Hospital Peru, IN

Dukes Memorial Hospital

Listed in its price file as “Dukes Health System LLC”.

Dukes Memorial Hospital in Peru, IN publishes cash prices for 390 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Indiana median for 336 of 386 procedures and below it for 48. By typical cash price it ranks #76 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

275 W. 12th St, Peru, IN 46970 Collected Sep 22, 2026 Source price file Check a bill from this hospital (765) 472-8000

Critical access hospital (rural, 25 beds or fewer) For-profit hospital Emergency department CMS star rating 2 of 5 CCN 151318 · CMS hospital register NPI 1619920949

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen WWO Liver Protocol 3Phase	$2,323.50	$4,647.00	$163.75–$4,647.00	71% above	50%
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen WWO	$2,323.50	$4,647.00	$163.75–$4,647.00	71% above	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen WWO	$2,555.85	$4,647.00	$1,477.75–$4,182.30	—	45%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen WWO Liver Protocol 3Phase	$2,555.85	$4,647.00	$1,477.75–$4,182.30	—	45%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2V DR	$441.50	$883.00	$33.68–$883.00	64% above	50%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2V DR	$485.65	$883.00	$280.79–$794.70	—	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$324.00	$648.00	$34.49–$648.00	65% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$324.00	$648.00	$34.49–$648.00	65% above	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Right DR	$356.40	$648.00	$206.06–$583.20	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete Min 3 V Left DR	$356.40	$648.00	$206.06–$583.20	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$358.00	$716.00	$76.95–$716.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$358.00	$716.00	$76.95–$716.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NI Seg Pres w Dopp UE LE Single	$358.00	$716.00	$76.95–$716.00	2% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 TcPO2 Extremity Study Left	$358.00	$716.00	$76.95–$716.00	2% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 TcPO2 Extremity Study Right	$358.00	$716.00	$76.95–$716.00	2% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Arterial Doppler Single Lvl Bilat	$393.80	$716.00	$227.69–$644.40	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US UE Arterial Doppler Single Lvl Bilat	$393.80	$716.00	$227.69–$644.40	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NI Seg Pres w Dopp UE LE Single	$393.80	$716.00	$227.69–$644.40	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 TcPO2 Extremity Study Left	$393.80	$716.00	$227.69–$644.40	—	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 TcPO2 Extremity Study Right	$393.80	$716.00	$227.69–$644.40	—	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity Rt WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity Lt WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Right WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Left WO	$1,471.50	$2,943.00	$97.84–$2,943.00	83% above	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Right WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Left WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity Rt WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity Lt WO	$1,618.65	$2,943.00	$935.87–$2,648.70	—	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Barium	$431.50	$863.00	$88.16–$863.00	7% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RF Esophagus Gastrografin	$431.50	$863.00	$88.16–$863.00	7% below	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Barium	$474.65	$863.00	$274.43–$776.70	—	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RF Esophagus Gastrografin	$474.65	$863.00	$274.43–$776.70	—	45%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,268.50	$2,537.00	$241.14–$2,537.00	20% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone and or Joint Whole Body Scan 1 - NM Bone	$1,395.35	$2,537.00	$806.77–$2,283.30	—	45%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$737.00	$1,474.00	$65.38–$1,474.00	70% above	50%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$737.00	$1,474.00	$65.38–$1,474.00	70% above	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$810.70	$1,474.00	$468.73–$1,326.60	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$810.70	$1,474.00	$468.73–$1,326.60	—	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$562.50	$1,125.00	$49.49–$1,125.00	73% above	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$562.50	$1,125.00	$49.49–$1,125.00	73% above	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$618.75	$1,125.00	$357.75–$1,012.50	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$618.75	$1,125.00	$357.75–$1,012.50	—	45%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abd Pelv Renal Transplant Evaluation	$4,496.50	$8,993.00	$328.54–$8,993.00	138% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen Pelvis	$4,496.50	$8,993.00	$328.54–$8,993.00	138% above	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 74174 CTA-ABDOMEN PELVIS	$4,496.50	$8,993.00	$328.54–$8,993.00	138% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen Pelvis	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abd Pelv Renal Transplant Evaluation	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 74174 CTA-ABDOMEN PELVIS	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT angiography (CTA) of the head CPT 70496 70496 CTA-HEAD	$2,458.00	$4,916.00	$163.90–$4,916.00	93% above	50%
CT angiography (CTA) of the head CPT 70496 CTA Head	$2,531.50	$5,063.00	$163.90–$5,063.00	99% above	50%
CT angiography (CTA) of the head inpatient CPT 70496 70496 CTA-HEAD	$2,703.80	$4,916.00	$1,563.29–$4,424.40	—	45%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head	$2,784.65	$5,063.00	$1,610.03–$4,556.70	—	45%
CT angiography (CTA) of the neck CPT 70498 70498 CTA-NECK	$2,531.50	$5,063.00	$163.90–$5,063.00	108% above	50%
CT angiography (CTA) of the neck CPT 70498 CTA Neck	$2,531.50	$5,063.00	$163.90–$5,063.00	108% above	50%
CT angiography (CTA) of the neck inpatient CPT 70498 70498 CTA-NECK	$2,784.65	$5,063.00	$1,610.03–$4,556.70	—	45%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck	$2,784.65	$5,063.00	$1,610.03–$4,556.70	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest	$2,626.00	$5,252.00	$163.90–$5,252.00	106% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 71275 CTA-CHEST	$2,626.00	$5,252.00	$163.90–$5,252.00	106% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest for PE	$2,626.00	$5,252.00	$163.90–$5,252.00	106% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest	$2,888.60	$5,252.00	$1,670.14–$4,726.80	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest for PE	$2,888.60	$5,252.00	$1,670.14–$4,726.80	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 71275 CTA-CHEST	$2,888.60	$5,252.00	$1,670.14–$4,726.80	—	45%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Score WO	$26.00	$52.00	$10.23–$1,190.00	86% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart WO	$27.00	$54.00	$10.63–$1,190.00	86% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 75571 26 CT HRT W/O DYE W/CA TEST	$38.00	$76.00	$14.96–$160.03	80% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 75571,26 CT HRT W/O DYE W/CA TEST	$38.00	$76.00	$14.96–$160.03	80% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Cardiac Score WO	$28.60	$52.00	$16.54–$46.80	—	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart WO	$29.70	$54.00	$17.17–$48.60	—	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 75571,26 CT HRT W/O DYE W/CA TEST	$41.80	$76.00	$24.17–$68.40	—	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 75571 26 CT HRT W/O DYE W/CA TEST	$41.80	$76.00	$24.17–$68.40	—	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis WO	$2,616.00	$5,232.00	$222.37–$5,232.00	118% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Trauma Abdomen Pelvis WO	$2,616.00	$5,232.00	$222.37–$5,232.00	118% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd Pelvis with Rectal WO	$2,616.00	$5,232.00	$222.37–$5,232.00	118% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,616.00	$5,232.00	$222.37–$5,232.00	118% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis Stone Protocol	$2,877.60	$5,232.00	$1,663.78–$4,708.80	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd Pelvis with Rectal WO	$2,877.60	$5,232.00	$1,663.78–$4,708.80	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis WO	$2,877.60	$5,232.00	$1,663.78–$4,708.80	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Trauma Abdomen Pelvis WO	$2,877.60	$5,232.00	$1,663.78–$4,708.80	—	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis W Pancreatic Protocol	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis with Rectal W	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT-ABD PELVIS W	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abdomen Pelvis	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Trauma Abdomen Pelvis W	$3,753.50	$7,507.00	$328.83–$7,507.00	118% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis with Rectal W	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Trauma Abdomen Pelvis W	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT-ABD PELVIS W	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis W Pancreatic Protocol	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abdomen Pelvis	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W	$4,128.85	$7,507.00	$2,387.23–$6,756.30	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis WWO Liver Protocol 3Phase	$4,496.50	$8,993.00	$328.69–$8,993.00	162% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis WWO	$4,496.50	$8,993.00	$328.69–$8,993.00	162% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis WWO Urology Protocol	$4,496.50	$8,993.00	$328.69–$8,993.00	162% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd Pelvis with Rectal WWO	$4,496.50	$8,993.00	$328.69–$8,993.00	162% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd Pelvis WWO Urology Protocol	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd Pelvis WWO Liver Protocol 3Phase	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd Pelvis with Rectal WWO	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis WWO	$4,946.15	$8,993.00	$2,859.77–$8,093.70	—	45%
CT scan of the abdomen with contrast CPT 74160 74160 CT-ABDOMEN W	$1,945.50	$3,891.00	$163.75–$3,891.00	83% above	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W	$1,945.50	$3,891.00	$163.75–$3,891.00	83% above	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W Pancreatic Protocol	$1,945.50	$3,891.00	$163.75–$3,891.00	83% above	50%
CT scan of the abdomen with contrast CPT 74160 CT Trauma Abdomen W	$1,945.50	$3,891.00	$163.75–$3,891.00	83% above	50%
CT scan of the abdomen with contrast inpatient CPT 74160 74160 CT-ABDOMEN W	$2,140.05	$3,891.00	$1,237.34–$3,501.90	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Trauma Abdomen W	$2,140.05	$3,891.00	$1,237.34–$3,501.90	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W Pancreatic Protocol	$2,140.05	$3,891.00	$1,237.34–$3,501.90	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W	$2,140.05	$3,891.00	$1,237.34–$3,501.90	—	45%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO	$1,476.00	$2,952.00	$97.68–$2,952.00	75% above	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO	$1,623.60	$2,952.00	$938.74–$2,656.80	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO	$1,295.00	$2,590.00	$97.98–$2,590.00	55% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus WO	$1,295.00	$2,590.00	$97.98–$2,590.00	55% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert	$1,237.50	$2,475.00	$97.84–$2,475.00	62% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Trauma Head WO	$1,237.50	$2,475.00	$97.84–$2,475.00	62% above	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO	$1,237.50	$2,475.00	$97.84–$2,475.00	62% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO	$1,361.25	$2,475.00	$787.05–$2,227.50	—	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert	$1,361.25	$2,475.00	$787.05–$2,227.50	—	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Trauma Head WO	$1,361.25	$2,475.00	$787.05–$2,227.50	—	45%
CT scan of the head with contrast CPT 70460 CT Head or Brain W	$1,492.50	$2,985.00	$163.76–$2,985.00	75% above	50%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain W	$1,641.75	$2,985.00	$949.23–$2,686.50	—	45%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain WWO	$2,283.00	$4,566.00	$163.61–$4,566.00	119% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain WWO	$2,511.30	$4,566.00	$1,451.99–$4,109.40	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar WO	$1,499.50	$2,999.00	$97.68–$2,999.00	69% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar WO	$1,649.45	$2,999.00	$953.68–$2,699.10	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Trauma Cervical Spine WO	$1,738.00	$3,476.00	$97.68–$3,476.00	109% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical WO	$1,738.00	$3,476.00	$97.68–$3,476.00	109% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Trauma Cervical Spine WO	$1,911.80	$3,476.00	$1,105.37–$3,128.40	—	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical WO	$1,911.80	$3,476.00	$1,105.37–$3,128.40	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT Trauma Pelvis W	$2,108.00	$4,216.00	$163.75–$4,216.00	129% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis with Rectal W	$2,108.00	$4,216.00	$163.75–$4,216.00	129% above	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W	$2,108.00	$4,216.00	$163.75–$4,216.00	129% above	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W	$2,318.80	$4,216.00	$1,340.69–$3,794.40	—	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis with Rectal W	$2,318.80	$4,216.00	$1,340.69–$3,794.40	—	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Trauma Pelvis W	$2,318.80	$4,216.00	$1,340.69–$3,794.40	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$819.00	$1,638.00	$175.68–$1,638.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$900.90	$1,638.00	$520.88–$1,474.20	—	45%
Chest CT scan without and with contrast CPT 71270 CT Chest Diagnostic WWO	$2,388.00	$4,776.00	$163.90–$4,776.00	120% above	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest Diagnostic WWO	$2,626.80	$4,776.00	$1,518.77–$4,298.40	—	45%
Chest X-ray, 2 views CPT 71046 XR Chest 2 V DR	$368.50	$737.00	$30.87–$737.00	79% above	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 V DR	$405.35	$737.00	$234.37–$663.30	—	45%
Chest X-ray, single view CPT 71045 XR Chest 1 V Portable DR	$265.00	$530.00	$23.68–$530.00	63% above	50%
Chest X-ray, single view CPT 71045 XR Chest 1 V Frontal DR	$265.00	$530.00	$23.68–$530.00	63% above	50%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Portable DR	$291.50	$530.00	$168.54–$477.00	—	45%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 V Frontal DR	$291.50	$530.00	$168.54–$477.00	—	45%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left DR	$361.50	$723.00	$31.06–$723.00	88% above	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right DR	$361.50	$723.00	$31.06–$723.00	88% above	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left DR	$397.65	$723.00	$229.91–$650.70	—	45%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right DR	$397.65	$723.00	$229.91–$650.70	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$1,012.50	$2,025.00	$97.70–$2,025.00	102% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete	$1,113.75	$2,025.00	$643.95–$1,822.50	—	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$469.50	$939.00	$36.73–$939.00	62% above	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$516.45	$939.00	$298.60–$845.10	—	45%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Pregnancy Complete w Detail	$814.50	$1,629.00	$171.64–$1,629.00	45% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 76811 US-PLV PRG 2T DETAIL	$814.50	$1,629.00	$171.64–$1,629.00	45% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US Pregnancy Complete w Detail	$895.95	$1,629.00	$518.02–$1,466.10	—	45%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 76811 US-PLV PRG 2T DETAIL	$895.95	$1,629.00	$518.02–$1,466.10	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Diagnostic WO	$1,657.00	$3,314.00	$97.68–$3,314.00	99% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Trauma Chest WO	$1,657.00	$3,314.00	$97.68–$3,314.00	99% above	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT High Resolution Chest	$1,657.00	$3,314.00	$97.68–$3,314.00	99% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Trauma Chest WO	$1,822.70	$3,314.00	$1,053.85–$2,982.60	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT High Resolution Chest	$1,822.70	$3,314.00	$1,053.85–$2,982.60	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Diagnostic WO	$1,822.70	$3,314.00	$1,053.85–$2,982.60	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT-CHEST W	$2,076.50	$4,153.00	$163.61–$4,153.00	121% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W	$2,076.50	$4,153.00	$163.61–$4,153.00	121% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest Diagnostic W For PE - CT Chest PE Protoco	$2,076.50	$4,153.00	$163.61–$4,153.00	121% above	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Trauma Chest W	$2,076.50	$4,153.00	$163.61–$4,153.00	121% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W	$2,284.15	$4,153.00	$1,320.65–$3,737.70	—	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Trauma Chest W	$2,284.15	$4,153.00	$1,320.65–$3,737.70	—	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest Diagnostic W For PE - CT Chest PE Protoco	$2,284.15	$4,153.00	$1,320.65–$3,737.70	—	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 71260 CT-CHEST W	$2,284.15	$4,153.00	$1,320.65–$3,737.70	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$346.00	$692.00	$99.63–$692.00	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$356.50	$713.00	$99.63–$713.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 BR-DIG MAMMO BILAT	$380.60	$692.00	$220.06–$622.80	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD	$392.15	$713.00	$226.73–$641.70	—	45%
Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT	$253.50	$507.00	$78.15–$507.00	14% above	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$261.00	$522.00	$78.15–$522.00	17% above	50%
Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT	$261.00	$522.00	$78.15–$522.00	17% above	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$261.00	$522.00	$78.15–$522.00	17% above	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT	$278.85	$507.00	$161.23–$456.30	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD	$287.10	$522.00	$166.00–$469.80	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT	$287.10	$522.00	$166.00–$469.80	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD	$287.10	$522.00	$166.00–$469.80	—	45%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral	$850.50	$1,701.00	$220.43–$1,701.00	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$850.50	$1,701.00	$220.43–$1,701.00	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 NI Duplex Scan Leg Arteries Comp Bilat	$850.50	$1,701.00	$220.43–$1,701.00	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Bypass Grafts Comp Bilat	$935.55	$1,701.00	$540.92–$1,530.90	—	45%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 NI Duplex Scan Leg Arteries Comp Bilat	$935.55	$1,701.00	$540.92–$1,530.90	—	45%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US LE Arterial Duplex Bilateral	$935.55	$1,701.00	$540.92–$1,530.90	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Insufficiency Doppler Bilat	$930.00	$1,860.00	$170.94–$1,860.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral	$930.00	$1,860.00	$170.94–$1,860.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 NI Duplex Venous Extremities Comp Bilat	$930.00	$1,860.00	$170.94–$1,860.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral	$930.00	$1,860.00	$170.94–$1,860.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US UE Venous Duplex Bilateral	$1,023.00	$1,860.00	$591.48–$1,674.00	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 NI Duplex Venous Extremities Comp Bilat	$1,023.00	$1,860.00	$591.48–$1,674.00	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Insufficiency Doppler Bilat	$1,023.00	$1,860.00	$591.48–$1,674.00	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LE Venous Duplex Bilateral	$1,023.00	$1,860.00	$591.48–$1,674.00	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Pediatric Echo Complete w Color Dop	$2,476.00	$4,952.00	$184.65–$4,952.00	50% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$2,476.00	$4,952.00	$184.65–$4,952.00	50% above	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Transthoracic Echo 2D Doppler Comp	$2,476.00	$4,952.00	$184.65–$4,952.00	50% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Pediatric Echo Complete w Color Dop	$2,723.60	$4,952.00	$1,574.74–$4,456.80	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 NI Echo TTE 2D Complete w Color Doppler	$2,723.60	$4,952.00	$1,574.74–$4,456.80	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Transthoracic Echo 2D Doppler Comp	$2,723.60	$4,952.00	$1,574.74–$4,456.80	—	45%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Left DR	$282.00	$564.00	$27.34–$564.00	70% above	50%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 V Right DR	$282.00	$564.00	$27.34–$564.00	70% above	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Left DR	$310.20	$564.00	$179.35–$507.60	—	45%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 V Right DR	$310.20	$564.00	$179.35–$507.60	—	45%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$302.00	$604.00	$30.77–$604.00	18% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$302.00	$604.00	$30.77–$604.00	18% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Min 3 V Right CR	$302.00	$604.00	$30.77–$604.00	18% above	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right DR - XR Elbow Com	$332.20	$604.00	$192.07–$543.60	—	45%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete Min 3 V Right CR	$332.20	$604.00	$192.07–$543.60	—	45%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Sella WO	$1,295.00	$2,590.00	$97.84–$2,590.00	52% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Mastoids WO	$1,295.00	$2,590.00	$97.84–$2,590.00	52% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC Temporal WO	$1,295.00	$2,590.00	$97.84–$2,590.00	52% above	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit WO	$1,295.00	$2,590.00	$97.84–$2,590.00	52% above	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Sella WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC Temporal WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Mastoids WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit WO	$1,424.50	$2,590.00	$823.62–$2,331.00	—	45%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$441.50	$883.00	$43.66–$883.00	62% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches Minimum 3V DR	$441.50	$883.00	$43.66–$883.00	62% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones Comp Minimum 3 V DR	$485.65	$883.00	$280.79–$794.70	—	45%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches Minimum 3V DR	$485.65	$883.00	$280.79–$794.70	—	45%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Left DR	$302.00	$604.00	$27.03–$604.00	64% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 V Right DR	$302.00	$604.00	$27.03–$604.00	64% above	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary System Scan 1	$1,524.00	$3,048.00	$264.54–$3,048.00	16% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary System Scan 1	$1,676.40	$3,048.00	$969.26–$2,743.20	—	45%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Right DR	$377.50	$755.00	$29.20–$755.00	120% above	50%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 V Left DR	$377.50	$755.00	$29.20–$755.00	120% above	50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Left DR	$415.25	$755.00	$240.09–$679.50	—	45%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 V Right DR	$415.25	$755.00	$240.09–$679.50	—	45%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 V Right DR	$302.00	$604.00	$26.41–$604.00	41% above	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus 2 V Left DR	$302.00	$604.00	$26.41–$604.00	41% above	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus 2 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SL VPAP	$6,361.00	$12,722.00	$477.30–$12,722.00	96% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SL CPAP w BiPAP	$6,361.00	$12,722.00	$477.30–$12,722.00	96% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SL Split Night	$6,361.00	$12,722.00	$477.30–$12,722.00	96% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$6,361.00	$12,722.00	$477.30–$12,722.00	96% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SL CPAP w BiPAP	$6,997.10	$12,722.00	$4,045.60–$11,449.80	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SL VPAP	$6,997.10	$12,722.00	$4,045.60–$11,449.80	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SL Split Night	$6,997.10	$12,722.00	$4,045.60–$11,449.80	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CHRG - POLYS-CPAP GT4 GE6YO	$6,997.10	$12,722.00	$4,045.60–$11,449.80	—	45%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Left DR	$350.00	$700.00	$39.47–$700.00	53% above	50%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 V Right DR	$350.00	$700.00	$39.47–$700.00	53% above	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Right DR	$385.00	$700.00	$222.60–$630.00	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 V Left DR	$385.00	$700.00	$222.60–$630.00	—	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Right DR	$370.00	$740.00	$46.04–$740.00	41% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Left DR	$370.00	$740.00	$46.04–$740.00	41% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee 4 V w Patella Left DR	$370.00	$740.00	$46.04–$740.00	41% above	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4 V Right DR	$370.00	$740.00	$46.04–$740.00	41% above	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Right DR	$407.00	$740.00	$235.32–$666.00	—	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Left DR	$407.00	$740.00	$235.32–$666.00	—	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4 V Right DR	$407.00	$740.00	$235.32–$666.00	—	45%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee 4 V w Patella Left DR	$407.00	$740.00	$235.32–$666.00	—	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity Lt WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia Fibula Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Right WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Left WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity Rt WO	$1,416.50	$2,833.00	$97.68–$2,833.00	81% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity Rt WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity Lt WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia Fibula Right WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Left WO	$1,558.15	$2,833.00	$900.89–$2,549.70	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Common Bile Duct	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ascites	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Wall	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus	$704.00	$1,408.00	$80.71–$1,408.00	54% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Common Bile Duct	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ascites	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Wall	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver	$774.40	$1,408.00	$447.74–$1,267.20	—	45%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Extremity Non Vascular Limited Bilat	$241.50	$483.00	$22.80–$483.00	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non Vascular Limited - zzUS Extremity	$241.50	$483.00	$22.80–$483.00	20% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Right	$241.50	$483.00	$22.80–$483.00	20% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Lt	$241.50	$483.00	$22.80–$483.00	20% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Left	$241.50	$483.00	$22.80–$483.00	20% below	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non Vascular Limited Rt	$241.50	$483.00	$22.80–$483.00	20% below	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Extremity Non Vascular Limited Bilat	$265.65	$483.00	$153.59–$434.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non Vascular Limited - zzUS Extremity	$265.65	$483.00	$153.59–$434.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Left	$265.65	$483.00	$153.59–$434.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Rt	$265.65	$483.00	$153.59–$434.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non Vascular Limited Lt	$265.65	$483.00	$153.59–$434.70	—	45%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Right	$265.65	$483.00	$153.59–$434.70	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cancer Screening WO	$257.50	$515.00	$79.35–$1,190.00	35% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$257.50	$515.00	$79.35–$1,190.00	35% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cancer Screening WO	$283.25	$515.00	$163.77–$463.50	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Low Dose Cncr Scrn Rtn Annual WO	$283.25	$515.00	$163.77–$463.50	—	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Left DR	$281.50	$563.00	$29.20–$563.00	42% above	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia Fibula Right DR	$281.50	$563.00	$29.20–$563.00	42% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Left DR	$309.65	$563.00	$179.03–$506.70	—	45%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia Fibula Right DR	$309.65	$563.00	$179.03–$506.70	—	45%
MR angiography (MRA) of the head without contrast CPT 70544 MRV Brain WO	$1,806.00	$3,612.00	$222.37–$3,612.00	61% above	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head WO	$1,806.00	$3,612.00	$222.37–$3,612.00	61% above	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Brain WO	$1,986.60	$3,612.00	$1,148.62–$3,250.80	—	45%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head WO	$1,986.60	$3,612.00	$1,148.62–$3,250.80	—	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO	$1,730.00	$3,460.00	$222.07–$3,460.00	68% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO	$1,903.00	$3,460.00	$1,100.28–$3,114.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO	$3,143.50	$6,287.00	$328.69–$6,287.00	117% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO	$2,209.00	$4,418.00	$222.22–$4,418.00	107% above	50%
MRI of the abdomen without contrast CPT 74181 MRI MRCP WO	$2,209.00	$4,418.00	$222.22–$4,418.00	107% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO	$2,429.90	$4,418.00	$1,404.92–$3,976.20	—	45%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP WO	$2,429.90	$4,418.00	$1,404.92–$3,976.20	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen WWO	$3,143.50	$6,287.00	$328.54–$6,287.00	99% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP WWO	$3,143.50	$6,287.00	$328.54–$6,287.00	99% above	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 74183 - MR-ABDOMEN WWO	$3,143.50	$6,287.00	$328.54–$6,287.00	99% above	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 74183 - MR-ABDOMEN WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen WWO	$3,457.85	$6,287.00	$1,999.27–$5,658.30	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO	$2,035.50	$4,071.00	$222.22–$4,071.00	100% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Stroke Alert	$2,035.50	$4,071.00	$222.22–$4,071.00	100% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO Stroke Alert	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO	$3,114.00	$6,228.00	$328.54–$6,228.00	138% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO	$3,425.40	$6,228.00	$1,980.50–$5,605.20	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO	$2,112.00	$4,224.00	$222.22–$4,224.00	108% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar Limited WO	$2,175.50	$4,351.00	$222.22–$4,351.00	114% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO	$2,323.20	$4,224.00	$1,343.23–$3,801.60	—	45%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar Limited WO	$2,393.05	$4,351.00	$1,383.62–$3,915.90	—	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar WWO	$3,608.50	$7,217.00	$328.54–$7,217.00	146% above	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar WWO	$3,969.35	$7,217.00	$2,295.01–$6,495.30	—	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic Limited WO	$732.00	$1,464.00	$222.22–$1,514.00	27% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic WO	$1,979.00	$3,958.00	$222.22–$3,958.00	97% above	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic Lumbar WO	$2,038.50	$4,077.00	$222.22–$4,077.00	103% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic Limited WO	$805.20	$1,464.00	$465.55–$1,317.60	—	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic WO	$2,176.90	$3,958.00	$1,258.64–$3,562.20	—	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic Lumbar WO	$2,242.35	$4,077.00	$1,296.49–$3,669.30	—	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical WWO	$3,608.50	$7,217.00	$328.54–$7,217.00	146% above	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical WWO	$3,969.35	$7,217.00	$2,295.01–$6,495.30	—	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical WO	$2,144.50	$4,289.00	$222.22–$4,289.00	106% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical WO	$2,358.95	$4,289.00	$1,363.90–$3,860.10	—	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO	$2,209.00	$4,418.00	$222.36–$4,418.00	110% above	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO	$2,429.90	$4,418.00	$1,404.92–$3,976.20	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Left WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Left WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Right WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow Right WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder Left WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist Right WO	$2,035.50	$4,071.00	$222.07–$4,071.00	91% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Right WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Right WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Left WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist Left WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow Left WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder Right WO	$2,239.05	$4,071.00	$1,294.58–$3,663.90	—	45%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Minimum 4 V DR	$564.50	$1,129.00	$51.28–$1,129.00	62% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical Minimum 4 V DR	$620.95	$1,129.00	$359.02–$1,016.10	—	45%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck W	$1,745.50	$3,491.00	$163.61–$3,491.00	78% above	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck W	$1,920.05	$3,491.00	$1,110.14–$3,141.90	—	45%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck WO	$1,413.50	$2,827.00	$97.98–$2,827.00	70% above	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck WO	$1,554.85	$2,827.00	$898.99–$2,544.30	—	45%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue DR	$297.50	$595.00	$28.94–$595.00	72% above	50%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue DR	$327.25	$595.00	$189.21–$535.50	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Stress Multi 1	$4,146.00	$8,292.00	$398.57–$8,292.00	8% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Perfusion Rest Multi 1	$4,270.50	$8,541.00	$398.57–$8,541.00	11% above	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Stress Multi 1	$4,560.60	$8,292.00	$2,636.86–$7,462.80	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Perfusion Rest Multi 1	$4,697.55	$8,541.00	$2,716.04–$7,686.90	—	45%
