388.58 | 17% above | 25% |
| X-ray of the abdomen, 1 view CPT 74018 HC Abd,1 View | $303.85 | $405.13 | $97.80–$405.13 | 22% above | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC Abd 1 View | $291.44 | $388.58 | $97.80–$388.58 | — | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC Abd,1 View | $303.85 | $405.13 | $97.80–$405.13 | — | 25% |
| X-ray of the ankle, 2 views one side CPT 73600 HC Ankle,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the ankle, 2 views one side CPT 73600 HC Ankle,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the ankle, 2 views one side CPT 73600 HC Ankle Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Ankle,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger,Left | $309.98 | $413.30 | $97.80–$413.30 | 42% above | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger,Right | $309.98 | $413.30 | $97.80–$413.30 | 42% above | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC Finger Lt | $309.98 | $413.30 | $97.80–$413.30 | 42% above | 25% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger Lt | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger,Right | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Finger,Left | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, 2 views one side CPT 73620 HC Foot,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 38% above | 25% |
| X-ray of the foot, 2 views one side CPT 73620 HC Foot,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 38% above | 25% |
| X-ray of the foot, 2 views one side CPT 73620 HC Foot Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | 38% above | 25% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC Foot Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot Lt 3 View | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot,Right 3 Views | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Foot,Left 3 Views | $309.98 | $413.30 | $97.80–$413.30 | 22% above | 25% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot,Left 3 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot Lt 3 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Foot,Right 3 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC Hand,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 9% above | 25% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC Hand,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | 9% above | 25% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC Hand Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | 9% above | 25% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand,Left 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand Lt 3 View | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Hand,Right 3 Views | $310.65 | $414.20 | $97.80–$414.20 | — | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee Left 1 Vw | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee Right 1 Vw | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC Knee,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | 26% above | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee Lt 2 View | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee,Left 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Knee,Right 2 Views | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee Right 1 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee Left 1 Vw | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbar 2 View | $404.78 | $539.71 | $118.12–$539.71 | 30% above | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine,Lumbar 2 Views | $404.78 | $539.71 | $118.12–$539.71 | 30% above | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine Lumbar 2 View | $404.78 | $539.71 | $118.12–$539.71 | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine,Lumbar 2 Views | $404.78 | $539.71 | $118.12–$539.71 | — | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbar 5 View | $462.93 | $617.24 | $118.12–$617.24 | 15% above | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine,Lumbar 5 Views | $462.93 | $617.24 | $118.12–$617.24 | 15% above | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine Lumbar 5 View | $462.93 | $617.24 | $118.12–$617.24 | — | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine,Lumbar 5 Views | $462.93 | $617.24 | $118.12–$617.24 | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine,Thoracic 2 Views | $320.90 | $427.87 | $118.12–$490.36 | 11% above | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2 View | $320.90 | $427.87 | $118.12–$490.36 | 11% above | 25% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine,Thoracic 2 Views | $320.90 | $427.87 | $118.12–$490.36 | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine Thoracic 2 View | $320.90 | $427.87 | $118.12–$490.36 | — | 25% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones Complete | $309.98 | $413.30 | $97.80–$413.30 | 40% above | 25% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Nasal Bones Complete | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2-3 View | $341.35 | $455.13 | $97.80–$490.36 | 32% above | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine,Cervical 2-3 Views | $341.35 | $455.13 | $97.80–$490.36 | 32% above | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 2-3 View | $341.35 | $455.13 | $97.80–$490.36 | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine,Cervical 2-3 Views | $341.35 | $455.13 | $97.80–$490.36 | — | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 1-2 View | $309.98 | $413.30 | $118.12–$490.36 | 14% above | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis,1-2 Views | $309.98 | $413.30 | $118.12–$490.36 | 14% above | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis 1-2 View | $309.98 | $413.30 | $118.12–$490.36 | — | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis,1-2 Views | $309.98 | $413.30 | $118.12–$490.36 | — | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacrum/Coccyx | $309.98 | $413.30 | $97.80–$413.30 | 24% above | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Sacrum/Coccyx | $309.98 | $413.30 | $97.80–$413.30 | — | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC Acth S/O | $196.01 | $261.34 | $38.62–$261.34 | 55% above | 25% |
| ACTH blood test inpatient CPT 82024 HC Acth S/O | $196.01 | $261.34 | $38.62–$261.34 | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt,Alt | $39.24 | $52.32 | $5.30–$52.32 | 64% above | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Transferase (Alt) (Sgpt), S/O | $41.33 | $55.11 | $5.30–$55.11 | 72% above | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Sgpt,Alt | $39.24 | $52.32 | $5.30–$52.32 | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Transferase (Alt) (Sgpt), S/O | $41.33 | $55.11 | $5.30–$55.11 | — | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Sgot,Ast | $38.55 | $51.40 | $5.18–$51.40 | 35% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase (Ast) (Sgot) , S/O | $41.33 | $55.11 | $5.18–$55.11 | 45% above | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Sgot,Ast | $38.55 | $51.40 | $5.18–$51.40 | — | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Transferase (Ast) (Sgot) , S/O | $41.33 | $55.11 | $5.18–$55.11 | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel | $287.24 | $382.99 | $47.63–$382.99 | 29% above | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel S/O | $299.49 | $399.32 | $47.63–$399.32 | 35% above | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel | $287.24 | $382.99 | $47.63–$382.99 | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel S/O | $299.49 | $399.32 | $47.63–$399.32 | — | 25% |
| Albumin blood test CPT 82040 HC Albumin,Serum | $41.76 | $55.68 | $4.95–$55.68 | 64% above | 25% |
| Albumin blood test CPT 82040 HC Mspm,Alb,Serum S/O | $41.76 | $55.68 | $4.95–$55.68 | 64% above | 25% |
| Albumin blood test inpatient CPT 82040 HC Albumin,Serum | $41.76 | $55.68 | $4.95–$55.68 | — | 25% |
| Albumin blood test inpatient CPT 82040 HC Mspm,Alb,Serum S/O | $41.76 | $55.68 | $4.95–$55.68 | — | 25% |
| Aldosterone blood test CPT 82088 HC Aldosterone,24 Hr Urine S/O | $197.15 | $262.86 | $40.75–$270.33 | 128% above | 25% |
| Aldosterone blood test CPT 82088 HC Aldosterone,Serum S/O | $300.56 | $400.74 | $40.75–$400.74 | 248% above | 25% |
| Aldosterone blood test inpatient CPT 82088 HC Aldosterone,24 Hr Urine S/O | $197.15 | $262.86 | $40.75–$270.33 | — | 25% |
| Aldosterone blood test inpatient CPT 82088 HC Aldosterone,Serum S/O | $300.56 | $400.74 | $40.75–$400.74 | — | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Alk Phos | $39.29 | $52.38 | $5.18–$52.38 | 71% above | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Alk Phos Total,S/O | $42.48 | $56.64 | $5.18–$56.64 | 85% above | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alk Phos | $39.29 | $52.38 | $5.18–$52.38 | — | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alk Phos Total,S/O | $42.48 | $56.64 | $5.18–$56.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Resp Profile, Reg 17, Pacific Nw, S/O | $20.63 | $27.50 | $5.22–$34.63 | 62% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #2 | $24.14 | $32.18 | $5.22–$34.63 | 89% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Bird Fancier,Hypersens Ohsu | $24.14 | $32.18 | $5.22–$34.63 | 89% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #3 | $24.86 | $33.14 | $5.22–$34.63 | 95% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #4 | $25.25 | $33.66 | $5.22–$34.63 | 98% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Peanut Comp Panel, S/O | $25.84 | $34.45 | $5.22–$34.63 | 103% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #5 | $26.93 | $35.90 | $5.22–$35.90 | 111% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Specific Ige, Ea | $28.89 | $38.52 | $5.22–$38.52 | 127% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #6 | $31.61 | $42.15 | $5.22–$42.15 | 148% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #7 | $33.20 | $44.26 | $5.22–$44.26 | 160% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #8 | $33.31 | $44.41 | $5.22–$44.41 | 161% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #9 | $33.32 | $44.42 | $5.22–$44.42 | 161% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #10 | $35.23 | $46.97 | $5.22–$46.97 | 176% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #11 | $36.85 | $49.13 | $5.22–$49.13 | 189% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #12 | $37.29 | $49.72 | $5.22–$49.72 | 192% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #13 | $38.14 | $50.85 | $5.22–$50.85 | 199% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #14 | $38.18 | $50.90 | $5.22–$50.90 | 199% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #16 | $38.44 | $51.25 | $5.22–$51.25 | 201% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #17 | $40.15 | $53.53 | $5.22–$53.53 | 215% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #1 | $40.15 | $53.53 | $5.22–$53.53 | 215% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #15 | $40.15 | $53.53 | $5.22–$53.53 | 215% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #18 | $40.15 | $53.53 | $5.22–$53.53 | 215% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #20 | $65.18 | $86.90 | $5.22–$86.90 | 411% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Each S/O #19 | $66.32 | $88.42 | $5.22–$88.42 | 420% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Bird Fancier,Hypersens/Ohsu | $68.13 | $90.84 | $5.22–$90.84 | 434% above | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Resp Profile, Reg 17, Pacific Nw, S/O | $20.63 | $27.50 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Bird Fancier,Hypersens Ohsu | $24.14 | $32.18 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #2 | $24.14 | $32.18 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #3 | $24.86 | $33.14 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #4 | $25.25 | $33.66 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Peanut Comp Panel, S/O | $25.84 | $34.45 | $5.22–$34.63 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #5 | $26.93 | $35.90 | $5.22–$35.90 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Specific Ige, Ea | $28.89 | $38.52 | $5.22–$38.52 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #6 | $31.61 | $42.15 | $5.22–$42.15 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #7 | $33.20 | $44.26 | $5.22–$44.26 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #8 | $33.31 | $44.41 | $5.22–$44.41 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #9 | $33.32 | $44.42 | $5.22–$44.42 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #10 | $35.23 | $46.97 | $5.22–$46.97 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #11 | $36.85 | $49.13 | $5.22–$49.13 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #12 | $37.29 | $49.72 | $5.22–$49.72 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #13 | $38.14 | $50.85 | $5.22–$50.85 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #14 | $38.18 | $50.90 | $5.22–$50.90 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #16 | $38.44 | $51.25 | $5.22–$51.25 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #1 | $40.15 | $53.53 | $5.22–$53.53 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #15 | $40.15 | $53.53 | $5.22–$53.53 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #18 | $40.15 | $53.53 | $5.22–$53.53 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #17 | $40.15 | $53.53 | $5.22–$53.53 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #20 | $65.18 | $86.90 | $5.22–$86.90 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Each S/O #19 | $66.32 | $88.42 | $5.22–$88.42 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Bird Fancier,Hypersens/Ohsu | $68.13 | $90.84 | $5.22–$90.84 | — | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Fetoprotein, Maternal S/O | $108.24 | $144.32 | $16.77–$144.32 | 49% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Fetoprotein,Maternal S/O | $110.97 | $147.96 | $16.77–$147.96 | 53% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Fetoprotein,Tum Mark S/O | $123.73 | $164.97 | $16.77–$164.97 | 70% above | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Fetoprotein, Maternal S/O | $108.24 | $144.32 | $16.77–$144.32 | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Fetoprotein,Maternal S/O | $110.97 | $147.96 | $16.77–$147.96 | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Fetoprotein,Tum Mark S/O | $123.73 | $164.97 | $16.77–$164.97 | — | 25% |
| Ammonia blood test CPT 82140 HC Ssatu Prof, Ammonium UR S/O | $54.80 | $73.07 | $14.57–$96.67 | 37% below | 25% |
| Ammonia blood test CPT 82140 HC Ammonia | $107.47 | $143.29 | $14.57–$143.29 | 23% above | 25% |
| Ammonia blood test inpatient CPT 82140 HC Ssatu Prof, Ammonium UR S/O | $54.80 | $73.07 | $14.57–$96.67 | — | 25% |
| Ammonia blood test inpatient CPT 82140 HC Ammonia | $107.47 | $143.29 | $14.57–$143.29 | — | 25% |
| Amylase blood test CPT 82150 HC Amylase Isoenzymes, S/O | $57.50 | $76.66 | $6.48–$76.66 | 20% above | 25% |
| Amylase blood test CPT 82150 HC Amylase | $57.50 | $76.66 | $6.48–$76.66 | 20% above | 25% |
| Amylase blood test CPT 82150 HC Amylase, Pancreatic Cyst S/O | $148.50 | $198.00 | $6.48–$198.00 | 209% above | 25% |
| Amylase blood test inpatient CPT 82150 HC Amylase | $57.50 | $76.66 | $6.48–$76.66 | — | 25% |
| Amylase blood test inpatient CPT 82150 HC Amylase Isoenzymes, S/O | $57.50 | $76.66 | $6.48–$76.66 | — | 25% |
| Amylase blood test inpatient CPT 82150 HC Amylase, Pancreatic Cyst S/O | $148.50 | $198.00 | $6.48–$198.00 | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Citrullinated Peptide Ab | $90.50 | $120.66 | $12.95–$120.66 | 71% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP-Citrulline Ab | $93.22 | $124.29 | $12.95–$124.29 | 76% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Citrullinated Peptide Ab | $90.50 | $120.66 | $12.95–$120.66 | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP-Citrulline Ab | $93.22 | $124.29 | $12.95–$124.29 | — | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Anti Nuclear Antibody,Ana | $87.84 | $117.12 | $12.09–$117.12 | 52% above | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Anti Nuclear Antibody,Ana | $87.84 | $117.12 | $12.09–$117.12 | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Nt-Pro Bnp, S/O | $144.88 | $193.17 | $39.26–$225.19 | 8% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Brain Natriuretic Peptide | $164.20 | $218.93 | $39.26–$225.19 | 4% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Pro Bnp | $164.20 | $218.93 | $39.26–$225.19 | 4% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC B-Type Natriuretic Peptide (Bnp) | $172.83 | $230.44 | $39.26–$230.44 | 9% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Nt-Pro Bnp, S/O | $144.88 | $193.17 | $39.26–$225.19 | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Brain Natriuretic Peptide | $164.20 | $218.93 | $39.26–$225.19 | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Pro Bnp | $164.20 | $218.93 | $39.26–$225.19 | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC B-Type Natriuretic Peptide (Bnp) | $172.83 | $230.44 | $39.26–$230.44 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture, Cystic Fibrosis | $144.19 | $192.25 | $8.62–$192.25 | 175% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture,Aerobic | $156.84 | $209.12 | $8.62–$209.12 | 199% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Culture, Environmental | $169.11 | $225.48 | $8.62–$225.48 | 223% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture, Cystic Fibrosis | $144.19 | $192.25 | $8.62–$192.25 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture,Aerobic | $156.84 | $209.12 | $8.62–$209.12 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Culture, Environmental | $169.11 | $225.48 | $8.62–$225.48 | — | 25% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel | $66.23 | $88.30 | $8.46–$88.30 | 38% above | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel | $66.23 | $88.30 | $8.46–$88.30 | — | 25% |
| Bilirubin blood test, total CPT 82247 HC Bilirubin,Total | $30.72 | $40.96 | $5.02–$40.96 | 20% above | 25% |
| Bilirubin blood test, total CPT 82247 HC Total Bilirubin, S/O | $39.22 | $52.29 | $5.02–$52.29 | 54% above | 25% |
| Bilirubin blood test, total CPT 82247 HC Bilirubin, Body Fluid, S/O | $93.23 | $124.30 | $5.02–$124.30 | 266% above | 25% |
| Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin,Total | $30.72 | $40.96 | $5.02–$40.96 | — | 25% |
| Bilirubin blood test, total inpatient CPT 82247 HC Total Bilirubin, S/O | $39.22 | $52.29 | $5.02–$52.29 | — | 25% |
| Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin, Body Fluid, S/O | $93.23 | $124.30 | $5.02–$124.30 | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Prostate Core Biopsy | $344.30 | $459.07 | $378.73–$1,019.88 | 76% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Lvl IV,Surg Path,Gross & Exam | $351.20 | $468.27 | $59.35–$468.27 | 79% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Prostate Core Biopsy | $344.30 | $459.07 | $378.73–$1,019.88 | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Lvl IV,Surg Path,Gross & Exam | $351.20 | $468.27 | $59.35–$468.27 | — | 25% |
| Blood culture for bacteria CPT 87040 HC Culture,Blood | $328.56 | $438.08 | $10.32–$438.08 | 198% above | 25% |
| Blood culture for bacteria inpatient CPT 87040 HC Culture,Blood | $328.56 | $438.08 | $10.32–$438.08 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture | $19.83 | $26.44 | $3.10–$42.03 | 2% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Alcohol Legal Draw | $23.21 | $30.94 | $3.10–$42.03 | 15% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Specimen Collection | $24.22 | $32.29 | $3.10–$42.03 | 20% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Venipuncture | $19.83 | $26.44 | $3.10–$42.03 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Alcohol Legal Draw | $23.21 | $30.94 | $3.10–$42.03 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Specimen Collection | $24.22 | $32.29 | $3.10–$42.03 | — | 25% |
