Summa Health System
Summa Health System in Akron, OH publishes cash prices for 53 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
525 East Market Street, Akron, OH 44309,1825 Franks Parkway, Uniontown, OH 44685,141 N Forge St, Akron, OH 44304,155 5th St NE, Barberton, OH 44203,195 Wadsworth Rd, Wadsworth, OH 44281 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $4,369.50 | $4,369.50 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $4,369.50 | $4,369.50 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast | $1,945.75 | $1,945.75 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast | $1,945.75 | $1,945.75 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast | $1,881.75 | $1,881.75 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast | $1,881.75 | $1,881.75 | — |
| Diagnostic mammogram, both breasts CPT 77066 Hc Dx Mammo Incl Cad Bil | $647.00 | $647.00 | — |
| Diagnostic mammogram, both breasts inpatient CPT 77066 Hc Dx Mammo Incl Cad Bil | $647.00 | $647.00 | — |
| Diagnostic mammogram, one breast CPT 77065 Hc Dx Mammo Incl Cad Uni | $487.50 | $487.50 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 Hc Dx Mammo Incl Cad Uni | $487.50 | $487.50 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Jnt Of Lwr Extre W/O Dye Mri Any Jt Low Ext Wo Cont Uni | $2,483.00 | $2,483.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Jnt Of Lwr Extre W/O Dye Mri Any Jt Low Ext Wo Cont Uni | $2,483.00 | $2,483.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Any Joint - Mri Any Jt Lo Ext W/Wo Cont Uni | $3,146.75 | $3,146.75 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Any Joint - Mri Any Jt Lo Ext W/Wo Cont Uni | $3,146.75 | $3,146.75 | — |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain - Mri Brain Wo Contrast | $3,267.25 | $3,267.25 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Brain - Mri Brain Wo Contrast | $3,267.25 | $3,267.25 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Combo - Mri Brain W Wo Contrast | $4,620.50 | $4,620.50 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain Combo - Mri Brain W Wo Contrast | $4,620.50 | $4,620.50 | — |
| MRI of the lower back, no contrast dye CPT 72148 Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast | $2,344.50 | $2,344.50 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast | $2,344.50 | $2,344.50 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Ob Us >/= 14 Wks Sngl Fetus - Us Ob 14+ Weeks Single Or First Gest | $738.25 | $738.25 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Ob Us >/= 14 Wks Sngl Fetus - Us Ob 14+ Weeks Single Or First Gest | $738.25 | $738.25 | — |
| Screening mammogram, both breasts both sides CPT 77067 Hc Scr Mammo Bi Incl Cad | $531.50 | $531.50 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Hc Scr Mammo Bi Incl Cad | $531.50 | $531.50 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Polysomnography 4+ Addl Param | $7,753.50 | $7,753.50 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysomnography 4+ Addl Param | $7,753.50 | $7,753.50 | — |
| Transvaginal pelvic ultrasound CPT 76830 Hc Echography,Transvaginal - Us Pelvis Transvaginal | $956.00 | $956.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Echography,Transvaginal - Us Pelvis Transvaginal | $956.00 | $956.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Hc Us Abd W Image Doc Complt | $1,149.00 | $1,149.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us Abd W Image Doc Complt | $1,149.00 | $1,149.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 Hc X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $618.25 | $618.25 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $618.25 | $618.25 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Noncdm Charge Record | $154.75 | $154.75 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Noncdm Charge Record | $154.75 | $154.75 | — |
| Obstetric blood test panel CPT 80055 Hc Obstetric Panel - Bundled Charge | $172.25 | $172.25 | — |
| Obstetric blood test panel inpatient CPT 80055 Hc Obstetric Panel - Bundled Charge | $172.25 | $172.25 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Psa Free | $42.04 | $42.04 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Psa Free | $42.04 | $42.04 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen,Total - Psa | $148.75 | $148.75 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Psa Total | $148.75 | $148.75 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Noncdm Charge Record | $190.88 | $190.88 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Psa Total | $148.75 | $148.75 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen,Total - Psa | $148.75 | $148.75 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Noncdm Charge Record | $190.88 | $190.88 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Aptt-Hypercoag | $70.25 | $70.25 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Noncdm Charge Record | $82.00 | $82.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Aptt-Hypercoag | $70.25 | $70.25 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Noncdm Charge Record | $82.00 | $82.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Protime-Hypercoag | $66.00 | $66.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time | $66.00 | $66.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Noncdm Charge Record | $77.00 | $77.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Protime-Hypercoag | $66.00 | $66.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time | $66.00 | $66.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Noncdm Charge Record | $77.00 | $77.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh | $9.00 | $9.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Tsh Nbs | $183.00 | $183.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Noncdm Charge Record | $196.25 | $196.25 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh | $9.00 | $9.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Tsh Nbs | $183.00 | $183.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Noncdm Charge Record | $196.25 | $196.25 | — |
| Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis Complete | $77.50 | $77.50 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis Complete | $77.50 | $77.50 | — |
| Urinalysis with microscope exam, manual CPT 81000 Hc N-Autom Urine Dip W Micro | $23.75 | $23.75 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Hc N-Autom Urine Dip W Micro | $23.75 | $23.75 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Autom Urinalysis Wo Micro | $3.53 | $3.53 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Autom Urinalysis Wo Micro | $3.53 | $3.53 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 Hc Asc Xcapsl Ctrc Rmvl W/O Ecp | $3,980.75 | $3,980.75 | — |
| Cataract surgery with lens implant inpatient CPT 66984 Hc Asc Xcapsl Ctrc Rmvl W/O Ecp | $3,980.75 | $3,980.75 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 Hc Gi Colonoscopy W/Endoscope Us | $4,916.75 | $4,916.75 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Hc Gi Colonoscopy W/Endoscope Us | $4,916.75 | $4,916.75 | — |
| Colonoscopy with polyp removal CPT 45385 Hc Asc Colon Flex W Rem Polyp Snare | $2,075.00 | $2,075.00 | — |
| Colonoscopy with polyp removal CPT 45385 Hc Gi Colon Flex W Rem Polyp Snare | $3,434.00 | $3,434.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Hc Asc Colon Flex W Rem Polyp Snare | $2,075.00 | $2,075.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Hc Gi Colon Flex W Rem Polyp Snare | $3,434.00 | $3,434.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Asc Colon Flex W Bx 1Mx | $2,075.00 | $2,075.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Gi Colon Flex W Bx 1Mx | $3,065.50 | $3,065.50 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Asc Colon Flex W Bx 1Mx | $2,075.00 | $2,075.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Gi Colon Flex W Bx 1Mx | $3,065.50 | $3,065.50 | — |
| Colonoscopy, diagnostic CPT 45378 Hc Asc Gi Colon/Diag (W Wo Brush) | $1,604.50 | $1,604.50 | — |
| Colonoscopy, diagnostic CPT 45378 Hc Gi Colon/Diag (W Wo Brush) | $3,113.50 | $3,113.50 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Hc Asc Gi Colon/Diag (W Wo Brush) | $1,604.50 | $1,604.50 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Hc Gi Colon/Diag (W Wo Brush) | $3,113.50 | $3,113.50 | — |
| Gallbladder removal, laparoscopic CPT 47562 Hc Asc Laparoscopic Cholecystectomy | $9,377.00 | $9,377.00 | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Hc Asc Laparoscopic Cholecystectomy | $9,377.00 | $9,377.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Hc Asc Prp I/Hern Init Reduc >5 Yr | $5,524.50 | $5,524.50 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Hc Asc Prp I/Hern Init Reduc >5 Yr | $5,524.50 | $5,524.50 | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Hc Asc After Cataract Laser Surgery | $965.50 | $965.50 | — |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Hc Disc 2Nd Memb Catarac Laser Uni | $3,988.75 | $3,988.75 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Hc Asc After Cataract Laser Surgery | $965.50 | $965.50 | — |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Hc Disc 2Nd Memb Catarac Laser Uni | $3,988.75 | $3,988.75 | — |
| Left heart catheterization, diagnostic one side CPT 93452 Hc Cc Left Hrt Cath W/Ventrclgrphy | $10,913.00 | $10,913.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Hc Cc Left Hrt Cath W/Ventrclgrphy | $10,913.00 | $10,913.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Hc Asc Inj Interlam Lmbr/Sac | $1,218.75 | $1,218.75 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Hc Inj Interlam Lmbr/Sac | $2,688.00 | $2,688.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Asc Inj Interlam Lmbr/Sac | $1,218.75 | $1,218.75 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Inj Interlam Lmbr/Sac | $2,688.00 | $2,688.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Hc Njx Interlaminar Lmbr/Sac | $2,912.25 | $2,912.25 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Njx Interlaminar Lmbr/Sac | $2,912.25 | $2,912.25 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Asc Inj Epidur Lumb/Sac 1 Lev Uni | $1,566.75 | $1,566.75 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Inj Epidur Lumb/Sac 1 Lev Uni | $4,050.75 | $4,050.75 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Asc Inj Epidur Lumb/Sac 1 Lev Uni | $1,566.75 | $1,566.75 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Inj Epidur Lumb/Sac 1 Lev Uni | $4,050.75 | $4,050.75 | — |
| Prostate biopsy CPT 55700 Hc Asc Bx Prostate Sing/Mult Any Appr | $3,146.75 | $3,146.75 | — |
| Prostate biopsy CPT 55700 Hc Bx Prostate Sing/Mult Any Appr | $4,879.25 | $4,879.25 | — |
| Prostate biopsy inpatient CPT 55700 Hc Asc Bx Prostate Sing/Mult Any Appr | $3,146.75 | $3,146.75 | — |
| Prostate biopsy inpatient CPT 55700 Hc Bx Prostate Sing/Mult Any Appr | $4,879.25 | $4,879.25 | — |
| Removal of a breast lump, open surgery CPT 19120 Hc Asc Removal Of Breast Lesion 1+ | $5,042.25 | $5,042.25 | — |