Pelvic CT scan without contrast CPT 72192 CT Pelvis with Rectal WO	$1,350.00	$2,700.00	$97.68–$2,700.00	62% above	50%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO	$1,350.00	$2,700.00	$97.68–$2,700.00	62% above	50%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis WO	$1,485.00	$2,700.00	$858.60–$2,430.00	—	45%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis with Rectal WO	$1,485.00	$2,700.00	$858.60–$2,430.00	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB FU	$523.00	$1,046.00	$47.98–$1,046.00	46% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB Limited	$523.00	$1,046.00	$47.98–$1,046.00	46% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB Limited	$575.30	$1,046.00	$332.63–$941.40	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB FU	$575.30	$1,046.00	$332.63–$941.40	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete	$783.00	$1,566.00	$97.70–$1,566.00	69% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete	$861.30	$1,566.00	$497.99–$1,409.40	—	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$785.50	$1,571.00	$97.70–$1,571.00	42% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US-PELVIS PREG	$785.50	$1,571.00	$97.70–$1,571.00	42% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal	$864.05	$1,571.00	$499.58–$1,413.90	—	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US-PELVIS PREG	$864.05	$1,571.00	$499.58–$1,413.90	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester Transabdominal	$785.50	$1,571.00	$97.84–$1,571.00	53% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 76801 US-PELV PREG 14 WKS	$785.50	$1,571.00	$97.84–$1,571.00	53% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 76801 US-PELV PREG 14 WKS	$864.05	$1,571.00	$499.58–$1,413.90	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnancy 1st Trimester Transabdominal	$864.05	$1,571.00	$499.58–$1,413.90	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$388.50	$777.00	$76.35–$777.00	2% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Fetal Position	$388.50	$777.00	$76.35–$777.00	2% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited Placenta Location	$388.50	$777.00	$76.35–$777.00	2% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Fetal Position	$427.35	$777.00	$247.09–$699.30	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited Placenta Location	$427.35	$777.00	$247.09–$699.30	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$427.35	$777.00	$247.09–$699.30	—	45%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Left DR	$331.00	$662.00	$33.66–$662.00	62% above	50%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 V Right DR	$331.00	$662.00	$33.66–$662.00	62% above	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Right DR	$364.10	$662.00	$210.52–$595.80	—	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 V Left DR	$364.10	$662.00	$210.52–$595.80	—	45%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$408.50	$817.00	$38.90–$817.00	68% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$408.50	$817.00	$38.90–$817.00	68% above	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Left Min 3 V DR	$449.35	$817.00	$259.81–$735.30	—	45%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w PA Chest Right Min 3 V DR	$449.35	$817.00	$259.81–$735.30	—	45%
Screening mammogram, both breasts both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$208.00	$416.00	$77.02–$416.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$214.00	$428.00	$79.24–$428.00	—	50%
Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT	$208.00	$416.00	$77.02–$416.00	17% below	50%
Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT	$208.00	$416.00	$77.02–$416.00	17% below	50%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD	$214.00	$428.00	$79.24–$428.00	14% below	50%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD	$214.00	$428.00	$79.24–$428.00	14% below	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI	$228.80	$416.00	$132.29–$374.40	—	45%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD	$235.40	$428.00	$136.10–$385.20	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT	$228.80	$416.00	$132.29–$374.40	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT	$228.80	$416.00	$132.29–$374.40	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD	$235.40	$428.00	$136.10–$385.20	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD	$235.40	$428.00	$136.10–$385.20	—	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$297.50	$595.00	$33.27–$595.00	42% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$297.50	$595.00	$33.27–$595.00	42% above	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Left DR	$327.25	$595.00	$189.21–$535.50	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete Min 2 V Right DR	$327.25	$595.00	$189.21–$535.50	—	45%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete DR	$412.50	$825.00	$35.21–$825.00	45% above	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete DR	$453.75	$825.00	$262.35–$742.50	—	45%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull Less Than 4 V DR	$258.00	$516.00	$33.27–$516.00	11% above	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull Less Than 4 V DR	$283.80	$516.00	$164.09–$464.40	—	45%
Sleep study in a lab (polysomnography) CPT 95810 SL Polysomnography Sleep Study	$4,329.00	$8,658.00	$455.23–$8,658.00	64% above	50%
Sleep study in a lab (polysomnography) CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$4,329.00	$8,658.00	$455.23–$8,658.00	64% above	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 CHRG - POLYSOMNO GT4 GE6YO	$4,761.90	$8,658.00	$2,753.24–$7,792.20	—	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SL Polysomnography Sleep Study	$4,761.90	$8,658.00	$2,753.24–$7,792.20	—	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RF Modified Barium Swallow	$392.00	$784.00	$112.14–$784.00	8% above	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RF Modified Barium Swallow	$431.20	$784.00	$249.31–$705.60	—	45%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Left DR	$288.00	$576.00	$33.27–$576.00	44% above	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur Minimum 2 Views Right DR	$288.00	$576.00	$33.27–$576.00	44% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Right DR	$316.80	$576.00	$183.17–$518.40	—	45%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur Minimum 2 Views Left DR	$316.80	$576.00	$183.17–$518.40	—	45%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic WO	$1,413.50	$2,827.00	$97.68–$2,827.00	66% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic WO	$1,554.85	$2,827.00	$898.99–$2,544.30	—	45%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Left DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Min 2 V Right DR	$208.00	$416.00	$26.65–$416.00	36% above	50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Min 2 V Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Min 2 V Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Min 2 V Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Min 2 V Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Min 2 V Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB	$427.50	$855.00	$97.70–$855.00	5% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB	$470.25	$855.00	$271.89–$769.50	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnancy Transvaginal	$331.00	$662.00	$87.12–$662.00	10% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnancy Transvaginal	$364.10	$662.00	$210.52–$595.80	—	45%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$1,012.50	$2,025.00	$97.70–$2,025.00	93% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,113.75	$2,025.00	$643.95–$1,822.50	—	45%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum Contents	$855.50	$1,711.00	$87.45–$1,711.00	102% above	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum Contents	$941.05	$1,711.00	$544.10–$1,539.90	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Soft Tissue	$773.50	$1,547.00	$97.70–$1,547.00	81% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parathyroid	$773.50	$1,547.00	$97.70–$1,547.00	81% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parotid	$773.50	$1,547.00	$97.70–$1,547.00	81% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$773.50	$1,547.00	$97.70–$1,547.00	81% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$850.85	$1,547.00	$491.95–$1,392.30	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parathyroid	$850.85	$1,547.00	$491.95–$1,392.30	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parotid	$850.85	$1,547.00	$491.95–$1,392.30	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Soft Tissue	$850.85	$1,547.00	$491.95–$1,392.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI wo KUB Barium	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Esophagus w Upper GI Barium	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Barium	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI w or wo KUB Gastrografin	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-UPPER GI SINGLE	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RF Upper GI wo KUB Gastrografin	$1,073.50	$2,147.00	$114.18–$2,147.00	105% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI wo KUB Gastrografin	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Barium	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Esophagus w Upper GI Barium	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-UPPER GI SINGLE	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI wo KUB Barium	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RF Upper GI w or wo KUB Gastrografin	$1,180.85	$2,147.00	$682.75–$1,932.30	—	45%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Right DR	$265.50	$531.00	$29.82–$531.00	38% above	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Min 2 V Left DR	$265.50	$531.00	$29.82–$531.00	38% above	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Left DR	$292.05	$531.00	$168.86–$477.90	—	45%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Min 2 V Right DR	$292.05	$531.00	$168.86–$477.90	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Insufficiency Doppler Left	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Insufficiency Doppler Right	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right	$590.00	$1,180.00	$97.84–$1,180.00	7% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Right	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Venous Duplex Left	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Right	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Venous Duplex Left	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Insufficiency Doppler Right	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Insufficiency Doppler Left	$649.00	$1,180.00	$375.24–$1,062.00	—	45%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Right DR	$218.50	$437.00	$31.99–$437.00	40% above	50%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 V Left DR	$218.50	$437.00	$31.99–$437.00	40% above	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Left DR	$240.35	$437.00	$138.97–$393.30	—	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 V Right DR	$240.35	$437.00	$138.97–$393.30	—	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$302.00	$604.00	$39.75–$604.00	19% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$302.00	$604.00	$39.75–$604.00	19% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$302.00	$604.00	$39.75–$604.00	19% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$302.00	$604.00	$39.75–$604.00	19% above	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Rt DR	$332.20	$604.00	$192.07–$543.60	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete Min 3 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete w Navicular Lt DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right 2 or 3 Views DR	$251.00	$502.00	$45.42–$502.00	5% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left 2 or 3 Views DR	$251.00	$502.00	$45.42–$502.00	5% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$251.00	$502.00	$45.42–$502.00	5% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$251.00	$502.00	$45.42–$502.00	5% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left 2 or 3 Views DR	$276.10	$502.00	$159.64–$451.80	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Left w Pelvis 2 or 3 Views DR	$276.10	$502.00	$159.64–$451.80	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right 2 or 3 Views DR	$276.10	$502.00	$159.64–$451.80	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip Right w Pelvis 2 or 3 Views DR	$276.10	$502.00	$159.64–$451.80	—	45%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP KUB DR	$258.00	$516.00	$27.70–$516.00	19% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen AP KUB DR	$283.80	$516.00	$164.09–$464.40	—	45%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Left DR	$302.00	$604.00	$30.13–$604.00	89% above	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 V Right DR	$302.00	$604.00	$30.13–$604.00	89% above	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$208.00	$416.00	$36.56–$416.00	31% above	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 2nd Digit Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 3rd Digit Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 4th Digit Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V 5th Digit Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Left DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Min 2 V Thumb Right DR	$228.80	$416.00	$132.29–$374.40	—	45%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Right DR	$297.50	$595.00	$26.72–$595.00	82% above	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 V Left DR	$297.50	$595.00	$26.72–$595.00	82% above	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Left DR	$327.25	$595.00	$189.21–$535.50	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 V Right DR	$327.25	$595.00	$189.21–$535.50	—	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Right DR	$302.00	$604.00	$31.70–$604.00	50% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete Min 3 V Left DR	$302.00	$604.00	$31.70–$604.00	50% above	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete Min 3 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Right DR	$302.00	$604.00	$35.42–$604.00	50% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete Min 3 V Left DR	$302.00	$604.00	$35.42–$604.00	50% above	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Right DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete Min 3 V Left DR	$332.20	$604.00	$192.07–$543.60	—	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Left DR	$285.00	$570.00	$31.99–$570.00	36% above	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 V Right DR	$285.00	$570.00	$31.99–$570.00	36% above	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Left DR	$313.50	$570.00	$181.26–$513.00	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 V Right DR	$313.50	$570.00	$181.26–$513.00	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$504.00	$1,008.00	$37.68–$1,008.00	101% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 V DR	$554.40	$1,008.00	$320.54–$907.20	—	45%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$482.50	$965.00	$49.71–$965.00	39% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR	$530.75	$965.00	$306.87–$868.50	—	45%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$261.00	$522.00	$34.80–$522.00	29% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Minimum 3 V DR	$287.10	$522.00	$166.00–$469.80	—	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 V DR	$305.00	$610.00	$37.06–$610.00	22% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 V DR	$335.50	$610.00	$193.98–$549.00	—	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 V DR	$232.50	$465.00	$26.13–$465.00	18% above	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 V DR	$255.75	$465.00	$147.87–$418.50	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$385.50	$771.00	$29.84–$771.00	76% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum Coccyx Minimum 2 V DR	$424.05	$771.00	$245.18–$693.90	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone Plasma (LC)	$379.50	$759.00	$37.46–$759.00	53% above	50%
ACTH blood test CPT 82024 Adrenocorticotropic Hormone Plasma	$379.50	$759.00	$37.46–$759.00	53% above	50%
ACTH blood test CPT 82024 Adrenocorticotropic Hormone Plasma (RL)	$379.50	$759.00	$37.46–$759.00	53% above	50%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone Plasma (RL)	$417.45	$759.00	$241.36–$683.10	—	45%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone Plasma	$417.45	$759.00	$241.36–$683.10	—	45%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone Plasma (LC)	$417.45	$759.00	$241.36–$683.10	—	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 .ALT FIB4 Index	$51.50	$103.00	$5.14–$103.00	87% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$51.50	$103.00	$5.14–$103.00	87% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 TRANSFERASE ALT	$51.50	$103.00	$5.14–$103.00	87% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) (LC)	$51.50	$103.00	$5.14–$103.00	87% above	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 NASH FIBROSURE PLUS (LC)	$51.50	$103.00	$5.14–$103.00	87% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) (LC)	$56.65	$103.00	$32.75–$92.70	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 NASH FIBROSURE PLUS (LC)	$56.65	$103.00	$32.75–$92.70	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 .ALT FIB4 Index	$56.65	$103.00	$32.75–$92.70	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$56.65	$103.00	$32.75–$92.70	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 TRANSFERASE ALT	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) (RL)	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 84450 TRANSFERASE AST	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 .AST FIB4 Index	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 84450 NASH FIBROSURE PLUS (LC)	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase Body Fluid	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$51.50	$103.00	$5.02–$103.00	78% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase Body Fluid	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 TRANSFERASE AST	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 .AST FIB4 Index	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 NASH FIBROSURE PLUS (LC)	$56.65	$103.00	$32.75–$92.70	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) (RL)	$56.65	$103.00	$32.75–$92.70	—	45%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute	$440.00	$880.00	$46.20–$880.00	39% above	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute (LC)	$440.00	$880.00	$46.20–$880.00	39% above	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute	$484.00	$880.00	$279.84–$792.00	—	45%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute (LC)	$484.00	$880.00	$279.84–$792.00	—	45%
Albumin blood test CPT 82040 82040 ALBUMIN SERUM	$51.50	$103.00	$4.80–$103.00	126% above	50%
Albumin blood test CPT 82040 Albumin Level	$51.50	$103.00	$4.80–$103.00	126% above	50%
Albumin blood test inpatient CPT 82040 Albumin Level	$56.65	$103.00	$32.75–$92.70	—	45%
Albumin blood test inpatient CPT 82040 82040 ALBUMIN SERUM	$56.65	$103.00	$32.75–$92.70	—	45%
Aldosterone blood test CPT 82088 82088 L703 ALDOSTERONE 889	$282.50	$565.00	$39.53–$565.00	37% above	50%
Aldosterone blood test CPT 82088 Aldosterone Urine (RL)	$291.00	$582.00	$39.53–$582.00	41% above	50%
Aldosterone blood test CPT 82088 Aldosterone Urine LC	$291.00	$582.00	$39.53–$582.00	41% above	50%
Aldosterone blood test CPT 82088 82088 L289116 ALDOSTERONE	$291.00	$582.00	$39.53–$582.00	41% above	50%
Aldosterone blood test CPT 82088 82088 L4354 ALDOSTERONE 889	$291.00	$582.00	$39.53–$582.00	41% above	50%
Aldosterone blood test CPT 82088 Aldosterone LC-MS/MS (RL)	$291.00	$582.00	$39.53–$582.00	41% above	50%
Aldosterone blood test inpatient CPT 82088 82088 L703 ALDOSTERONE 889	$310.75	$565.00	$179.67–$508.50	—	45%
Aldosterone blood test inpatient CPT 82088 Aldosterone Urine LC	$320.10	$582.00	$185.08–$523.80	—	45%
Aldosterone blood test inpatient CPT 82088 Aldosterone Urine (RL)	$320.10	$582.00	$185.08–$523.80	—	45%
Aldosterone blood test inpatient CPT 82088 82088 L289116 ALDOSTERONE	$320.10	$582.00	$185.08–$523.80	—	45%
Aldosterone blood test inpatient CPT 82088 82088 L4354 ALDOSTERONE 889	$320.10	$582.00	$185.08–$523.80	—	45%
Aldosterone blood test inpatient CPT 82088 Aldosterone LC-MS/MS (RL)	$320.10	$582.00	$185.08–$523.80	—	45%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 PHOSPHATASE,ALKALINE	$51.50	$103.00	$5.02–$103.00	61% above	50%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$51.50	$103.00	$5.02–$103.00	61% above	50%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 L1612 PHOSPHATAS ALK	$51.50	$103.00	$5.02–$103.00	61% above	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$56.65	$103.00	$32.75–$92.70	—	45%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 PHOSPHATASE,ALKALINE	$56.65	$103.00	$32.75–$92.70	—	45%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 L1612 PHOSPHATAS ALK	$56.65	$103.00	$32.75–$92.70	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607748 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607746 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607744 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L605878 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607749 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L602797 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607751 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L601288 ALG IGE QT	$37.00	$74.00	$5.06–$74.00	93% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Walnut IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree White Ash IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Potato IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aspergillus Fumigatus IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cladosporium herbarum IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D farinae IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D pteronyssinus IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen English Plantain IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Pecan Hickory IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lambs Quarters IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Mulberry White IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ragweed Common IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rough Marsh Elder IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Russian Thistle IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Sycamore IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aureobas pullans IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Alternaria alternata IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Box Elder IgE Qnt	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mountain Juniper IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cocklebur IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ragweed Giant IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Cashew IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Hazelnut IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Hazelnut IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pigweed Common IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W010 IgE Lamb's Quarter (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W014 IgE Pigweed Rough (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F075 IgE Egg Yolk (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F037 IgE Mussel (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W003 IgE Ragweed Giant (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 W011-IgE Thistle Russian LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W018 IgE Sheep Sorrel Dock (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M002 IgE Cladosporium herbarum (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M008 IgE Helminthosporium halodes (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen K082 IgE Latex (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F092 IgE Banana (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F049 IgE Apple (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T022 IgE Pecan Tree (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F017 IgE Hazelnut Filbert (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W016 IgE Marsh Elder Rough (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Gluten F079 IgE LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F018 IgE Brazil Nut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F207 IgE Clam (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F338 IgE Scallop (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F256 IgE Walnut Food (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 F259-IgE Grape LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M012 IgE Aureobasidium pullulan (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F033 IgE Orange (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F202 IgE Cashew Nut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F027 IgE Beef (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F026 IgE Pork (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F025 IgE Tomato (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F020 IgE Almond (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F006 IgE Barley Whole Grain (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F083 IgE Chicken (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F003 IgE Codfish (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F080 IgE Lobster (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F007 IgE Oat (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F012 IgE Green Pea (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F201 IgE Pecan Nut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F009 IgE Rice (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F041 IgE Salmon (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F010 IgE Sesame Seed (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F044 IgE Strawberry (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F284 IgE Turkey (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F045 IgE Yeast Baker's (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Green Bean F315 LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T015 IgE Ash White (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T001 IgE Maple/Box Elder (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T008 IgE Elm American White (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen G002 IgE Bermuda Grass (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen G010 IgE Johnson Grass (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W013 IgE Cocklebur (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W009 IgE Plantain English (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen I006 IgE German Cockroach (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T006 IgE Cedar Mountain (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F031 IgE Carrot (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Apple IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chocolate IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Orchard IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Birch IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Walnut IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Blue Mussell IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Carrot IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Helminthosporium (m8) IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Horse Dander IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass KY Blue IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lettuce IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mushroom IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pea IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Penicillium notatum IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Turkey IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bakers Yeast IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D002 IgE D farinae Mite (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D001 IgE D pteronyssinus (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen E001 IgE Cat Hair Dander (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen E005 IgE Dog Hair Dander (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F001 IgE Egg White (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F002 IgE Milk Cow (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F004 IgE Wheat (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F008 IgE Corn (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F013 IgE Peanut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F014 IgE Soybean (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F023 IgE Crab (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F024 IgE Shrimp (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F035 IgE Potato White (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F093 IgE Chocolate Cacao (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F203 IgE Pistachio Nut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F245 IgE Egg Whole (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen G006 IgE Timothy (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen I100 IgE Cockroach American (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M001 IgE Penicillium notatum (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M003 IgE Aspergillus fumigatus (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen M006 IgE Alternaria tenuis (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T007 IgE Oak White (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W001 IgE Ragweed Short Commo (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium herbarum (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen G008 IgE Kentucky Bluegrass (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Carmine Red Dye (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Codfish (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Egg White w/Component Rflx (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Maple/Box Elder (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Mouse Urine (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Ragweed, Giant (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Salmon (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Anisakis IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cheese Cheddar IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Corn Cultivated (Zea mays); IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Curvularia