| Blood glucose (sugar) test CPT 82947 HC Glucose | $39.03 | $52.04 | $3.93–$52.04 | 74% above | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC Glucose | $39.03 | $52.04 | $3.93–$52.04 | — | 25% |
| Blood lead test CPT 83655 HC Lead,Blood,Quant S/O | $66.58 | $88.77 | $12.11–$88.77 | 83% above | 25% |
| Blood lead test CPT 83655 HC Lead, Capillary W/Demographics | $67.01 | $89.35 | $12.11–$89.35 | 84% above | 25% |
| Blood lead test CPT 83655 HC Lead S/O | $68.67 | $91.56 | $12.11–$91.56 | 89% above | 25% |
| Blood lead test CPT 83655 HC Lead,Urine,Quant S/O | $83.81 | $111.74 | $12.11–$111.74 | 130% above | 25% |
| Blood lead test CPT 83655 HC Lead,Urine S/O | $93.96 | $125.28 | $12.11–$125.28 | 158% above | 25% |
| Blood lead test inpatient CPT 83655 HC Lead,Blood,Quant S/O | $66.58 | $88.77 | $12.11–$88.77 | — | 25% |
| Blood lead test inpatient CPT 83655 HC Lead, Capillary W/Demographics | $67.01 | $89.35 | $12.11–$89.35 | — | 25% |
| Blood lead test inpatient CPT 83655 HC Lead S/O | $68.67 | $91.56 | $12.11–$91.56 | — | 25% |
| Blood lead test inpatient CPT 83655 HC Lead,Urine,Quant S/O | $83.81 | $111.74 | $12.11–$111.74 | — | 25% |
| Blood lead test inpatient CPT 83655 HC Lead,Urine S/O | $93.96 | $125.28 | $12.11–$125.28 | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Hcg,Qual,Preg Test | $80.54 | $107.39 | $7.52–$107.39 | 16% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Hcg,Qual,Preg Test | $80.54 | $107.39 | $7.52–$107.39 | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing Abo | $102.90 | $137.20 | $58.01–$272.43 | 85% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Arc Abo Type | $127.79 | $170.38 | $72.04–$272.43 | 130% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing Abo | $102.90 | $137.20 | $58.01–$272.43 | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Arc Abo Type | $127.79 | $170.38 | $72.04–$272.43 | — | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 HC Bun,Blood Urea Nitrog | $38.21 | $50.95 | $3.95–$50.95 | 50% above | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Bun,Blood Urea Nitrog | $38.21 | $50.95 | $3.95–$50.95 | — | 25% |
| C-peptide blood test CPT 84681 HC C-Peptide | $112.96 | $150.61 | $20.81–$150.61 | 26% above | 25% |
| C-peptide blood test inpatient CPT 84681 HC C-Peptide | $112.96 | $150.61 | $20.81–$150.61 | — | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C Reactive Protein | $34.50 | $46.00 | $5.18–$46.00 | 8% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C Reactive Protein | $34.50 | $46.00 | $5.18–$46.00 | — | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C Diff Amplified Probe | $378.61 | $504.81 | $37.27–$504.81 | 147% above | 25% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C Diff Amplified Probe | $378.61 | $504.81 | $37.27–$504.81 | — | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Ca 19-9 S/O | $104.09 | $138.79 | $20.81–$138.79 | 11% above | 25% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Ca 19-9 S/O | $104.09 | $138.79 | $20.81–$138.79 | — | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Ca 125 | $122.08 | $162.77 | $20.81–$162.77 | 12% above | 25% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Ca 125 | $122.08 | $162.77 | $20.81–$162.77 | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Covid-19 High Throughput | $224.31 | $299.08 | $51.31–$299.08 | 87% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Covid-19 High Throughput | $224.31 | $299.08 | $51.31–$299.08 | — | 25% |
| Calcium blood test, total CPT 82310 HC Calcium, Urine | $35.64 | $47.52 | $5.16–$47.52 | 40% above | 25% |
| Calcium blood test, total CPT 82310 HC Calcium,Serum | $37.78 | $50.37 | $5.16–$50.37 | 49% above | 25% |
| Calcium blood test, total CPT 82310 HC Parathyroid Horm,Ca Int S/O | $37.78 | $50.37 | $5.16–$50.37 | 49% above | 25% |
| Calcium blood test, total inpatient CPT 82310 HC Calcium, Urine | $35.64 | $47.52 | $5.16–$47.52 | — | 25% |
| Calcium blood test, total inpatient CPT 82310 HC Calcium,Serum | $37.78 | $50.37 | $5.16–$50.37 | — | 25% |
| Calcium blood test, total inpatient CPT 82310 HC Parathyroid Horm,Ca Int S/O | $37.78 | $50.37 | $5.16–$50.37 | — | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea | $129.12 | $172.16 | $18.96–$172.16 | 58% above | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea, Peritoneal Fluid S/O | $178.93 | $238.57 | $18.96–$238.57 | 119% above | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea, Pancreatic Cyst Fluid | $184.85 | $246.46 | $18.96–$246.46 | 126% above | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea | $129.12 | $172.16 | $18.96–$172.16 | — | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea, Peritoneal Fluid S/O | $178.93 | $238.57 | $18.96–$238.57 | — | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea, Pancreatic Cyst Fluid | $184.85 | $246.46 | $18.96–$246.46 | — | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella Zoster Ab, Igm S/O | $79.26 | $105.68 | $12.88–$105.68 | 30% above | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella Zoster Ab | $79.26 | $105.68 | $12.88–$105.68 | 30% above | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Varicella Ab Igg,S/O Mod 90 Ref Lab | $132.08 | $176.11 | $12.88–$176.11 | 117% above | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella Zoster Ab, Igm S/O | $79.26 | $105.68 | $12.88–$105.68 | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella Zoster Ab | $79.26 | $105.68 | $12.88–$105.68 | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Varicella Ab Igg,S/O Mod 90 Ref Lab | $132.08 | $176.11 | $12.88–$176.11 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia,Dna Probe | $105.09 | $140.12 | $35.09–$232.79 | 12% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Trachomatis Dna (Labcorp) | $151.98 | $202.64 | $35.09–$232.79 | 62% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC C Trachomatis Nuc Acid Amp So | $231.35 | $308.47 | $35.09–$308.47 | 146% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Trachomatis Amp Rna, S/O | $270.00 | $360.00 | $35.09–$360.00 | 187% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Dna Probe | $378.61 | $504.81 | $35.09–$504.81 | 302% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia,Dna Probe | $105.09 | $140.12 | $35.09–$232.79 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Trachomatis Dna (Labcorp) | $151.98 | $202.64 | $35.09–$232.79 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC C Trachomatis Nuc Acid Amp So | $231.35 | $308.47 | $35.09–$308.47 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Trachomatis Amp Rna, S/O | $270.00 | $360.00 | $35.09–$360.00 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Dna Probe | $378.61 | $504.81 | $35.09–$504.81 | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Cardiac Risk,Lipid Prof | $86.34 | $115.12 | $13.39–$115.12 | 50% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $86.34 | $115.12 | $13.39–$115.12 | 50% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $86.34 | $115.12 | $13.39–$115.12 | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Cardiac Risk,Lipid Prof | $86.34 | $115.12 | $13.39–$115.12 | — | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc Auto W/Plts | $91.28 | $121.70 | $7.77–$121.70 | 121% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc W/Automated Diff | $91.69 | $122.25 | $7.77–$122.25 | 122% above | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Auto W/Plts | $91.28 | $121.70 | $7.77–$121.70 | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc W/Automated Diff | $91.69 | $122.25 | $7.77–$122.25 | — | 25% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc,Auto(W/Man Diff) | $65.39 | $87.18 | $6.47–$87.18 | 112% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 HC Hemogram W/Plts | $65.39 | $87.18 | $6.47–$87.18 | 112% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 HC Hemogram#2 | $69.17 | $92.22 | $6.47–$92.22 | 124% above | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Hemogram W/Plts | $65.39 | $87.18 | $6.47–$87.18 | — | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc,Auto(W/Man Diff) | $65.39 | $87.18 | $6.47–$87.18 | — | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Hemogram#2 | $69.17 | $92.22 | $6.47–$92.22 | — | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $76.82 | $102.43 | $10.56–$102.43 | 53% above | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Compre Metabolic Panel | $81.94 | $109.25 | $10.56–$109.25 | 64% above | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $76.82 | $102.43 | $10.56–$102.43 | — | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Compre Metabolic Panel | $81.94 | $109.25 | $10.56–$109.25 | — | 25% |
| Cortisol blood test, total CPT 82533 HC Cortisol, Lc-Ms/Ms, S/O | $81.21 | $108.28 | $16.30–$108.28 | 2% below | 25% |
| Cortisol blood test, total CPT 82533 HC Cortisol, Saliva S/O | $112.87 | $150.49 | $16.30–$150.49 | 36% above | 25% |
| Cortisol blood test, total CPT 82533 HC Cortisol,Serum | $120.25 | $160.33 | $16.30–$160.33 | 45% above | 25% |
| Cortisol blood test, total inpatient CPT 82533 HC Cortisol, Lc-Ms/Ms, S/O | $81.21 | $108.28 | $16.30–$108.28 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 HC Cortisol, Saliva S/O | $112.87 | $150.49 | $16.30–$150.49 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 HC Cortisol,Serum | $120.25 | $160.33 | $16.30–$160.33 | — | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC Cpk | $56.56 | $75.41 | $6.51–$75.41 | 39% above | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC CK Isoenzymes S/O | $61.71 | $82.28 | $6.51–$82.28 | 52% above | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Cpk | $56.56 | $75.41 | $6.51–$75.41 | — | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK Isoenzymes S/O | $61.71 | $82.28 | $6.51–$82.28 | — | 25% |
| Creatinine blood test CPT 82565 HC Creatinine,Serum | $40.59 | $54.12 | $5.12–$54.12 | 64% above | 25% |
| Creatinine blood test inpatient CPT 82565 HC Creatinine,Serum | $40.59 | $54.12 | $5.12–$54.12 | — | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Torch P,Cmv Igg S/O | $79.15 | $105.53 | $14.39–$105.53 | 35% above | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Antibodies,Igg S/O | $87.64 | $116.85 | $14.39–$116.85 | 49% above | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Torch P,Cmv Igg S/O | $79.15 | $105.53 | $14.39–$105.53 | — | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Antibodies,Igg S/O | $87.64 | $116.85 | $14.39–$116.85 | — | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 HC Fibrin Degradation Quant S/O | $72.52 | $96.69 | $10.18–$96.69 | 44% below | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 HC D Dimer,Rflx S/O | $135.07 | $180.09 | $10.18–$180.09 | 4% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 HC D-Dimer,Quant | $140.30 | $187.07 | $10.18–$187.07 | 8% above | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC Fibrin Degradation Quant S/O | $72.52 | $96.69 | $10.18–$96.69 | — | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D Dimer,Rflx S/O | $135.07 | $180.09 | $10.18–$180.09 | — | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-Dimer,Quant | $140.30 | $187.07 | $10.18–$187.07 | — | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea, Sulfate S/O | $151.96 | $202.61 | $22.23–$202.61 | 82% above | 25% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dhea, Sulfate S/O | $151.96 | $202.61 | $22.23–$202.61 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Drugs of Abuse (>5) | $53.59 | $71.45 | $30.21–$295.79 | 7% below | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Qual Multi Panel 1 | $72.60 | $96.80 | $40.93–$295.79 | 26% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Etoh Screen S/O | $74.25 | $99.00 | $41.86–$295.79 | 29% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Presumptive | $74.25 | $99.00 | $41.86–$295.79 | 29% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Ethyl Glucuronide Urine, S/O | $81.68 | $108.90 | $46.04–$295.79 | 41% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Drugs of Abuse (<5) | $90.75 | $121.00 | $51.16–$295.79 | 57% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Fentanyl Screening,Urine Legacy | $98.01 | $130.68 | $55.25–$544.69 | 70% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Dau 4 Mec, S/O | $107.25 | $143.00 | $60.46–$295.79 | 86% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Scr Prescription/Otc | $158.51 | $211.34 | $62.14–$295.79 | 174% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Multi Drug Screen S/O | $217.80 | $290.40 | $62.14–$295.79 | 277% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Qual Multi Panel 2 | $231.00 | $308.00 | $62.14–$308.00 | 300% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Abuse Scr Meconium | $299.42 | $399.23 | $62.14–$399.23 | 418% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Umbilical Cord Drug Screen 15 Panel W/Etg | $307.59 | $410.12 | $114.43–$544.69 | 433% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Qual Multi Panel 4 | $346.50 | $462.00 | $62.14–$462.00 | 500% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Qual Multi Panel 3 | $350.46 | $467.28 | $62.14–$467.28 | 507% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Umbilical Cord Drug Scrn 18 Panel W/Etg | $372.84 | $497.12 | $62.14–$497.12 | 546% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Mecstat5 Drug Screen S/O | $392.29 | $523.05 | $62.14–$523.05 | 579% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen 9 Pnl | $395.81 | $527.74 | $62.14–$527.74 | 585% above | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Drugs of Abuse (>5) | $53.59 | $71.45 | $30.21–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Qual Multi Panel 1 | $72.60 | $96.80 | $40.93–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Etoh Screen S/O | $74.25 | $99.00 | $41.86–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Presumptive | $74.25 | $99.00 | $41.86–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Ethyl Glucuronide Urine, S/O | $81.68 | $108.90 | $46.04–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Drugs of Abuse (<5) | $90.75 | $121.00 | $51.16–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Fentanyl Screening,Urine Legacy | $98.01 | $130.68 | $55.25–$544.69 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Dau 4 Mec, S/O | $107.25 | $143.00 | $60.46–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Scr Prescription/Otc | $158.51 | $211.34 | $62.14–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Multi Drug Screen S/O | $217.80 | $290.40 | $62.14–$295.79 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Qual Multi Panel 2 | $231.00 | $308.00 | $62.14–$308.00 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Abuse Scr Meconium | $299.42 | $399.23 | $62.14–$399.23 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB Umbilical Cord Drug Screen 15 Panel W/Etg | $307.59 | $410.12 | $114.43–$544.69 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Qual Multi Panel 4 | $346.50 | $462.00 | $62.14–$462.00 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Qual Multi Panel 3 | $350.46 | $467.28 | $62.14–$467.28 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Umbilical Cord Drug Scrn 18 Panel W/Etg | $372.84 | $497.12 | $62.14–$497.12 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Mecstat5 Drug Screen S/O | $392.29 | $523.05 | $62.14–$523.05 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen 9 Pnl | $395.81 | $527.74 | $62.14–$527.74 | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolytes | $49.94 | $66.58 | $7.01–$66.58 | 39% above | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolytes | $49.94 | $66.58 | $7.01–$66.58 | — | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein Barr Vir Ab V Cap Ag Igm So | $86.47 | $115.29 | $18.14–$120.39 | 17% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein Barr Vir Ab V Cap Ag Igg So | $86.47 | $115.29 | $18.14–$120.39 | 17% above | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein Barr Vir Ab V Cap Ag Igg So | $86.47 | $115.29 | $18.14–$120.39 | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein Barr Vir Ab V Cap Ag Igm So | $86.47 | $115.29 | $18.14–$120.39 | — | 25% |
| Estradiol blood test CPT 82670 HC Estrogen Fract,Estrodiol S/O | $151.37 | $201.83 | $27.94–$201.83 | 42% above | 25% |
| Estradiol blood test CPT 82670 HC Estradiol S/O | $151.37 | $201.83 | $27.94–$201.83 | 42% above | 25% |
| Estradiol blood test CPT 82670 HC Estradiol | $159.34 | $212.45 | $27.94–$212.45 | 49% above | 25% |
| Estradiol blood test inpatient CPT 82670 HC Estrogen Fract,Estrodiol S/O | $151.37 | $201.83 | $27.94–$201.83 | — | 25% |
| Estradiol blood test inpatient CPT 82670 HC Estradiol S/O | $151.37 | $201.83 | $27.94–$201.83 | — | 25% |
| Estradiol blood test inpatient CPT 82670 HC Estradiol | $159.34 | $212.45 | $27.94–$212.45 | — | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh S/O | $91.97 | $122.63 | $18.58–$123.26 | 18% above | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh | $137.09 | $182.78 | $18.58–$182.78 | 76% above | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh S/O | $91.97 | $122.63 | $18.58–$123.26 | — | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh | $137.09 | $182.78 | $18.58–$182.78 | — | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC Fecal Calprotectin S/O | $235.83 | $314.44 | $19.63–$314.44 | 144% above | 25% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Fecal Calprotectin S/O | $235.83 | $314.44 | $19.63–$314.44 | — | 25% |
| Ferritin blood test (iron stores) CPT 82728 HC Ferritin | $100.46 | $133.94 | $13.63–$133.94 | 81% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 HC Ferritin, S/O | $110.50 | $147.33 | $13.63–$147.33 | 99% above | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin | $100.46 | $133.94 | $13.63–$133.94 | — | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin, S/O | $110.50 | $147.33 | $13.63–$147.33 | — | 25% |
| Fibrinogen blood test CPT 85384 HC Fibrinogen Clauss | $50.82 | $67.76 | $9.72–$67.76 | 20% below | 25% |
| Fibrinogen blood test CPT 85384 HC Fibrinogen | $66.23 | $88.30 | $9.72–$88.30 | 4% above | 25% |
| Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Clauss | $50.82 | $67.76 | $9.72–$67.76 | — | 25% |
| Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen | $66.23 | $88.30 | $9.72–$88.30 | — | 25% |
| Folate (folic acid) blood test CPT 82746 HC Folate | $108.42 | $144.56 | $14.70–$144.56 | 24% above | 25% |
| Folate (folic acid) blood test inpatient CPT 82746 HC Folate | $108.42 | $144.56 | $14.70–$144.56 | — | 25% |
| Free T3 thyroid hormone test CPT 84481 HC T3,Free | $131.52 | $175.36 | $16.94–$175.36 | 85% above | 25% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC T3,Free | $131.52 | $175.36 | $16.94–$175.36 | — | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 (Thyroxine), Free, S/O | $49.92 | $66.56 | $9.02–$66.56 | 9% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T-4,Free | $66.51 | $88.68 | $9.02–$88.68 | 45% above | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 (Thyroxine), Free, S/O | $49.92 | $66.56 | $9.02–$66.56 | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T-4,Free | $66.51 | $88.68 | $9.02–$88.68 | — | 25% |
| Free testosterone test CPT 84402 HC Testfw,Testosterone,Free S/O | $132.08 | $176.11 | $25.47–$176.11 | 128% above | 25% |
| Free testosterone test CPT 84402 HC Free Testosterone S/O | $132.08 | $176.11 | $25.47–$176.11 | 128% above | 25% |