| Removal of a breast lump, open surgery CPT 19120 Hc Removal Of Breast Lesion 1+ | $10,599.50 | $10,599.50 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 Hc Asc Removal Of Breast Lesion 1+ | $5,042.25 | $5,042.25 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 Hc Removal Of Breast Lesion 1+ | $10,599.50 | $10,599.50 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Asc Ugi W Bx 1/Mx | $1,650.25 | $1,650.25 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Ugi W Bx 1/Mx | $2,918.25 | $2,918.25 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Asc Ugi W Bx 1/Mx | $1,650.25 | $1,650.25 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Ugi W Bx 1/Mx | $2,918.25 | $2,918.25 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Asc Ugi Egd Dx W/Wo Coll/Wash | $1,650.25 | $1,650.25 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Ugi Egd Dx W/Wo Coll/Wash | $3,038.25 | $3,038.25 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Asc Ugi Egd Dx W/Wo Coll/Wash | $1,650.25 | $1,650.25 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Ugi Egd Dx W/Wo Coll/Wash | $3,038.25 | $3,038.25 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 Hc Psych Php Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Psych Iop Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Psychotherapy W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Chem Iop Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Psychotherapy W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Psych Php Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Psych Iop Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Chem Iop Family Psytx W Pt 50 Mins | $231.00 | $231.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Psych Php Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Psych Iop Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Chem Iop Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Psych Iop Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Chem Iop Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Psych Php Family Psytx Wo Pt 50 Mins | $305.00 | $305.00 | — |
| Group psychotherapy session CPT 90853 Hc Chem Drug Iop Group Psytx | $339.75 | $339.75 | — |
| Group psychotherapy session CPT 90853 Hc Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session CPT 90853 Hc Chem Alcohol Iop Group Psytx | $339.75 | $339.75 | — |
| Group psychotherapy session CPT 90853 Hc Psych Php Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session CPT 90853 Hc Psych Iop Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Psych Iop Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Psych Php Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Group Psychotherapy | $339.75 | $339.75 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Chem Drug Iop Group Psytx | $339.75 | $339.75 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Chem Alcohol Iop Group Psytx | $339.75 | $339.75 | — |
| New patient office visit, about 30 minutes CPT 99203 Hc Ov New Pt Level 3 | $219.00 | $219.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Hc Ov New Pt Level 3 | $219.00 | $219.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Hc Ov New Pt Level 4 | $329.00 | $329.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Hc Ov New Pt Level 4 | $329.00 | $329.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Hc Ov New Pt Level 5 | $435.00 | $435.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Hc Ov New Pt Level 5 | $435.00 | $435.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Sv Preventive Ov New 18-39 Yrs | $266.00 | $266.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Iv Preventive Ov New 18-39 Years | $266.00 | $266.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Sv Preventive Ov New 18-39 Yrs | $266.00 | $266.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Iv Preventive Ov New 18-39 Years | $266.00 | $266.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Hc Sv Preventive Ov New 40-64 Yrs | $236.00 | $236.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Hc Iv Preventive Ov New 40-64 Years | $236.00 | $236.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Sv Preventive Ov New 40-64 Yrs | $236.00 | $236.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Iv Preventive Ov New 40-64 Years | $236.00 | $236.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Psych Php Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Psych Iop Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Chem Iop Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Psytx W Patient 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psych Php Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psytx W Patient 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psych Iop Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Chem Iop Psytx W Pt 30 Mins | $203.50 | $203.50 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Psytx W Patient 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Psych Php Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Psych Iop Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Chem Iop Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psych Php Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psytx W Patient 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psych Iop Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Chem Iop Psytx W Pt 45 Mins | $306.00 | $306.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Chem Iop Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Psych Php Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Psytx W Patient 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Psych Iop Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psych Php Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psych Iop Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Chem Iop Psytx W Pt 60 Mins | $331.25 | $331.25 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psytx W Patient 60 Mins | $331.25 | $331.25 | — |