spicifera/Bipolaris IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium oxysporum/vasinfectum IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Haddock IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Halibut IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mango IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple Sugar Tree (Acer saccharum)IgE(VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Alg Melon IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mushroom IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Oyster IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Pineapple IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Tilapia IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Venom Honey Bee IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Venom Paper Wasp IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Venom W-F Hornet IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Venom Yellow Hornet IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Component Panel (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium Proliferatum/monilifor IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Carmine Dye/Red Dye IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicilloyl G IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chestnut Sweet Food (Castanea sativa) IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Peach IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Bass Black IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Bean Navy/White IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Perch Ocean IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Kiwi IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cherry IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Sole IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Pollock White IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Whey IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Rye Food IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Coconut IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Grape IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Rye Grass Perennial IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Willow (Salix caprea) IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Pine White (Pinus strobus) IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Hollister-Stier IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Greer IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Candida albicans IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mucor racemosus IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Phoma betae IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Rhizopus nigricans IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Epicoccum purpurascens IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Curvularia lunata IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Acremonium kiliense IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus niger IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chaetomium globosum IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Stemph Herbarum/botryosum IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cow Dander IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Goose Feathers IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Redtop/Bent Grass IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Reed Common (Phragmite communis) IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb's Quarters/Goosefoot IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Trichoderma viride IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Botrytis cinerea IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Olive Tree (Olea europaea) IgE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Spinach IgE (F214) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sunflower Seed IgE (K084) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F054 IgE Sweet Potato (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Gelatin IgE (C074) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Date IgE F289 (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Black Bean IgE LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grapefruit IgE F209 (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lime IgE F209 (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mustard IgE (F089) (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pear IgE F094 (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Raspberry IgE F343 (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN MOSQUITO (I071) (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT IGE (VC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Squid IgE (F058) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cinnamon IgE (F220) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Acacia Gum IgE (F297) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Coffee IgE (F221) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rabbit Dander IgE	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Buckwheat IgE (F011) LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L62448 ALG IGE QT	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T004 IgE Hazelnut Tree (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen E003 IgE Horse Dander (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F212 IgE Mushroom (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 L607745 ALG IGE QT	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Almond IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Banana IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Barley IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Beef IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Bermuda IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Brazil IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Casein IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Dander IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken Meat IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Clam IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach American IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cod IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Cottonwood IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Epithelial IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Whole IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Yolk IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Elm IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Johnson IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Latex IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mugwort IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nettle IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree Oak IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oat IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Orange IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Peanut IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Pecan IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Pistachio IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pork Meat IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Rice IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Salmon IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Scallop IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Nut Sesame Seed IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sheep Sorrel IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Strawberry IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass Timothy IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tomato IgE Quant	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W006 IgE Mugwort (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T070 IgE White Mulberry (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen F215 IgE Lettuce (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen G003 IgE Orchard Grass (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T003 IgE Common Silver Birch (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T011 IgE Maple Leaf Sycamore (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W020 IgE Nettle (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mint (F332) IgE (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN IGE QUANT	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 T006-IgE Cedar, Mountain LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T010 IgE Walnut (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 G010-IgE Johnson Grass LC	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen W011 IgE Thistle Russian (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen T014 IgE Cottonwood (LC)	$38.00	$76.00	$5.06–$76.00	98% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607751 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L601288 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L605878 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607749 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607744 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607748 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L602797 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607746 ALG IGE QT	$40.70	$74.00	$23.53–$66.60	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Spinach IgE (F214) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mint (F332) IgE (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W020 IgE Nettle (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T011 IgE Maple Leaf Sycamore (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T003 IgE Common Silver Birch (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen G003 IgE Orchard Grass (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F215 IgE Lettuce (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T070 IgE White Mulberry (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W006 IgE Mugwort (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T014 IgE Cottonwood (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W011 IgE Thistle Russian (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G010-IgE Johnson Grass LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T010 IgE Walnut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T006-IgE Cedar, Mountain LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLERGEN IGE QUANT	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Botrytis cinerea IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Trichoderma viride IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lamb's Quarters/Goosefoot IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Reed Common (Phragmite communis) IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Redtop/Bent Grass IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goose Feathers IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cow Dander IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stemph Herbarum/botryosum IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chaetomium globosum IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus niger IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Acremonium kiliense IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curvularia lunata IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Epicoccum purpurascens IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rhizopus nigricans IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Phoma betae IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mucor racemosus IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Candida albicans IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Greer IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Hollister-Stier IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Olive Tree (Olea europaea) IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pine White (Pinus strobus) IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Willow (Salix caprea) IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rye Grass Perennial IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Grape IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rye Food IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Whey IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pollock White IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sole IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cherry IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Kiwi IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Perch Ocean IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bean Navy/White IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bass Black IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peach IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chestnut Sweet Food (Castanea sativa) IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicilloyl G IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Carmine Dye/Red Dye IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fusarium Proliferatum/monilifor IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut Component Panel (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venom Yellow Hornet IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venom W-F Hornet IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venom Paper Wasp IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Venom Honey Bee IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tilapia IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pineapple IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oyster IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mushroom IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alg Melon IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maple Sugar Tree (Acer saccharum)IgE(VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mango IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Macadamia Nut IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Halibut IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Haddock IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fusarium oxysporum/vasinfectum IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curvularia spicifera/Bipolaris IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn Cultivated (Zea mays); IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cheese Cheddar IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Anisakis IgE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Salmon (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Ragweed, Giant (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Mouse Urine (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Maple/Box Elder (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Egg White w/Component Rflx (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Codfish (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Carmine Red Dye (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen G008 IgE Kentucky Bluegrass (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium herbarum (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W001 IgE Ragweed Short Commo (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T007 IgE Oak White (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M006 IgE Alternaria tenuis (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M003 IgE Aspergillus fumigatus (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M001 IgE Penicillium notatum (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen I100 IgE Cockroach American (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen G006 IgE Timothy (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F245 IgE Egg Whole (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F203 IgE Pistachio Nut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F093 IgE Chocolate Cacao (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F035 IgE Potato White (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F024 IgE Shrimp (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F023 IgE Crab (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F014 IgE Soybean (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F013 IgE Peanut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F008 IgE Corn (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F004 IgE Wheat (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F002 IgE Milk Cow (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F001 IgE Egg White (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen E005 IgE Dog Hair Dander (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen E001 IgE Cat Hair Dander (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D001 IgE D pteronyssinus (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D002 IgE D farinae Mite (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bakers Yeast IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Turkey IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Penicillium notatum IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pea IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mushroom IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lettuce IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass KY Blue IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Horse Dander IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Helminthosporium (m8) IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Carrot IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Blue Mussell IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Walnut IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Birch IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Orchard IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chocolate IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Apple IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F031 IgE Carrot (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T006 IgE Cedar Mountain (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen I006 IgE German Cockroach (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W009 IgE Plantain English (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W013 IgE Cocklebur (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen G010 IgE Johnson Grass (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen G002 IgE Bermuda Grass (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T008 IgE Elm American White (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T001 IgE Maple/Box Elder (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T015 IgE Ash White (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Green Bean F315 LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F045 IgE Yeast Baker's (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F284 IgE Turkey (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F044 IgE Strawberry (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F010 IgE Sesame Seed (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F041 IgE Salmon (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F009 IgE Rice (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F201 IgE Pecan Nut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F012 IgE Green Pea (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F007 IgE Oat (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F080 IgE Lobster (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F003 IgE Codfish (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F083 IgE Chicken (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F006 IgE Barley Whole Grain (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F020 IgE Almond (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F025 IgE Tomato (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F026 IgE Pork (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F027 IgE Beef (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F202 IgE Cashew Nut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F033 IgE Orange (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M012 IgE Aureobasidium pullulan (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F259-IgE Grape LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F256 IgE Walnut Food (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F338 IgE Scallop (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F207 IgE Clam (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F018 IgE Brazil Nut (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Gluten F079 IgE LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W016 IgE Marsh Elder Rough (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F017 IgE Hazelnut Filbert (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T022 IgE Pecan Tree (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F049 IgE Apple (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F092 IgE Banana (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen K082 IgE Latex (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M008 IgE Helminthosporium halodes (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen M002 IgE Cladosporium herbarum (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W018 IgE Sheep Sorrel Dock (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W011-IgE Thistle Russian LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W003 IgE Ragweed Giant (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F037 IgE Mussel (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F075 IgE Egg Yolk (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W014 IgE Pigweed Rough (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen W010 IgE Lamb's Quarter (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pigweed Common IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Hazelnut IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Hazelnut IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Cashew IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ragweed Giant IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cocklebur IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mountain Juniper IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Box Elder IgE Qnt	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Alternaria alternata IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aureobas pullans IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Sycamore IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Russian Thistle IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rough Marsh Elder IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ragweed Common IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Mulberry White IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lambs Quarters IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Pecan Hickory IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen English Plantain IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D pteronyssinus IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D farinae IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cladosporium herbarum IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aspergillus Fumigatus IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Potato IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree White Ash IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Walnut IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tomato IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Timothy IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Strawberry IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sheep Sorrel IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Sesame Seed IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Scallop IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Salmon IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rice IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pork Meat IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Pistachio IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Pecan IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Peanut IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Orange IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oat IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Oak IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nettle IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mugwort IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Latex IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Johnson IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Elm IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Yolk IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Whole IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Epithelial IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree Cottonwood IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cod IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach American IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Clam IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken Meat IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Dander IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Casein IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Brazil IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass Bermuda IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Beef IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Barley IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Banana IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Nut Almond IgE Quant	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L607745 ALG IGE QT	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F212 IgE Mushroom (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen E003 IgE Horse Dander (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen T004 IgE Hazelnut Tree (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 L62448 ALG IGE QT	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Buckwheat IgE (F011) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Rabbit Dander IgE	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Coffee IgE (F221) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Acacia Gum IgE (F297) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cinnamon IgE (F220) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Squid IgE (F058) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT IGE (VC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN MOSQUITO (I071) (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Raspberry IgE F343 (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pear IgE F094 (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mustard IgE (F089) (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lime IgE F209 (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grapefruit IgE F209 (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Black Bean IgE LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Date IgE F289 (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Gelatin IgE (C074) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen F054 IgE Sweet Potato (LC)	$41.80	$76.00	$24.17–$68.40	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sunflower Seed IgE (K084) LC	$41.80	$76.00	$24.17–$68.40	—	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Tumor Marker (Serial) (LC)	$140.50	$281.00	$16.27–$281.00	38% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Open Spina Bifida (RL)	$140.50	$281.00	$16.27–$281.00	38% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 82105 AFP SERUM	$140.50	$281.00	$16.27–$281.00	38% above	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker (RL)	$140.50	$281.00	$16.27–$281.00	38% above	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker (RL)	$154.55	$281.00	$89.36–$252.90	—	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 82105 AFP SERUM	$154.55	$281.00	$89.36–$252.90	—	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Open Spina Bifida (RL)	$154.55	$281.00	$89.36–$252.90	—	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Tumor Marker (Serial) (LC)	$154.55	$281.00	$89.36–$252.90	—	45%
Ammonia blood test CPT 82140 82140 L306266 AMMONIA	$120.50	$241.00	$14.13–$241.00	at median	50%
Ammonia blood test CPT 82140 Ammonia Level	$120.50	$241.00	$14.13–$241.00	at median	50%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$132.55	$241.00	$76.64–$216.90	—	45%
Ammonia blood test inpatient CPT 82140 82140 L306266 AMMONIA	$132.55	$241.00	$76.64–$216.90	—	45%
Amylase blood test CPT 82150 Amylase Blood	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase Urine (LC) 24 Hr	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase Urine Timed	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase, Body Fluid (LC)	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase 24 Hour Urine	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase Urine	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test CPT 82150 Amylase Body Fluid	$110.00	$220.00	$6.29–$220.00	112% above	50%
Amylase blood test inpatient CPT 82150 Amylase Blood	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase 24 Hour Urine	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase, Body Fluid (LC)	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase Urine Timed	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase Urine	$121.00	$220.00	$69.96–$198.00	—	45%
Amylase blood test inpatient CPT 82150 Amylase Urine (LC) 24 Hr	$121.00	$220.00	$69.96–$198.00	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG IgA (LC)	$105.50	$211.00	$12.56–$211.00	100% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 86200 L164065 CCP AB	$105.50	$211.00	$12.56–$211.00	100% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG (CQ)	$105.50	$211.00	$12.56–$211.00	100% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG (CQ)	$116.05	$211.00	$67.10–$189.90	—	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG IgA (LC)	$116.05	$211.00	$67.10–$189.90	—	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 86200 L164065 CCP AB	$116.05	$211.00	$67.10–$189.90	—	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86225 L54619 DNA DS AB 889	$102.00	$204.00	$11.73–$204.00	70% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 L806596 ANA IGG FLD	$143.00	$286.00	$11.73–$286.00	139% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab Reflex Cascade (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 ANA	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 zzANA LC	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/reflex to DNA/DS (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 L520293 ANA	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Direct (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex (LC)	$147.50	$295.00	$11.73–$295.00	146% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86225 L54619 DNA DS AB 889	$112.20	$204.00	$64.87–$183.60	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 L806596 ANA IGG FLD	$157.30	$286.00	$90.95–$257.40	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Direct (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 ANA	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 L520293 ANA	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/reflex to DNA/DS (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab Reflex Cascade (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 zzANA LC	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex (LC)	$162.25	$295.00	$93.81–$265.50	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide Prohormone	$240.50	$481.00	$38.08–$481.00	41% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP (RL)	$240.50	$481.00	$38.08–$481.00	41% above	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide	$240.50	$481.00	$38.08–$481.00	41% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide	$264.55	$481.00	$152.96–$432.90	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B Type Natriuretic Peptide Prohormone	$264.55	$481.00	$152.96–$432.90	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 proBNP (RL)	$264.55	$481.00	$152.96–$432.90	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Foreign Body Culture	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Transfusion Reaction Culture	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 zzEnvironmental Culture	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cystic Fibrosis Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 CULTURE BACTERIA OTH	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture, Sterile (LC)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture without Gram stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Org ID Bacteria (CQ)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Upper Respiratory Culture (LC)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 B pertussis Nasopharnyx Culture (LC)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture without Gram Stain	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture, Routine (LC)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Bacterial Culture (LC)	$127.50	$255.00	$8.36–$255.00	36% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Org ID Bacteria (CQ)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture, Sterile (LC)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture without Gram stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 B pertussis Nasopharnyx Culture (LC)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cystic Fibrosis Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 zzEnvironmental Culture	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 87070 CULTURE BACTERIA OTH	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture, Routine (LC)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Transfusion Reaction Culture	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Bacterial Culture (LC)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Upper Respiratory Culture (LC)	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Foreign Body Culture	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture without Gram Stain	$140.25	$255.00	$81.09–$229.50	—	45%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel w/Total Calcium	$121.50	$243.00	$8.21–$243.00	55% above	50%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel (8) (RL)	$121.50	$243.00	$8.21–$243.00	55% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel w/Total Calcium	$133.65	$243.00	$77.27–$218.70	—	45%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel (8) (RL)	$133.65	$243.00	$77.27–$218.70	—	45%