| Free testosterone test CPT 84402 HC Testosterone Free | $139.03 | $185.37 | $25.47–$185.37 | 140% above | 25% |
| Free testosterone test CPT 84402 HC Free Testosterone, Eso S/O | $180.86 | $241.15 | $25.47–$241.15 | 212% above | 25% |
| Free testosterone test inpatient CPT 84402 HC Testfw,Testosterone,Free S/O | $132.08 | $176.11 | $25.47–$176.11 | — | 25% |
| Free testosterone test inpatient CPT 84402 HC Free Testosterone S/O | $132.08 | $176.11 | $25.47–$176.11 | — | 25% |
| Free testosterone test inpatient CPT 84402 HC Testosterone Free | $139.03 | $185.37 | $25.47–$185.37 | — | 25% |
| Free testosterone test inpatient CPT 84402 HC Free Testosterone, Eso S/O | $180.86 | $241.15 | $25.47–$241.15 | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Ggtp | $53.11 | $70.81 | $7.20–$70.81 | 79% above | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Ggt, S/O | $56.23 | $74.97 | $7.20–$74.97 | 89% above | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Ggtp | $53.11 | $70.81 | $7.20–$70.81 | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Ggt, S/O | $56.23 | $74.97 | $7.20–$74.97 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose, Post Dose #2 | $38.41 | $51.21 | $4.75–$51.21 | 11% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose, Quantitative/Post | $42.08 | $56.10 | $4.75–$56.10 | 22% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC 1hr Post Dose Glucose OB | $42.98 | $57.30 | $4.75–$57.30 | 25% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Post Glucose Dose | $47.57 | $63.43 | $4.75–$63.43 | 38% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose,Post Glucola | $50.08 | $66.77 | $4.75–$66.77 | 45% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose, Post Dose #2 | $38.41 | $51.21 | $4.75–$51.21 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose, Quantitative/Post | $42.08 | $56.10 | $4.75–$56.10 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC 1hr Post Dose Glucose OB | $42.98 | $57.30 | $4.75–$57.30 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Post Glucose Dose | $47.57 | $63.43 | $4.75–$63.43 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose,Post Glucola | $50.08 | $66.77 | $4.75–$66.77 | — | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tol,1st 3 Spec | $76.36 | $101.81 | $12.87–$101.81 | 3% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC Lactose Tol X 3,Sp | $89.54 | $119.38 | $12.87–$119.38 | 14% above | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tol,1st 3 Spec | $76.36 | $101.81 | $12.87–$101.81 | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC Lactose Tol X 3,Sp | $89.54 | $119.38 | $12.87–$119.38 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Neisseria Gonorrhoeae Amp Rna, S/O | $262.86 | $350.48 | $35.09–$350.48 | 180% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Gc,Dna Probe | $378.61 | $504.81 | $35.09–$504.81 | 304% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N Gonorrhoea Nuc Acid Amp So | $427.04 | $569.38 | $35.09–$569.38 | 356% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Neisseria Gonorrhoeae, Rna S/O | $427.04 | $569.38 | $35.09–$569.38 | 356% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Neisseria Gonorrhoeae Amp Rna, S/O | $262.86 | $350.48 | $35.09–$350.48 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Gc,Dna Probe | $378.61 | $504.81 | $35.09–$504.81 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N Gonorrhoea Nuc Acid Amp So | $427.04 | $569.38 | $35.09–$569.38 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Neisseria Gonorrhoeae, Rna S/O | $427.04 | $569.38 | $35.09–$569.38 | — | 25% |
| H. pylori antibody blood test CPT 86677 HC H Pylori Ab, Igg, Igm, Iga S/O | $42.08 | $56.10 | $16.85–$56.10 | 42% below | 25% |
| H. pylori antibody blood test CPT 86677 HC Helicobacter Pylori, Iga | $83.41 | $111.21 | $16.85–$111.21 | 16% above | 25% |
| H. pylori antibody blood test CPT 86677 HC H Pylori Ab,Igg | $95.15 | $126.87 | $16.85–$126.87 | 32% above | 25% |
| H. pylori antibody blood test CPT 86677 HC Helicobacter Pylori Ab, Igm, S/O | $102.57 | $136.76 | $16.85–$136.76 | 42% above | 25% |
| H. pylori antibody blood test CPT 86677 HC H Pylori Ab,Igg Mod 90 Ref Lab | $121.36 | $161.81 | $16.85–$161.81 | 68% above | 25% |
| H. pylori antibody blood test inpatient CPT 86677 HC H Pylori Ab, Igg, Igm, Iga S/O | $42.08 | $56.10 | $16.85–$56.10 | — | 25% |
| H. pylori antibody blood test inpatient CPT 86677 HC Helicobacter Pylori, Iga | $83.41 | $111.21 | $16.85–$111.21 | — | 25% |
| H. pylori antibody blood test inpatient CPT 86677 HC H Pylori Ab,Igg | $95.15 | $126.87 | $16.85–$126.87 | — | 25% |
| H. pylori antibody blood test inpatient CPT 86677 HC Helicobacter Pylori Ab, Igm, S/O | $102.57 | $136.76 | $16.85–$136.76 | — | 25% |
| H. pylori antibody blood test inpatient CPT 86677 HC H Pylori Ab,Igg Mod 90 Ref Lab | $121.36 | $161.81 | $16.85–$161.81 | — | 25% |
| H. pylori stool antigen test CPT 87338 HC H Pylori Ag, Stool | $227.59 | $303.45 | $14.38–$303.45 | 243% above | 25% |
| H. pylori stool antigen test inpatient CPT 87338 HC H Pylori Ag, Stool | $227.59 | $303.45 | $14.38–$303.45 | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv,Ultra High Sens,Quant S/O | $712.23 | $949.64 | $85.10–$949.64 | 158% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hivrna,Pcr(Quant) | $882.63 | $1,176.84 | $85.10–$1,176.84 | 220% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv,Ultra High Sens,Quant S/O | $712.23 | $949.64 | $85.10–$949.64 | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hivrna,Pcr(Quant) | $882.63 | $1,176.84 | $85.10–$1,176.84 | — | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC Hiv Antibody (Hiv-1 & Hiv-2) | $65.35 | $87.13 | $13.71–$87.13 | 1% below | 25% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Hiv Antibody (Hiv-1 & Hiv-2) | $65.35 | $87.13 | $13.71–$87.13 | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv 1/2 Ag and Ab Screen | $162.67 | $216.89 | $24.08–$216.89 | 104% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv 1/2 Ag and Ab Screen | $162.67 | $216.89 | $24.08–$216.89 | — | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv High Risk | $359.55 | $479.40 | $35.09–$479.40 | 307% above | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv Screening | $359.55 | $479.40 | $35.09–$479.40 | 307% above | 25% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv Screening | $359.55 | $479.40 | $35.09–$479.40 | — | 25% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv High Risk | $359.55 | $479.40 | $35.09–$479.40 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC POC A1c | $35.71 | $47.61 | $9.71–$64.38 | 26% below | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycosylated Hemoglobin Test POCT | $59.74 | $79.65 | $9.71–$79.65 | 24% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hgb A1c to Mayo | $71.58 | $95.44 | $9.71–$95.44 | 49% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycohemoglobin A1c | $71.58 | $95.44 | $9.71–$95.44 | 49% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin, Glycosylated | $75.35 | $100.46 | $9.71–$100.46 | 57% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC POC A1c | $35.71 | $47.61 | $9.71–$64.38 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycosylated Hemoglobin Test POCT | $59.74 | $79.65 | $9.71–$79.65 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hgb A1c to Mayo | $71.58 | $95.44 | $9.71–$95.44 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycohemoglobin A1c | $71.58 | $95.44 | $9.71–$95.44 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin, Glycosylated | $75.35 | $100.46 | $9.71–$100.46 | — | 25% |
| Hemoglobin blood test CPT 85018 HC G-6-Pd (Hgb) Quant S/O | $11.73 | $15.64 | $2.37–$15.73 | 32% below | 25% |
| Hemoglobin blood test CPT 85018 HC Hemoglobin | $34.18 | $45.57 | $2.37–$45.57 | 98% above | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC G-6-Pd (Hgb) Quant S/O | $11.73 | $15.64 | $2.37–$15.73 | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin | $34.18 | $45.57 | $2.37–$45.57 | — | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Antibody | $72.07 | $96.09 | $12.05–$96.09 | 8% above | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Antibody S/O | $87.58 | $116.77 | $12.05–$116.77 | 31% above | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Core Antibody | $72.07 | $96.09 | $12.05–$96.09 | — | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Core Antibody S/O | $87.58 | $116.77 | $12.05–$116.77 | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hep B Surface Antibody | $78.06 | $104.08 | $10.74–$104.08 | 24% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hep B Surface Antibody | $78.06 | $104.08 | $10.74–$104.08 | — | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hep B Surface Antigen #3 | $171.26 | $228.35 | $10.33–$228.35 | 210% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hep B Surface Antigen | $199.91 | $266.55 | $10.33–$266.55 | 262% above | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hep B Surface Antigen #3 | $171.26 | $228.35 | $10.33–$228.35 | — | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hep B Surface Antigen | $199.91 | $266.55 | $10.33–$266.55 | — | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hcv Ab W/ Reflex S/O | $98.06 | $130.74 | $46.35–$220.63 | 29% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hep C Antibody | $98.06 | $130.74 | $46.35–$220.63 | 29% above | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hep C Antibody | $98.06 | $130.74 | $46.35–$220.63 | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hcv Ab W/ Reflex S/O | $98.06 | $130.74 | $46.35–$220.63 | — | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hep C Rna Pcr (Quant) S/O | $458.39 | $611.19 | $42.84–$611.19 | 134% above | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hepatitis C Revrs Trnscrp | $601.46 | $801.94 | $42.84–$801.94 | 207% above | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hep C Rna Pcr (Quant) S/O | $458.39 | $611.19 | $42.84–$611.19 | — | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hepatitis C Revrs Trnscrp | $601.46 | $801.94 | $42.84–$801.94 | — | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex,1(Wb) | $65.29 | $87.05 | $13.19–$87.51 | 9% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv Type 1 Igg Specific Ab | $68.90 | $91.87 | $13.19–$91.87 | 15% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Torch P,Hsv1 Igg S/O | $72.52 | $96.69 | $13.19–$96.69 | 21% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex 1 Igg S/O | $82.34 | $109.79 | $13.19–$109.79 | 38% above | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Herpes Simplex,1(Wb) | $65.29 | $87.05 | $13.19–$87.51 | — | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsv Type 1 Igg Specific Ab | $68.90 | $91.87 | $13.19–$91.87 | — | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Torch P,Hsv1 Igg S/O | $72.52 | $96.69 | $13.19–$96.69 | — | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Herpes Simplex 1 Igg S/O | $82.34 | $109.79 | $13.19–$109.79 | — | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex 2,Igg S/O | $92.22 | $122.96 | $19.35–$128.42 | 27% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex,2(Wb) | $95.35 | $127.13 | $19.35–$128.42 | 31% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex,2(Wb) S/O | $95.78 | $127.71 | $19.35–$128.42 | 32% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Hsv Type 2 Igg Specific Ab | $101.13 | $134.84 | $19.35–$134.84 | 39% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Torch P,Hsvii,Igg S/O | $106.48 | $141.97 | $19.35–$141.97 | 47% above | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex 2,Igg S/O | $92.22 | $122.96 | $19.35–$128.42 | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex,2(Wb) | $95.35 | $127.13 | $19.35–$128.42 | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex,2(Wb) S/O | $95.78 | $127.71 | $19.35–$128.42 | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Hsv Type 2 Igg Specific Ab | $101.13 | $134.84 | $19.35–$134.84 | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Torch P,Hsvii,Igg S/O | $106.48 | $141.97 | $19.35–$141.97 | — | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC Crp,High Sensitivity | $94.08 | $125.44 | $12.95–$125.44 | 55% above | 25% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC Crp,High Sensitivity | $94.08 | $125.44 | $12.95–$125.44 | — | 25% |
| Homocysteine blood test CPT 83090 HC Homocystine, Urine S/O | $116.79 | $155.72 | $17.92–$155.72 | 38% above | 25% |
| Homocysteine blood test CPT 83090 HC Homocysteine | $124.42 | $165.89 | $17.92–$165.89 | 47% above | 25% |
| Homocysteine blood test inpatient CPT 83090 HC Homocystine, Urine S/O | $116.79 | $155.72 | $17.92–$155.72 | — | 25% |
| Homocysteine blood test inpatient CPT 83090 HC Homocysteine | $124.42 | $165.89 | $17.92–$165.89 | — | 25% |
| Insulin blood test CPT 83525 HC Insulin,Total | $62.60 | $83.47 | $11.43–$83.47 | 16% above | 25% |
| Insulin blood test CPT 83525 HC Insulin | $86.22 | $114.96 | $11.43–$114.96 | 59% above | 25% |
| Insulin blood test CPT 83525 HC Insulin S/O | $90.75 | $121.00 | $11.43–$121.00 | 68% above | 25% |
| Insulin blood test inpatient CPT 83525 HC Insulin,Total | $62.60 | $83.47 | $11.43–$83.47 | — | 25% |
| Insulin blood test inpatient CPT 83525 HC Insulin | $86.22 | $114.96 | $11.43–$114.96 | — | 25% |
| Insulin blood test inpatient CPT 83525 HC Insulin S/O | $90.75 | $121.00 | $11.43–$121.00 | — | 25% |
| Iron blood test (serum iron) CPT 83540 HC Iron 24 Hour Urine | $54.63 | $72.84 | $6.47–$72.84 | 56% above | 25% |
| Iron blood test (serum iron) CPT 83540 HC Iron,Total | $54.63 | $72.84 | $6.47–$72.84 | 56% above | 25% |
| Iron blood test (serum iron) CPT 83540 HC Liron,Iron Liver Tissue S/O | $68.34 | $91.12 | $6.47–$91.12 | 95% above | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Iron,Total | $54.63 | $72.84 | $6.47–$72.84 | — | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Iron 24 Hour Urine | $54.63 | $72.84 | $6.47–$72.84 | — | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Liron,Iron Liver Tissue S/O | $68.34 | $91.12 | $6.47–$91.12 | — | 25% |
| Kidney function blood test panel CPT 80069 HC Chem Panel,Renal | $74.66 | $99.54 | $8.68–$99.54 | 56% above | 25% |
| Kidney function blood test panel inpatient CPT 80069 HC Chem Panel,Renal | $74.66 | $99.54 | $8.68–$99.54 | — | 25% |
| LH (luteinizing hormone) test CPT 83002 HC Gonadotropin Lh | $87.19 | $116.25 | $18.52–$122.82 | 7% above | 25% |
| LH (luteinizing hormone) test CPT 83002 HC Luteinizing Horome S/O | $91.67 | $122.23 | $18.52–$122.82 | 13% above | 25% |
| LH (luteinizing hormone) test CPT 83002 HC Lh,Leutinizing Hormone | $136.61 | $182.15 | $18.52–$182.15 | 68% above | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Gonadotropin Lh | $87.19 | $116.25 | $18.52–$122.82 | — | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Luteinizing Horome S/O | $91.67 | $122.23 | $18.52–$122.82 | — | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Lh,Leutinizing Hormone | $136.61 | $182.15 | $18.52–$182.15 | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid | $78.77 | $105.02 | $11.57–$105.02 | 14% above | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid | $78.77 | $105.02 | $11.57–$105.02 | — | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh | $44.55 | $59.40 | $6.04–$59.40 | 45% above | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh Isoenzymes,Total Ldh S/O | $44.55 | $59.40 | $6.04–$59.40 | 45% above | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh | $44.55 | $59.40 | $6.04–$59.40 | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh Isoenzymes,Total Ldh S/O | $44.55 | $59.40 | $6.04–$59.40 | — | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase | $61.13 | $81.50 | $6.89–$81.50 | 4% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase S/O | $64.05 | $85.40 | $6.89–$85.40 | 1% above | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase | $61.13 | $81.50 | $6.89–$81.50 | — | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase S/O | $64.05 | $85.40 | $6.89–$85.40 | — | 25% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $57.66 | $76.88 | $8.17–$76.88 | 39% above | 25% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $57.66 | $76.88 | $8.17–$76.88 | — | 25% |
| Lyme disease antibody test CPT 86618 HC Lyme Cns Infection Igg, S/O | $84.30 | $112.40 | $17.03–$112.98 | 93% above | 25% |
| Lyme disease antibody test CPT 86618 HC Borrelia Ab Igm,Lyme S/O | $108.08 | $144.10 | $17.03–$144.10 | 148% above | 25% |
| Lyme disease antibody test CPT 86618 HC Borrelia Ab Lymes | $108.08 | $144.10 | $17.03–$144.10 | 148% above | 25% |
| Lyme disease antibody test inpatient CPT 86618 HC Lyme Cns Infection Igg, S/O | $84.30 | $112.40 | $17.03–$112.98 | — | 25% |
| Lyme disease antibody test inpatient CPT 86618 HC Borrelia Ab Igm,Lyme S/O | $108.08 | $144.10 | $17.03–$144.10 | — | 25% |
| Lyme disease antibody test inpatient CPT 86618 HC Borrelia Ab Lymes | $108.08 | $144.10 | $17.03–$144.10 | — | 25% |
| Magnesium blood test CPT 83735 HC Ssatu Prof,Mg,UR S/O | $36.54 | $48.72 | $6.70–$48.72 | 15% above | 25% |
| Magnesium blood test CPT 83735 HC Magnesium,Urine,Quant S/O | $54.15 | $72.20 | $6.70–$72.20 | 70% above | 25% |
| Magnesium blood test CPT 83735 HC Magnesium RBC S/O | $63.82 | $85.09 | $6.70–$85.09 | 100% above | 25% |
| Magnesium blood test CPT 83735 HC Magnesium S/O | $63.82 | $85.09 | $6.70–$85.09 | 100% above | 25% |
| Magnesium blood test CPT 83735 HC Magnesium | $65.09 | $86.79 | $6.70–$86.79 | 104% above | 25% |
| Magnesium blood test CPT 83735 HC Magnesium,Urine,Quant | $68.52 | $91.36 | $6.70–$91.36 | 115% above | 25% |
| Magnesium blood test inpatient CPT 83735 HC Ssatu Prof,Mg,UR S/O | $36.54 | $48.72 | $6.70–$48.72 | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium,Urine,Quant S/O | $54.15 | $72.20 | $6.70–$72.20 | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium RBC S/O | $63.82 | $85.09 | $6.70–$85.09 | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium S/O | $63.82 | $85.09 | $6.70–$85.09 | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium | $65.09 | $86.79 | $6.70–$86.79 | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium,Urine,Quant | $68.52 | $91.36 | $6.70–$91.36 | — | 25% |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola Ab | $54.13 | $72.17 | $12.88–$85.47 | 9% below | 25% |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola Ab Scrn S/O | $61.40 | $81.87 | $12.88–$85.47 | 4% above | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Ab | $54.13 | $72.17 | $12.88–$85.47 | — | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Ab Scrn S/O | $61.40 | $81.87 | $12.88–$85.47 | — | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Mononucleosis Test | $38.82 | $51.76 | $5.18–$51.76 | 22% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Mono Test | $39.98 | $53.31 | $5.18–$53.31 | 19% below | 25% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mononucleosis Test | $38.82 | $51.76 | $5.18–$51.76 | — | 25% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mono Test | $39.98 | $53.31 | $5.18–$53.31 | — | 25% |
| Mumps immunity blood test CPT 86735 HC Mumps Ab #17 | $41.25 | $55.00 | $13.05–$86.54 | 10% below | 25% |
| Mumps immunity blood test CPT 86735 HC Mumps Antibody | $66.21 | $88.28 | $13.05–$88.28 | 45% above | 25% |
| Mumps immunity blood test CPT 86735 HC HC Mumps Igm S/O | $83.31 | $111.08 | $13.05–$111.08 | 82% above | 25% |
| Mumps immunity blood test CPT 86735 HC Mumpst,Mumps Igm S/O | $83.31 | $111.08 | $13.05–$111.08 | 82% above | 25% |
| Mumps immunity blood test CPT 86735 HC HC Mumps Igg S/O | $85.81 | $114.41 | $13.05–$114.41 | 88% above | 25% |
| Mumps immunity blood test CPT 86735 HC Mumpst,Mumps Igg S/O | $85.81 | $114.41 | $13.05–$114.41 | 88% above | 25% |
| Mumps immunity blood test CPT 86735 HC Mumpm,Mumps Igm S/O | $147.02 | $196.03 | $13.05–$196.03 | 221% above | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumps Ab #17 | $41.25 | $55.00 | $13.05–$86.54 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumps Antibody | $66.21 | $88.28 | $13.05–$88.28 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC HC Mumps Igm S/O | $83.31 | $111.08 | $13.05–$111.08 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumpst,Mumps Igm S/O | $83.31 | $111.08 | $13.05–$111.08 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC HC Mumps Igg S/O | $85.81 | $114.41 | $13.05–$114.41 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumpst,Mumps Igg S/O | $85.81 | $114.41 | $13.05–$114.41 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumpm,Mumps Igm S/O | $147.02 | $196.03 | $13.05–$196.03 | — | 25% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $123.17 | $164.23 | $47.81–$164.23 | 30% below | 25% |
| Obstetric blood test panel inpatient CPT 80055 HC Obstetric Panel | $123.17 | $164.23 | $47.81–$164.23 | — | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa, Free S/O | $135.65 | $180.87 | $18.39–$180.87 | 81% above | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa,T&F,Free | $142.80 | $190.40 | $18.39–$190.40 | 91% above | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa, Free S/O | $135.65 | $180.87 | $18.39–$180.87 | — | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa,T&F,Free | $142.80 | $190.40 | $18.39–$190.40 | — | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa | $117.70 | $156.93 | $18.39–$156.93 | 57% above | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa | $117.70 | $156.93 | $18.39–$156.93 | — | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC Pap Imager | $214.46 | $285.95 | $26.49–$285.95 | 136% above | 25% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Pap Imager | $214.46 | $285.95 | $26.49–$285.95 | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cyto Prep Lb Pap | $209.45 | $279.26 | $20.26–$279.26 | 162% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cyto Prep Lb Pap | $209.45 | $279.26 | $20.26–$279.26 | — | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Parathyroid Horm,Int Oml S/O | $199.66 | $266.21 | $41.28–$273.84 | 20% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Parathyroid Hormone,Intact | $199.66 | $266.21 | $41.28–$273.84 | 20% above | 25% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathyroid Horm,Int Oml S/O | $199.66 | $266.21 | $41.28–$273.84 | — | 25% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathyroid Hormone,Intact | $199.66 | $266.21 | $41.28–$273.84 | — | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Activated Partial Thromboplastin S/O | $42.77 | $57.02 | $6.01–$57.02 | 22% below | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt | $80.17 | $106.89 | $6.01–$106.89 | 47% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Lisb,Ptt So | $104.57 | $139.43 | $6.01–$139.43 | 92% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt, Plasma/Wb | $104.57 | $139.43 | $6.01–$139.43 | 92% above | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Activated Partial Thromboplastin S/O | $42.77 | $57.02 | $6.01–$57.02 | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt | $80.17 | $106.89 | $6.01–$106.89 | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt, Plasma/Wb | $104.57 | $139.43 | $6.01–$139.43 | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Lisb,Ptt So | $104.57 | $139.43 | $6.01–$139.43 | — | 25% |
| Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus S/O | $34.91 | $46.55 | $4.74–$46.55 | 19% above | 25% |
| Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus,Serum | $35.62 | $47.49 | $4.74–$47.49 | 22% above | 25% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus S/O | $34.91 | $46.55 | $4.74–$46.55 | — | 25% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus,Serum | $35.62 | $47.49 | $4.74–$47.49 | — | 25% |
| Potassium blood test CPT 84132 HC Potassium | $33.89 | $45.19 | $4.76–$45.19 | 56% above | 25% |
| Potassium blood test inpatient CPT 84132 HC Potassium | $33.89 | $45.19 | $4.76–$45.19 | — | 25% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Maternit21 Plus Panel | $616.50 | $822.00 | $347.54–$3,613.08 | 51% below | 25% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC Maternit21 Plus Panel | $616.50 | $822.00 | $347.54–$3,613.08 | — | 25% |
| Progesterone blood test CPT 84144 HC Progesterone | $153.87 | $205.16 | $20.86–$205.16 | 57% above | 25% |
| Progesterone blood test inpatient CPT 84144 HC Progesterone | $153.87 | $205.16 | $20.86–$205.16 | — | 25% |
| Prolactin blood test CPT 84146 HC Prolactin, Unprecipitated S/O | $134.16 | $178.88 | $19.38–$178.88 | 67% above | 25% |
| Prolactin blood test CPT 84146 HC Prolactin,Total� S/O | $134.16 | $178.88 | $19.38–$178.88 | 67% above | 25% |
| Prolactin blood test CPT 84146 HC Prolactin | $142.95 | $190.60 | $19.38–$190.60 | 77% above | 25% |
| Prolactin blood test inpatient CPT 84146 HC Prolactin, Unprecipitated S/O | $134.16 | $178.88 | $19.38–$178.88 | — | 25% |
| Prolactin blood test inpatient CPT 84146 HC Prolactin,Total� S/O | $134.16 | $178.88 | $19.38–$178.88 | — | 25% |
| Prolactin blood test inpatient CPT 84146 HC Prolactin | $142.95 | $190.60 | $19.38–$190.60 | — | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC POC Pt | $25.36 | $33.81 | $4.29–$33.81 | 12% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time POCT | $25.36 | $33.81 | $4.29–$33.81 | 12% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Pt S/O | $28.03 | $37.37 | $4.29–$37.37 | 3% below | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Pt | $49.00 | $65.33 | $4.29–$65.33 | 70% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Slac POC Pt Inr | $50.40 | $67.20 | $4.29–$67.20 | 75% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Protime | $51.32 | $68.42 | $4.29–$68.42 | 78% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Protime POC Inr | $51.32 | $68.42 | $4.29–$68.42 | 78% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $58.73 | $78.31 | $4.29–$78.31 | 103% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Lisb,Pt S/O | $102.07 | $136.09 | $4.29–$136.09 | 254% above | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time POCT | $25.36 | $33.81 | $4.29–$33.81 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POC Pt | $25.36 | $33.81 | $4.29–$33.81 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Pt S/O | $28.03 | $37.37 | $4.29–$37.37 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Pt | $49.00 | $65.33 | $4.29–$65.33 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Slac POC Pt Inr | $50.40 | $67.20 | $4.29–$67.20 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Protime | $51.32 | $68.42 | $4.29–$68.42 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Protime POC Inr | $51.32 | $68.42 | $4.29–$68.42 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $58.73 | $78.31 | $4.29–$78.31 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Lisb,Pt S/O | $102.07 | $136.09 | $4.29–$136.09 | — | 25% |
| Rapid flu test (influenza antigen) CPT 87804 HC Flu Test | $232.82 | $310.43 | $16.55–$310.43 | 227% above | 25% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC Flu Test | $232.82 | $310.43 | $16.55–$310.43 | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Quick Strep,Group A | $138.37 | $184.49 | $16.53–$184.49 | 151% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Assay W/Optic POCT | $138.37 | $184.49 | $16.53–$184.49 | 151% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Strep a Assay W/Optic POCT | $138.37 | $184.49 | $16.53–$184.49 | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Quick Strep,Group A | $138.37 | $184.49 | $16.53–$184.49 | — | 25% |
| Renin blood test CPT 84244 HC Renin, Eso, S/O | $118.67 | $158.22 | $21.99–$158.22 | 86% above | 25% |
| Renin blood test CPT 84244 HC Renin,Plasma S/O | $162.20 | $216.27 | $21.99–$216.27 | 154% above | 25% |
| Renin blood test inpatient CPT 84244 HC Renin, Eso, S/O | $118.67 | $158.22 | $21.99–$158.22 | — | 25% |
| Renin blood test inpatient CPT 84244 HC Renin,Plasma S/O | $162.20 | $216.27 | $21.99–$216.27 | — | 25% |
| Rh blood typing CPT 86901 HC Blood Typing Rh | $78.64 | $104.85 | $43.60–$148.58 | 89% above | 25% |
| Rh blood typing CPT 86901 HC Arc Rh Type | $115.22 | $153.62 | $43.60–$153.62 | 177% above | 25% |
| Rh blood typing inpatient CPT 86901 HC Blood Typing Rh | $78.64 | $104.85 | $43.60–$148.58 | — | 25% |
| Rh blood typing inpatient CPT 86901 HC Arc Rh Type | $115.22 | $153.62 | $43.60–$153.62 | — | 25% |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor, S/O | $43.69 | $58.25 | $5.67–$58.25 | 7% above | 25% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor, S/O | $43.69 | $58.25 | $5.67–$58.25 | — | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella Ab Igg | $66.61 | $88.81 | $14.39–$95.50 | 46% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella Antibody #3 | $70.17 | $93.56 | $14.39–$95.50 | 54% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC Torch P,Rubella,Igg S/O | $79.15 | $105.53 | $14.39–$105.53 | 74% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella | $108.95 | $145.27 | $14.39–$145.27 | 139% above | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Ab Igg | $66.61 | $88.81 | $14.39–$95.50 | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Antibody #3 | $70.17 | $93.56 | $14.39–$95.50 | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Torch P,Rubella,Igg S/O | $79.15 | $105.53 | $14.39–$105.53 | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella | $108.95 | $145.27 | $14.39–$145.27 | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sedimentation Rate | $40.72 | $54.29 | $2.70–$54.29 | 45% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sedimentation Rate | $40.72 | $54.29 | $2.70–$54.29 | — | 25% |
| Sodium blood test CPT 84295 HC Sodium | $39.98 | $53.31 | $4.81–$53.31 | 57% above | 25% |
| Sodium blood test inpatient CPT 84295 HC Sodium | $39.98 | $53.31 | $4.81–$53.31 | — | 25% |
| Stool ova and parasites exam CPT 87177 HC Ova&Parasites,Stool Conc | $91.91 | $122.55 | $8.90–$122.55 | 70% above | 25% |
| Stool ova and parasites exam inpatient CPT 87177 HC Ova&Parasites,Stool Conc | $91.91 | $122.55 | $8.90–$122.55 | — | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Occult Blood | $15.76 | $21.01 | $4.38–$21.57 | 54% below | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Hemacult | $20.64 | $27.52 | $4.38–$27.52 | 40% below | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Occult Blood, Screen | $20.72 | $27.63 | $18.05–$85.92 | 40% below | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Occult Blood Feces POCT | $21.83 | $29.10 | $4.38–$29.10 | 37% below | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Occult Blood | $15.76 | $21.01 | $4.38–$21.57 | — | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Hemacult | $20.64 | $27.52 | $4.38–$27.52 | — | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Occult Blood, Screen | $20.72 | $27.63 | $18.05–$85.92 | — | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Occult Blood Feces POCT | $21.83 | $29.10 | $4.38–$29.10 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Assay Test for Blood Fecal POCT | $41.45 | $55.26 | $15.92–$105.53 | 25% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Blood Fecal Immunoassay | $51.15 | $68.20 | $15.92–$105.53 | 8% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Fecal Occult Blood | $77.33 | $103.11 | $15.92–$105.53 | 39% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood by Immunoassay | $81.40 | $108.53 | $15.92–$108.53 | 47% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Assay Test for Blood Fecal POCT | $41.45 | $55.26 | $15.92–$105.53 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Blood Fecal Immunoassay | $51.15 | $68.20 | $15.92–$105.53 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Fecal Occult Blood | $77.33 | $103.11 | $15.92–$105.53 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Blood by Immunoassay | $81.40 | $108.53 | $15.92–$108.53 | — | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Syphilis Antibody Tp-Pa | $60.67 | $80.89 | $13.24–$87.81 | 83% above | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Ftam,Fta-Abs Igg S/O | $60.67 | $80.89 | $13.24–$87.81 | 83% above | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Pallidum, Tp-Pa, S/O | $65.54 | $87.38 | $13.24–$87.81 | 98% above | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponema Ab | $89.90 | $119.86 | $13.24–$119.86 | 171% above | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Syphilis Antibody Tp-Pa | $60.67 | $80.89 | $13.24–$87.81 | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Ftam,Fta-Abs Igg S/O | $60.67 | $80.89 | $13.24–$87.81 | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Pallidum, Tp-Pa, S/O | $65.54 | $87.38 | $13.24–$87.81 | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponema Ab | $89.90 | $119.86 | $13.24–$119.86 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl,CSF S/O | $32.70 | $43.60 | $4.27–$43.60 | 13% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Vdrl,CSF | $35.33 | $47.11 | $4.27–$47.11 | 22% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr,Qualitative S/O | $45.44 | $60.59 | $4.27–$60.59 | 57% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr | $45.44 | $60.59 | $4.27–$60.59 | 57% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr/Vdrl | $47.03 | $62.70 | $4.27–$62.70 | 63% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Vdrl,CSF S/O | $32.70 | $43.60 | $4.27–$43.60 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Vdrl,CSF | $35.33 | $47.11 | $4.27–$47.11 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr,Qualitative S/O | $45.44 | $60.59 | $4.27–$60.59 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr | $45.44 | $60.59 | $4.27–$60.59 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr/Vdrl | $47.03 | $62.70 | $4.27–$62.70 | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Quantiferon,TB Gold S/O | $186.89 | $249.19 | $61.98–$411.17 | 13% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Quantiferon,TB Gold S/O | $186.89 | $249.19 | $61.98–$411.17 | — | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone | $124.89 | $166.52 | $25.81–$171.28 | 75% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Fted,Total Testosterone (ED) S/O | $146.53 | $195.37 | $25.81–$195.37 | 105% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Testfw,Testosterone,Total S/O | $146.53 | $195.37 | $25.81–$195.37 | 105% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Total Testosterone S/O | $173.90 | $231.86 | $25.81–$231.86 | 144% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Total Testosterone, Eso S/O | $197.75 | $263.66 | $25.81–$263.66 | 177% above | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone | $124.89 | $166.52 | $25.81–$171.28 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Fted,Total Testosterone (ED) S/O | $146.53 | $195.37 | $25.81–$195.37 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testfw,Testosterone,Total S/O | $146.53 | $195.37 | $25.81–$195.37 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Total Testosterone S/O | $173.90 | $231.86 | $25.81–$231.86 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Total Testosterone, Eso S/O | $197.75 | $263.66 | $25.81–$263.66 | — | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Ab Each | $82.50 | $110.00 | $14.55–$110.00 | 21% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Liver/Kidney Microsome Type 1 Ab, Serum | $88.91 | $118.54 | $14.55–$118.54 | 30% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Thyroperoxidase (Tpo) Ab S/O | $154.74 | $206.32 | $14.55–$206.32 | 127% above | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Ab Each | $82.50 | $110.00 | $14.55–$110.00 | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Liver/Kidney Microsome Type 1 Ab, Serum | $88.91 | $118.54 | $14.55–$118.54 | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Thyroperoxidase (Tpo) Ab S/O | $154.74 | $206.32 | $14.55–$206.32 | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tsh | $123.89 | $165.19 | $16.80–$165.19 | 76% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tsh S/O | $130.41 | $173.88 | $16.80–$173.88 | 85% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tsh | $123.89 | $165.19 | $16.80–$165.19 | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tsh S/O | $130.41 | $173.88 | $16.80–$173.88 | — | 25% |
| Total IgE blood test CPT 82785 HC Immunoglobulin E,Ige S/O | $58.13 | $77.51 | $16.46–$109.23 | 6% above | 25% |
| Total IgE blood test CPT 82785 HC Gammaglobulin Ige | $83.87 | $111.82 | $16.46–$111.82 | 54% above | 25% |
| Total IgE blood test inpatient CPT 82785 HC Immunoglobulin E,Ige S/O | $58.13 | $77.51 | $16.46–$109.23 | — | 25% |
| Total IgE blood test inpatient CPT 82785 HC Gammaglobulin Ige | $83.87 | $111.82 | $16.46–$111.82 | — | 25% |
| Total cholesterol blood test CPT 82465 HC Assay of Cholesterol | $15.25 | $20.33 | $4.35–$28.83 | 37% below | 25% |
| Total cholesterol blood test CPT 82465 HC Cholesterol | $34.13 | $45.51 | $4.35–$45.51 | 42% above | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC Assay of Cholesterol | $15.25 | $20.33 | $4.35–$28.83 | — | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC Cholesterol | $34.13 | $45.51 | $4.35–$45.51 | — | 25% |
| Total thyroxine (T4) blood test CPT 84436 HC T4-Thyroxine S/O | $47.57 | $63.42 | $6.87–$63.42 | 70% above | 25% |
| Total thyroxine (T4) blood test CPT 84436 HC T-4,Free by Dialysis-Tot S/O | $59.38 | $79.17 | $6.87–$79.17 | 112% above | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC T4-Thyroxine S/O | $47.57 | $63.42 | $6.87–$63.42 | — | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC T-4,Free by Dialysis-Tot S/O | $59.38 | $79.17 | $6.87–$79.17 | — | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 HC T3 (Triiodothyronine), Total, S/O | $78.47 | $104.63 | $14.18–$104.63 | 6% above | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 HC T3 (Triidothyronine),Total Serum So | $104.57 | $139.43 | $14.18–$139.43 | 41% above | 25% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 (Triiodothyronine), Total, S/O | $78.47 | $104.63 | $14.18–$104.63 | — | 25% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 (Triidothyronine),Total Serum So | $104.57 | $139.43 | $14.18–$139.43 | — | 25% |
| Transferrin blood test CPT 84466 HC Transferrin | $61.76 | $82.34 | $12.76–$84.69 | 18% above | 25% |
| Transferrin blood test CPT 84466 HC Transferrin S/O | $61.76 | $82.34 | $12.76–$84.69 | 18% above | 25% |
| Transferrin blood test inpatient CPT 84466 HC Transferrin S/O | $61.76 | $82.34 | $12.76–$84.69 | — | 25% |
| Transferrin blood test inpatient CPT 84466 HC Transferrin | $61.76 | $82.34 | $12.76–$84.69 | — | 25% |
| Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amp Rna | $194.21 | $258.94 | $35.09–$258.94 | 305% above | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas Vaginalis Amp Rna | $194.21 | $258.94 | $35.09–$258.94 | — | 25% |
| Triglycerides blood test CPT 84478 HC Triglycerides | $47.72 | $63.62 | $5.74–$63.62 | 87% above | 25% |
| Triglycerides blood test CPT 84478 HC Triglycerides, Body Fluid | $50.24 | $66.98 | $5.74–$66.98 | 97% above | 25% |
| Triglycerides blood test inpatient CPT 84478 HC Triglycerides | $47.72 | $63.62 | $5.74–$63.62 | — | 25% |
| Triglycerides blood test inpatient CPT 84478 HC Triglycerides, Body Fluid | $50.24 | $66.98 | $5.74–$66.98 | — | 25% |