Bilirubin blood test, total CPT 82247 82247 NASH FIBROSURE PLUS (LC)	$55.00	$110.00	$4.87–$110.00	59% above	50%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$55.00	$110.00	$4.87–$110.00	59% above	50%
Bilirubin blood test, total CPT 82247 Bilirubin Total Body Fluid (LC)	$55.00	$110.00	$4.87–$110.00	59% above	50%
Bilirubin blood test, total CPT 82247 82247 BILIRUBIN TOTAL	$55.00	$110.00	$4.87–$110.00	59% above	50%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Body Fluid (LC)	$60.50	$110.00	$34.98–$99.00	—	45%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$60.50	$110.00	$34.98–$99.00	—	45%
Bilirubin blood test, total inpatient CPT 82247 82247 NASH FIBROSURE PLUS (LC)	$60.50	$110.00	$34.98–$99.00	—	45%
Bilirubin blood test, total inpatient CPT 82247 82247 BILIRUBIN TOTAL	$60.50	$110.00	$34.98–$99.00	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$171.00	$342.00	$27.96–$342.00	34% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$171.00	$342.00	$27.96–$342.00	34% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$171.00	$342.00	$27.96–$342.00	34% below	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SO 88305 Bill Surg Compre Review of Data	$171.00	$342.00	$27.96–$342.00	34% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$188.10	$342.00	$108.76–$307.80	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SO 88305 Bill Surg Compre Review of Data	$188.10	$342.00	$108.76–$307.80	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$188.10	$342.00	$108.76–$307.80	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$188.10	$342.00	$108.76–$307.80	—	45%
Blood culture for bacteria CPT 87040 Blood Culture	$141.00	$282.00	$10.01–$282.00	8% above	50%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$155.10	$282.00	$89.68–$253.80	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw Chg	$20.00	$40.00	$7.41–$36.00	20% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw Chg	$22.00	$40.00	$12.72–$36.00	—	45%
Blood glucose (sugar) test CPT 82947 .Glucose POC Bedside	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 Glucose Level	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hr OB	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .ISTAT Glucose Ven POC	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 Glucose 2 Hour Postprandial	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .BG Glucose DM Ven POC	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .BG Glucose DM Cap POC	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 82947 GLUCOSE, QUANT	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .BG Glucose DM Art POC	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .ISTAT Glucose Cap POC	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 82947 NASH FIBROSURE PLUS (LC)	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test CPT 82947 .GTT 2nd Hour OB	$20.50	$41.00	$3.81–$41.00	23% below	50%
Blood glucose (sugar) test inpatient CPT 82947 .Glucose POC Bedside	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hour OB	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .BG Glucose DM Art POC	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .ISTAT Glucose Ven POC	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 2 Hour Postprandial	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 82947 NASH FIBROSURE PLUS (LC)	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .BG Glucose DM Ven POC	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .ISTAT Glucose Cap POC	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .BG Glucose DM Cap POC	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE, QUANT	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$22.55	$41.00	$13.04–$36.90	—	45%
Blood glucose (sugar) test inpatient CPT 82947 .GTT 2nd Hr OB	$22.55	$41.00	$13.04–$36.90	—	45%
Blood lead test CPT 83655 Lead, Blood, Filter Paper (LC)	$131.97	$263.94	$11.75–$263.94	85% above	50%
Blood lead test CPT 83655 Lead Blood Adult (RL)	$135.00	$270.00	$11.75–$270.00	89% above	50%
Blood lead test CPT 83655 83655 L7633 LEAD	$135.00	$270.00	$11.75–$270.00	89% above	50%
Blood lead test CPT 83655 Lead Blood Pediatric RL	$135.00	$270.00	$11.75–$270.00	89% above	50%
Blood lead test CPT 83655 Lead, Blood (Pediatric), Capillary (LC)	$135.00	$270.00	$11.75–$270.00	89% above	50%
Blood lead test CPT 83655 83655 LEAD	$138.50	$277.00	$11.75–$277.00	94% above	50%
Blood lead test inpatient CPT 83655 Lead, Blood, Filter Paper (LC)	$145.17	$263.94	$83.93–$237.55	—	45%
Blood lead test inpatient CPT 83655 83655 L7633 LEAD	$148.50	$270.00	$85.86–$243.00	—	45%
Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric), Capillary (LC)	$148.50	$270.00	$85.86–$243.00	—	45%
Blood lead test inpatient CPT 83655 Lead Blood Adult (RL)	$148.50	$270.00	$85.86–$243.00	—	45%
Blood lead test inpatient CPT 83655 Lead Blood Pediatric RL	$148.50	$270.00	$85.86–$243.00	—	45%
Blood lead test inpatient CPT 83655 83655 LEAD	$152.35	$277.00	$88.09–$249.30	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Chorionic Gonadotropin Qual	$83.50	$167.00	$7.29–$167.00	15% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Chorionic Gonadotropin Qual Auto	$83.50	$167.00	$7.29–$167.00	15% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Human Chorionic Gonadotropin Qual Auto	$91.85	$167.00	$53.11–$150.30	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Human Chorionic Gonadotropin Qual	$91.85	$167.00	$53.11–$150.30	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Transplant Living Donor ABO RNLI (IBC)	$162.50	$325.00	$2.90–$325.00	231% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Forward	$162.50	$325.00	$2.90–$325.00	231% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO Reverse	$162.50	$325.00	$2.90–$325.00	231% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Bill ABO	$162.50	$325.00	$2.90–$325.00	231% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO	$178.75	$325.00	$103.35–$292.50	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Forward	$178.75	$325.00	$103.35–$292.50	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Transplant Living Donor ABO RNLI (IBC)	$178.75	$325.00	$103.35–$292.50	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Bill ABO Reverse	$178.75	$325.00	$103.35–$292.50	—	45%
Blood urea nitrogen (BUN) test CPT 84520 84520 UREA NITROGEN,QUAN	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test CPT 84520 84520 Chem 6 Panel CQ	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Body Fluid	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test CPT 84520 .ISTAT Blood Urea Nitrogen	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test CPT 84520 .ISTAT BUN Ven POC	$47.50	$95.00	$3.83–$95.00	101% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Body Fluid	$52.25	$95.00	$30.21–$85.50	—	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 .ISTAT BUN Ven POC	$52.25	$95.00	$30.21–$85.50	—	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 .ISTAT Blood Urea Nitrogen	$52.25	$95.00	$30.21–$85.50	—	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 84520 UREA NITROGEN,QUAN	$52.25	$95.00	$30.21–$85.50	—	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 84520 Chem 6 Panel CQ	$52.25	$95.00	$30.21–$85.50	—	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$52.25	$95.00	$30.21–$85.50	—	45%
C-peptide blood test CPT 84681 C Peptide Level (RL)	$217.50	$435.00	$20.19–$435.00	58% above	50%
C-peptide blood test CPT 84681 C Peptide	$217.50	$435.00	$20.19–$435.00	58% above	50%
C-peptide blood test inpatient CPT 84681 C Peptide	$239.25	$435.00	$138.33–$391.50	—	45%
C-peptide blood test inpatient CPT 84681 C Peptide Level (RL)	$239.25	$435.00	$138.33–$391.50	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein Quant (RL)	$100.50	$201.00	$5.02–$201.00	46% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein	$100.50	$201.00	$5.02–$201.00	46% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 86140 L805628 IBD SGI DIAG 889	$100.50	$201.00	$5.02–$201.00	46% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 86140 C-REACTIVE PROTEIN	$100.50	$201.00	$5.02–$201.00	46% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 86140 C-REACTIVE PROTEIN	$110.55	$201.00	$63.92–$180.90	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein Quant (RL)	$110.55	$201.00	$63.92–$180.90	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein	$110.55	$201.00	$63.92–$180.90	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 86140 L805628 IBD SGI DIAG 889	$110.55	$201.00	$63.92–$180.90	—	45%
C. difficile toxin gene test (stool PCR) CPT 87493 87493 CDIFF AMPLI PROBE	$224.50	$449.00	$36.15–$449.00	69% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile Toxin Gene NAA (RL)	$224.50	$449.00	$36.15–$449.00	69% above	50%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin A B Amp Probe	$224.50	$449.00	$36.15–$449.00	69% above	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin A B Amp Probe	$246.95	$449.00	$142.78–$404.10	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 87493 CDIFF AMPLI PROBE	$246.95	$449.00	$142.78–$404.10	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile Toxin Gene NAA (RL)	$246.95	$449.00	$142.78–$404.10	—	45%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen 19-9 (RL)	$224.50	$449.00	$20.19–$449.00	55% above	50%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen G1 BF (LC)	$224.50	$449.00	$20.19–$449.00	55% above	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen 19-9 (RL)	$246.95	$449.00	$142.78–$404.10	—	45%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen G1 BF (LC)	$246.95	$449.00	$142.78–$404.10	—	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125, Serum (Serial) (LC)	$176.00	$352.00	$20.19–$352.00	8% above	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 (LC)	$176.00	$352.00	$20.19–$352.00	8% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 (LC)	$193.60	$352.00	$111.94–$316.80	—	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125, Serum (Serial) (LC)	$193.60	$352.00	$111.94–$316.80	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 U0003 L139900 COVID19 NAA 889	$159.00	$318.00	$49.77–$286.20	50% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$159.00	$318.00	$49.77–$286.20	50% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 NAA (LC)	$298.50	$597.00	$49.77–$537.30	182% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 U0003 L139900 COVID19 NAA 889	$174.90	$318.00	$101.12–$286.20	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$174.90	$318.00	$101.12–$286.20	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 NAA (LC)	$328.35	$597.00	$189.85–$537.30	—	45%
Calcium blood test, total CPT 82310 82310 CALCIUM TOTAL	$51.50	$103.00	$5.01–$103.00	95% above	50%
Calcium blood test, total CPT 82310 Calcium Urine	$51.50	$103.00	$5.01–$103.00	95% above	50%
Calcium blood test, total CPT 82310 Calcium Level	$51.50	$103.00	$5.01–$103.00	95% above	50%
Calcium blood test, total inpatient CPT 82310 Calcium Urine	$56.65	$103.00	$32.75–$92.70	—	45%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$56.65	$103.00	$32.75–$92.70	—	45%
Calcium blood test, total inpatient CPT 82310 82310 CALCIUM TOTAL	$56.65	$103.00	$32.75–$92.70	—	45%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$157.50	$315.00	$18.39–$315.00	31% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (LC)	$157.50	$315.00	$18.39–$315.00	31% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Fluid (LC)	$157.50	$315.00	$18.39–$315.00	31% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen (LC)	$173.25	$315.00	$100.17–$283.50	—	45%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$173.25	$315.00	$100.17–$283.50	—	45%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen Fluid (LC)	$173.25	$315.00	$100.17–$283.50	—	45%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab IgG (RL)	$147.50	$295.00	$12.49–$295.00	51% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 86787 VARICELLA-ZOSTER AB	$147.50	$295.00	$12.49–$295.00	51% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Virus IgG	$147.50	$295.00	$12.49–$295.00	51% above	50%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab IgM (RL)	$147.50	$295.00	$12.49–$295.00	51% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Virus IgG	$162.25	$295.00	$93.81–$265.50	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab IgG (RL)	$162.25	$295.00	$93.81–$265.50	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 86787 VARICELLA-ZOSTER AB	$162.25	$295.00	$93.81–$265.50	—	45%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab IgM (RL)	$162.25	$295.00	$93.81–$265.50	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis NAA (RL)	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 C TRACH PRB	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHLMYD TRACH DNA AMP	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHALMYDIA TRACH DNA AMP	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L188698 CTRACH AMPPR	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Pap IG, Ct-Ng TV LC	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 IGP, CtNgTv Rfx HPV ASCU LC	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L183160 C TRACH AMP 889	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 IGP, CtNgTv HPV Rfx 16/18,45 LC	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L199320 8894835 C TRCH PRB	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L188070 C TRACH AMP 889	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Amplified Pr I	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 L199310 PAPIG 889	$131.50	$263.00	$34.04–$263.00	35% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 PapIG CtNg rfx Aptima HPV ASCU LC	$148.50	$297.00	$34.04–$297.00	53% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHLMYD TRACH DNA AMP	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L183160 C TRACH AMP 889	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L199310 PAPIG 889	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 IGP, CtNgTv Rfx HPV ASCU LC	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L199320 8894835 C TRCH PRB	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L188698 CTRACH AMPPR	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Pap IG, Ct-Ng TV LC	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Amplified Pr I	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis NAA (RL)	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 L188070 C TRACH AMP 889	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHALMYDIA TRACH DNA AMP	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 IGP, CtNgTv HPV Rfx 16/18,45 LC	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 C TRACH PRB	$144.65	$263.00	$83.63–$236.70	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 PapIG CtNg rfx Aptima HPV ASCU LC	$163.35	$297.00	$94.45–$267.30	—	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel With LDL/HDL Ratio (LC)	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 LIPID PANEL	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with Reflex LDL Direct	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L235036 LIPID PANEL 889	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (RL)	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L33886 LIPID PANEL 889	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC)	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair	$156.00	$312.00	$12.99–$312.00	49% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC)	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with Reflex LDL Direct	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L33886 LIPID PANEL 889	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (RL)	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel With LDL/HDL Ratio (LC)	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 LIPID PANEL	$171.60	$312.00	$99.22–$280.80	—	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L235036 LIPID PANEL 889	$171.60	$312.00	$99.22–$280.80	—	45%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW B	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential CPT 85025 CBCWPLTA	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff + Platelets (RL)	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential CPT 85025 85025 CBC W-PLT AUTO COMPD	$103.50	$207.00	$7.54–$207.00	150% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff + Platelets (RL)	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 85025 CBC W-PLT AUTO COMPD	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW B	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 CBCWPLTA	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW	$113.85	$207.00	$65.83–$186.30	—	45%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Diff Manual MW A	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Manual	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/o Diff	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential CPT 85027 CBC, Platelet, No Differential (LC)	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Auto	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT	$68.50	$137.00	$6.28–$137.00	132% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Auto	$75.35	$137.00	$43.57–$123.30	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/o Diff	$75.35	$137.00	$43.57–$123.30	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Manual	$75.35	$137.00	$43.57–$123.30	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC, Platelet, No Differential (LC)	$75.35	$137.00	$43.57–$123.30	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT	$75.35	$137.00	$43.57–$123.30	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Diff Manual MW A	$75.35	$137.00	$43.57–$123.30	—	45%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$159.00	$318.00	$10.24–$318.00	80% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$174.90	$318.00	$101.12–$286.20	—	45%
Cortisol blood test, total CPT 82533 Cortisol AM	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Salivary Cortisol MS (RL)	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Dexamethasone Suppression w/Rfx to Dexamethasone L	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 82533 L500440 CORTISOL TOT	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Dexamethasone Suppression LC	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol Level	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol 15 Minute	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol 30 Minute	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol Sendout to LabCorp	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 82533 CORTISOL TOTAL	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol Baseline	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol (RL)	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol 60 Minute	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol 90 Minute	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total CPT 82533 Cortisol 40 Minute	$123.50	$247.00	$15.81–$247.00	31% above	50%
Cortisol blood test, total inpatient CPT 82533 Cortisol 40 Minute	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Dexamethasone Suppression w/Rfx to Dexamethasone L	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 82533 CORTISOL TOTAL	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 82533 L500440 CORTISOL TOT	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol 15 Minute	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Dexamethasone Suppression LC	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol Sendout to LabCorp	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol Level	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol AM	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol (RL)	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol 90 Minute	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol 60 Minute	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Cortisol 30 Minute	$135.85	$247.00	$78.55–$222.30	—	45%
Cortisol blood test, total inpatient CPT 82533 Salivary Cortisol MS (RL)	$135.85	$247.00	$78.55–$222.30	—	45%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$73.50	$147.00	$6.31–$147.00	89% above	50%
Creatine kinase (CK) blood test, total CPT 82550 82550 CPK TOTAL	$73.50	$147.00	$6.31–$147.00	89% above	50%
Creatine kinase (CK) blood test, total CPT 82550 zzCK w/Reflex CKMB w/Relative Index	$73.50	$147.00	$6.31–$147.00	89% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 zzCK w/Reflex CKMB w/Relative Index	$80.85	$147.00	$46.75–$132.30	—	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 CPK TOTAL	$80.85	$147.00	$46.75–$132.30	—	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$80.85	$147.00	$46.75–$132.30	—	45%
Creatinine blood test CPT 82565 .ISTAT Creatinine POC	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test CPT 82565 82565 Chem 6 Panel CQ	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test CPT 82565 82565 CREATININE BLOOD	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test CPT 82565 Creatinine Blood	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test CPT 82565 .ISTAT Creatinine POC Art	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test CPT 82565 .ISTAT Creatinine POC Ven	$47.50	$95.00	$4.97–$95.00	65% above	50%
Creatinine blood test inpatient CPT 82565 .ISTAT Creatinine POC	$52.25	$95.00	$30.21–$85.50	—	45%
Creatinine blood test inpatient CPT 82565 .ISTAT Creatinine POC Ven	$52.25	$95.00	$30.21–$85.50	—	45%
Creatinine blood test inpatient CPT 82565 82565 Chem 6 Panel CQ	$52.25	$95.00	$30.21–$85.50	—	45%
Creatinine blood test inpatient CPT 82565 82565 CREATININE BLOOD	$52.25	$95.00	$30.21–$85.50	—	45%
Creatinine blood test inpatient CPT 82565 .ISTAT Creatinine POC Art	$52.25	$95.00	$30.21–$85.50	—	45%
Creatinine blood test inpatient CPT 82565 Creatinine Blood	$52.25	$95.00	$30.21–$85.50	—	45%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Antibody IgG LC	$163.50	$327.00	$13.96–$327.00	105% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus IgG	$163.50	$327.00	$13.96–$327.00	105% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 86644 CMV AB	$163.50	$327.00	$13.96–$327.00	105% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 86644 L221085 CMV AB - 889	$164.50	$329.00	$13.96–$329.00	107% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus IgG	$179.85	$327.00	$103.99–$294.30	—	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 CMV AB	$179.85	$327.00	$103.99–$294.30	—	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Antibody IgG LC	$179.85	$327.00	$103.99–$294.30	—	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 L221085 CMV AB - 889	$180.95	$329.00	$104.62–$296.10	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quant	$128.00	$256.00	$9.87–$256.00	5% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quant	$140.80	$256.00	$81.41–$230.40	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate, Serum LC	$224.50	$449.00	$21.56–$449.00	53% above	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (RL)	$224.50	$449.00	$21.56–$449.00	53% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate, Serum LC	$246.95	$449.00	$142.78–$404.10	—	45%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (RL)	$246.95	$449.00	$142.78–$404.10	—	45%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Citric Acid Random Urine (LC)	$53.50	$107.00	$19.81–$107.00	53% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PM Phencyclidine Screen Urine w/Reflex Conf LC	$203.00	$406.00	$60.28–$406.00	78% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor, Pnl 5, w/Conf,w/Medmatch,Urine (CQ)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 13 w/Conf, Serum (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 - ToxAssure Comprehensive Profile (Labcorp M	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen 8A Qual CS Auto	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Profile Ur 9 Drugs Sendout to LabCorp	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen Panel 8A Qual Auto	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Qual Urine	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Qual Urine	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates Qual Urine	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 6-Acetylmorphine, Urine (RL)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 7 Drug Bundle Blood (RL)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine, Urine (RL)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid, Qual, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CORDSTAT 13 (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Profile + Etoh Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen (10) Panel Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen (7) Panel (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 w/Conf, WB (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 EDDP, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethanol Urine LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 zzEthyl Glucuronide Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium 5 Panel (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Ur Scr w Rflx (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolites, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone/Oxymorphone Scr, Ur (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone/Oxymorphone, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 .Synthetic Cannabinoids Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tapentadol, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol, Urine (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Synthetic Cannabinoids Scr Ur (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Phencyclidine Screen, Urine LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 13+Oxycodone+Crt-Scr (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 10+Oxycodone+Crt-Scr (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 12+Oxycodone+Crt-Unbund (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Monitor Drug Profile 10(MW) LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Monitor Drug Profile 14(MW) LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor, Pnl 1, w/conf Urine CQ	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 L738526 DAB SCN PRES 889	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Umbil. Cord Tissue LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 w/Conf, Serum LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium10LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Drug Screen 10 Panel LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor, Pnl 1, w/Conf,w/Medmatch,Urine (CQ)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB SCREEN URINE (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Flunitrazepam (Rohypnol) Screen Ur LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB Screen, w/Conf Rfx Whole Blood (LC)	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Heroin Metabolite (6-AM), Screen Only, Urine LC	$232.00	$464.00	$60.28–$464.00	103% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Carisoprodol/Meprobamate, Screen Only, Urine (LC)	$237.50	$475.00	$60.28–$475.00	108% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines screen LC	$237.50	$475.00	$60.28–$475.00	108% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol, Screen and Conf Urine (LC)	$292.00	$584.00	$60.28–$584.00	156% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor, Methadone Metab w/ Conf Urine CQ	$313.23	$626.46	$60.28–$626.46	174% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Citric Acid Random Urine (LC)	$58.85	$107.00	$34.03–$96.30	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PM Phencyclidine Screen Urine w/Reflex Conf LC	$223.30	$406.00	$129.11–$365.40	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Umbil. Cord Tissue LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Profile + Etoh Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 w/Conf, WB (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 EDDP, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .Synthetic Cannabinoids Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine, Urine (RL)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 7 Drug Bundle Blood (RL)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 6-Acetylmorphine, Urine (RL)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiates Qual Urine	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Qual Urine	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Qual Urine	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen Panel 8A Qual Auto	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Profile Ur 9 Drugs Sendout to LabCorp	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen 8A Qual CS Auto	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307 - ToxAssure Comprehensive Profile (Labcorp M	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 w/Conf, Serum LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tapentadol, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Heroin Metabolite (6-AM), Screen Only, Urine LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 13 w/Conf, Serum (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tramadol, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Synthetic Cannabinoids Scr Ur (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Phencyclidine Screen, Urine LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium10LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 13+Oxycodone+Crt-Scr (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 10+Oxycodone+Crt-Scr (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Drug Screen 10 Panel LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 12+Oxycodone+Crt-Unbund (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen (7) Panel (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Monitor Drug Profile 10(MW) LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor, Pnl 1, w/Conf,w/Medmatch,Urine (CQ)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Monitor Drug Profile 14(MW) LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GHB Screen, w/Conf Rfx Whole Blood (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor, Pnl 1, w/conf Urine CQ	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen (10) Panel Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GHB SCREEN URINE (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid, Qual, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Urine LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 zzEthyl Glucuronide Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307 L738526 DAB SCN PRES 889	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium 5 Panel (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor, Pnl 5, w/Conf,w/Medmatch,Urine (CQ)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Ur Scr w Rflx (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CORDSTAT 13 (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolites, Urine (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Flunitrazepam (Rohypnol) Screen Ur LC	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone Scr, Ur (LC)	$255.20	$464.00	$147.55–$417.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines screen LC	$261.25	$475.00	$151.05–$427.50	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Carisoprodol/Meprobamate, Screen Only, Urine (LC)	$261.25	$475.00	$151.05–$427.50	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tramadol, Screen and Conf Urine (LC)	$321.20	$584.00	$185.71–$525.60	—	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Monitor, Methadone Metab w/ Conf Urine CQ	$344.55	$626.46	$199.21–$563.81	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 80051 Chem 6 Panel CQ	$47.50	$95.00	$6.80–$95.00	26% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolytes Panel	$131.00	$262.00	$6.80–$262.00	104% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 80051 ELECTROLYTE PANEL	$131.00	$262.00	$6.80–$262.00	104% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 80051 Chem 6 Panel CQ	$52.25	$95.00	$30.21–$85.50	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 80051 ELECTROLYTE PANEL	$144.10	$262.00	$83.32–$235.80	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolytes Panel	$144.10	$262.00	$83.32–$235.80	—	45%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgG (LC)	$184.50	$369.00	$17.60–$369.00	126% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EBV AB PROF LC	$184.50	$369.00	$17.60–$369.00	126% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EPSTEIN-BARR, VCA	$184.50	$369.00	$17.60–$369.00	126% above	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgM (RL)	$184.50	$369.00	$17.60–$369.00	126% above	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 EPSTEIN-BARR, VCA	$202.95	$369.00	$117.34–$332.10	—	45%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 EBV AB PROF LC	$202.95	$369.00	$117.34–$332.10	—	45%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IgG (LC)	$202.95	$369.00	$117.34–$332.10	—	45%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IgM (RL)	$202.95	$369.00	$117.34–$332.10	—	45%
Estradiol blood test CPT 82670 Estradiol (LC)	$233.50	$467.00	$27.10–$467.00	82% above	50%
Estradiol blood test CPT 82670 Estradiol, LC/MS (Endocrine Sciences) (LC)	$241.50	$483.00	$27.10–$483.00	88% above	50%
Estradiol blood test CPT 82670 Estradiol Level	$241.50	$483.00	$27.10–$483.00	88% above	50%
Estradiol blood test CPT 82670 82670 L4606 ESTRADIOL 889	$241.50	$483.00	$27.10–$483.00	88% above	50%
Estradiol blood test CPT 82670 Estradiol, Sensitive LC/MS (LC)	$241.50	$483.00	$27.10–$483.00	88% above	50%
Estradiol blood test CPT 82670 Estradiol Ultrasensitive LC-MS/MS RL	$241.50	$483.00	$27.10–$483.00	88% above	50%
Estradiol blood test inpatient CPT 82670 Estradiol (LC)	$256.85	$467.00	$148.51–$420.30	—	45%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$265.65	$483.00	$153.59–$434.70	—	45%
Estradiol blood test inpatient CPT 82670 Estradiol Ultrasensitive LC-MS/MS RL	$265.65	$483.00	$153.59–$434.70	—	45%
Estradiol blood test inpatient CPT 82670 82670 L4606 ESTRADIOL 889	$265.65	$483.00	$153.59–$434.70	—	45%
Estradiol blood test inpatient CPT 82670 Estradiol, LC/MS (Endocrine Sciences) (LC)	$265.65	$483.00	$153.59–$434.70	—	45%
Estradiol blood test inpatient CPT 82670 Estradiol, Sensitive LC/MS (LC)	$265.65	$483.00	$153.59–$434.70	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone (RL)	$200.50	$401.00	$18.02–$401.00	57% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Pediatric (LC)	$200.50	$401.00	$18.02–$401.00	57% above	50%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum	$200.50	$401.00	$18.02–$401.00	57% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone (RL)	$220.55	$401.00	$127.52–$360.90	—	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum	$220.55	$401.00	$127.52–$360.90	—	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Pediatric (LC)	$220.55	$401.00	$127.52–$360.90	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Feces (RL)	$269.50	$539.00	$19.04–$539.00	49% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Feces (RL)	$296.45	$539.00	$171.40–$485.10	—	45%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$130.00	$260.00	$13.22–$260.00	63% above	50%
Ferritin blood test (iron stores) CPT 82728 Ferritin, Serum (LC)	$130.00	$260.00	$13.22–$260.00	63% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$143.00	$260.00	$82.68–$234.00	—	45%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin, Serum (LC)	$143.00	$260.00	$82.68–$234.00	—	45%
Fibrinogen blood test CPT 85384 85384 FIBRINOGEN ACTIVITY	$75.00	$150.00	$9.43–$150.00	26% above	50%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$75.00	$150.00	$9.43–$150.00	26% above	50%
Fibrinogen blood test inpatient CPT 85384 85384 FIBRINOGEN ACTIVITY	$82.50	$150.00	$47.70–$135.00	—	45%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$82.50	$150.00	$47.70–$135.00	—	45%
Folate (folic acid) blood test CPT 82746 82746 L810 FOLATE SERUM 889	$143.00	$286.00	$14.26–$286.00	86% above	50%
Folate (folic acid) blood test CPT 82746 Folate Level	$143.00	$286.00	$14.26–$286.00	86% above	50%
Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) Serum LC	$143.00	$286.00	$14.26–$286.00	86% above	50%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$157.30	$286.00	$90.95–$257.40	—	45%
Folate (folic acid) blood test inpatient CPT 82746 82746 L810 FOLATE SERUM 889	$157.30	$286.00	$90.95–$257.40	—	45%
Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) Serum LC	$157.30	$286.00	$90.95–$257.40	—	45%
Free T3 thyroid hormone test CPT 84481 84481 T3,FREE	$203.00	$406.00	$16.43–$406.00	53% above	50%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free	$203.00	$406.00	$16.43–$406.00	53% above	50%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine 3 Free Serum (RL)	$203.00	$406.00	$16.43–$406.00	53% above	50%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free	$223.30	$406.00	$129.11–$365.40	—	45%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine 3 Free Serum (RL)	$223.30	$406.00	$129.11–$365.40	—	45%
Free T3 thyroid hormone test inpatient CPT 84481 84481 T3,FREE	$223.30	$406.00	$129.11–$365.40	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$91.00	$182.00	$8.75–$182.00	12% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 84439 THYROXINE T4, FREE	$91.00	$182.00	$8.75–$182.00	12% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 by Dialysis/Mass Spec (RL)	$91.00	$182.00	$8.75–$182.00	12% above	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine 4 Free	$91.00	$182.00	$8.75–$182.00	12% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, S (LC)	$100.10	$182.00	$57.88–$163.80	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 84439 THYROXINE T4, FREE	$100.10	$182.00	$57.88–$163.80	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 by Dialysis/Mass Spec (RL)	$100.10	$182.00	$57.88–$163.80	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine 4 Free	$100.10	$182.00	$57.88–$163.80	—	45%
Free testosterone test CPT 84402 Testosterone Free Direct (LC)	$121.50	$243.00	$24.71–$243.00	45% above	50%
Free testosterone test CPT 84402 84402-L500726 TST EQ MS PN	$121.50	$243.00	$24.71–$243.00	45% above	50%
Free testosterone test CPT 84402 84402 TESTOSTERONE, FREE	$121.50	$243.00	$24.71–$243.00	45% above	50%
Free testosterone test inpatient CPT 84402 84402 TESTOSTERONE, FREE	$133.65	$243.00	$77.27–$218.70	—	45%
Free testosterone test inpatient CPT 84402 84402-L500726 TST EQ MS PN	$133.65	$243.00	$77.27–$218.70	—	45%
Free testosterone test inpatient CPT 84402 Testosterone Free Direct (LC)	$133.65	$243.00	$77.27–$218.70	—	45%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 82977 NASH FIBROSURE PLUS (LC)	$58.50	$117.00	$6.98–$117.00	80% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$58.50	$117.00	$6.98–$117.00	80% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 82977 GGT	$58.50	$117.00	$6.98–$117.00	80% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 82977 GGT	$64.35	$117.00	$37.21–$105.30	—	45%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$64.35	$117.00	$37.21–$105.30	—	45%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 82977 NASH FIBROSURE PLUS (LC)	$64.35	$117.00	$37.21–$105.30	—	45%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel CS INSJ	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel CS INDM	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel CS INKC	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel CS INDH	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel INBR	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel INLH	$194.00	$388.00	$71.83–$620.80	37% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel CS INSJ	$213.40	$388.00	$123.38–$349.20	—	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel CS INDM	$213.40	$388.00	$123.38–$349.20	—	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel CS INDH	$213.40	$388.00	$123.38–$349.20	—	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel INLH	$213.40	$388.00	$123.38–$349.20	—	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel CS INKC	$213.40	$388.00	$123.38–$349.20	—	45%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel INBR	$213.40	$388.00	$123.38–$349.20	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Postprandial	$74.00	$148.00	$4.61–$148.00	80% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 1st Hr OB	$74.00	$148.00	$4.61–$148.00	80% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT 1st Hour OB	$74.00	$148.00	$4.61–$148.00	80% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gest. Diabetes 1-Hr Screen (RL)	$74.00	$148.00	$4.61–$148.00	80% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 1st Hour OB	$81.40	$148.00	$47.06–$133.20	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Postprandial	$81.40	$148.00	$47.06–$133.20	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Gest. Diabetes 1-Hr Screen (RL)	$81.40	$148.00	$47.06–$133.20	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT 1st Hr OB	$81.40	$148.00	$47.06–$133.20	—	45%
Glucose tolerance test, 3 samples CPT 82951 .GTT Fasting	$85.50	$171.00	$12.48–$171.00	16% above	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2Hr Pnl	$85.50	$171.00	$12.48–$171.00	16% above	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test, 3 Specimensn++CQ	$85.50	$171.00	$12.48–$171.00	16% above	50%
Glucose tolerance test, 3 samples CPT 82951 .GTT 1st Hr	$86.00	$172.00	$12.87–$172.00	16% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2Hr Pnl	$94.05	$171.00	$54.38–$153.90	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test, 3 Specimensn++CQ	$94.05	$171.00	$54.38–$153.90	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT Fasting	$94.05	$171.00	$54.38–$153.90	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT 1st Hr	$94.60	$172.00	$54.70–$154.80	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 PapIG CtNg rfx Aptima HPV ASCU LC	$83.00	$166.00	$30.73–$166.00	15% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L188070 N GONO AMP 889	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea DNA Amplified Probe I	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L188698 NG AMP PRB	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L199320 NG AMP PRB	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L183160 N GONO AMP 889	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L199310 PAPIG 889	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 L199320 8894836 NG AMP PRB	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N.GONORRHO,DNA,AMPPR 131	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Pap IG, Ct-Ng TV LC	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 IGP, CtNgTv HPV Rfx 16/18,45 LC	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 IGP, CtNgTv Rfx HPV ASCU LC	$148.50	$297.00	$34.04–$297.00	53% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 PapIG CtNg rfx Aptima HPV ASCU LC	$91.30	$166.00	$52.79–$149.40	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Pap IG, Ct-Ng TV LC	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L188070 N GONO AMP 889	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N.GONORRHO,DNA,AMPPR 131	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L199320 NG AMP PRB	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 IGP, CtNgTv Rfx HPV ASCU LC	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L199320 8894836 NG AMP PRB	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L188698 NG AMP PRB	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea DNA Amplified Probe I	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N.GONORRHO,DNA,AMPPR	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L199310 PAPIG 889	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 IGP, CtNgTv HPV Rfx 16/18,45 LC	$163.35	$297.00	$94.45–$267.30	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 L183160 N GONO AMP 889	$163.35	$297.00	$94.45–$267.30	—	45%
H. pylori antibody blood test CPT 86677 H pylori Antibody IgA (LC)	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test CPT 86677 Helicobacter pylori Ab IgG	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test CPT 86677 86677 H PYLORI AB QL 889	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test CPT 86677 86677 H PYLORI AB QL	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test CPT 86677 H pylori Antibody IgM (LC)	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test CPT 86677 H pylori Antibody IgG (LC)	$93.00	$186.00	$16.34–$186.00	4% below	50%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori Ab IgG	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori antibody blood test inpatient CPT 86677 H pylori Antibody IgM (LC)	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori antibody blood test inpatient CPT 86677 86677 H PYLORI AB QL 889	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori antibody blood test inpatient CPT 86677 H pylori Antibody IgA (LC)	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori antibody blood test inpatient CPT 86677 86677 H PYLORI AB QL	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori antibody blood test inpatient CPT 86677 H pylori Antibody IgG (LC)	$102.30	$186.00	$59.15–$167.40	—	45%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Fecal IA	$111.00	$222.00	$13.95–$222.00	15% below	50%
H. pylori stool antigen test CPT 87338 H pylori Stool Antigen EIA (RL)	$111.00	$222.00	$13.95–$222.00	15% below	50%
H. pylori stool antigen test inpatient CPT 87338 H pylori Stool Antigen EIA (RL)	$122.10	$222.00	$70.60–$199.80	—	45%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Fecal IA	$122.10	$222.00	$70.60–$199.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA, PCR (Graph) rfx/Geno EDI (LC)	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .GenoSure(R) MG Quant RNA PCR (LC)	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 QT PCR w/ Reflex Graphical LC	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 RNA RT PCR Graph (LC)	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV1 RNA RT PCR Non-Graph (LC)	$751.00	$1,502.00	$82.55–$1,502.00	112% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .GenoSure PRIme(R) Quant RNA PCR (LC)	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 .GenoSure(R) MG Quant RNA PCR (LC)	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA, PCR (Graph) rfx/Geno EDI (LC)	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 QT PCR w/ Reflex Graphical LC	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 RNA RT PCR Graph (LC)	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV1 RNA RT PCR Non-Graph (LC)	$826.10	$1,502.00	$477.64–$1,351.80	—	45%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 L198190 HPV HR 889	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA Low High Risk (RL)	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 L199310 PAPIG 889	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 L199305 HPV HR 889	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SO 87624 AP Bill HPV High Risk Types	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 HPV HIGH RISK TYPES	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 .HPV Low Risk (LC)	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Aptima LC	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 IGP, CtNgTv HPV Rfx 16/18,45 LC	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 PAP IGP Aptima HPV L199330	$97.00	$194.00	$34.04–$194.00	7% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 IGP, cobasHPV, rfx16/18 (LC)	$100.00	$200.00	$34.04–$200.00	4% below	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SO 87624 AP Bill HPV High Risk Types	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA Low High Risk (RL)	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 IGP, CtNgTv HPV Rfx 16/18,45 LC	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 PAP IGP Aptima HPV L199330	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 L199310 PAPIG 889	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 L199305 HPV HR 889	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 L198190 HPV HR 889	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Aptima LC	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 HPV HIGH RISK TYPES	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 .HPV Low Risk (LC)	$106.70	$194.00	$61.69–$174.60	—	45%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 IGP, cobasHPV, rfx16/18 (LC)	$110.00	$200.00	$63.60–$180.00	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (RL)	$85.50	$171.00	$9.42–$171.00	31% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HgbA1c w/ Estimated Average Glucose	$85.50	$171.00	$9.42–$171.00	31% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HgbA1c w/ Estimated Average Glucose	$94.05	$171.00	$54.38–$153.90	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (RL)	$94.05	$171.00	$54.38–$153.90	—	45%
Hemoglobin blood test CPT 85018 .BG Hgb DM Ven POC	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 .BG Hgb + Hct Arterial POC	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 Blood Gas Hemoglobin + Hematocrit Arterial Only	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 Hemoglobin	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 .BG Hgb DM Art POC	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 .BG Hgb + Hct Ven POC	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 85018 HEMOGLOBIN	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 Hemoglobin RL	$34.50	$69.00	$2.30–$69.00	88% above	50%
Hemoglobin blood test CPT 85018 85018 L121003 HEMOGLOBIN 889	$35.00	$70.00	$2.30–$70.00	90% above	50%
Hemoglobin blood test inpatient CPT 85018 .BG Hgb DM Art POC	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 .BG Hgb + Hct Ven POC	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 85018 HEMOGLOBIN	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin RL	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 .BG Hgb + Hct Arterial POC	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 Blood Gas Hemoglobin + Hematocrit Arterial Only	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 .BG Hgb DM Ven POC	$37.95	$69.00	$21.94–$62.10	—	45%
Hemoglobin blood test inpatient CPT 85018 85018 L121003 HEMOGLOBIN 889	$38.50	$70.00	$22.26–$63.00	—	45%
Hepatitis B core antibody test (total) CPT 86704 HBV Core Antibody Total (RL)	$153.00	$306.00	$11.69–$306.00	129% above	50%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total	$153.00	$306.00	$11.69–$306.00	129% above	50%
Hepatitis B core antibody test (total) CPT 86704 86704 HEP B CORE AB, TOTAL	$153.00	$306.00	$11.69–$306.00	129% above	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 86704 HEP B CORE AB, TOTAL	$168.30	$306.00	$97.31–$275.40	—	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody Total	$168.30	$306.00	$97.31–$275.40	—	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 HBV Core Antibody Total (RL)	$168.30	$306.00	$97.31–$275.40	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab Qual (RL)	$87.00	$174.00	$10.42–$174.00	33% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$87.00	$174.00	$10.42–$174.00	33% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 86706 HEP B SURFACE AB	$87.00	$174.00	$10.42–$174.00	33% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 86706 HEP B SURFACE AB	$95.70	$174.00	$55.33–$156.60	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$95.70	$174.00	$55.33–$156.60	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab Qual (RL)	$95.70	$174.00	$55.33–$156.60	—	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 HBSAG	$104.00	$208.00	$10.02–$208.00	70% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBV Surface Antigen Screen (RL)	$104.00	$208.00	$10.02–$208.00	70% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$104.00	$208.00	$10.02–$208.00	70% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBV Surface Antigen Screen (RL)	$114.40	$208.00	$66.14–$187.20	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 87340 HBSAG	$114.40	$208.00	$66.14–$187.20	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$114.40	$208.00	$66.14–$187.20	—	45%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody rfx Quant PCR (RL)	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Reflex HCV Quant	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody w/Rfx HCV RNA PCR Rfx Geno Li	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C IgG Antibody	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Reflex to Verification (LC)	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody (LC)	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody reflex to NAA (LC)	$167.50	$335.00	$13.84–$335.00	68% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody reflex to NAA (LC)	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C IgG Antibody	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab w/Reflex to Verification (LC)	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody rfx Quant PCR (RL)	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody w/Rfx HCV RNA PCR Rfx Geno Li	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab w/Reflex HCV Quant	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody (LC)	$184.25	$335.00	$106.53–$301.50	—	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV qRT-PCR (plasma) (VC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV Quant GT1a NS5A Profile LC	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RealTime Abbott (LC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (HCV) RNA, Diagnosis (LC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV Real-Time, PCR, Quant (LC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hepatitis C Virus RT PCR Quant Graph (LC)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT PCR Quant Non-Graph (RL)	$400.00	$800.00	$41.55–$800.00	79% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA PCR Quant Reflex Geno (LC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV Real-Time, PCR, Quant (LC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RealTime Abbott (LC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV Quant GT1a NS5A Profile LC	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus (HCV) RNA, Diagnosis (LC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV qRT-PCR (plasma) (VC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Hepatitis C Virus RT PCR Quant Graph (LC)	$440.00	$800.00	$254.40–$720.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT PCR Quant Non-Graph (RL)	$440.00	$800.00	$254.40–$720.00	—	45%
Herpes blood test, HSV-1 antibody CPT 86695 86695 HERPES SIMP TYPE 1	$36.50	$73.00	$12.79–$73.00	28% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 HERPES SIMP TYPE 1	$40.15	$73.00	$23.21–$65.70	—	45%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Specific Ab IgG (LC)	$59.00	$118.00	$18.77–$118.00	19% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 .HSV2 IgG Supplemental (LC)	$59.00	$118.00	$18.77–$118.00	19% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 86696 HERPES SIMP TYPE 2	$59.00	$118.00	$18.77–$118.00	19% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 HERPES SIMP TYPE 2	$64.90	$118.00	$37.52–$106.20	—	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV2 IgG Supplemental (LC)	$64.90	$118.00	$37.52–$106.20	—	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Specific Ab IgG (LC)	$64.90	$118.00	$37.52–$106.20	—	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitivity	$103.00	$206.00	$12.56–$206.00	40% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein High Sensitivity	$113.30	$206.00	$65.51–$185.40	—	45%
Homocysteine blood test CPT 83090 Homocysteine Plasma (LC)	$190.00	$380.00	$17.38–$380.00	46% above	50%
Homocysteine blood test CPT 83090 83090 HOMOCYSTEINE	$190.00	$380.00	$17.38–$380.00	46% above	50%
Homocysteine blood test CPT 83090 Homocysteine Level	$190.00	$380.00	$17.38–$380.00	46% above	50%
Homocysteine blood test inpatient CPT 83090 Homocysteine Plasma (LC)	$209.00	$380.00	$120.84–$342.00	—	45%
Homocysteine blood test inpatient CPT 83090 Homocysteine Level	$209.00	$380.00	$120.84–$342.00	—	45%
Homocysteine blood test inpatient CPT 83090 83090 HOMOCYSTEINE	$209.00	$380.00	$120.84–$342.00	—	45%
Insulin blood test CPT 83525 Insulin Total	$153.00	$306.00	$11.09–$306.00	114% above	50%
Insulin blood test CPT 83525 83525 INSULIN, TOTAL	$153.00	$306.00	$11.09–$306.00	114% above	50%
Insulin blood test CPT 83525 Insulin (LC)	$153.00	$306.00	$11.09–$306.00	114% above	50%
Insulin blood test inpatient CPT 83525 Insulin Total	$168.30	$306.00	$97.31–$275.40	—	45%
Insulin blood test inpatient CPT 83525 Insulin (LC)	$168.30	$306.00	$97.31–$275.40	—	45%
Insulin blood test inpatient CPT 83525 83525 INSULIN, TOTAL	$168.30	$306.00	$97.31–$275.40	—	45%
Iron blood test (serum iron) CPT 83540 Iron Blood	$87.00	$174.00	$6.28–$174.00	81% above	50%
Iron blood test (serum iron) CPT 83540 83540 IRON	$87.00	$174.00	$6.28–$174.00	81% above	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron Blood	$95.70	$174.00	$55.33–$156.60	—	45%
Iron blood test (serum iron) inpatient CPT 83540 83540 IRON	$95.70	$174.00	$55.33–$156.60	—	45%
Iron-binding capacity (TIBC) test CPT 83550 Unsaturated Iron Binding Capacity	$80.00	$160.00	$8.48–$160.00	81% above	50%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACIT	$80.00	$160.00	$8.48–$160.00	81% above	50%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity DM	$80.00	$160.00	$8.48–$160.00	81% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity DM	$88.00	$160.00	$50.88–$144.00	—	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Unsaturated Iron Binding Capacity	$88.00	$160.00	$50.88–$144.00	—	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING CAPACIT	$88.00	$160.00	$50.88–$144.00	—	45%
Kidney function blood test panel CPT 80069 Renal Function Panel	$150.00	$300.00	$8.42–$300.00	48% above	50%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$165.00	$300.00	$95.40–$270.00	—	45%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone S (RL)	$229.50	$459.00	$17.96–$459.00	62% above	50%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$229.50	$459.00	$17.96–$459.00	62% above	50%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone, Pediatric LC	$229.50	$459.00	$17.96–$459.00	62% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone, Pediatric LC	$252.45	$459.00	$145.96–$413.10	—	45%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$252.45	$459.00	$145.96–$413.10	—	45%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone S (RL)	$252.45	$459.00	$145.96–$413.10	—	45%
Lactate (lactic acid) blood test CPT 83605 .BG Lactate DM Ven POC	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 .Lactate DM Ven POC	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 .Lactate DM Arterial POC	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 83605 LACTIC ACID	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex 2	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactate D LC	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 .BG Lactate DM Art POC	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 .Lactic Acid Reflex	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid w/ Reflex LA	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 Blood Gas Lactic Acid Arterial	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid, Plasma RL	$118.50	$237.00	$11.22–$237.00	32% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Blood Gas Lactic Acid Arterial	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex 2	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 83605 LACTIC ACID	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactate DM Arterial POC	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactate DM Ven POC	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid, Plasma RL	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .BG Lactate DM Ven POC	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate D LC	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .BG Lactate DM Art POC	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 .Lactic Acid Reflex	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid w/ Reflex LA	$130.35	$237.00	$75.37–$213.30	—	45%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$39.50	$79.00	$5.86–$79.00	8% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid (LC)	$39.50	$79.00	$5.86–$79.00	8% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 83615 LACTATE DEHYDROLDH	$39.50	$79.00	$5.86–$79.00	8% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase (CQ)	$39.50	$79.00	$5.86–$79.00	8% below	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$39.50	$79.00	$5.86–$79.00	8% below	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$43.45	$79.00	$25.12–$71.10	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase (CQ)	$43.45	$79.00	$25.12–$71.10	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$43.45	$79.00	$25.12–$71.10	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 83615 LACTATE DEHYDROLDH	$43.45	$79.00	$25.12–$71.10	—	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid (LC)	$43.45	$79.00	$25.12–$71.10	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$95.00	$190.00	$6.68–$190.00	7% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid (LC)	$95.00	$190.00	$6.68–$190.00	7% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid (LC)	$104.50	$190.00	$60.42–$171.00	—	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$104.50	$190.00	$60.42–$171.00	—	45%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$196.00	$392.00	$7.92–$392.00	107% above	50%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$215.60	$392.00	$124.66–$352.80	—	45%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Test w/Reflex (LC)	$167.50	$335.00	$16.52–$335.00	36% above	50%
Lyme disease antibody test CPT 86618 86618 LYME DISEASE AB	$167.50	$335.00	$16.52–$335.00	36% above	50%
Lyme disease antibody test CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$172.00	$344.00	$16.52–$344.00	40% above	50%
Lyme disease antibody test inpatient CPT 86618 86618 LYME DISEASE AB	$184.25	$335.00	$106.53–$301.50	—	45%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Test w/Reflex (LC)	$184.25	$335.00	$106.53–$301.50	—	45%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Ab Rfx Immunoassay LC	$189.20	$344.00	$109.39–$309.60	—	45%
Magnesium blood test CPT 83735 Magnesium, Serum CQ	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 Magnesium Serum	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 Magnesium Red Blood Cell (RL)	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 Magnesium, U (LC)	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 83735 MAGNESIUM	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 Magnesium, Serum LC	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test CPT 83735 83735 L306266 MAGNESIUM	$101.00	$202.00	$6.50–$202.00	112% above	50%
Magnesium blood test inpatient CPT 83735 Magnesium, U (LC)	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium, Serum CQ	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 83735 L306266 MAGNESIUM	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium, Serum LC	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 83735 MAGNESIUM	$111.10	$202.00	$64.24–$181.80	—	45%
Magnesium blood test inpatient CPT 83735 Magnesium Red Blood Cell (RL)	$111.10	$202.00	$64.24–$181.80	—	45%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibody IgM (RL)	$127.50	$255.00	$12.49–$255.00	62% above	50%
Measles (rubeola) antibody test CPT 86765 86765 RUBEOLA AB	$127.50	$255.00	$12.49–$255.00	62% above	50%
Measles (rubeola) antibody test CPT 86765 Measles IgG	$127.50	$255.00	$12.49–$255.00	62% above	50%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibody IgG (RL)	$127.50	$255.00	$12.49–$255.00	62% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibody IgM (RL)	$140.25	$255.00	$81.09–$229.50	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibody IgG (RL)	$140.25	$255.00	$81.09–$229.50	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 86765 RUBEOLA AB	$140.25	$255.00	$81.09–$229.50	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 Measles IgG	$140.25	$255.00	$81.09–$229.50	—	45%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Qual W/Rflx Qn (LC)	$68.50	$137.00	$5.02–$137.00	12% below	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$68.50	$137.00	$5.02–$137.00	12% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Qual W/Rflx Qn (LC)	$75.35	$137.00	$43.57–$123.30	—	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$75.35	$137.00	$43.57–$123.30	—	45%
Mumps immunity blood test CPT 86735 Mumps Antibody IgG Scr	$98.00	$196.00	$12.66–$196.00	29% above	50%
Mumps immunity blood test CPT 86735 Mumps Antibody IgM (RL)	$98.00	$196.00	$12.66–$196.00	29% above	50%
Mumps immunity blood test CPT 86735 Mumps Antibody IgG (RL)	$98.00	$196.00	$12.66–$196.00	29% above	50%
Mumps immunity blood test CPT 86735 86735 MUMPS AB	$98.00	$196.00	$12.66–$196.00	29% above	50%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgG Scr	$107.80	$196.00	$62.33–$176.40	—	45%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgM (RL)	$107.80	$196.00	$62.33–$176.40	—	45%
Mumps immunity blood test inpatient CPT 86735 86735 MUMPS AB	$107.80	$196.00	$62.33–$176.40	—	45%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibody IgG (RL)	$107.80	$196.00	$62.33–$176.40	—	45%