| Troponin test, quantitative CPT 84484 HC Troponin | $105.58 | $140.77 | $12.47–$140.77 | at median | 25% |
| Troponin test, quantitative CPT 84484 HC Troponin I | $116.14 | $154.85 | $12.47–$154.85 | 11% above | 25% |
| Troponin test, quantitative CPT 84484 HC POC Troponin | $125.33 | $167.10 | $12.47–$167.10 | 19% above | 25% |
| Troponin test, quantitative inpatient CPT 84484 HC Troponin | $105.58 | $140.77 | $12.47–$140.77 | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 HC Troponin I | $116.14 | $154.85 | $12.47–$154.85 | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 HC POC Troponin | $125.33 | $167.10 | $12.47–$167.10 | — | 25% |
| Uric acid blood test CPT 84550 HC Uric Acid,Serum | $37.78 | $50.37 | $4.52–$50.37 | 48% above | 25% |
| Uric acid blood test inpatient CPT 84550 HC Uric Acid,Serum | $37.78 | $50.37 | $4.52–$50.37 | — | 25% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis W/Micro | $68.30 | $91.07 | $3.17–$91.07 | 111% above | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis W/Micro | $68.30 | $91.07 | $3.17–$91.07 | — | 25% |
| Urinalysis with microscope exam, manual CPT 81000 HC Urine Dip With Microscopy | $23.42 | $31.22 | $4.02–$31.22 | 23% below | 25% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 HC Urine Dip With Microscopy | $23.42 | $31.22 | $4.02–$31.22 | — | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC Post Transfusion Urine Check | $18.59 | $24.79 | $2.25–$24.79 | 5% below | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC POC Urogram (Slafm) | $30.93 | $41.24 | $2.25–$41.24 | 59% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urogram-No Microscopic | $31.43 | $41.90 | $2.25–$41.90 | 61% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Auto POCT | $32.75 | $43.67 | $2.25–$43.67 | 68% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urine Ph | $33.51 | $44.68 | $2.25–$44.68 | 72% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urine,Dipstick | $33.71 | $44.94 | $2.25–$44.94 | 73% above | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Post Transfusion Urine Check | $18.59 | $24.79 | $2.25–$24.79 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC POC Urogram (Slafm) | $30.93 | $41.24 | $2.25–$41.24 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urogram-No Microscopic | $31.43 | $41.90 | $2.25–$41.90 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Auto POCT | $32.75 | $43.67 | $2.25–$43.67 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urine Ph | $33.51 | $44.68 | $2.25–$44.68 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urine,Dipstick | $33.71 | $44.94 | $2.25–$44.94 | — | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC Urinalysis Nonauto W/O Scope POCT | $18.16 | $24.21 | $3.48–$24.21 | 24% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC Metsc,Urinalysis S/O | $19.58 | $26.10 | $3.48–$26.10 | 18% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC Hemoglobin Qual Urine | $23.93 | $31.90 | $3.48–$31.90 | at median | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Urinalysis Nonauto W/O Scope POCT | $18.16 | $24.21 | $3.48–$24.21 | — | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Metsc,Urinalysis S/O | $19.58 | $26.10 | $3.48–$26.10 | — | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Hemoglobin Qual Urine | $23.93 | $31.90 | $3.48–$31.90 | — | 25% |
| Urine culture for bacteria, with colony count CPT 87086 HC Culture Urine | $182.60 | $243.46 | $8.07–$243.46 | 247% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 HC Culture,Urine | $190.35 | $253.80 | $8.07–$253.80 | 262% above | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture Urine | $182.60 | $243.46 | $8.07–$243.46 | — | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture,Urine | $190.35 | $253.80 | $8.07–$253.80 | — | 25% |
| Urine microalbumin (albumin) test CPT 82043 HC Microalbumin Ratio, Urine | $48.81 | $65.08 | $5.78–$65.08 | 10% above | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin Ratio, Urine | $48.81 | $65.08 | $5.78–$65.08 | — | 25% |
| Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test POCT | $42.43 | $56.57 | $8.61–$56.57 | 20% below | 25% |
| Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test | $47.03 | $62.70 | $8.61–$62.70 | 12% below | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy Test POCT | $42.43 | $56.57 | $8.61–$56.57 | — | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy Test | $47.03 | $62.70 | $8.61–$62.70 | — | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B12 | $111.17 | $148.23 | $15.08–$148.23 | 43% above | 25% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B12 | $111.17 | $148.23 | $15.08–$148.23 | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vit D,25-Hydroxy,Total | $153.92 | $205.23 | $29.60–$205.23 | 54% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vit D2 and D3, 25 Hydroxy | $157.00 | $209.33 | $29.60–$209.33 | 57% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vit D,25-Hydroxy,Total | $153.92 | $205.23 | $29.60–$205.23 | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vit D2 and D3, 25 Hydroxy | $157.00 | $209.33 | $29.60–$209.33 | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vitamin D 1-25 Dihydroxy S/O | $36.09 | $48.12 | $20.35–$255.38 | 66% below | 25% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Vitamin D 1-25 Dihydroxy S/O | $36.09 | $48.12 | $20.35–$255.38 | — | 25% |
| Zinc blood test CPT 84630 HC Zinc,Blood Quant S/O | $83.98 | $111.97 | $11.39–$111.97 | 195% above | 25% |
| Zinc blood test CPT 84630 HC Zinc Red Blood Cells S/O | $91.22 | $121.62 | $11.39–$121.62 | 220% above | 25% |
| Zinc blood test CPT 84630 HC Eha,Zn S/O | $91.22 | $121.62 | $11.39–$121.62 | 220% above | 25% |
| Zinc blood test inpatient CPT 84630 HC Zinc,Blood Quant S/O | $83.98 | $111.97 | $11.39–$111.97 | — | 25% |
| Zinc blood test inpatient CPT 84630 HC Zinc Red Blood Cells S/O | $91.22 | $121.62 | $11.39–$121.62 | — | 25% |
| Zinc blood test inpatient CPT 84630 HC Eha,Zn S/O | $91.22 | $121.62 | $11.39–$121.62 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg,Quant,Tumor Mark | $112.94 | $150.58 | $15.05–$150.58 | 67% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg,Quant | $117.61 | $156.81 | $15.05–$156.81 | 74% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg,Quant,Preg Monitor | $122.07 | $162.76 | $15.05–$162.76 | 81% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg,Quant,Tumor Mark | $112.94 | $150.58 | $15.05–$150.58 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg,Quant | $117.61 | $156.81 | $15.05–$156.81 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg,Quant,Preg Monitor | $122.07 | $162.76 | $15.05–$162.76 | — | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC Nasal/Sinus Endoscopy,W/Dilat Maxillary Sinus Ostium | $6,043.22 | $8,057.62 | $6,647.54–$8,057.62 | 62% below | 25% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC Nasal/Sinus Endoscopy,W/Dilat Maxillary Sinus Ostium | $6,043.22 | $8,057.62 | $6,647.54–$8,057.62 | — | 25% |
| Botox injections for chronic migraine CPT 64615 HC Chemodenerve Muscs Bil Tech | $277.24 | $369.65 | $304.96–$1,089.71 | 20% below | 25% |
| Botox injections for chronic migraine inpatient CPT 64615 HC Chemodenerve Muscs Bil Tech | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Stereo Breast Bx Clip Spec 1st Lesion Rt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | 22% below | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Stereo Breast Bx Clip Spec 1st Lesion Lt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | 22% below | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Stereo Breast Bx Clip Spec 1st Lesion Rt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | — | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Stereo Breast Bx Clip Spec 1st Lesion Lt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | — | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Closed Rx Dist Fibula Fx | $252.11 | $336.15 | $266.45–$336.15 | 54% below | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC F-Clsd Tx Fibla Fx WO Manip | $641.90 | $855.87 | $266.45–$855.87 | 17% above | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC Closed Rx Dist Fibula Fx | $252.11 | $336.15 | $266.45–$336.15 | — | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC F-Clsd Tx Fibla Fx WO Manip | $641.90 | $855.87 | $266.45–$855.87 | — | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Closed Rx Metatarsal Fx | $252.11 | $336.15 | $266.45–$336.15 | 46% below | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Metatarsal Fx W/O Manip | $584.00 | $778.66 | $266.45–$778.66 | 25% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC Closed Rx Metatarsal Fx | $252.11 | $336.15 | $266.45–$336.15 | — | 25% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC Metatarsal Fx W/O Manip | $584.00 | $778.66 | $266.45–$778.66 | — | 25% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HC Left Heart W/Cors | $9,550.73 | $12,734.30 | $3,572.71–$12,734.30 | 2% below | 25% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC Left Heart W/Cors | $9,550.73 | $12,734.30 | $3,572.71–$12,734.30 | — | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion | $1,332.05 | $1,776.07 | $726.87–$2,274.73 | 2% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion, Elect, Ext | $1,366.19 | $1,821.59 | $726.87–$2,274.73 | 1% above | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion | $1,332.05 | $1,776.07 | $726.87–$2,274.73 | — | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion, Elect, Ext | $1,366.19 | $1,821.59 | $726.87–$2,274.73 | — | 25% |
| Cervical biopsy CPT 57500 HC Biopsy of Cervix Tech Fee | $626.24 | $834.99 | $688.87–$3,101.41 | 37% below | 25% |
| Cervical biopsy inpatient CPT 57500 HC Biopsy of Cervix Tech Fee | $626.24 | $834.99 | $688.87–$3,101.41 | — | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcise W/Region Blck Tech | $1,951.41 | $2,601.88 | $2,146.55–$7,336.27 | 304% above | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC Circumcise W/Region Blck Tech | $1,951.41 | $2,601.88 | $2,146.55–$7,336.27 | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Clsd Tx Fx Radius/Ulna Tech | $252.11 | $336.15 | $266.45–$336.15 | 52% below | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Distal Rad Fx W/O Manip | $637.83 | $850.44 | $266.45–$850.44 | 23% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Clsd Tx Fx Radius/Ulna Tech | $252.11 | $336.15 | $266.45–$336.15 | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Distal Rad Fx W/O Manip | $637.83 | $850.44 | $266.45–$850.44 | — | 25% |
| Colonoscopy, diagnostic CPT 45378 HC Colonoscopy Flex Dx | $1,698.30 | $2,264.40 | $1,012.71–$2,264.40 | 17% below | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC Colonoscopy Flex Dx | $1,698.30 | $2,264.40 | $1,012.71–$2,264.40 | — | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Bx of Cervix W/Scope Leep | $2,772.71 | $3,696.94 | $3,049.98–$3,696.94 | 64% above | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC Bx of Cervix W/Scope Leep | $2,772.71 | $3,696.94 | $3,049.98–$3,696.94 | — | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Colpo W/ Cerv Bx/Ecc Tech Fee | $320.29 | $427.05 | $337.89–$1,221.88 | 27% below | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC Colpo W/ Cerv Bx/Ecc Tech Fee | $320.29 | $427.05 | $337.89–$1,221.88 | — | 25% |
| Coronary stent placement, one artery CPT 92928 HC Card De Stent/Plasty 1 Art Ld 1 Lesion | $13,363.16 | $17,817.54 | $12,596.84–$46,471.24 | 23% below | 25% |
| Coronary stent placement, one artery inpatient CPT 92928 HC Card De Stent/Plasty 1 Art Ld 1 Lesion | $13,363.16 | $17,817.54 | $12,596.84–$46,471.24 | — | 25% |
| Cystoscopy with ureteral stent placement CPT 52332 HC Cystoscopy Indwelling Stent | $3,055.41 | $4,073.88 | $3,360.95–$4,073.88 | 28% below | 25% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC Cystoscopy Indwelling Stent | $3,055.41 | $4,073.88 | $3,360.95–$4,073.88 | — | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystoscopy Tech Fee | $660.30 | $880.40 | $726.33–$2,554.22 | 4% above | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystoscopy Tech Fee | $660.30 | $880.40 | $726.33–$2,554.22 | — | 25% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Endometrial Curettage Tech Fee | $2,648.54 | $3,531.38 | $2,913.39–$3,531.75 | 55% below | 25% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC D&C Non-OB | $4,870.16 | $6,493.55 | $3,531.75–$6,493.55 | 17% below | 25% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC Endometrial Curettage Tech Fee | $2,648.54 | $3,531.38 | $2,913.39–$3,531.75 | — | 25% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC D&C Non-OB | $4,870.16 | $6,493.55 | $3,531.75–$6,493.55 | — | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destruct Premalg Lesions Tech | $198.28 | $264.37 | $218.11–$573.83 | 15% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC Destruct Premalg Lesions Tech | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Create Eardrum Opening Tech | $546.40 | $728.53 | $565.66–$1,523.97 | 3% below | 25% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC Create Eardrum Opening Tech | $546.40 | $728.53 | $565.66–$1,523.97 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Remove Impacted Ear Wax Uni | $69.08 | $92.11 | $65.98–$272.43 | 10% below | 25% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Remove Impacted Cerumen Irrig/Lvg Unilat | $260.19 | $346.92 | $65.98–$346.92 | 239% above | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC Remove Impacted Ear Wax Uni | $69.08 | $92.11 | $65.98–$272.43 | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC Remove Impacted Cerumen Irrig/Lvg Unilat | $260.19 | $346.92 | $65.98–$346.92 | — | 25% |
| Earwax removal with instruments, one ear CPT 69210 HC Remove Impacted Ear Wax Tech | $69.08 | $92.11 | $65.98–$272.43 | 37% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 HC Rmv Impacted Ear Wax | $201.47 | $268.62 | $65.98–$272.43 | 84% above | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC Remove Impacted Ear Wax Tech | $69.08 | $92.11 | $65.98–$272.43 | — | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC Rmv Impacted Ear Wax | $201.47 | $268.62 | $65.98–$272.43 | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Biopsy Uterus Lining Tech Fee | $185.72 | $247.63 | $204.29–$684.67 | 55% below | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Endometrial Biopsy W/O Dilation | $518.75 | $691.66 | $223.45–$691.66 | 25% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Biopsy Uterus Lining Tech Fee | $185.72 | $247.63 | $204.29–$684.67 | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Endometrial Biopsy W/O Dilation | $518.75 | $691.66 | $223.45–$691.66 | — | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Inj. Thor.Cervical | $1,137.81 | $1,517.08 | $769.24–$1,517.08 | 41% below | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Inj. Thor.Cervical | $1,137.81 | $1,517.08 | $769.24–$1,517.08 | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Blt | $2,607.59 | $3,476.78 | $988.91–$4,003.63 | 26% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Rt | $2,770.72 | $3,694.29 | $988.91–$4,003.63 | 34% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Lt | $2,770.72 | $3,694.29 | $988.91–$4,003.63 | 34% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Blt | $2,607.59 | $3,476.78 | $988.91–$4,003.63 | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Rt | $2,770.72 | $3,694.29 | $988.91–$4,003.63 | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 HC Inj Facet Lum/Sac 1st Lvl Lt | $2,770.72 | $3,694.29 | $988.91–$4,003.63 | — | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Diagnostic Sigmoidoscopy | $1,184.22 | $1,578.96 | $1,012.71–$1,578.96 | 14% above | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC Diagnostic Sigmoidoscopy | $1,184.22 | $1,578.96 | $1,012.71–$1,578.96 | — | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Ligation of Hemorrhoid(S) | $835.29 | $1,113.72 | $918.82–$1,113.72 | 13% above | 25% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Ligation of Hemorrhoid(S) | $835.29 | $1,113.72 | $918.82–$1,113.72 | — | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC Remove Int/Ext Hem 1 Group | $2,618.03 | $3,490.70 | $2,879.83–$3,490.70 | 55% below | 25% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC Remove Int/Ext Hem 1 Group | $2,618.03 | $3,490.70 | $2,879.83–$3,490.70 | — | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Inj Hysterosalpingography | $257.28 | $343.04 | $280.46–$343.04 | 8% below | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Inj Hysterosalpingography | $257.28 | $343.04 | $280.46–$343.04 | — | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 HC Insertion Iud Tech Fee | $170.74 | $227.65 | $47.51–$227.65 | 61% below | 25% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC Insertion Iud Tech Fee | $170.74 | $227.65 | $47.51–$227.65 | — | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Phy P Exf Incisision&Drng Abscess,Simple | $153.00 | $204.00 | $168.30–$573.83 | 53% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Drainage of Skin Abscess Simpl | $198.28 | $264.37 | $218.11–$573.83 | 39% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Smpl/Sngl Abscess | $688.40 | $917.86 | $220.71–$917.86 | 113% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Exf F-I&D Smpl/Sngl Abscess | $717.76 | $957.01 | $220.71–$957.01 | 122% above | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Phy P Exf Incisision&Drng Abscess,Simple | $153.00 | $204.00 | $168.30–$573.83 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Drainage of Skin Abscess Simpl | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D Smpl/Sngl Abscess | $688.40 | $917.86 | $220.71–$917.86 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Exf F-I&D Smpl/Sngl Abscess | $717.76 | $957.01 | $220.71–$957.01 | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon, Ligament Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | 32% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon or Ligament | $815.63 | $1,087.51 | $327.89–$1,089.71 | 288% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj Tendon, Ligament | $1,118.24 | $1,490.98 | $327.89–$1,490.98 | 432% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inj Tendon, Ligament Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inj Tendon or Ligament | $815.63 | $1,087.51 | $327.89–$1,089.71 | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inj Tendon, Ligament | $1,118.24 | $1,490.98 | $327.89–$1,490.98 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Major Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | 8% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthro/Asp Mj Jt | $982.85 | $1,310.46 | $327.89–$1,310.46 | 226% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Inj Arthro Major Jt | $982.85 | $1,310.46 | $327.89–$1,310.46 | 226% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC Inj Arthro Major Jt Lt | $1,025.26 | $1,367.01 | $327.89–$1,367.01 | 240% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC Inj Arthro Major Jt Rt | $1,025.26 | $1,367.01 | $327.89–$1,367.01 | 240% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Major Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Inj Arthro Major Jt | $982.85 | $1,310.46 | $327.89–$1,310.46 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthro/Asp Mj Jt | $982.85 | $1,310.46 | $327.89–$1,310.46 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC Inj Arthro Major Jt Lt | $1,025.26 | $1,367.01 | $327.89–$1,367.01 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC Inj Arthro Major Jt Rt | $1,025.26 | $1,367.01 | $327.89–$1,367.01 | — | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Contraceptive Cap Tech | $131.26 | $175.01 | $143.18–$444.05 | 49% below | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC Insert Contraceptive Cap Tech | $131.26 | $175.01 | $143.18–$444.05 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Interm Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | 13% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US | $919.22 | $1,225.63 | $327.89–$1,225.63 | 188% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Inj Arthro Intermed Jt | $964.90 | $1,286.53 | $327.89–$1,286.53 | 202% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HC Inj Arthro Intermed Jt Lt | $1,006.49 | $1,341.99 | $327.89–$1,341.99 | 215% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 HC Inj Arthro Intermed Jt Rt | $1,006.49 | $1,341.99 | $327.89–$1,341.99 | 215% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentesis Interm Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US | $919.22 | $1,225.63 | $327.89–$1,225.63 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Inj Arthro Intermed Jt | $964.90 | $1,286.53 | $327.89–$1,286.53 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 HC Inj Arthro Intermed Jt Lt | $1,006.49 | $1,341.99 | $327.89–$1,341.99 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 HC Inj Arthro Intermed Jt Rt | $1,006.49 | $1,341.99 | $327.89–$1,341.99 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Drain/Inject Joint/Bursa Tech | $277.24 | $369.65 | $304.96–$1,089.71 | 12% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Injection/Asp Small Joint | $798.51 | $1,064.68 | $327.89–$1,089.71 | 153% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $798.51 | $1,064.68 | $327.89–$1,089.71 | 153% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Drain/Inject Joint/Bursa Tech | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $798.51 | $1,064.68 | $327.89–$1,089.71 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Injection/Asp Small Joint | $798.51 | $1,064.68 | $327.89–$1,089.71 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Int Repair Tnk/Sclp/Ext <2.5cm | $352.60 | $470.13 | $387.86–$1,098.43 | 44% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Lac Int <2.5cm Sc/Tr | $558.71 | $744.95 | $443.79–$1,098.43 | 11% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Int Repair Tnk/Sclp/Ext <2.5cm | $352.60 | $470.13 | $387.86–$1,098.43 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Lac Int <2.5cm Sc/Tr | $558.71 | $744.95 | $443.79–$1,098.43 | — | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Inj. Lumbar/Sacral | $1,137.81 | $1,517.08 | $769.24–$1,517.08 | 27% below | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Inj. Lumbar/Sacral | $1,137.81 | $1,517.08 | $769.24–$1,517.08 | — | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC Inj Epidural Lumbar/Sacral(Caudal) | $1,563.58 | $2,084.77 | $988.91–$2,084.77 | 4% above | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC Inj Epidural Lumbar/Sacral(Caudal) | $1,563.58 | $2,084.77 | $988.91–$2,084.77 | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Proc Epidur Lum/Sac Sngl | $2,770.72 | $3,694.29 | $988.91–$3,694.29 | 72% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 HC Inj Proc Epidur Lum/Sac Rt,Sngl | $2,658.16 | $3,544.21 | $988.91–$3,544.21 | 65% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj Proc Epidur Lum/Sac Sngl | $2,770.72 | $3,694.29 | $988.91–$3,694.29 | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 HC Inj Proc Epidur Lum/Sac Rt,Sngl | $2,658.16 | $3,544.21 | $988.91–$3,544.21 | — | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC Care of Miscarriage | $4,444.40 | $5,925.87 | $3,531.75–$5,925.87 | 2% below | 25% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC Care of Miscarriage | $4,444.40 | $5,925.87 | $3,531.75–$5,925.87 | — | 25% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 HC Mohs, 1 Stage, Head/Neck/Hand/Feet/Gential | $541.91 | $722.54 | $596.10–$2,087.62 | 56% below | 25% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 HC Mohs, 1 Stage, Head/Neck/Hand/Feet/Gential | $541.91 | $722.54 | $596.10–$2,087.62 | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Tr-Ext B9+Marg 0.5<Cm Tech | $649.58 | $866.10 | $714.53–$2,340.72 | 28% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Excise Les 0.5cm or Less Trnk | $1,470.59 | $1,960.79 | $781.53–$2,340.72 | 190% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Tr-Ext B9+Marg 0.5<Cm Tech | $649.58 | $866.10 | $714.53–$2,340.72 | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Excise Les 0.5cm or Less Trnk | $1,470.59 | $1,960.79 | $781.53–$2,340.72 | — | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Exc Benign Les Face <0.5 Cm | $649.58 | $866.10 | $714.53–$2,340.72 | 25% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC Exc Benign Les Face <0.5 Cm | $649.58 | $866.10 | $714.53–$2,340.72 | — | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC Removal Nail Plate Tech Fee | $198.28 | $264.37 | $218.11–$573.83 | at median | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC Nail Plate Rem/Avulsion | $426.58 | $568.77 | $220.71–$573.83 | 115% above | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC Removal Nail Plate Tech Fee | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC Nail Plate Rem/Avulsion | $426.58 | $568.77 | $220.71–$573.83 | — | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC N Block Inj Occipital | $277.24 | $369.65 | $304.96–$1,089.71 | 33% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Injection Aa&/Strd Greater Occipital Nerve | $279.71 | $372.95 | $307.68–$1,089.71 | 32% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Occipital Nerve Block | $1,334.38 | $1,779.17 | $327.89–$1,779.17 | 224% above | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC N Block Inj Occipital | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Injection Aa&/Strd Greater Occipital Nerve | $279.71 | $372.95 | $307.68–$1,089.71 | — | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Occipital Nerve Block | $1,334.38 | $1,779.17 | $327.89–$1,779.17 | — | 25% |
| Pacemaker implant (dual chamber) CPT 33208 HC Insrt/Repl Pacer W/Leads,Dual | $15,232.92 | $20,310.56 | $11,624.65–$45,161.46 | 5% below | 25% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC Insrt/Repl Pacer W/Leads,Dual | $15,232.92 | $20,310.56 | $11,624.65–$45,161.46 | — | 25% |
| Paracentesis with imaging guidance CPT 49083 HC CT Paracentesis Abd W/Img | $1,797.11 | $2,396.15 | $1,041.42–$2,396.15 | 56% above | 25% |
| Paracentesis with imaging guidance CPT 49083 HC US Paracentesis Abd W/Img | $1,906.26 | $2,541.68 | $1,041.42–$2,541.68 | 65% above | 25% |
| Paracentesis with imaging guidance CPT 49083 HC F-Paracentesis Abd W/ US | $2,085.61 | $2,780.81 | $1,041.42–$2,780.81 | 81% above | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC CT Paracentesis Abd W/Img | $1,797.11 | $2,396.15 | $1,041.42–$2,396.15 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC US Paracentesis Abd W/Img | $1,906.26 | $2,541.68 | $1,041.42–$2,541.68 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC F-Paracentesis Abd W/ US | $2,085.61 | $2,780.81 | $1,041.42–$2,780.81 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal of Nail Bed Tech Fee | $352.60 | $470.13 | $387.86–$1,111.67 | 44% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Nail Prtl/Full Perm Removal | $1,749.54 | $2,332.72 | $443.79–$2,332.72 | 176% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Removal of Nail Bed Tech Fee | $352.60 | $470.13 | $387.86–$1,111.67 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Nail Prtl/Full Perm Removal | $1,749.54 | $2,332.72 | $443.79–$2,332.72 | — | 25% |
| Prostate biopsy CPT 55700 HC Biopsy of Prostate Tech Fee | $1,951.41 | $2,601.88 | $2,146.55–$7,336.27 | 20% below | 25% |
| Prostate biopsy CPT 55700 HC Needle Biopsy,Prostate | $4,112.44 | $5,483.25 | $2,275.44–$7,336.27 | 68% above | 25% |
| Prostate biopsy inpatient CPT 55700 HC Biopsy of Prostate Tech Fee | $1,951.41 | $2,601.88 | $2,146.55–$7,336.27 | — | 25% |
| Prostate biopsy inpatient CPT 55700 HC Needle Biopsy,Prostate | $4,112.44 | $5,483.25 | $2,275.44–$7,336.27 | — | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Rf Ablation Facet Lum/Sacral | $2,116.33 | $2,821.77 | $2,169.09–$2,821.77 | 26% below | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC Rf Ablation Facet Lum/Sacral | $2,116.33 | $2,821.77 | $2,169.09–$2,821.77 | — | 25% |
| Removal of a breast lump, open surgery CPT 19120 HC Removal Breast Lesion Tech Fee | $3,158.15 | $4,210.86 | $3,473.96–$10,655.27 | 97% above | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC Removal Breast Lesion Tech Fee | $3,158.15 | $4,210.86 | $3,473.96–$10,655.27 | — | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Remove Foreign Body Simpl | $352.60 | $470.13 | $387.86–$1,098.43 | 13% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Remove Subq FB Simple | $637.83 | $850.44 | $443.79–$1,098.43 | 57% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC F-Remove FB Sq Tissue Simple | $664.74 | $886.32 | $443.79–$1,098.43 | 64% above | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove Foreign Body Simpl | $352.60 | $470.13 | $387.86–$1,098.43 | — | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove Subq FB Simple | $637.83 | $850.44 | $443.79–$1,098.43 | — | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC F-Remove FB Sq Tissue Simple | $664.74 | $886.32 | $443.79–$1,098.43 | — | 25% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Lithotripsy - Eswl | $6,573.94 | $8,765.25 | $3,831.04–$8,765.25 | 294% above | 25% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 HC Lithotripsy Eswl | $7,589.49 | $10,119.32 | $3,831.04–$10,119.32 | 355% above | 25% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC Lithotripsy - Eswl | $6,573.94 | $8,765.25 | $3,831.04–$8,765.25 | — | 25% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 HC Lithotripsy Eswl | $7,589.49 | $10,119.32 | $3,831.04–$10,119.32 | — | 25% |
| Short arm cast (elbow to hand) CPT 29075 HC Short Arm Cast Tech Fee | $263.78 | $351.70 | $290.15–$1,012.38 | at median | 25% |
| Short arm cast (elbow to hand) CPT 29075 HC Apply Forearm Cast | $476.33 | $635.11 | $295.00–$1,012.38 | 81% above | 25% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC Short Arm Cast Tech Fee | $263.78 | $351.70 | $290.15–$1,012.38 | — | 25% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC Apply Forearm Cast | $476.33 | $635.11 | $295.00–$1,012.38 | — | 25% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint Tech Fee | $131.26 | $175.01 | $143.18–$444.05 | 21% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 HC Short Arm Splint | $434.74 | $579.65 | $143.18–$579.65 | 160% above | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Apply Forearm Splint Tech Fee | $131.26 | $175.01 | $143.18–$444.05 | — | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Short Arm Splint | $434.74 | $579.65 | $143.18–$579.65 | — | 25% |
| Short leg cast (below the knee) CPT 29405 HC Apply Short Leg Cast Tech Fee | $263.78 | $351.70 | $290.15–$351.70 | 9% below | 25% |
| Short leg cast (below the knee) CPT 29405 HC Apply Short Leg Cast | $382.53 | $510.04 | $295.00–$510.04 | 31% above | 25% |
| Short leg cast (below the knee) inpatient CPT 29405 HC Apply Short Leg Cast Tech Fee | $263.78 | $351.70 | $290.15–$351.70 | — | 25% |
| Short leg cast (below the knee) inpatient CPT 29405 HC Apply Short Leg Cast | $382.53 | $510.04 | $295.00–$510.04 | — | 25% |
| Short leg splint (calf to foot) CPT 29515 HC Splint, Short Leg Tech Fee | $165.80 | $221.07 | $175.27–$221.07 | 19% below | 25% |
| Short leg splint (calf to foot) CPT 29515 HC Short Leg Splint | $296.90 | $395.86 | $175.27–$395.86 | 44% above | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Splint, Short Leg Tech Fee | $165.80 | $221.07 | $175.27–$221.07 | — | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Short Leg Splint | $296.90 | $395.86 | $175.27–$395.86 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC 270 12001 or Supplies - General Classification | $95.91 | $127.88 | $105.50–$573.83 | 72% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Rpr Superficial Wnd(S) <2.5cm | $198.28 | $264.37 | $218.11–$573.83 | 42% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Lac Simp <2.5cm Sc/Tr | $426.58 | $568.77 | $220.71–$573.83 | 26% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC 270 12001 or Supplies - General Classification | $95.91 | $127.88 | $105.50–$573.83 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Rpr Superficial Wnd(S) <2.5cm | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Lac Simp <2.5cm Sc/Tr | $426.58 | $568.77 | $220.71–$573.83 | — | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion | $217.13 | $289.50 | $238.84–$443.79 | 17% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC Bx Punch Skin Single Lesion | $1,003.23 | $1,337.64 | $443.79–$1,337.64 | 286% above | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy Skin Single Lesion | $217.13 | $289.50 | $238.84–$443.79 | — | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC Bx Punch Skin Single Lesion | $1,003.23 | $1,337.64 | $443.79–$1,337.64 | — | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC Exc Tr-Ext Mlg+Marg 0.5<Cm | $649.58 | $866.10 | $714.53–$4,587.44 | 38% above | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC Exc Tr-Ext Mlg+Marg 0.5<Cm | $649.58 | $866.10 | $714.53–$4,587.44 | — | 25% |
| Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags Tech Fee | $198.28 | $264.37 | $218.11–$573.83 | 15% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 HC Skin Tab Rem to 15 Lesions | $338.49 | $451.32 | $220.71–$573.83 | 44% above | 25% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Removal of Skin Tags Tech Fee | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Skin Tab Rem to 15 Lesions | $338.49 | $451.32 | $220.71–$573.83 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Diagnostic Lumbar Spinal Puncture | $679.64 | $906.18 | $747.60–$906.18 | 31% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Lumbar Puncture | $1,346.62 | $1,795.49 | $769.24–$1,795.49 | 37% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Fluid Tap Diagnostic | $2,338.43 | $3,117.90 | $769.24–$3,117.90 | 138% above | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Diagnostic Lumbar Spinal Puncture | $679.64 | $906.18 | $747.60–$906.18 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Lumbar Puncture | $1,346.62 | $1,795.49 | $769.24–$1,795.49 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Fluid Tap Diagnostic | $2,338.43 | $3,117.90 | $769.24–$3,117.90 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Rpr S/N/Ax/Gen/Trnk2.6-7.5cm | $198.28 | $264.37 | $218.11–$573.83 | 49% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Lac Simp 2.6-7.5cm Sc/Tr | $426.58 | $568.77 | $220.71–$573.83 | 9% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Rpr S/N/Ax/Gen/Trnk2.6-7.5cm | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Lac Simp 2.6-7.5cm Sc/Tr | $426.58 | $568.77 | $220.71–$573.83 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Rpr Sprficial Wnd(S) =/<2.5cm | $198.28 | $264.37 | $218.11–$573.83 | 42% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Lac Simp<2.5cm Face | $426.58 | $568.77 | $220.71–$573.83 | 25% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Rpr Sprficial Wnd(S) =/<2.5cm | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Lac Simp<2.5cm Face | $426.58 | $568.77 | $220.71–$573.83 | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy Skin Single Lesion | $217.13 | $289.50 | $220.71–$289.50 | at median | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion | $423.32 | $564.42 | $220.71–$564.42 | 95% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy Skin Single Lesion | $217.13 | $289.50 | $220.71–$289.50 | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy of Skin (Eg, Shave, Scoop, Saucerize, Curette); Single Lesion | $423.32 | $564.42 | $220.71–$564.42 | — | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging | $695.33 | $927.11 | $686.75–$2,351.38 | 51% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC F-Thoracentesis Asp Pleura W/Img | $1,641.88 | $2,189.17 | $686.75–$2,351.38 | 15% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis W/Img | $2,199.77 | $2,933.03 | $686.75–$2,933.03 | 55% above | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Aspirate Pleura W/ Imaging | $695.33 | $927.11 | $686.75–$2,351.38 | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC F-Thoracentesis Asp Pleura W/Img | $1,641.88 | $2,189.17 | $686.75–$2,351.38 | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis W/Img | $2,199.77 | $2,933.03 | $686.75–$2,933.03 | — | 25% |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $1,473.20 | $1,964.27 | $1,620.52–$1,964.27 | 6% above | 25% |
| Trigger finger release surgery inpatient CPT 26055 HC Incise Finger Tendon Sheath | $1,473.20 | $1,964.27 | $1,620.52–$1,964.27 | — | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj Trigger Pts 1-2 Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | 16% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inject Trigger Point, 1 or 2 | $831.95 | $1,109.27 | $327.89–$1,109.27 | 248% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Pt Inj 1-2muscles | $1,269.13 | $1,692.17 | $327.89–$1,692.17 | 431% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj 1 or 2 Tendon(S)/Muscle(S) | $1,269.13 | $1,692.17 | $327.89–$1,692.17 | 431% above | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inj Trigger Pts 1-2 Tech Fee | $277.24 | $369.65 | $304.96–$1,089.71 | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inject Trigger Point, 1 or 2 | $831.95 | $1,109.27 | $327.89–$1,109.27 | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inj 1 or 2 Tendon(S)/Muscle(S) | $1,269.13 | $1,692.17 | $327.89–$1,692.17 | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Trigger Pt Inj 1-2muscles | $1,269.13 | $1,692.17 | $327.89–$1,692.17 | — | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US Breast Bx Clip Spec 1st Lesion Rt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | 6% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US Breast Bx Clip Spec 1st Lesion Lt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | 6% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC US Breast Bx Clip Spec 1st Lesion Rt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | — | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC US Breast Bx Clip Spec 1st Lesion Lt | $3,099.20 | $4,132.27 | $1,799.73–$4,587.44 | — | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Esoph Egd Dilation <30 Mm | $1,377.90 | $1,837.20 | $1,515.69–$2,107.13 | 36% below | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC Esoph Egd Dilation <30 Mm | $1,377.90 | $1,837.20 | $1,515.69–$2,107.13 | — | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Upper GI Endo W/Biopsy | $1,496.11 | $1,994.81 | $1,041.42–$1,994.81 | at median | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Upper GI Endo W/Biopsy | $1,496.11 | $1,994.81 | $1,041.42–$1,994.81 | — | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd GI Endoscopy | $2,235.75 | $2,981.00 | $1,041.42–$2,981.00 | 41% above | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd GI Endoscopy | $2,235.75 | $2,981.00 | $1,041.42–$2,981.00 | — | 25% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 HC Vasectomy Bilat/Uni Tech Fee | $2,521.88 | $3,362.51 | $2,275.44–$7,336.27 | — | 25% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC Vasectomy Tech Fee | $3,129.30 | $4,172.40 | $2,275.44–$7,336.27 | 298% above | 25% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 HC Vasectomy Bilat/Uni Tech Fee | $2,521.88 | $3,362.51 | $2,275.44–$7,336.27 | — | 25% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC Vasectomy Tech Fee | $3,129.30 | $4,172.40 | $2,275.44–$7,336.27 | — | 25% |