Obstetric blood test panel CPT 80055 Obstetrics Panel A CS	$101.50	$203.00	$37.58–$203.00	68% below	50%
Obstetric blood test panel CPT 80055 Obstetric Panel CS	$101.50	$203.00	$37.58–$203.00	68% below	50%
Obstetric blood test panel CPT 80055 Obstetric Panel CS INDH	$101.50	$203.00	$37.58–$203.00	68% below	50%
Obstetric blood test panel inpatient CPT 80055 80055 OB Panel	$111.10	$202.00	$64.24–$181.80	—	45%
Obstetric blood test panel inpatient CPT 80055 Obstetrics Panel A CS	$111.65	$203.00	$64.55–$182.70	—	45%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS INDH	$111.65	$203.00	$64.55–$182.70	—	45%
Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS	$111.65	$203.00	$64.55–$182.70	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 %fPSA Reflex (LC)	$152.50	$305.00	$17.84–$305.00	119% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 84154 PSA, FREE	$152.50	$305.00	$17.84–$305.00	119% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480780 PSA, FREE 889	$152.50	$305.00	$17.84–$305.00	119% above	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480947 PSA, FREE	$152.50	$305.00	$17.84–$305.00	119% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480780 PSA, FREE 889	$167.75	$305.00	$96.99–$274.50	—	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 PSA, FREE	$167.75	$305.00	$96.99–$274.50	—	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 %fPSA Reflex (LC)	$167.75	$305.00	$96.99–$274.50	—	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480947 PSA, FREE	$167.75	$305.00	$96.99–$274.50	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Serum (Serial Monitor) LC	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (Reflex To Free) (LC)	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480947 PSA, TOTAL	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480780 PSA, TOTAL 889	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 PSA, TOTAL	$118.50	$237.00	$17.84–$237.00	49% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free) (LC)	$130.35	$237.00	$75.37–$213.30	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 PSA, TOTAL	$130.35	$237.00	$75.37–$213.30	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480947 PSA, TOTAL	$130.35	$237.00	$75.37–$213.30	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480780 PSA, TOTAL 889	$130.35	$237.00	$75.37–$213.30	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total	$130.35	$237.00	$75.37–$213.30	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Serum (Serial Monitor) LC	$130.35	$237.00	$75.37–$213.30	—	45%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 IGP, CtNgTv HPV Rfx 16/18,45 LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 Pap IG, Ct-Ng TV LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap IG, rflx HPV ASCU LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap IG, rflx HPV all pth LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 AP Bill Cytopath C-V Autoprep Rescr u MD	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L198190 PAP AU MN RS 889	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 PAP DIAG AUTO MAN RS	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L199305 PAP AU MN RS 889	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 IGP, CtNgTv Rfx HPV ASCU LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L199320 PAP AU MN RS	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L199310 PAPIG 889	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 PAP IGP Aptima HPV L199330	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 L199320 8894837 PAP AU MN RS	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap IG (Image Guided) (LC)	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PapIG rfx Aptima HPV ASCU LC	$83.00	$166.00	$25.81–$166.00	at median	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 IGP, cobasHPV, rfx16/18 (LC)	$85.00	$170.00	$25.81–$170.00	2% above	50%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 PapIG CtNg rfx Aptima HPV ASCU LC	$131.50	$263.00	$25.81–$263.00	58% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 PAP DIAG AUTO MAN RS	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L198190 PAP AU MN RS 889	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L199305 PAP AU MN RS 889	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L199320 PAP AU MN RS	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L199310 PAPIG 889	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PapIG rfx Aptima HPV ASCU LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 L199320 8894837 PAP AU MN RS	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 PAP IGP Aptima HPV L199330	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap IG, rflx HPV all pth LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap IG, rflx HPV ASCU LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 Pap IG, Ct-Ng TV LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 IGP, CtNgTv HPV Rfx 16/18,45 LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 IGP, CtNgTv Rfx HPV ASCU LC	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 AP Bill Cytopath C-V Autoprep Rescr u MD	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap IG (Image Guided) (LC)	$91.30	$166.00	$52.79–$149.40	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 IGP, cobasHPV, rfx16/18 (LC)	$93.50	$170.00	$54.06–$153.00	—	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 PapIG CtNg rfx Aptima HPV ASCU LC	$144.65	$263.00	$83.63–$236.70	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Liquid Based (LC)	$39.00	$78.00	$14.44–$78.00	44% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAPLBRHPV LC	$42.50	$85.00	$15.74–$85.00	39% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$42.50	$85.00	$15.74–$85.00	39% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 CYTOPATH C-V THINLAY	$42.50	$85.00	$15.74–$85.00	39% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$42.50	$85.00	$15.74–$85.00	39% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Change IG Pap to LB Pap	$42.50	$85.00	$15.74–$85.00	39% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pap Liquid Based (LC)	$42.90	$78.00	$24.80–$70.20	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 Pap IG,CtNg HPV APTIMA RfxGeno 16/18/45 LC	$46.75	$85.00	$27.03–$76.50	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 CYTOPATH C-V THINLAY	$46.75	$85.00	$27.03–$76.50	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$46.75	$85.00	$27.03–$76.50	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAPLBRHPV LC	$46.75	$85.00	$27.03–$76.50	—	45%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Change IG Pap to LB Pap	$46.75	$85.00	$27.03–$76.50	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact (RL)	$457.50	$915.00	$40.04–$915.00	137% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$457.50	$915.00	$40.04–$915.00	137% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact (RL)	$503.25	$915.00	$290.97–$823.50	—	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$503.25	$915.00	$290.97–$823.50	—	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLAST TIMEPTT	$96.00	$192.00	$5.83–$192.00	92% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$96.00	$192.00	$5.83–$192.00	92% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L503426 APTT 889	$96.00	$192.00	$5.83–$192.00	92% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L500070 APTT 889	$96.00	$192.00	$5.83–$192.00	92% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L117079 APTT 889	$97.00	$194.00	$5.83–$194.00	94% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLAST TIMEPTT	$105.60	$192.00	$61.06–$172.80	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L503426 APTT 889	$105.60	$192.00	$61.06–$172.80	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$105.60	$192.00	$61.06–$172.80	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L500070 APTT 889	$105.60	$192.00	$61.06–$172.80	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L117079 APTT 889	$106.70	$194.00	$61.69–$174.60	—	45%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum	$49.00	$98.00	$4.60–$98.00	71% above	50%
Phosphorus (phosphate) blood test CPT 84100 84100 PHOSPHORUS, BLOOD	$49.00	$98.00	$4.60–$98.00	71% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum	$53.90	$98.00	$31.16–$88.20	—	45%
Phosphorus (phosphate) blood test inpatient CPT 84100 84100 PHOSPHORUS, BLOOD	$53.90	$98.00	$31.16–$88.20	—	45%
Potassium blood test CPT 84132 .ISTAT Potassium Cap POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 84132 POTASSIUM SER PL WB	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .BG Potassium DM Cap POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Blood Gas Potassium DM Arterial	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Potassium, Serum LC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .BG Potassium DM Art POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .BG Potassium DM Ven POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Potassium Serum	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .BG Potassium DM CB Ven POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .ISTAT Potassium Art POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Blood Gas Potassium DM Venous	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .ISTAT Potassium DM Ven POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 .BG Potassium DM CB Art POC	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Blood Gas Potassium DM Capillary	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test CPT 84132 Potassium CQ	$40.00	$80.00	$4.62–$80.00	40% above	50%
Potassium blood test inpatient CPT 84132 .BG Potassium DM CB Ven POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .BG Potassium DM Cap POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .BG Potassium DM CB Art POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .BG Potassium DM Ven POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Blood Gas Potassium DM Venous	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Potassium Serum	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Blood Gas Potassium DM Capillary	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .BG Potassium DM Art POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 84132 POTASSIUM SER PL WB	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .ISTAT Potassium Cap POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .ISTAT Potassium Art POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 .ISTAT Potassium DM Ven POC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Potassium, Serum LC	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Blood Gas Potassium DM Arterial	$44.00	$80.00	$25.44–$72.00	—	45%
Potassium blood test inpatient CPT 84132 Potassium CQ	$44.00	$80.00	$25.44–$72.00	—	45%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MaterniT21 PLUS Core (chr21,18,13,sex) LC	$1,410.33	$2,820.66	$555.10–$2,820.66	66% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MaterniT21 PLUS Core+ESS+SCA LC	$1,610.50	$3,221.00	$633.89–$3,221.00	89% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MaterniT21 PLUS Core (chr21,18,13,sex) LC	$1,551.36	$2,820.66	$896.97–$2,538.59	—	45%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MaterniT21 PLUS Core+ESS+SCA LC	$1,771.55	$3,221.00	$1,024.28–$2,898.90	—	45%
Progesterone blood test CPT 84144 Progesterone Level	$173.00	$346.00	$20.23–$346.00	26% above	50%
Progesterone blood test CPT 84144 Progesterone (LC)	$173.00	$346.00	$20.23–$346.00	26% above	50%
Progesterone blood test inpatient CPT 84144 Progesterone (LC)	$190.30	$346.00	$110.03–$311.40	—	45%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$190.30	$346.00	$110.03–$311.40	—	45%
Prolactin blood test CPT 84146 Prolactin Serum (LC)	$249.50	$499.00	$18.80–$499.00	148% above	50%
Prolactin blood test CPT 84146 Prolactin Level	$249.50	$499.00	$18.80–$499.00	148% above	50%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$274.45	$499.00	$158.68–$449.10	—	45%
Prolactin blood test inpatient CPT 84146 Prolactin Serum (LC)	$274.45	$499.00	$158.68–$449.10	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 Coag Clinic POC PT INR	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 L503426 PT 889	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 .ISTAT PT w/INR POC	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 L500070 PT 889	$55.50	$111.00	$4.16–$111.00	109% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 85610 L117079 PT 889	$56.00	$112.00	$4.16–$112.00	111% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Coag Clinic POC PT INR	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L500070 PT 889	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .ISTAT PT w/INR POC	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L503426 PT 889	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME	$61.05	$111.00	$35.30–$99.90	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L117079 PT 889	$61.60	$112.00	$35.62–$100.80	—	45%
Rapid flu test (influenza antigen) CPT 87804 Influenza B Antigen Result	$35.00	$70.00	$12.96–$70.00	33% below	50%
Rapid flu test (influenza antigen) CPT 87804 87804 59 INFLUENZA ASSAY W-OP	$93.50	$187.00	$16.05–$187.00	78% above	50%
Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W-OP	$93.50	$187.00	$16.05–$187.00	78% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B Antigen Result	$38.50	$70.00	$22.26–$63.00	—	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 59 INFLUENZA ASSAY W-OP	$102.85	$187.00	$59.47–$168.30	—	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W-OP	$102.85	$187.00	$59.47–$168.30	—	45%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Streptococcus A Antigen IA1	$72.50	$145.00	$16.03–$145.00	7% below	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Antigen Result Quidel	$72.50	$145.00	$16.03–$145.00	7% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Streptococcus A Antigen IA1	$79.75	$145.00	$46.11–$130.50	—	45%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Antigen Result Quidel	$79.75	$145.00	$46.11–$130.50	—	45%
Renin blood test CPT 84244 84244 L703 RENIN 889	$215.00	$430.00	$21.33–$430.00	94% above	50%
Renin blood test CPT 84244 84244 L4354 RENIN 889	$221.50	$443.00	$21.33–$443.00	100% above	50%
Renin blood test CPT 84244 Renin Activity Plasma (RL)	$221.50	$443.00	$21.33–$443.00	100% above	50%
Renin blood test inpatient CPT 84244 84244 L703 RENIN 889	$236.50	$430.00	$136.74–$387.00	—	45%
Renin blood test inpatient CPT 84244 Renin Activity Plasma (RL)	$243.65	$443.00	$140.87–$398.70	—	45%
Renin blood test inpatient CPT 84244 84244 L4354 RENIN 889	$243.65	$443.00	$140.87–$398.70	—	45%
Rh blood typing CPT 86901 BB Bill Rh Test	$49.50	$99.00	$2.90–$99.00	28% above	50%
Rh blood typing CPT 86901 86901 Rh Type	$49.50	$99.00	$2.90–$99.00	28% above	50%
Rh blood typing inpatient CPT 86901 BB Bill Rh Test	$54.45	$99.00	$31.48–$89.10	—	45%
Rh blood typing inpatient CPT 86901 86901 Rh Type	$54.45	$99.00	$31.48–$89.10	—	45%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF), IgM LC	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 86431 RHEUMATOID FACT QUAN	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor (RL)	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant Auto	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Titer	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 86431 L520293 RA FACT QT	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, IgM by EIA (RDL) (LC)	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test CPT 86431 86431 Rheumatoid Fact Quant	$12.50	$25.00	$4.63–$25.00	74% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 86431 L520293 RA FACT QT	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 86431 Rheumatoid Fact Quant	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, IgM by EIA (RDL) (LC)	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF), IgM LC	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 86431 RHEUMATOID FACT QUAN	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor (RL)	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant Auto	$13.75	$25.00	$7.95–$22.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Titer	$13.75	$25.00	$7.95–$22.50	—	45%
Rubella antibody test (immunity check) CPT 86762 86762 RUBELLA AB	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG Auto	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgM (RL)	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG (LC)	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab IgG Auto w/Interp	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody	$31.00	$62.00	$11.48–$62.00	53% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab IgG Auto w/Interp	$34.10	$62.00	$19.72–$55.80	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 86762 RUBELLA AB	$34.10	$62.00	$19.72–$55.80	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG (LC)	$34.10	$62.00	$19.72–$55.80	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG Auto	$34.10	$62.00	$19.72–$55.80	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody	$34.10	$62.00	$19.72–$55.80	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgM (RL)	$34.10	$62.00	$19.72–$55.80	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Erythrocyte Sedimentation Rate Automated	$18.00	$36.00	$2.62–$36.00	54% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Erythrocyte Sedimentation Rate Automated	$19.80	$36.00	$11.45–$32.40	—	45%
Sodium blood test CPT 84295 .ISTAT Sodium DM Cap POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .BG Sodium DM Art POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .ISTAT Sodium DM	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 Sodium Serum	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 Blood Gas Sodium DM Capillary	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 Blood Gas Sodium DM Venous	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .BG Sodium DM Ven POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .BG Sodium DM Cap POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .BG Sodium DM CB Art POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 .BG Sodium DM CB Ven POC	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 84295 SODIUM,SER PL OR WB	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test CPT 84295 Blood Gas Sodium DM Arterial	$40.00	$80.00	$4.67–$80.00	9% above	50%
Sodium blood test inpatient CPT 84295 .BG Sodium DM Cap POC	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .BG Sodium DM Ven POC	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .ISTAT Sodium DM	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 84295 SODIUM,SER PL OR WB	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .BG Sodium DM Art POC	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .ISTAT Sodium DM Cap POC	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 Blood Gas Sodium DM Arterial	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 Blood Gas Sodium DM Venous	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 Sodium Serum	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 Blood Gas Sodium DM Capillary	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .BG Sodium DM CB Ven POC	$44.00	$80.00	$25.44–$72.00	—	45%
Sodium blood test inpatient CPT 84295 .BG Sodium DM CB Art POC	$44.00	$80.00	$25.44–$72.00	—	45%
Stool ova and parasites exam CPT 87177 87177 OVA-PARASITES SMEARS	$151.00	$302.00	$8.63–$302.00	211% above	50%
Stool ova and parasites exam CPT 87177 87177 L188110 OP SMEAR 889	$151.00	$302.00	$8.63–$302.00	211% above	50%
Stool ova and parasites exam CPT 87177 O+P Exam, Formalin Only (LC)	$151.00	$302.00	$8.63–$302.00	211% above	50%
Stool ova and parasites exam inpatient CPT 87177 87177 OVA-PARASITES SMEARS	$166.10	$302.00	$96.04–$271.80	—	45%
Stool ova and parasites exam inpatient CPT 87177 87177 L188110 OP SMEAR 889	$166.10	$302.00	$96.04–$271.80	—	45%
Stool ova and parasites exam inpatient CPT 87177 O+P Exam, Formalin Only (LC)	$166.10	$302.00	$96.04–$271.80	—	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 .Occult Bood Feces Screen A POC	$31.50	$63.00	$4.25–$63.00	12% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces Screen 1-3 D	$31.50	$63.00	$4.25–$63.00	12% below	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces Screen 1-3 A	$31.50	$63.00	$4.25–$63.00	12% below	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces Screen 1-3 D	$34.65	$63.00	$20.03–$56.70	—	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 .Occult Bood Feces Screen A POC	$34.65	$63.00	$20.03–$56.70	—	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces Screen 1-3 A	$34.65	$63.00	$20.03–$56.70	—	45%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Feces Diagnostic 1-3 D	$34.00	$68.00	$12.59–$68.00	34% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$34.00	$68.00	$12.59–$68.00	34% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Feces Diagnostic 1-3 D	$37.40	$68.00	$21.62–$61.20	—	45%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood Diagnostic	$37.40	$68.00	$21.62–$61.20	—	45%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum IgG ELISA (LC)	$108.00	$216.00	$12.84–$216.00	60% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibodies (LC)	$108.00	$216.00	$12.84–$216.00	60% above	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 zzTreponema pallidum Ab FTA RL	$108.00	$216.00	$12.84–$216.00	60% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum IgG ELISA (LC)	$118.80	$216.00	$68.69–$194.40	—	45%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 zzTreponema pallidum Ab FTA RL	$118.80	$216.00	$68.69–$194.40	—	45%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibodies (LC)	$118.80	$216.00	$68.69–$194.40	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 86592 SYPHILIS TEST, QUAL	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF (LC)	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Reflex Titer TP-PA (LC)	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (LC)	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin w/Reflex Titer + FTA-ABS	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Qual	$11.00	$22.00	$4.07–$22.00	73% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Titer w/Reflex Titer	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF (LC)	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 86592 SYPHILIS TEST, QUAL	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Qual	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin Reflex Titer TP-PA (LC)	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (LC)	$12.10	$22.00	$7.00–$19.80	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin w/Reflex Titer + FTA-ABS	$12.10	$22.00	$7.00–$19.80	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 .Quantiferon TB Antigen 1	$131.50	$263.00	$48.69–$263.00	11% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC	$131.50	$263.00	$48.69–$263.00	11% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 .QuantiFERON In Tube RL	$131.50	$263.00	$48.69–$263.00	11% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Lab Incubated) LC	$131.50	$263.00	$48.69–$263.00	11% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 .QuantiFERON-TB Gold Plus LC	$132.50	$265.00	$49.06–$265.00	10% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (Lab Incubated) LC	$144.65	$263.00	$83.63–$236.70	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 .QuantiFERON In Tube RL	$144.65	$263.00	$83.63–$236.70	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 .Quantiferon TB Antigen 1	$144.65	$263.00	$83.63–$236.70	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus LC	$144.65	$263.00	$83.63–$236.70	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 .QuantiFERON-TB Gold Plus LC	$145.75	$265.00	$84.27–$238.50	—	45%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 84403-L500726 TST EQ MS PN	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 L146688 TESTOST TOT 889	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 TESTOSTERONE, TOTAL	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone LCMS Pediatric LC	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Serum (LC)	$155.50	$311.00	$25.04–$311.00	31% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 TESTOSTERONE, TOTAL	$171.05	$311.00	$98.90–$279.90	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403-L500726 TST EQ MS PN	$171.05	$311.00	$98.90–$279.90	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 L146688 TESTOST TOT 889	$171.05	$311.00	$98.90–$279.90	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$171.05	$311.00	$98.90–$279.90	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Serum (LC)	$171.05	$311.00	$98.90–$279.90	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone LCMS Pediatric LC	$171.05	$311.00	$98.90–$279.90	—	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Cytosol Autoantibodies (CQ)	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 MICROSOMAL AB	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody (RL)	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsomal Antibody (RL)	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Cytosol Type 1 Antibodies (LC)	$142.50	$285.00	$14.11–$285.00	54% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Cytosol Type 1 Antibodies (LC)	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Kidney Microsomal Antibody (RL)	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Antibody (RL)	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 MICROSOMAL AB	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Cytosol Autoantibodies (CQ)	$156.75	$285.00	$90.63–$256.50	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$39.00	$78.00	$14.44–$78.00	52% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$39.00	$78.00	$14.44–$78.00	52% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (RL)	$39.00	$78.00	$14.44–$78.00	52% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 THYROID STIM TSH	$39.00	$78.00	$14.44–$78.00	52% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 NBS THYROID STIM TSH	$155.50	$311.00	$16.30–$311.00	91% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 THYROID STIM TSH	$42.90	$78.00	$24.80–$70.20	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4	$42.90	$78.00	$24.80–$70.20	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (RL)	$42.90	$78.00	$24.80–$70.20	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$42.90	$78.00	$24.80–$70.20	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 NBS THYROID STIM TSH	$171.05	$311.00	$98.90–$279.90	—	45%
Total IgE blood test CPT 82785 82785 L601288 IGE	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 82785 L607748 IGE	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 82785 L607751 IGE	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 82785 GAMMAGLOBULIN IGE	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 82785 L607745 IGE	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 Immunoglobulin E Antibody	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test CPT 82785 Immunoglobulin E Total LC	$177.50	$355.00	$15.97–$355.00	136% above	50%
Total IgE blood test inpatient CPT 82785 82785 L601288 IGE	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 82785 L607748 IGE	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E Antibody	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 82785 L607745 IGE	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E Total LC	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 82785 GAMMAGLOBULIN IGE	$195.25	$355.00	$112.89–$319.50	—	45%
Total IgE blood test inpatient CPT 82785 82785 L607751 IGE	$195.25	$355.00	$112.89–$319.50	—	45%
Total cholesterol blood test CPT 82465 82465 CHOLESTEROL TOTAL	$57.00	$114.00	$4.22–$114.00	86% above	50%
Total cholesterol blood test CPT 82465 82465 NASH FIBROSURE PLUS (LC)	$57.00	$114.00	$4.22–$114.00	86% above	50%
Total cholesterol blood test CPT 82465 Cholesterol Body Fluid	$57.00	$114.00	$4.22–$114.00	86% above	50%
Total cholesterol blood test CPT 82465 Cholesterol	$57.00	$114.00	$4.22–$114.00	86% above	50%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Body Fluid	$62.70	$114.00	$36.25–$102.60	—	45%
Total cholesterol blood test inpatient CPT 82465 82465 NASH FIBROSURE PLUS (LC)	$62.70	$114.00	$36.25–$102.60	—	45%
Total cholesterol blood test inpatient CPT 82465 Cholesterol	$62.70	$114.00	$36.25–$102.60	—	45%
Total cholesterol blood test inpatient CPT 82465 82465 CHOLESTEROL TOTAL	$62.70	$114.00	$36.25–$102.60	—	45%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 Total	$64.00	$128.00	$6.66–$128.00	35% above	50%
Total thyroxine (T4) blood test CPT 84436 Thyroxine 4 Total (CQ)	$64.00	$128.00	$6.66–$128.00	35% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 Total (CQ)	$70.40	$128.00	$40.70–$115.20	—	45%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine 4 Total	$70.40	$128.00	$40.70–$115.20	—	45%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (LC)	$154.00	$308.00	$13.75–$308.00	27% above	50%
Total triiodothyronine (T3) blood test CPT 84480 84480 T3,TOTAL	$154.00	$308.00	$13.75–$308.00	27% above	50%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine 3 Total	$154.00	$308.00	$13.75–$308.00	27% above	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine 3 Total	$169.40	$308.00	$97.94–$277.20	—	45%
Total triiodothyronine (T3) blood test inpatient CPT 84480 84480 T3,TOTAL	$169.40	$308.00	$97.94–$277.20	—	45%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (LC)	$169.40	$308.00	$97.94–$277.20	—	45%
Transferrin blood test CPT 84466 Transferrin (LC)	$134.50	$269.00	$12.38–$269.00	58% above	50%
Transferrin blood test CPT 84466 Transferrin	$134.50	$269.00	$12.38–$269.00	58% above	50%
Transferrin blood test CPT 84466 84466 TRANSFERRIN	$134.50	$269.00	$12.38–$269.00	58% above	50%
Transferrin blood test inpatient CPT 84466 Transferrin	$147.95	$269.00	$85.54–$242.10	—	45%
Transferrin blood test inpatient CPT 84466 Transferrin (LC)	$147.95	$269.00	$85.54–$242.10	—	45%
Transferrin blood test inpatient CPT 84466 84466 TRANSFERRIN	$147.95	$269.00	$85.54–$242.10	—	45%
Trichomonas test (NAAT) CPT 87661 87661 IGP, CtNgTv Rfx HPV ASCU LC	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis RNA	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 IGP, CtNgTv HPV Rfx 16/18,45 LC	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 Pap IG, Ct-Ng TV LC	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 L183160 T VAG AMP 889	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (LC)	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 L180039 T VAG AMP 889	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 L188070 T VAG AMP 889	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 87661 T VAGINALIS AMP	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis RNA I	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (CQ)	$93.00	$186.00	$34.04–$186.00	2% below	50%
Trichomonas test (NAAT) inpatient CPT 87661 87661 L188070 T VAG AMP 889	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (CQ)	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 IGP, CtNgTv Rfx HPV ASCU LC	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 T VAGINALIS AMP	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 L183160 T VAG AMP 889	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 Pap IG, Ct-Ng TV LC	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (LC)	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis RNA	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis RNA I	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 L180039 T VAG AMP 889	$102.30	$186.00	$59.15–$167.40	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 87661 IGP, CtNgTv HPV Rfx 16/18,45 LC	$102.30	$186.00	$59.15–$167.40	—	45%
Triglycerides blood test CPT 84478 Triglycerides Body Fluid	$58.50	$117.00	$5.57–$117.00	64% above	50%
Triglycerides blood test CPT 84478 84478 NASH FIBROSURE PLUS (LC)	$58.50	$117.00	$5.57–$117.00	64% above	50%
Triglycerides blood test CPT 84478 Triglycerides	$58.50	$117.00	$5.57–$117.00	64% above	50%
Triglycerides blood test CPT 84478 84478 TRIGLYCERIDES	$58.50	$117.00	$5.57–$117.00	64% above	50%
Triglycerides blood test inpatient CPT 84478 84478 NASH FIBROSURE PLUS (LC)	$64.35	$117.00	$37.21–$105.30	—	45%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$64.35	$117.00	$37.21–$105.30	—	45%
Triglycerides blood test inpatient CPT 84478 84478 TRIGLYCERIDES	$64.35	$117.00	$37.21–$105.30	—	45%
Triglycerides blood test inpatient CPT 84478 Triglycerides Body Fluid	$64.35	$117.00	$37.21–$105.30	—	45%