| Wart removal, up to 14 warts CPT 17110 HC Destruct Benign Les 1-14 Tech | $198.28 | $264.37 | $218.11–$573.83 | 21% below | 25% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC Destruct Benign Les 1-14 Tech | $198.28 | $264.37 | $218.11–$573.83 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Deb Subq Tissue 20 Sq Cm/< | $352.60 | $470.13 | $387.86–$1,098.43 | 28% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC F-Debride Sq 1st 20 Sq Cm | $1,309.91 | $1,746.55 | $443.79–$1,746.55 | 169% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Deb Subq Tissue 20 Sq Cm/< | $352.60 | $470.13 | $387.86–$1,098.43 | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC F-Debride Sq 1st 20 Sq Cm | $1,309.91 | $1,746.55 | $443.79–$1,746.55 | — | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Prod Transfusion | $483.68 | $644.90 | $485.61–$1,700.31 | 41% below | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Prod Transfusion | $483.68 | $644.90 | $485.61–$1,700.31 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Nebulizer Treatment | $153.94 | $205.25 | $169.33–$727.87 | 19% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Aerosol Treatment | $153.94 | $205.25 | $169.33–$727.87 | 19% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Mdi Treatment | $160.51 | $214.01 | $176.56–$727.87 | 24% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Sputum Induction | $193.19 | $257.59 | $212.51–$727.87 | 49% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Inhalation Treatment Tech Fee | $215.33 | $287.10 | $225.92–$727.87 | 66% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Aerosol Treatment | $153.94 | $205.25 | $169.33–$727.87 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Nebulizer Treatment | $153.94 | $205.25 | $169.33–$727.87 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Mdi Treatment | $160.51 | $214.01 | $176.56–$727.87 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Sputum Induction | $193.19 | $257.59 | $212.51–$727.87 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Inhalation Treatment Tech Fee | $215.33 | $287.10 | $225.92–$727.87 | — | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemo Infusion Up to 1 Hour | $909.95 | $1,213.26 | $368.43–$1,364.91 | 18% above | 25% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo Infusion Up to 1 Hour | $909.95 | $1,213.26 | $368.43–$1,364.91 | — | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Comprehensive Hearing Test | $186.68 | $248.90 | $173.79–$631.88 | 37% below | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Comp Hearing Test Tech Fee | $399.12 | $532.16 | $173.79–$631.88 | 34% above | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC Comprehensive Hearing Test | $186.68 | $248.90 | $173.79–$631.88 | — | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC Comp Hearing Test Tech Fee | $399.12 | $532.16 | $173.79–$631.88 | — | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC HB-Critical Care 30-74 Min | $3,340.41 | $4,453.88 | $935.95–$4,453.88 | 31% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC in-House Trauma W/Cc Service-Mod | $5,840.42 | $7,787.22 | $935.95–$7,787.22 | 130% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC in-House Trauma W/Cc Service-Full | $7,669.82 | $10,226.43 | $935.95–$10,226.43 | 201% above | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC HB-Critical Care 30-74 Min | $3,340.41 | $4,453.88 | $935.95–$4,453.88 | — | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC in-House Trauma W/Cc Service-Mod | $5,840.42 | $7,787.22 | $935.95–$7,787.22 | — | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC in-House Trauma W/Cc Service-Full | $7,669.82 | $10,226.43 | $935.95–$10,226.43 | — | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HC Complete Ekg Tech Fee | $53.46 | $71.28 | $13.57–$80.99 | 23% above | 25% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 HC Complete Ekg Tech Fee | $53.46 | $71.28 | $13.57–$80.99 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ekg Tracing | $82.37 | $109.82 | $65.98–$272.43 | 65% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Ekg Tracing | $82.37 | $109.82 | $65.98–$272.43 | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Department Visit | $342.11 | $456.15 | $97.80–$456.15 | 111% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Department Visit | $342.11 | $456.15 | $97.80–$456.15 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Phy Emerg Dept-Level 2 | $245.44 | $327.25 | $175.90–$533.27 | 46% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Department Visit | $596.03 | $794.71 | $175.90–$794.71 | 32% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC in-House Trauma W/Lvl 2 Service - Mod | $3,453.94 | $4,605.25 | $175.90–$4,605.25 | 663% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC in-House Trauma W/Lvl 2 Service - Full | $5,283.35 | $7,044.46 | $175.90–$7,044.46 | 1067% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC Phy Emerg Dept-Level 2 | $245.44 | $327.25 | $175.90–$533.27 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Department Visit | $596.03 | $794.71 | $175.90–$794.71 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC in-House Trauma W/Lvl 2 Service - Mod | $3,453.94 | $4,605.25 | $175.90–$4,605.25 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC in-House Trauma W/Lvl 2 Service - Full | $5,283.35 | $7,044.46 | $175.90–$7,044.46 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Phy Emerg Dept-Level 3 | $337.50 | $450.00 | $307.56–$954.42 | 61% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Department Visit | $878.78 | $1,171.71 | $307.56–$1,171.71 | 1% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC in-House Trauma W/Lvl 3 Service - Mod | $3,736.69 | $4,982.25 | $307.56–$4,982.25 | 329% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC in-House Trauma W/Lvl 3 Service - Full | $5,566.10 | $7,421.46 | $307.56–$7,421.46 | 540% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC Phy Emerg Dept-Level 3 | $337.50 | $450.00 | $307.56–$954.42 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Department Visit | $878.78 | $1,171.71 | $307.56–$1,171.71 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC in-House Trauma W/Lvl 3 Service - Mod | $3,736.69 | $4,982.25 | $307.56–$4,982.25 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC in-House Trauma W/Lvl 3 Service - Full | $5,566.10 | $7,421.46 | $307.56–$7,421.46 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC Phy Emerg Dept-Level 4 | $637.50 | $850.00 | $472.99–$1,592.44 | 45% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Department Visit | $1,267.86 | $1,690.48 | $472.99–$1,690.48 | 10% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC in-House Trauma W/Lvl 4 Service - Mod | $4,125.77 | $5,501.02 | $472.99–$5,501.02 | 257% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC in-House Trauma W/Lvl 4 Service - Full | $5,955.17 | $7,940.23 | $472.99–$7,940.23 | 415% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC Phy Emerg Dept-Level 4 | $637.50 | $850.00 | $472.99–$1,592.44 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Department Visit | $1,267.86 | $1,690.48 | $472.99–$1,690.48 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC in-House Trauma W/Lvl 4 Service - Mod | $4,125.77 | $5,501.02 | $472.99–$5,501.02 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC in-House Trauma W/Lvl 4 Service - Full | $5,955.17 | $7,940.23 | $472.99–$7,940.23 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC F-ED Exp Lvl 5 | $1,927.85 | $2,570.46 | $448.63–$2,570.46 | 1% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Department Visit | $1,927.85 | $2,570.46 | $681.02–$2,570.46 | 1% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC in-House Trauma W/Lvl 5 Service-Mod | $4,579.19 | $6,105.59 | $681.02–$6,105.59 | 140% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC in-House Trauma W/Lvl 5 Service-Full | $6,408.60 | $8,544.80 | $681.02–$8,544.80 | 236% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC F-ED Exp Lvl 5 | $1,927.85 | $2,570.46 | $448.63–$2,570.46 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Department Visit | $1,927.85 | $2,570.46 | $681.02–$2,570.46 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC in-House Trauma W/Lvl 5 Service-Mod | $4,579.19 | $6,105.59 | $681.02–$6,105.59 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC in-House Trauma W/Lvl 5 Service-Full | $6,408.60 | $8,544.80 | $681.02–$8,544.80 | — | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiac Stress Test | $1,113.42 | $1,484.56 | $345.90–$1,484.56 | 66% above | 25% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiac Stress Test | $1,113.42 | $1,484.56 | $345.90–$1,484.56 | — | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC Family Psychotherapy W/Pt | $131.18 | $174.90 | $144.29–$608.94 | 17% below | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC Family Psychotherapy W/Pt | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC Family Psychotherapy No Pt | $131.18 | $174.90 | $144.29–$608.94 | 15% below | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC Family Psychotherapy No Pt | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Group psychotherapy session CPT 90853 HC Group Psychotherapy | $78.38 | $104.50 | $86.21–$104.50 | 8% above | 25% |
| Group psychotherapy session inpatient CPT 90853 HC Group Psychotherapy | $78.38 | $104.50 | $86.21–$104.50 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration | $233.22 | $310.96 | $234.03–$449.99 | 41% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration 31 Mins-1hr Tech | $243.51 | $324.68 | $234.03–$449.99 | 38% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Initial Hour | $418.75 | $558.33 | $234.03–$558.33 | 6% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Up to 1 Hr | $542.18 | $722.91 | $234.03–$722.91 | 38% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration | $233.22 | $310.96 | $234.03–$449.99 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration 31 Mins-1hr Tech | $243.51 | $324.68 | $234.03–$449.99 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration Initial Hour | $418.75 | $558.33 | $234.03–$558.33 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration Up to 1 Hr | $542.18 | $722.91 | $234.03–$722.91 | — | 25% |
| IV infusion of a medicine, first hour CPT 96365 HC Ther/Proph/Diag IV Inf Init | $243.51 | $324.68 | $234.03–$843.39 | 39% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Infusion Initial Hour | $523.43 | $697.91 | $234.03–$843.39 | 32% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Infusion Therapy 1 Hour | $589.84 | $786.45 | $234.03–$843.39 | 49% above | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC Ther/Proph/Diag IV Inf Init | $243.51 | $324.68 | $234.03–$843.39 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infusion Initial Hour | $523.43 | $697.91 | $234.03–$843.39 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infusion Therapy 1 Hour | $589.84 | $786.45 | $234.03–$843.39 | — | 25% |
| IV push of a medicine, first drug CPT 96374 HC Ther/Proph/Diag Inj IV Push | $243.51 | $324.68 | $234.03–$449.99 | 2% below | 25% |
| IV push of a medicine, first drug CPT 96374 HC Injection IV Single Drug | $253.01 | $337.34 | $234.03–$449.99 | 2% above | 25% |
| IV push of a medicine, first drug CPT 96374 HC IV Push Initial Drug | $274.91 | $366.54 | $234.03–$449.99 | 11% above | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 HC Ther/Proph/Diag Inj IV Push | $243.51 | $324.68 | $234.03–$449.99 | — | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 HC Injection IV Single Drug | $253.01 | $337.34 | $234.03–$449.99 | — | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 HC IV Push Initial Drug | $274.91 | $366.54 | $234.03–$449.99 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Im/Sq Tech Fee | $78.05 | $104.06 | $79.05–$206.05 | 19% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Im/Sq Inj Ea | $141.35 | $188.46 | $79.05–$206.05 | 47% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Subq or Im | $210.77 | $281.02 | $79.05–$281.02 | 120% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Im/Sq Tech Fee | $78.05 | $104.06 | $79.05–$206.05 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Im/Sq Inj Ea | $141.35 | $188.46 | $79.05–$206.05 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Subq or Im | $210.77 | $281.02 | $79.05–$281.02 | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Diagnostic Eval Tech Fee | $131.18 | $174.90 | $144.29–$608.94 | 54% below | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Psych Diagnostic Eval Tech Fee | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction Studies 7-8 Studies | $315.12 | $420.16 | $345.90–$1,073.10 | at median | 25% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC Nerve Conduction Studies 7-8 Studies | $315.12 | $420.16 | $345.90–$1,073.10 | — | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular Re-ED Pt(15) | $99.25 | $132.33 | $31.33–$155.79 | at median | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuromuscular Re-ED Pt(15) | $99.25 | $132.33 | $31.33–$155.79 | — | 25% |
| New patient office visit, about 30 minutes CPT 99203 HC F-New Office Visit Expanded | $104.01 | $138.68 | $114.41–$143.15 | 49% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 HC Phy Exam Office Level 3 New Pt | $520.74 | $694.32 | $77.09–$694.32 | 154% above | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC F-New Office Visit Expanded | $104.01 | $138.68 | $114.41–$143.15 | — | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC Phy Exam Office Level 3 New Pt | $520.74 | $694.32 | $77.09–$694.32 | — | 25% |
| New patient office visit, about 45 minutes CPT 99204 HC F-Office Consult Comprehensive | $139.99 | $186.65 | $143.15–$186.65 | 52% below | 25% |
| New patient office visit, about 45 minutes CPT 99204 HC Phy Exam Office Level 4 New Pt | $738.38 | $984.50 | $125.77–$984.50 | 152% above | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC F-Office Consult Comprehensive | $139.99 | $186.65 | $143.15–$186.65 | — | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC Phy Exam Office Level 4 New Pt | $738.38 | $984.50 | $125.77–$984.50 | — | 25% |
| New patient office visit, about 60 minutes CPT 99205 HC F-New Office Visit Complex | $186.65 | $248.87 | $143.15–$248.87 | 46% below | 25% |
| New patient office visit, about 60 minutes CPT 99205 HC Phy Exam Office Level 5 New Pt | $963.75 | $1,285.00 | $171.00–$1,285.00 | 178% above | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC F-New Office Visit Complex | $186.65 | $248.87 | $143.15–$248.87 | — | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC Phy Exam Office Level 5 New Pt | $963.75 | $1,285.00 | $171.00–$1,285.00 | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Phy Exam Office Level 2 New Pt | $393.83 | $525.10 | $44.30–$525.10 | 193% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Phy Exam Office Level 2 New Pt | $393.83 | $525.10 | $44.30–$525.10 | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Mnt-Med Nutrition Education Init P/15 Min | $54.73 | $72.97 | $30.80–$157.25 | 22% below | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Mnt-Med Nutrition Education Init P/15 Min | $54.73 | $72.97 | $30.80–$157.25 | — | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low | $242.65 | $323.53 | $91.01–$468.43 | 4% below | 25% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Low | $242.65 | $323.53 | $91.01–$468.43 | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High | $242.65 | $323.53 | $84.74–$463.81 | 19% below | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval High | $242.65 | $323.53 | $84.74–$463.81 | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low | $242.65 | $323.53 | $84.74–$463.81 | 1% below | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Low | $242.65 | $323.53 | $84.74–$463.81 | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Mod | $242.65 | $323.53 | $84.74–$463.81 | 20% below | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Mod | $242.65 | $323.53 | $84.74–$463.81 | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Therapy 15 | $96.07 | $128.09 | $26.24–$128.09 | 2% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Manual Therapy 15 | $96.07 | $128.09 | $26.24–$128.09 | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Therapeutic Ex 15min | $95.75 | $127.67 | $28.16–$135.71 | 1% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Therapeutic Ex 15min | $95.75 | $127.67 | $28.16–$135.71 | — | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC Prev Care New Pt 18-39yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | 13% below | 25% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC Prev Care New Pt 18-39yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC Prev Care New 40-64yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | 42% below | 25% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC Prev Care New 40-64yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC Prev Care New Pt 65+ Yrs | $119.63 | $159.50 | $67.44–$159.50 | 47% below | 25% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC Prev Care New Pt 65+ Yrs | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC Prev Care Est 18-39 Yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | at median | 25% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC Prev Care Est 18-39 Yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC Prev Care Est 40-64 Yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | 31% below | 25% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC Prev Care Est 40-64 Yrs Tech | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC Prev Care Est Adult 65+ Tech | $119.63 | $159.50 | $67.44–$159.50 | 36% below | 25% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC Prev Care Est Adult 65+ Tech | $119.63 | $159.50 | $67.44–$159.50 | — | 25% |