Troponin test, quantitative CPT 84484 .Troponin I HS 4 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I HS 1 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I HS 2 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 Troponin I Quant	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I Quant 3 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I HS 3 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I Quant	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I Quant 1 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 Troponin T Quant x 3 Series	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 Troponin I HS x 3 Series	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 Troponin I Quant x 3 Series	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin T Quant 1 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin T Quant 3 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative CPT 84484 .Troponin I Quant 6 Hour	$186.00	$372.00	$12.10–$372.00	53% above	50%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 4 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 6 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 3 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 1 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin T Quant 1 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin T Quant 3 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 1 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant 3 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 Troponin I HS x 3 Series	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 Troponin T Quant x 3 Series	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 Troponin I Quant	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I HS 2 Hour	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 Troponin I Quant x 3 Series	$204.60	$372.00	$118.30–$334.80	—	45%
Troponin test, quantitative inpatient CPT 84484 .Troponin I Quant	$204.60	$372.00	$118.30–$334.80	—	45%
Uric acid blood test CPT 84550 Uric Acid Level	$51.50	$103.00	$4.38–$103.00	7% above	50%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$56.65	$103.00	$32.75–$92.70	—	45%
Urinalysis with microscope exam, automated CPT 81001 Reflex Microscopic Type? - Manual	$68.50	$137.00	$3.07–$137.00	63% above	50%
Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd	$68.50	$137.00	$3.07–$137.00	63% above	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Micro Auto Rfx Culture	$68.50	$137.00	$3.07–$137.00	63% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Reflex Microscopic Type? - Manual	$75.35	$137.00	$43.57–$123.30	—	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd	$75.35	$137.00	$43.57–$123.30	—	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Micro Auto Rfx Culture	$75.35	$137.00	$43.57–$123.30	—	45%
Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd	$67.50	$135.00	$3.90–$135.00	154% above	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd	$74.25	$135.00	$42.93–$121.50	—	45%
Urinalysis without microscope exam, automated CPT 81003 Protein Urine Dipstick Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Bilirubin Urine Dipstick Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Glucose Urine Dipstick Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Blood Urine Dipstick Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Reflex Microscopic Type? - Not Required	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Ketones Urine Dipstk Qual Automated	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Auto	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated CPT 81003 81003 L306266 UA AUTO WO S	$38.50	$77.00	$2.18–$77.00	57% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Blood Urine Dipstick Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Protein Urine Dipstick Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose Urine Dipstick Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Bilirubin Urine Dipstick Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Reflex Microscopic Type? - Not Required	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones Urine Dipstk Qual Automated	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Auto	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 81003 L306266 UA AUTO WO S	$42.35	$77.00	$24.49–$69.30	—	45%
Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Manual	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 .Urinalysis Manual w/o MicroSc POC	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Manual w/o MicroSc POC AMB	$7.00	$14.00	$2.59–$14.00	55% below	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Manual	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 .Urinalysis Manual w/o MicroSc POC	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE	$7.70	$14.00	$4.45–$12.60	—	45%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Manual w/o MicroSc POC AMB	$7.70	$14.00	$4.45–$12.60	—	45%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Qn	$20.50	$41.00	$7.59–$41.00	53% below	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Qn	$22.55	$41.00	$13.04–$36.90	—	45%
Urine microalbumin (albumin) test CPT 82043 82043 MICROALB QNT	$59.50	$119.00	$5.61–$119.00	72% above	50%
Urine microalbumin (albumin) test CPT 82043 MicroAlb QNT Random	$59.50	$119.00	$5.61–$119.00	72% above	50%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine 24 Hour	$59.50	$119.00	$5.61–$119.00	72% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 24 Hour	$65.45	$119.00	$37.84–$107.10	—	45%
Urine microalbumin (albumin) test inpatient CPT 82043 MicroAlb QNT Random	$65.45	$119.00	$37.84–$107.10	—	45%
Urine microalbumin (albumin) test inpatient CPT 82043 82043 MICROALB QNT	$65.45	$119.00	$37.84–$107.10	—	45%
Urine pregnancy test, read by color change CPT 81025 .HCG Urine Ql POC	$83.50	$167.00	$8.35–$167.00	55% above	50%
Urine pregnancy test, read by color change CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$83.50	$167.00	$8.35–$167.00	55% above	50%
Urine pregnancy test, read by color change CPT 81025 POC HCG Patient Test Result	$83.50	$167.00	$8.35–$167.00	55% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Human Chorionic Gonadotropin Urine Qual Manual	$91.85	$167.00	$53.11–$150.30	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 .HCG Urine Ql POC	$91.85	$167.00	$53.11–$150.30	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 POC HCG Patient Test Result	$91.85	$167.00	$53.11–$150.30	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$157.00	$314.00	$14.63–$314.00	113% above	50%
Vitamin B12 (cobalamin) blood test CPT 82607 82607 L810 VIT B12 IA 889	$157.00	$314.00	$14.63–$314.00	113% above	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Deficiency Cascade (LC)	$157.00	$314.00	$14.63–$314.00	113% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 82607 L810 VIT B12 IA 889	$172.70	$314.00	$99.85–$282.60	—	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$172.70	$314.00	$99.85–$282.60	—	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Deficiency Cascade (LC)	$172.70	$314.00	$99.85–$282.60	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 82306 VITAMIN D 25OH	$299.00	$598.00	$28.71–$598.00	122% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 OH D2 + D3 (RL)	$299.00	$598.00	$28.71–$598.00	122% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$299.00	$598.00	$28.71–$598.00	122% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 hydroxy	$299.00	$598.00	$28.71–$598.00	122% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 OH (LC)	$299.00	$598.00	$28.71–$598.00	122% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 OH D2 + D3 (RL)	$328.90	$598.00	$190.16–$538.20	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 OH (LC)	$328.90	$598.00	$190.16–$538.20	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 hydroxy	$328.90	$598.00	$190.16–$538.20	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy D2 + D3 LC	$328.90	$598.00	$190.16–$538.20	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 82306 VITAMIN D 25OH	$328.90	$598.00	$190.16–$538.20	—	45%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 82652 DIHYDROXY VITAMIN D	$266.50	$533.00	$37.35–$533.00	50% above	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol Level (LC)	$266.50	$533.00	$37.35–$533.00	50% above	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol Level (LC)	$293.15	$533.00	$169.49–$479.70	—	45%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 82652 DIHYDROXY VITAMIN D	$293.15	$533.00	$169.49–$479.70	—	45%
Zinc blood test CPT 84630 Zinc Plasma or Serum (RL)	$155.50	$311.00	$11.05–$311.00	88% above	50%
Zinc blood test CPT 84630 Zinc, RBC (RL)	$155.50	$311.00	$11.05–$311.00	88% above	50%
Zinc blood test CPT 84630 Zinc, Whole Blood LC	$155.50	$311.00	$11.05–$311.00	88% above	50%
Zinc blood test inpatient CPT 84630 Zinc, RBC (RL)	$171.05	$311.00	$98.90–$279.90	—	45%
Zinc blood test inpatient CPT 84630 Zinc Plasma or Serum (RL)	$171.05	$311.00	$98.90–$279.90	—	45%
Zinc blood test inpatient CPT 84630 Zinc, Whole Blood LC	$171.05	$311.00	$98.90–$279.90	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin Quant	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Beta Sub unit Quant Level (RL)	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG, Beta Subunit, Qn (Serial) (LC)	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 HCG QUANT	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .ISTAT B-hCG Qual & Semi-Quant POC	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .ISTAT B-hCG POC Quant	$184.50	$369.00	$14.60–$369.00	131% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG, Beta Subunit, Qn (Serial) (LC)	$202.95	$369.00	$117.34–$332.10	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .ISTAT B-hCG POC Quant	$202.95	$369.00	$117.34–$332.10	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Beta Sub unit Quant Level (RL)	$202.95	$369.00	$117.34–$332.10	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin Quant	$202.95	$369.00	$117.34–$332.10	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 HCG QUANT	$202.95	$369.00	$117.34–$332.10	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .ISTAT B-hCG Qual & Semi-Quant POC	$202.95	$369.00	$117.34–$332.10	—	45%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$876.00	$1,752.00	$90.48–$1,752.00	38% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 $ED Cardioversion/Defibrillation	$876.00	$1,752.00	$90.48–$1,752.00	38% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI Cardioversion	$876.00	$1,752.00	$90.48–$1,752.00	38% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC, EXT	$3,249.63	$6,499.26	$90.48–$6,499.26	132% above	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI Cardioversion	$963.60	$1,752.00	$557.14–$1,576.80	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion Set up for procedure - Cardiovers	$963.60	$1,752.00	$557.14–$1,576.80	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 $ED Cardioversion/Defibrillation	$963.60	$1,752.00	$557.14–$1,576.80	—	45%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION	$14,759.40	$29,518.79	$169.53–$29,518.79	178% above	50%
Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY	$8,947.94	$17,895.88	$210.50–$17,895.88	194% above	50%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$8,471.96	$16,943.92	$167.00–$16,943.92	187% above	50%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$6,879.64	$13,759.28	$154.36–$13,759.28	240% above	50%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$24,244.74	$48,489.48	$130.83–$48,489.48	248% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$17,677.49	$35,354.98	$66.64–$35,354.98	547% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$893.85	$1,787.70	$13.88–$1,787.70	408% above	50%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HRN 1ST 3-10 RDC	$34,136.66	$68,273.32	$472.67–$68,273.32	82% above	50%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HRN 1ST > 10 RDC	$34,813.04	$69,626.08	$635.03–$69,626.08	13% above	50%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HRN 1ST < 3 CM RDC	$23,977.52	$47,955.03	$284.82–$47,955.03	168% above	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$7,018.23	$14,036.46	$50.08–$14,036.46	238% above	50%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$26,340.87	$52,681.73	$571.38–$52,681.73	60% above	50%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$26,874.84	$53,749.67	$347.91–$53,749.67	117% above	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$10,711.54	$21,423.07	$182.98–$21,423.07	387% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 S-INJ CATH HYSTERSO	$357.00	$714.00	$48.34–$714.00	24% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$987.50	$1,975.00	$48.34–$1,975.00	244% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 S-INJ CATH HYSTERSO	$392.70	$714.00	$227.05–$642.60	—	45%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY, ABLATION	$30,065.29	$60,130.57	$200.40–$60,130.57	261% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$4,193.92	$8,387.83	$94.18–$8,387.83	809% above	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA	$27,054.94	$54,109.87	$459.67–$54,109.87	208% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 - Arthrocentesis, aspiration and/or injectio	$492.00	$984.00	$36.81–$984.00	19% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 S-JOINT ASP-INJ LG	$492.00	$984.00	$36.81–$984.00	19% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 - Arthrocentesis, aspiration and/or injectio	$541.20	$984.00	$312.91–$885.60	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 S-JOINT ASP-INJ LG	$541.20	$984.00	$312.91–$885.60	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT, JOINT/BURSA	$4,197.02	$8,394.03	$30.16–$8,394.03	882% above	50%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY, APPENDECTOMY	$33,090.39	$66,180.77	$523.36–$66,180.77	132% above	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY, REMOVE ADNEXA	$24,132.92	$48,265.84	$539.01–$48,265.84	49% above	50%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$19,537.86	$39,075.72	$573.11–$39,075.72	149% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 REMOVAL OF SKIN LESION	$16,505.87	$33,011.74	$71.43–$33,011.74	635% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF SKIN LESION	$16,492.85	$32,985.69	$91.59–$32,985.69	2136% above	50%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image WO Labs	$1,396.50	$2,793.00	$87.74–$2,793.00	1% above	50%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image W Labs	$1,438.50	$2,877.00	$87.74–$2,877.00	4% above	50%
Paracentesis with imaging guidance CPT 49083 US Paracentesis Abd w Image	$1,438.50	$2,877.00	$87.74–$2,877.00	4% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image WO Labs	$1,536.15	$2,793.00	$888.17–$2,513.70	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image	$1,582.35	$2,877.00	$914.89–$2,589.30	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis Abd w Image W Labs	$1,582.35	$2,877.00	$914.89–$2,589.30	—	45%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$11,642.84	$23,285.68	$370.76–$23,285.68	131% above	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$1,721.02	$3,442.03	$95.59–$3,442.03	180% above	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 COLON CA SCRN NOT HI RSK IND	$414.00	$828.00	$153.29–$828.00	78% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121,53 COLON CA SCRN NOT HI RSK IND	$414.00	$828.00	$153.29–$828.00	78% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121,52 COLON CA SCRN NOT HI RSK IND	$414.00	$828.00	$153.29–$828.00	78% below	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$6,517.02	$13,034.03	$154.52–$13,034.03	248% above	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0121,52 COLON CA SCRN NOT HI RSK IND	$455.40	$828.00	$263.30–$745.20	—	45%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0121 COLON CA SCRN NOT HI RSK IND	$455.40	$828.00	$263.30–$745.20	—	45%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0121,53 COLON CA SCRN NOT HI RSK IND	$455.40	$828.00	$263.30–$745.20	—	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105,53 COLORECTAL SCRN; HI RISK IND	$398.50	$797.00	$147.55–$797.00	77% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105,53,GA COLORECTAL SCRN; HI RISK IND,WAIVER O	$398.50	$797.00	$147.55–$797.00	77% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 COLORECTAL SCRN; HI RISK IND	$398.50	$797.00	$147.55–$797.00	77% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$6,680.85	$13,361.69	$154.36–$13,361.69	289% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 G0105,53,GA COLORECTAL SCRN; HI RISK IND,WAIVER O	$438.35	$797.00	$253.45–$717.30	—	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 G0105 COLORECTAL SCRN; HI RISK IND	$438.35	$797.00	$253.45–$717.30	—	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 G0105,53 COLORECTAL SCRN; HI RISK IND	$438.35	$797.00	$253.45–$717.30	—	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$25,376.35	$50,752.69	$488.14–$50,752.69	103% above	50%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Charge	$339.50	$679.00	$37.95–$679.00	87% above	50%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPICATION SHORT ARM STATIC COTA - Redoc 18	$339.50	$679.00	$37.95–$679.00	87% above	50%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Units	$339.50	$679.00	$37.95–$679.00	87% above	50%
Short arm splint (forearm and hand) CPT 29125 OT Static Short Arm Splint Assist Units	$339.50	$679.00	$37.95–$679.00	87% above	50%
Short arm splint (forearm and hand) CPT 29125 SPLNT SHRT ARM STATC - REDOC 185	$339.50	$679.00	$37.95–$679.00	87% above	50%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$2,833.25	$5,666.49	$37.95–$5,666.49	1458% above	50%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLNT SHRT ARM STATC - REDOC 185	$373.45	$679.00	$215.92–$611.10	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Charge	$373.45	$679.00	$215.92–$611.10	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Assist Units	$373.45	$679.00	$215.92–$611.10	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPICATION SHORT ARM STATIC COTA - Redoc 18	$373.45	$679.00	$215.92–$611.10	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT Static Short Arm Splint Units	$373.45	$679.00	$215.92–$611.10	—	45%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$3,471.21	$6,942.41	$46.10–$6,942.41	1337% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICIAL WOUND(S)	$2,130.67	$4,261.34	$40.22–$4,261.34	387% above	50%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$17,952.01	$35,904.01	$35.95–$35,904.01	3878% above	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS	$11,219.96	$22,439.91	$64.86–$22,439.91	3864% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 S-SPINAL TAP DIAGNST	$1,029.00	$2,058.00	$53.12–$2,058.00	at median	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$1,092.00	$2,184.00	$53.12–$2,184.00	7% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 S-SPINAL TAP DIAGNST	$1,131.90	$2,058.00	$654.44–$1,852.20	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$1,201.20	$2,184.00	$694.51–$1,965.60	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFICIAL WOUND(S)	$3,038.83	$6,077.65	$52.43–$6,077.65	662% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUND(S)	$3,573.21	$7,146.42	$49.62–$7,146.42	729% above	50%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$21,375.52	$42,751.04	$492.88–$42,751.04	33% above	50%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis w Imging Guidance - US Thoracente	$1,354.50	$2,709.00	$89.15–$2,709.00	24% above	50%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis Aspiration W Labs	$1,354.50	$2,709.00	$89.15–$2,709.00	24% above	50%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis Aspiration WO Labs	$1,354.50	$2,709.00	$89.15–$2,709.00	24% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis Aspiration W Labs	$1,489.95	$2,709.00	$861.46–$2,438.10	—	45%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis w Imging Guidance - US Thoracente	$1,489.95	$2,709.00	$861.46–$2,438.10	—	45%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis Aspiration WO Labs	$1,489.95	$2,709.00	$861.46–$2,438.10	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$5,114.20	$10,228.40	$123.42–$10,228.40	120% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$2,613.00	$5,226.00	$123.42–$5,226.00	12% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$2,613.00	$5,226.00	$123.42–$5,226.00	12% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$2,613.00	$5,226.00	$123.42–$5,226.00	12% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Right	$2,874.30	$5,226.00	$1,661.87–$4,703.40	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Left	$2,874.30	$5,226.00	$1,661.87–$4,703.40	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w Loc 1 Lesion Lt	$2,874.30	$5,226.00	$1,661.87–$4,703.40	—	45%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH ENDOSCOPY, DILATION	$7,748.60	$15,497.20	$128.25–$15,497.20	143% above	50%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY	$8,966.93	$17,933.86	$116.27–$17,933.86	197% above	50%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY	$9,938.45	$19,876.90	$162.88–$19,876.90	153% above	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPR GI ENDOSCOPY/GUIDE WIRE	$7,952.38	$15,904.75	$139.08–$15,904.75	194% above	50%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS	$8,379.05	$16,758.10	$103.93–$16,758.10	253% above	50%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$28,480.96	$56,961.92	$342.42–$56,961.92	78% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE	$22,645.74	$45,291.47	$52.18–$45,291.47	2811% above	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Whole blood	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 $ED Transfusion >2 yrs	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusions	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (single donor)	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Platelets (random donor)	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Packed red blood cells	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Fee	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Cryoprecipitate	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Unit Product: - Fresh frozen plasma	$1,049.50	$2,099.00	$38.05–$2,099.00	17% above	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$7,841.04	$15,682.07	$38.05–$15,682.07	771% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Whole blood	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (preoperativ	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Red blood cells (postoperati	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (single donor)	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Fee	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Cryoprecipitate	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Fresh frozen plasma	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Packed red blood cells	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Product: - Platelets (random donor)	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusions	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Unit Verified with Pt Information: - Transfu	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 $ED Transfusion >2 yrs	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHRG - BLOOD TRANSFUSION - Blood Transfusion Perfo	$1,154.45	$2,099.00	$667.48–$1,889.10	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Initial	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Initial	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler Charge - Subsequent	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Initial	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Initial	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - Subsequent	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 High Humidity Charge - Initial	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 High Humidity Charge - Subsequent	$155.50	$311.00	$7.02–$311.00	38% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Initial	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Subsequent	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 High Humidity Charge - Initial	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Initial	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 High Humidity Charge - Subsequent	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Initial	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler Charge - Initial	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - Subsequent	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPPB Subsequent	$171.05	$311.00	$98.90–$279.90	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Treatment Charge - IPV Subsequent	$171.05	$311.00	$98.90–$279.90	—	45%
Chemotherapy IV infusion, first hour CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$726.50	$1,453.00	$109.91–$1,453.00	7% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHRG - CHEMO IV INFU 1ST HR	$799.15	$1,453.00	$462.05–$1,307.70	—	45%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care	$3,750.00	$7,500.00	$188.73–$7,690.00	77% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care	$4,125.00	$7,500.00	$2,385.00–$6,750.00	—	45%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Including Recording Awake and Drowsy	$1,090.50	$2,181.00	$296.48–$2,181.00	59% above	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 CHRG - EEG AWAKE DROWSY	$1,090.50	$2,181.00	$296.48–$2,181.00	59% above	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Including Recording Awake and Drowsy	$1,199.55	$2,181.00	$693.56–$1,962.90	—	45%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 CHRG - EEG AWAKE DROWSY	$1,199.55	$2,181.00	$693.56–$1,962.90	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Start Time	$249.50	$499.00	$6.35–$499.00	23% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 3 Hours	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Serial x 3	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG 12 Lead Series Now	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 1 Hour	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 1 Hour	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG Series 3 Hours	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead Series Now	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Series 6 Hours	$257.00	$514.00	$6.35–$514.00	27% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Start Time	$274.45	$499.00	$158.68–$449.10	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Series Now	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 1 Hour	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG Series 3 Hours	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 1 Hour	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead Serial x 3	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 3 Hours	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Series 6 Hours	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG 12 Lead Series Now	$282.70	$514.00	$163.45–$462.60	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$282.70	$514.00	$163.45–$462.60	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$288.00	$576.00	$10.35–$576.00	32% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$316.80	$576.00	$183.17–$518.40	—	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$636.50	$1,273.00	$38.11–$1,273.00	52% above	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$700.15	$1,273.00	$404.81–$1,145.70	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$984.00	$1,968.00	$64.70–$1,968.00	27% above	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$1,082.40	$1,968.00	$625.82–$1,771.20	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$1,378.50	$2,757.00	$110.18–$2,757.00	16% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$1,516.35	$2,757.00	$876.73–$2,481.30	—	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,781.50	$3,563.00	$159.69–$4,746.00	2% above	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,959.65	$3,563.00	$1,133.03–$3,206.70	—	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiac Stress Test	$1,325.00	$2,650.00	$34.01–$2,650.00	74% above	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI Stress Test	$1,325.00	$2,650.00	$34.01–$2,650.00	74% above	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI Stress Test	$1,457.50	$2,650.00	$842.70–$2,385.00	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiac Stress Test	$1,457.50	$2,650.00	$842.70–$2,385.00	—	45%
Family therapy with the patient, 50 minutes CPT 90847 BH CHRG - FAM THERAPY W/PATIEN	$435.00	$870.00	$61.20–$783.00	130% above	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 BH CHRG - FAM THERAPY W/PATIEN	$478.50	$870.00	$276.66–$783.00	—	45%
Family therapy without the patient, 50 minutes CPT 90846 BH CHRG - Fam Therapy W/O Pt	$414.50	$829.00	$61.20–$746.10	103% above	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 BH CHRG - Fam Therapy W/O Pt	$455.95	$829.00	$263.62–$746.10	—	45%
Group psychotherapy session CPT 90853 BH CHRG - PSYCH GROUP THERAPY	$378.50	$757.00	$24.09–$681.30	88% above	50%
Group psychotherapy session inpatient CPT 90853 BH CHRG - PSYCH GROUP THERAPY	$416.35	$757.00	$240.73–$681.30	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$461.50	$923.00	$28.02–$923.00	26% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$461.50	$923.00	$28.02–$923.00	26% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration therapy 1st hour	$461.50	$923.00	$28.02–$923.00	26% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$461.50	$923.00	$28.02–$830.70	26% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHRG - Inf/Inj/Hydration - IV HYDRATION 1 HR	$507.65	$923.00	$293.51–$830.70	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$507.65	$923.00	$293.51–$830.70	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration therapy 1st hour	$507.65	$923.00	$293.51–$830.70	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OB CHRG - Inf/Inj/Hydration Once - IV HYDRATION 1	$507.65	$923.00	$293.51–$830.70	—	45%
IV infusion of a medicine, first hour CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$419.00	$838.00	$53.35–$838.00	4% above	50%
IV infusion of a medicine, first hour CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$419.00	$838.00	$53.35–$838.00	4% above	50%
IV infusion of a medicine, first hour CPT 96365 96365 - IV tx, first hour	$419.00	$838.00	$53.35–$754.20	4% above	50%
IV infusion of a medicine, first hour CPT 96365 Infusion 1st hour	$419.00	$838.00	$53.35–$838.00	4% above	50%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 - IV tx, first hour	$460.90	$838.00	$266.48–$754.20	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 OB CHRG - Inf/Inj/Hydration Once - IV THERAPY DX 1	$460.90	$838.00	$266.48–$754.20	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 CHRG - Inf/Inj/Hydration - IV THERAPY DX 1 HR	$460.90	$838.00	$266.48–$754.20	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion 1st hour	$460.90	$838.00	$266.48–$754.20	—	45%
IV push of a medicine, first drug CPT 96374 IV push initial	$191.00	$382.00	$31.49–$382.00	10% below	50%
IV push of a medicine, first drug CPT 96374 96374 - IV Injection, single/initial	$191.00	$382.00	$31.49–$343.80	10% below	50%
IV push of a medicine, first drug CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$191.00	$382.00	$31.49–$382.00	10% below	50%
IV push of a medicine, first drug CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$191.00	$382.00	$31.49–$382.00	10% below	50%
IV push of a medicine, first drug inpatient CPT 96374 OB CHRG - Inf/Inj/Hydration Once - THERAPEUTIC IV	$210.10	$382.00	$121.48–$343.80	—	45%
IV push of a medicine, first drug inpatient CPT 96374 96374 - IV Injection, single/initial	$210.10	$382.00	$121.48–$343.80	—	45%
IV push of a medicine, first drug inpatient CPT 96374 CHRG - Inf/Inj/Hydration - THERAPEUTIC IV PUSH	$210.10	$382.00	$121.48–$343.80	—	45%