| Psychiatric evaluation with medical services CPT 90792 HC Psych Diag Eval W/Med Svc Tech | $131.18 | $174.90 | $144.29–$608.94 | 49% below | 25% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC Psych Diag Eval W/Med Svc Tech | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC Psychotherapy for Crisis Initial 60 Min | $131.18 | $174.90 | $144.29–$174.90 | 56% below | 25% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC Psychotherapy for Crisis Initial 60 Min | $131.18 | $174.90 | $144.29–$174.90 | — | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy Pt &/ Family 30 Min | $131.18 | $174.90 | $144.29–$339.20 | 11% above | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy Pt &/ Family 30 Min | $131.18 | $174.90 | $144.29–$339.20 | — | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC Psychotx 45 Mins W/Pt/Fm | $131.18 | $174.90 | $144.29–$608.94 | 27% below | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotx 45 Mins W/Pt/Fm | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psychotx 60 Mins W/Pt/Fm Tech | $131.18 | $174.90 | $144.29–$608.94 | 42% below | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotx 60 Mins W/Pt/Fm Tech | $131.18 | $174.90 | $144.29–$608.94 | — | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Behav Chng Smok/Tob 3-10m Tech | $34.65 | $46.20 | $33.09–$132.07 | 3% above | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Tobacco-Use Counsel 3-10 Min | $41.25 | $55.00 | $33.09–$132.07 | 22% above | 25% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Behav Chng Smok/Tob 3-10m Tech | $34.65 | $46.20 | $33.09–$132.07 | — | 25% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Tobacco-Use Counsel 3-10 Min | $41.25 | $55.00 | $33.09–$132.07 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC F-Est Office Visit Complex | $130.80 | $174.40 | $143.15–$174.40 | 61% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Clinic Facility Fee Level 5 Est | $152.92 | $203.89 | $143.15–$203.89 | 54% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Airway Transport Assessment | $405.75 | $541.00 | $43.60–$541.00 | 21% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Phy Est Pt Prob High | $588.06 | $784.08 | $143.15–$784.08 | 75% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC F-Est Office Visit Complex | $130.80 | $174.40 | $143.15–$174.40 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Clinic Facility Fee Level 5 Est | $152.92 | $203.89 | $143.15–$203.89 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Airway Transport Assessment | $405.75 | $541.00 | $43.60–$541.00 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Phy Est Pt Prob High | $588.06 | $784.08 | $143.15–$784.08 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC F-C-Sect Aft Vag Try Pp Visit | $104.01 | $138.68 | $114.41–$143.15 | 45% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Clinic Facility Fee Level 3 Est | $152.92 | $203.89 | $143.15–$203.89 | 19% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Phy Est Pt Prob Expand | $248.36 | $331.14 | $143.15–$331.14 | 31% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Care Lvl 3/Est | $455.51 | $607.34 | $143.15–$607.34 | 141% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC F-C-Sect Aft Vag Try Pp Visit | $104.01 | $138.68 | $114.41–$143.15 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Clinic Facility Fee Level 3 Est | $152.92 | $203.89 | $143.15–$203.89 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Phy Est Pt Prob Expand | $248.36 | $331.14 | $143.15–$331.14 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Care Lvl 3/Est | $455.51 | $607.34 | $143.15–$607.34 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC F-Est Office Visit Detailed | $112.41 | $149.88 | $123.65–$149.88 | 54% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Clinic Facility Fee Level 4 Est | $152.92 | $203.89 | $143.15–$203.89 | 37% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Phy Est Pt Prob Detailed | $322.91 | $430.54 | $143.15–$430.54 | 32% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC F-Est Office Visit Detailed | $112.41 | $149.88 | $123.65–$149.88 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Clinic Facility Fee Level 4 Est | $152.92 | $203.89 | $143.15–$203.89 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Phy Est Pt Prob Detailed | $322.91 | $430.54 | $143.15–$430.54 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC F-Est Office Visit Prob Focused | $104.01 | $138.68 | $114.41–$143.15 | 3% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Clinic Facility Fee Level 2 Est | $152.92 | $203.89 | $143.15–$203.89 | 52% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Phy Est Pt Prob Focused | $217.28 | $289.70 | $143.15–$289.70 | 116% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC F-Est Office Visit Prob Focused | $104.01 | $138.68 | $114.41–$143.15 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Clinic Facility Fee Level 2 Est | $152.92 | $203.89 | $143.15–$203.89 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Phy Est Pt Prob Focused | $217.28 | $289.70 | $143.15–$289.70 | — | 25% |
| Speech and language evaluation CPT 92523 HC Eval of Speech Sound Prod W/ Eval of Lang Comp and Expression 105 Min | $323.69 | $431.59 | $195.91–$1,054.20 | 7% below | 25% |
| Speech and language evaluation inpatient CPT 92523 HC Eval of Speech Sound Prod W/ Eval of Lang Comp and Expression 105 Min | $323.69 | $431.59 | $195.91–$1,054.20 | — | 25% |
| Speech therapy session, individual CPT 92507 HC Speech/Lang/Comm Ther | $260.58 | $347.44 | $73.32–$353.14 | 6% below | 25% |
| Speech therapy session, individual CPT 92507 HC Speech/Lang/Comm Ther 45 Min | $281.19 | $374.92 | $73.32–$374.92 | 2% above | 25% |
| Speech therapy session, individual inpatient CPT 92507 HC Speech/Lang/Comm Ther | $260.58 | $347.44 | $73.32–$353.14 | — | 25% |
| Speech therapy session, individual inpatient CPT 92507 HC Speech/Lang/Comm Ther 45 Min | $281.19 | $374.92 | $73.32–$374.92 | — | 25% |
| Spirometry (breathing test) CPT 94010 HC Spirometry Tech Fee | $186.68 | $248.90 | $173.79–$631.88 | 17% below | 25% |
| Spirometry (breathing test) CPT 94010 HC Spirometry W/O Broncho | $445.77 | $594.36 | $173.79–$631.88 | 99% above | 25% |
| Spirometry (breathing test) CPT 94010 HC Abrtd Spirometry | $639.49 | $852.65 | $173.79–$852.65 | 185% above | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC Spirometry Tech Fee | $186.68 | $248.90 | $173.79–$631.88 | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC Spirometry W/O Broncho | $445.77 | $594.36 | $173.79–$631.88 | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC Abrtd Spirometry | $639.49 | $852.65 | $173.79–$852.65 | — | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC Eval of Bronchospasm Clinic | $314.45 | $419.27 | $345.90–$1,073.10 | 23% below | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC Spiro Before/After Bronch | $747.06 | $996.08 | $345.90–$1,073.10 | 83% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC Spirom Handheld Pre/Post | $747.06 | $996.08 | $345.90–$1,073.10 | 83% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC Abrtd Spiro Before/After Bronch | $1,033.08 | $1,377.44 | $345.90–$1,377.44 | 153% above | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Eval of Bronchospasm Clinic | $314.45 | $419.27 | $345.90–$1,073.10 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spiro Before/After Bronch | $747.06 | $996.08 | $345.90–$1,073.10 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirom Handheld Pre/Post | $747.06 | $996.08 | $345.90–$1,073.10 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Abrtd Spiro Before/After Bronch | $1,033.08 | $1,377.44 | $345.90–$1,377.44 | — | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ther Activities | $97.61 | $130.14 | $33.90–$169.46 | 11% above | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ther Activities | $97.61 | $130.14 | $33.90–$169.46 | — | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy, Therapeutic Tech | $131.26 | $175.01 | $143.18–$444.05 | 34% below | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy, Therapeutic | $310.76 | $414.34 | $143.18–$444.05 | 55% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Phlebotomy, Therapeutic Tech | $131.26 | $175.01 | $143.18–$444.05 | — | 25% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Phlebotomy, Therapeutic | $310.76 | $414.34 | $143.18–$444.05 | — | 25% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC Cardiovascular Stress Test | $167.67 | $223.56 | $69.63–$223.56 | 67% below | 25% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 HC Cardiovascular Stress Test | $167.67 | $223.56 | $69.63–$223.56 | — | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE | $156.50 | $208.66 | $88.22–$208.66 | 28% below | 25% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID VACC 2025-26 (12 YRS UP) (MODERNA)(PF) 50 MCG/0.5 ML IM SYRINGE | $156.50 | $208.66 | $88.22–$208.66 | — | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $201.11 | $268.14 | $113.37–$268.14 | 25% below | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP | $201.11 | $268.14 | $113.37–$268.14 | — | 25% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH,PERTUS(ACELL),TET,POLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE | $84.87 | $113.16 | $93.36–$113.16 | 16% above | 25% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH,PERTUS(ACELL),TET,POLIO (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SYRINGE | $84.87 | $113.16 | $93.36–$113.16 | — | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE | $54.47 | $72.63 | $59.92–$72.63 | 18% below | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $55.22 | $73.63 | $60.74–$73.63 | 17% below | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE | $54.47 | $72.63 | $59.92–$72.63 | — | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP | $55.22 | $73.63 | $60.74–$73.63 | — | 25% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE | $125.60 | $167.46 | $70.80–$167.46 | 22% above | 25% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE | $125.60 | $167.46 | $70.80–$167.46 | — | 25% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG | $175.46 | $233.94 | $98.91–$233.94 | 58% above | 25% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DIP,PERT(A)TET-HEPB-POLIO-HIB PED(PF) 15-5 UNIT-10 MCG/0.5 ML IM SYRNG | $175.46 | $233.94 | $98.91–$233.94 | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $26.66 | $35.54 | $15.03–$35.54 | 28% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE | $26.66 | $35.54 | $15.03–$35.54 | — | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $324.38 | $432.51 | $182.87–$432.51 | at median | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION | $324.38 | $432.51 | $182.87–$432.51 | at median | 25% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT (PF) 0.5 ML IM SUSPENSION | $324.38 | $432.51 | $182.87–$432.51 | — | 25% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE | $324.38 | $432.51 | $182.87–$432.51 | — | 25% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE | $154.97 | $206.62 | $170.46–$206.62 | 2% above | 25% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE | $154.97 | $206.62 | $170.46–$206.62 | — | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $103.57 | $138.09 | $113.92–$138.09 | 3% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $104.78 | $139.70 | $115.25–$139.70 | 4% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $108.82 | $145.09 | $119.70–$145.09 | 8% above | 25% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE | $103.57 | $138.09 | $113.92–$138.09 | — | 25% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 50 UNIT/ML INTRAMUSCULAR SUSPENSION | $104.78 | $139.70 | $115.25–$139.70 | — | 25% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE | $108.82 | $145.09 | $119.70–$145.09 | — | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $64.19 | $85.59 | $70.61–$85.59 | 15% above | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $64.19 | $85.59 | $70.61–$85.59 | 15% above | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE | $64.46 | $85.94 | $70.90–$85.94 | 15% above | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SUSPENSION | $64.19 | $85.59 | $70.61–$85.59 | — | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML INTRAMUSCULAR SYRINGE | $64.19 | $85.59 | $70.61–$85.59 | — | 25% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE | $64.46 | $85.94 | $70.90–$85.94 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP | $54.54 | $72.72 | $30.75–$72.72 | 21% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $54.54 | $72.72 | $30.75–$72.72 | 21% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $55.30 | $73.73 | $31.17–$73.73 | 20% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $95.79 | $127.72 | $54.00–$127.72 | 39% above | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP | $54.54 | $72.72 | $30.75–$72.72 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECMB(PF) 5 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $54.54 | $72.72 | $30.75–$72.72 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE | $55.30 | $73.73 | $31.17–$73.73 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE | $95.79 | $127.72 | $54.00–$127.72 | — | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN | $40.73 | $54.30 | $44.80–$54.30 | 2% below | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN | $40.73 | $54.30 | $44.80–$54.30 | — | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $75.65 | $100.87 | $42.65–$100.87 | 6% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $75.65 | $100.87 | $42.65–$100.87 | — | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $115.04 | $153.39 | $126.55–$153.39 | 39% below | 25% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT | $115.04 | $153.39 | $126.55–$153.39 | — | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION | $28.88 | $38.50 | $16.28–$474.78 | 84% below | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION | $187.24 | $249.65 | $105.55–$474.78 | 4% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $187.24 | $249.65 | $105.55–$474.78 | 4% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $655.53 | $874.04 | $369.54–$2,373.88 | 264% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION | $28.88 | $38.50 | $16.28–$474.78 | — | 25% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A CONJ VACC 2 OF 2(PF) 10 MCG/0.5 ML (FINAL) IM SOLUTION | $187.24 | $249.65 | $105.55–$474.78 | — | 25% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION | $187.24 | $249.65 | $105.55–$474.78 | — | 25% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS) | $655.53 | $874.04 | $369.54–$2,373.88 | — | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $254.39 | $339.18 | $143.41–$717.69 | 5% below | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE | $254.39 | $339.18 | $143.41–$717.69 | — | 25% |
| Meningococcal B vaccine (Trumenba) CPT 90621 N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $231.53 | $308.70 | $254.68–$308.70 | 21% above | 25% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $231.53 | $308.70 | $254.68–$308.70 | — | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HC Pneumovax-13 Immunization | $302.42 | $403.22 | $170.48–$403.22 | 14% below | 25% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 HC Pneumovax-13 Immunization | $302.42 | $403.22 | $170.48–$403.22 | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE (PCV20) (PF) 0.5 ML IM SYRINGE | $305.97 | $407.96 | $172.49–$407.96 | 6% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE (PCV20) (PF) 0.5 ML IM SYRINGE | $305.97 | $407.96 | $172.49–$407.96 | — | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $134.25 | $179.00 | $75.68–$179.00 | 28% below | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE | $134.25 | $179.00 | $75.68–$179.00 | — | 25% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION | $71.24 | $94.98 | $78.36–$94.98 | 25% below | 25% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40 UNIT-8 UNIT-32 UNIT/0.5 ML INJECTION SUSPENSION | $71.24 | $94.98 | $78.36–$94.98 | — | 25% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE | $564.44 | $752.58 | $318.19–$752.58 | 11% below | 25% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE | $564.44 | $752.58 | $318.19–$752.58 | — | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $564.44 | $752.58 | $318.19–$752.58 | 11% below | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE | $564.44 | $752.58 | $318.19–$752.58 | — | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION | $316.04 | $421.39 | $178.16–$421.39 | 44% below | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION | $316.04 | $421.39 | $178.16–$421.39 | — | 25% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT | $304.59 | $406.12 | $171.71–$406.12 | 9% below | 25% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, ANTIGEN (2 OF 2) 120 MCG IM SUSP | $304.59 | $406.12 | $171.71–$406.12 | 9% below | 25% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RESPIRATORY SYNCYTIAL VIRUS VACCINE, ANTIGEN (2 OF 2) 120 MCG IM SUSP | $304.59 | $406.12 | $171.71–$406.12 | — | 25% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 ANTIGEN-AS01E ADJUVANT(PF) 120 MCG/0.5 ML IM SUSPENSION, KIT | $304.59 | $406.12 | $171.71–$406.12 | — | 25% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 HC Rotarix - Free Vaccine | $20.47 | $27.29 | $11.54–$27.29 | 85% below | 25% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACCINE, LIVE, 89-12 STRAIN G1P(8) 10EXP6 CCID50/1.5 ML SUSP | $168.42 | $224.56 | $94.94–$224.56 | 25% above | 25% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 HC Rotarix - Free Vaccine | $20.47 | $27.29 | $11.54–$27.29 | — | 25% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACCINE, LIVE, 89-12 STRAIN G1P(8) 10EXP6 CCID50/1.5 ML SUSP | $168.42 | $224.56 | $94.94–$224.56 | — | 25% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION | $113.96 | $151.95 | $64.24–$151.95 | 18% below | 25% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION | $113.96 | $151.95 | $64.24–$151.95 | — | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $222.84 | $297.12 | $125.62–$297.12 | 1% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE | $247.28 | $329.71 | $139.40–$329.71 | 12% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT | $222.84 | $297.12 | $125.62–$297.12 | — | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACCINE-AS01B ADJ(PF) 50 MCG/0.5 ML IM SYRINGE | $247.28 | $329.71 | $139.40–$329.71 | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $68.85 | $91.80 | $75.74–$91.80 | 48% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP | $68.85 | $91.80 | $75.74–$91.80 | 48% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP | $68.85 | $91.80 | $75.74–$91.80 | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE | $68.85 | $91.80 | $75.74–$91.80 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $71.98 | $95.97 | $79.18–$95.97 | 1% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $72.83 | $97.10 | $80.11–$97.10 | at median | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE | $71.98 | $95.97 | $79.18–$95.97 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACEL)TETANUS(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP | $72.83 | $97.10 | $80.11–$97.10 | — | 25% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $174.32 | $232.42 | $191.75–$232.42 | 18% above | 25% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE | $174.32 | $232.42 | $191.75–$232.42 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Admin-Flu | $56.19 | $74.92 | $51.25–$150.34 | 3% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Admin-Hep B | $56.19 | $74.92 | $51.25–$206.05 | 3% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Admin-Pneumonia | $56.19 | $74.92 | $51.25–$150.34 | 3% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Vaccine Im Immunization | $56.19 | $74.92 | $61.81–$206.05 | 3% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Admin | $74.93 | $99.90 | $79.05–$206.05 | 29% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Im Immunization | $56.19 | $74.92 | $61.81–$206.05 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Admin-Flu | $56.19 | $74.92 | $51.25–$150.34 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Admin-Hep B | $56.19 | $74.92 | $51.25–$206.05 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Vaccine Admin-Pneumonia | $56.19 | $74.92 | $51.25–$150.34 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Admin | $74.93 | $99.90 | $79.05–$206.05 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Vaccine Admin,Ea Add'l | $28.10 | $37.46 | $30.90–$59.41 | 27% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Admin Each Add | $37.47 | $49.96 | $41.22–$59.41 | 2% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Vaccine Admin,Ea Add'l | $28.10 | $37.46 | $30.90–$59.41 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immunization Admin Each Add | $37.47 | $49.96 | $41.22–$59.41 | — | 25% |
| Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP | $259.58 | $346.10 | $285.53–$346.10 | 14% above | 25% |
| Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP | $259.58 | $346.10 | $285.53–$346.10 | — | 25% |
Source file: https://www.skylakes.org/wp-content/uploads/2026/03/930508781_sky-lakes-medical-center_standardcharges.zip