IV push of a medicine, first drug inpatient CPT 96374 IV push initial	$210.10	$382.00	$121.48–$343.80	—	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$88.50	$177.00	$13.11–$177.00	16% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - Subq/IM Injection	$88.50	$177.00	$13.11–$295.62	16% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$88.50	$177.00	$13.11–$177.00	16% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM Injection	$88.50	$177.00	$13.11–$177.00	16% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CHRG - THERAPEUTIC DX SQ IM	$97.35	$177.00	$56.29–$159.30	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB CHRG - THERAPEUTIC DX SQ IM	$97.35	$177.00	$56.29–$159.30	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM Injection	$97.35	$177.00	$56.29–$159.30	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - Subq/IM Injection	$97.35	$177.00	$56.29–$159.30	—	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - UDS 185	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromusclr Reeducation Assist Charge	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Charges	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - UDS 181	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$138.00	$276.00	$30.65–$276.00	82% above	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducatn Assist Charge	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromusclr Reeducation Assist Charge	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA - Redoc 1	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - UDS 185	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - UDS 181	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 185	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN - REDOC 181	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Charges	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$151.80	$276.00	$87.77–$248.40	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA - Redoc 1	$151.80	$276.00	$87.77–$248.40	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$67.50	$135.00	$24.99–$135.00	97% above	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 CHRG - MNT INITIAL EA 15 MIN	$74.25	$135.00	$42.93–$121.50	—	45%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - UDS 185	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low Assistant Unit - Yes	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity CPT 97165 IRF OT EVAL LOW	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW Unit - Yes	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP - REDOC 185	$365.50	$731.00	$95.00–$731.00	130% above	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 IRF OT EVAL LOW	$402.05	$731.00	$232.46–$657.90	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPAT THERAPY EVAL LOW COMPLEXITY COTA - Redoc 1	$402.05	$731.00	$232.46–$657.90	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - UDS 185	$402.05	$731.00	$232.46–$657.90	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP - REDOC 185	$402.05	$731.00	$232.46–$657.90	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW Unit - Yes	$402.05	$731.00	$232.46–$657.90	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low Assistant Unit - Yes	$402.05	$731.00	$232.46–$657.90	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - REDOC 181	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP - UDS 181	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH Unit - Yes	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 IRF PT EVAL HIGH	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval High Assistant Unit - Yes	$304.50	$609.00	$93.69–$609.00	30% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval High Assistant Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - REDOC 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP - UDS 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVAL HGH COMPLEXITY PTA - Redoc 1	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 IRF PT EVAL HIGH	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 IRF PT EVAL LOW	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW Unit - Yes	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - UDS 181	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low Assistant Unit - Yes	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP - REDOC 181	$304.50	$609.00	$93.69–$609.00	112% above	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low Assistant Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - UDS 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP - REDOC 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 IRF PT EVAL LOW	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVAL LOW COMPLEXITY PTA - Redoc 1	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - UDS 181	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod Assistant Unit - Yes	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 IRF PT EVAL MOD	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP - REDOC 181	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD Unit - Yes	$304.50	$609.00	$93.69–$609.00	63% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - UDS 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod Assistant Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVAL MOD COMPLEXITY PTA - Redoc 1	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD Unit - Yes	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP - REDOC 181	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 IRF PT EVAL MOD	$334.95	$609.00	$193.66–$548.10	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charges	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Charges	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Charges	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - UDS 185	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - UDS 181	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Charges	$157.50	$315.00	$26.00–$315.00	84% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Charges	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Charges	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Charges	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA - Redoc 181	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA - Redoc 185	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charges	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 181	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - REDOC 185	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - UDS 181	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN - UDS 185	$173.25	$315.00	$100.17–$283.50	—	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - UDS 185	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - UDS 181	$133.00	$266.00	$27.54–$266.00	76% above	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - UDS 181	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - UDS 185	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181	$146.30	$266.00	$84.59–$239.40	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges	$146.30	$266.00	$84.59–$239.40	—	45%
Psychotherapy session, 30 minutes CPT 90832 BH CHRG - PSYCHOTHERAPY 30 MIN	$314.00	$628.00	$68.99–$565.20	219% above	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 BH CHRG - PSYCHOTHERAPY 30 MIN	$345.40	$628.00	$199.70–$565.20	—	45%
Psychotherapy session, 45 minutes CPT 90834 BH CHRG - PSYCHOTHERAPY 45 MIN	$389.00	$778.00	$91.09–$700.20	176% above	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 BH CHRG - PSYCHOTHERAPY 45 MIN	$427.90	$778.00	$247.40–$700.20	—	45%
Psychotherapy session, 60 minutes CPT 90837 BH CHRG - PSYCHOTHERAPY 60 MIN	$396.50	$793.00	$122.40–$713.70	86% above	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 BH CHRG - PSYCHOTHERAPY 60 MIN	$436.15	$793.00	$252.17–$713.70	—	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco counseling Charge - 3-10 minutes	$45.50	$91.00	$10.20–$91.00	52% above	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$45.50	$91.00	$10.20–$91.00	52% above	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behavior change Smoke Charge - 1-10 minutes	$50.05	$91.00	$28.94–$81.90	—	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco counseling Charge - 3-10 minutes	$50.05	$91.00	$28.94–$81.90	—	45%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Units	$325.00	$650.00	$95.00–$650.00	59% above	50%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - REDOC 187	$325.00	$650.00	$95.00–$650.00	59% above	50%
Speech and language evaluation CPT 92523 Speech Evaluation with Language Charge - Yes	$325.00	$650.00	$95.00–$650.00	59% above	50%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP - UDS 187	$325.00	$650.00	$95.00–$650.00	59% above	50%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Units	$357.50	$650.00	$206.70–$585.00	—	45%
Speech and language evaluation inpatient CPT 92523 Speech Evaluation with Language Charge - Yes	$357.50	$650.00	$206.70–$585.00	—	45%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - REDOC 187	$357.50	$650.00	$206.70–$585.00	—	45%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP - UDS 187	$357.50	$650.00	$206.70–$585.00	—	45%
Speech therapy session, individual CPT 92507 Speech Treatment Charge - Yes	$139.50	$279.00	$54.91–$279.00	4% below	50%
Speech therapy session, individual CPT 92507 Speech Treatment Charge	$139.50	$279.00	$54.91–$279.00	4% below	50%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$139.50	$279.00	$54.91–$279.00	4% below	50%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$139.50	$279.00	$54.91–$279.00	4% below	50%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST - UDS 187	$139.50	$279.00	$54.91–$279.00	4% below	50%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge	$153.45	$279.00	$88.72–$251.10	—	45%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - UDS 187	$153.45	$279.00	$88.72–$251.10	—	45%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST - REDOC 187	$153.45	$279.00	$88.72–$251.10	—	45%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$153.45	$279.00	$88.72–$251.10	—	45%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Charge - Yes	$153.45	$279.00	$88.72–$251.10	—	45%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Charge - spirometry	$333.50	$667.00	$27.68–$667.00	36% above	50%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Charge - spirometry	$366.85	$667.00	$212.11–$600.30	—	45%
Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$704.50	$1,409.00	$40.47–$1,409.00	30% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Charge - Pre and post bron	$774.95	$1,409.00	$448.06–$1,268.10	—	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assist Charges	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Assist Charge	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activities Charge	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - UDS 185	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN - UDS 181	$171.50	$343.00	$32.88–$343.00	127% above	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - UDS 185	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Charge	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assist Charges	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA - Redoc 1	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activities Assist Charge	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - UDS 181	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA - Redoc 1	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 185	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN - REDOC 181	$188.65	$343.00	$109.07–$308.70	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$185.50	$371.00	$68.68–$409.66	12% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$192.00	$384.00	$71.09–$409.66	9% below	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 CHRG- PHLEBOTOMY THERAPEUT	$204.05	$371.00	$117.98–$333.90	—	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$211.20	$384.00	$122.11–$345.60	—	45%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$663.16	$1,326.32	$155.07–$1,326.32	98% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$663.16	$1,326.32	$155.07–$1,326.32	98% above	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2432-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$729.48	$1,326.32	$421.77–$1,193.69	—	45%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2377-10 - SARS-CoV-2 (COVID-19) mRNA-LNP vac	$729.48	$1,326.32	$421.77–$1,193.69	—	45%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$861.35	$1,722.70	$128.09–$2,756.32	110% above	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$861.35	$1,722.70	$128.09–$2,756.32	110% above	50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$861.35	$1,722.70	$128.09–$2,756.32	110% above	50%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 54569-4056-00 - varicella virus vaccine - Powder	$947.49	$1,722.70	$547.82–$1,550.43	—	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4826-00 - varicella virus vaccine REC Inject	$947.49	$1,722.70	$547.82–$1,550.43	—	45%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 00006-4827-00 - varicella virus vaccine REC Inject	$947.49	$1,722.70	$547.82–$1,550.43	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$240.20	$480.40	$80.11–$480.40	63% above	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$262.51	$525.02	$80.11–$525.02	79% above	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$262.51	$525.02	$80.11–$525.02	79% above	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 49281-0562-10 - diphtheria-pertussis,acel-tetanus-	$262.51	$525.02	$80.11–$525.02	79% above	50%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0564-15 - diphtheria/pertussis,acel/tetanus/	$264.22	$480.40	$152.77–$432.36	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-11 - diphtheria/pertussis,acel/tetanus/	$288.76	$525.02	$166.96–$472.52	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 58160-0812-52 - diphtheria/pertussis,acel/tetanus/	$288.76	$525.02	$166.96–$472.52	—	45%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 49281-0562-10 - diphtheria-pertussis,acel-tetanus-	$288.76	$525.02	$166.96–$472.52	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$111.02	$222.03	$39.95–$222.03	35% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis acel	$111.02	$222.03	$39.95–$222.03	35% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$143.58	$287.16	$39.95–$287.16	75% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$143.58	$287.16	$39.95–$287.16	75% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$167.58	$335.15	$39.95–$335.15	104% above	50%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis acel	$122.12	$222.03	$70.61–$199.83	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0286-10 - diphtheria/tetanus/pertussis, acel	$122.12	$222.03	$70.61–$199.83	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-11 - diphtheria/tetanus/pertussis, acel	$157.94	$287.16	$91.32–$258.44	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-52 - diphtheria/tetanus/pertussis, acel	$157.94	$287.16	$91.32–$258.44	—	45%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 49281-0298-10 - diphtheria/tetanus/pertussis, acel	$184.33	$335.15	$106.58–$301.64	—	45%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 49281-0489-01 - meningococcal polysaccharide vacci	$703.35	$1,406.69	$113.85–$2,250.71	270% above	50%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 49281-0489-01 - meningococcal polysaccharide vacci	$773.68	$1,406.69	$447.33–$1,266.02	—	45%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$354.39	$708.78	$116.28–$708.78	43% above	50%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 49281-0510-05 - diphth/haemophilus/pertussis/tetan	$389.83	$708.78	$225.39–$637.90	—	45%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$341.50	$683.00	$56.80–$683.00	508% above	50%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 49281-0724-10 - 2024-2025 influenza virus vaccine,	$375.65	$683.00	$217.19–$614.70	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$74.78	$149.55	$23.22–$149.55	92% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$74.78	$149.55	$23.22–$149.55	92% above	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 19515-0810-52 - influenza virus vaccine, inactivat	$82.25	$149.55	$47.56–$134.60	—	45%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 49281-0424-50 - 2024-2025 influenza virus vaccine,	$82.25	$149.55	$47.56–$134.60	—	45%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$1,337.47	$2,674.93	$245.26–$4,279.90	112% above	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 00006-4121-02 - human papillomavirus vaccine 9-val	$1,471.21	$2,674.93	$850.63–$2,407.44	—	45%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-11 - hepatitis A-hepatitis B vaccine Su	$605.77	$1,211.53	$137.48–$1,211.53	154% above	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-52 - hepatitis A-hepatitis B vaccine Su	$605.77	$1,211.53	$137.48–$1,211.53	154% above	50%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$605.77	$1,211.53	$137.48–$1,211.53	154% above	50%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-11 - hepatitis A-hepatitis B vaccine Su	$666.34	$1,211.53	$385.27–$1,090.38	—	45%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-46 - hepatitis A-hepatitis B vaccine 72	$666.34	$1,211.53	$385.27–$1,090.38	—	45%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 58160-0815-52 - hepatitis A-hepatitis B vaccine Su	$666.34	$1,211.53	$385.27–$1,090.38	—	45%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$333.53	$667.06	$87.83–$667.06	96% above	50%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$333.53	$667.06	$87.83–$667.06	96% above	50%
Hepatitis A vaccine, adult dose CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$333.53	$667.06	$87.83–$667.06	96% above	50%
Hepatitis A vaccine, adult dose CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$333.53	$667.06	$87.83–$667.06	96% above	50%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$397.68	$795.35	$87.83–$795.35	133% above	50%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-11 - hepatitis A adult vaccine 1440. S	$397.68	$795.35	$87.83–$795.35	133% above	50%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-52 - hepatitis A adult vaccine 1440. S	$397.68	$795.35	$87.83–$795.35	133% above	50%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-00 - hepatitis A adult vaccine 50. Sus	$366.88	$667.06	$212.13–$600.35	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4841-41 - hepatitis A adult vaccine 50 units	$366.88	$667.06	$212.13–$600.35	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-09 - hepatitis A adult vaccine 50 units	$366.88	$667.06	$212.13–$600.35	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 00006-4096-02 - hepatitis A adult vaccine 50 units	$366.88	$667.06	$212.13–$600.35	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-48 - hepatitis A adult vaccine 1440 uni	$437.44	$795.35	$252.92–$715.82	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-11 - hepatitis A adult vaccine 1440. S	$437.44	$795.35	$252.92–$715.82	—	45%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-52 - hepatitis A adult vaccine 1440. S	$437.44	$795.35	$252.92–$715.82	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$136.47	$272.94	$50.53–$272.94	60% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$136.47	$272.94	$50.53–$272.94	60% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$136.47	$272.94	$50.53–$272.94	60% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$182.57	$365.13	$67.60–$365.13	114% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$182.57	$365.13	$67.60–$365.13	114% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$182.57	$365.13	$67.60–$365.13	114% above	50%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-09 - hepatitis A pediatric vaccine 25 u	$150.12	$272.94	$86.79–$245.65	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4831-41 - hepatitis A pediatric vaccine 25.	$150.12	$272.94	$86.79–$245.65	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 00006-4095-02 - hepatitis A pediatric vaccine 25 u	$150.12	$272.94	$86.79–$245.65	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-11 - hepatitis A pediatric vaccine 720.	$200.82	$365.13	$116.11–$328.62	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-52 - hepatitis A pediatric vaccine 720.	$200.82	$365.13	$116.11–$328.62	—	45%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 58160-0825-01 - hepatitis A pediatric vaccine 720	$200.82	$365.13	$116.11–$328.62	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$345.41	$690.81	$75.15–$690.81	96% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$345.41	$690.81	$75.15–$690.81	96% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$345.41	$690.81	$75.15–$690.81	96% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$345.41	$690.81	$75.15–$690.81	96% above	50%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-11 - hepatitis B adult vaccine Susp	$379.95	$690.81	$219.68–$621.73	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0857-01 - hepatitis B adult vaccine Susp	$379.95	$690.81	$219.68–$621.73	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/m	$379.95	$690.81	$219.68–$621.73	—	45%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 58160-0821-32 - hepatitis B adult vaccine 20 mcg/m	$379.95	$690.81	$219.68–$621.73	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$103.51	$207.02	$33.20–$207.02	41% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$103.51	$207.02	$33.20–$207.02	41% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$103.51	$207.02	$33.20–$207.02	41% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$137.80	$275.60	$33.20–$275.60	88% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$137.80	$275.60	$33.20–$275.60	88% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$137.80	$275.60	$33.20–$275.60	88% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$137.80	$275.60	$33.20–$275.60	88% above	50%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-09 - hepatitis B pediatric vaccine 5 mc	$113.86	$207.02	$65.83–$186.32	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4981-00 - hepatitis B pediatric vaccine Susp	$113.86	$207.02	$65.83–$186.32	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 00006-4093-02 - hepatitis B pediatric vaccine 5 mc	$113.86	$207.02	$65.83–$186.32	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-52 - hepatitis B pediatric vaccine Susp	$151.58	$275.60	$87.64–$248.04	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-11 - hepatitis B pediatric vaccine Susp	$151.58	$275.60	$87.64–$248.04	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-01 - hepatitis B pediatric vaccine 10 m	$151.58	$275.60	$87.64–$248.04	—	45%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0856-01 - hepatitis B pediatric vaccine Susp	$151.58	$275.60	$87.64–$248.04	—	45%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 00006-4897-00 - haemophilus b conjugate (PRP-OMP)	$137.16	$274.31	$45.00–$274.31	109% above	50%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 00006-4897-00 - haemophilus b conjugate (PRP-OMP)	$150.87	$274.31	$87.23–$246.88	—	45%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$57.57	$115.13	$21.31–$115.13	18% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$57.57	$115.13	$21.31–$115.13	18% above	50%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-05 - haemophilus b conjugate (PRP-T) va	$63.32	$115.13	$36.61–$103.62	—	45%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-03 - haemophilus b conjugate (PRP-T) va	$63.32	$115.13	$36.61–$103.62	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$276.90	$553.80	$91.75–$553.80	54% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$276.90	$553.80	$91.75–$553.80	54% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0405-65 - influenza virus vaccine, inactivat	$276.90	$553.80	$91.75–$553.80	54% above	50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0403-65 - influenza virus vaccine, inactivat	$304.59	$553.80	$176.11–$498.42	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0405-65 - influenza virus vaccine, inactivat	$304.59	$553.80	$176.11–$498.42	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0124-65 - 2024-2025 influenza virus vaccine,	$304.59	$553.80	$176.11–$498.42	—	45%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 42515-0001-01 - Japanese encephalitis virus vaccin	$1,493.44	$2,986.88	$255.07–$4,779.02	74% above	50%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 42515-0001-01 - Japanese encephalitis virus vaccin	$1,642.78	$2,986.88	$949.83–$2,688.19	—	45%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$414.10	$828.19	$91.22–$828.19	61% above	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 00006-4681-00 - measles/mumps/rubella virus vaccin	$455.50	$828.19	$263.36–$745.37	—	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$1,307.53	$2,615.06	$484.13–$4,184.09	208% above	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$1,307.53	$2,615.06	$484.13–$4,184.09	208% above	50%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4171-00 - measles/mumps/rubella/varicella vi	$1,438.28	$2,615.06	$831.59–$2,353.55	—	45%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 00006-4999-00 - measles/mumps/rubella/varicella vi	$1,438.28	$2,615.06	$831.59–$2,353.55	—	45%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$522.94	$1,045.87	$193.63–$1,673.38	49% above	50%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 49281-0589-05 - meningococcal conjugate vaccine So	$575.23	$1,045.87	$332.59–$941.28	—	45%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$554.83	$1,109.66	$205.43–$1,775.45	77% above	50%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 49281-0590-05 - meningococcal conjugate vaccine po	$610.31	$1,109.66	$352.87–$998.69	—	45%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$1,030.04	$2,060.08	$228.85–$3,296.14	166% above	50%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 46028-0114-01 - meningococcal group B vaccine reco	$1,133.04	$2,060.08	$655.11–$1,854.07	—	45%
Meningococcal B vaccine (Trumenba) CPT 90621 00005-0100-10 - meningococcal group B vaccine full	$769.75	$1,539.49	$285.01–$2,463.19	81% above	50%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 00005-0100-10 - meningococcal group B vaccine full	$846.72	$1,539.49	$489.56–$1,385.54	—	45%
Nasal spray flu vaccine, live (FluMist) CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$290.33	$580.66	$29.71–$580.66	657% above	50%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 66019-0311-10 - 2024-2025 influenza virus vaccine,	$319.36	$580.66	$184.65–$522.59	—	45%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$1,120.08	$2,240.16	$226.43–$2,240.16	140% above	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$1,120.08	$2,240.16	$226.43–$2,240.16	140% above	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$1,120.08	$2,240.16	$226.43–$2,240.16	140% above	50%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-01 - pneumococcal 13-valent conjugate v	$1,232.09	$2,240.16	$712.37–$2,016.14	—	45%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-05 - pneumococcal 13-valent conjugate v	$1,232.09	$2,240.16	$712.37–$2,016.14	—	45%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 00005-1971-02 - pneumococcal 13-valent conjugate v	$1,232.09	$2,240.16	$712.37–$2,016.14	—	45%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$1,046.01	$2,092.01	$247.39–$2,092.01	86% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$1,046.01	$2,092.01	$247.39–$2,092.01	86% above	50%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-03 - pneumococcal 15-valent conjugate v	$1,150.61	$2,092.01	$665.26–$1,882.81	—	45%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-02 - pneumococcal 15-valent conjugate v	$1,150.61	$2,092.01	$665.26–$1,882.81	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$1,236.85	$2,473.69	$287.54–$2,473.69	98% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$1,236.85	$2,473.69	$287.54–$2,473.69	98% above	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-02 - pneumococcal 20-valent conjugate v	$1,360.53	$2,473.69	$786.63–$2,226.32	—	45%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-10 - pneumococcal 20-valent conjugate v	$1,360.53	$2,473.69	$786.63–$2,226.32	—	45%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$1,163.99	$2,327.97	$344.25–$2,327.97	187% above	50%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 00006-4347-02 - pneumococcal 21-valent conjugate v	$1,280.38	$2,327.97	$740.29–$2,095.17	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$538.76	$1,077.52	$122.94–$1,077.52	155% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$538.76	$1,077.52	$122.94–$1,077.52	155% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$538.76	$1,077.52	$122.94–$1,077.52	155% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$538.76	$1,077.52	$122.94–$1,077.52	155% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - pneumococcal 23-polyvalent vaccine	$592.64	$1,077.52	$342.65–$969.77	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-01 - pneumococcal 23-polyvalent vaccine	$592.64	$1,077.52	$342.65–$969.77	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-00 - pneumococcal 23-valent vaccine Sol	$592.64	$1,077.52	$342.65–$969.77	—	45%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-02 - pneumococcal 23-polyvalent vaccine	$592.64	$1,077.52	$342.65–$969.77	—	45%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-10 - poliovirus vaccine inactivated Su	$115.88	$231.75	$42.90–$231.75	7% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$115.88	$231.75	$42.90–$231.75	7% below	50%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$161.29	$322.57	$44.17–$322.57	30% above	50%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-10 - poliovirus vaccine, inactivated Su	$127.46	$231.75	$73.70–$208.58	—	45%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-10 - poliovirus vaccine inactivated Su	$127.46	$231.75	$73.70–$208.58	—	45%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-55 - poliovirus vaccine, inactivated Su	$177.41	$322.57	$102.58–$290.31	—	45%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$2,062.01	$4,124.02	$763.49–$6,598.42	82% above	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 49281-0574-15 - nirsevimab (cvx 307) alip preserva	$2,062.01	$4,124.02	$763.49–$6,598.42	82% above	50%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 49281-0574-15 - nirsevimab (cvx 307) alip preserva	$2,268.21	$4,124.02	$1,311.44–$3,711.62	—	45%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 49281-0574-88 - nirsevimab (cvx 307) alip preserva	$2,268.21	$4,124.02	$1,311.44–$3,711.62	—	45%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$2,062.01	$4,124.02	$763.49–$6,598.42	82% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$2,062.01	$4,124.02	$763.49–$6,598.42	82% above	50%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-00 - nirsevimab (cvx 306) alip preserva	$2,268.21	$4,124.02	$1,311.44–$3,711.62	—	45%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preserva	$2,268.21	$4,124.02	$1,311.44–$3,711.62	—	45%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$1,324.18	$2,648.36	$490.30–$4,237.37	118% above	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$1,324.18	$2,648.36	$490.30–$4,237.37	118% above	50%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-01 - RSV vaccine, preF A-preF B, recomb	$1,456.60	$2,648.36	$842.18–$2,383.52	—	45%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 00069-0344-05 - RSV vaccine, preF A-preF B, recomb	$1,456.60	$2,648.36	$842.18–$2,383.52	—	45%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$1,324.44	$2,648.88	$490.40–$4,238.22	74% above	50%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 58160-0848-11 - RSV vaccine preF3, recombinant pre	$1,456.88	$2,648.88	$842.34–$2,383.99	—	45%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$1,680.54	$3,361.07	$405.93–$3,361.07	110% above	50%
Rabies vaccine, one dose CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$1,680.54	$3,361.07	$405.93–$3,361.07	110% above	50%
Rabies vaccine, one dose CPT 90675 49999-0414-01 - rabies vaccine human diploid cell	$1,680.54	$3,361.07	$405.93–$3,361.07	110% above	50%
Rabies vaccine, one dose CPT 90675 49281-0250-10 - rabies vaccine, human diploid cell	$1,680.54	$3,361.07	$405.93–$3,361.07	110% above	50%
Rabies vaccine, one dose CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$2,004.91	$4,009.82	$405.93–$4,009.82	150% above	50%
Rabies vaccine, one dose CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$2,004.91	$4,009.82	$405.93–$4,009.82	150% above	50%
Rabies vaccine, one dose CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$2,004.91	$4,009.82	$405.93–$4,009.82	150% above	50%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-51 - rabies vaccine, human diploid cell	$1,848.59	$3,361.07	$1,068.82–$3,024.96	—	45%
Rabies vaccine, one dose inpatient CPT 90675 49999-0414-01 - rabies vaccine, human diploid cell	$1,848.59	$3,361.07	$1,068.82–$3,024.96	—	45%
Rabies vaccine, one dose inpatient CPT 90675 49999-0414-01 - rabies vaccine human diploid cell	$1,848.59	$3,361.07	$1,068.82–$3,024.96	—	45%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-10 - rabies vaccine, human diploid cell	$1,848.59	$3,361.07	$1,068.82–$3,024.96	—	45%
Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - rabies vaccine, purified chick emb	$2,205.40	$4,009.82	$1,275.12–$3,608.84	—	45%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-01 - rabies vaccine, purified chick emb	$2,205.40	$4,009.82	$1,275.12–$3,608.84	—	45%
Rabies vaccine, one dose inpatient CPT 90675 63851-0501-02 - rabies vaccine, purified chick emb	$2,205.40	$4,009.82	$1,275.12–$3,608.84	—	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$1,047.52	$2,095.03	$116.10–$2,095.03	446% above	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$1,047.52	$2,095.03	$116.10–$2,095.03	446% above	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$1,047.52	$2,095.03	$116.10–$2,095.03	446% above	50%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-20 - rotavirus vaccine pentavalent Susp	$1,152.27	$2,095.03	$666.22–$1,885.53	—	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-41 - rotavirus vaccine Susp	$1,152.27	$2,095.03	$666.22–$1,885.53	—	45%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 00006-4047-01 - rotavirus vaccine 2 mL Susp	$1,152.27	$2,095.03	$666.22–$1,885.53	—	45%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$957.61	$1,915.21	$354.57–$3,064.33	145% above	50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$957.61	$1,915.21	$354.57–$3,064.33	145% above	50%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuva	$1,053.37	$1,915.21	$609.04–$1,723.69	—	45%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 58160-0819-12 - zoster vaccine, inactivated adjuva	$1,053.37	$1,915.21	$609.04–$1,723.69	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$114.50	$228.99	$37.93–$228.99	at median	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$114.50	$228.99	$37.93–$228.99	at median	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$114.50	$228.99	$37.93–$228.99	at median	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$148.84	$297.67	$37.93–$297.67	30% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$148.84	$297.67	$37.93–$297.67	30% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$148.84	$297.67	$37.93–$297.67	30% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$148.84	$297.67	$37.93–$297.67	30% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$148.84	$297.67	$37.93–$297.67	30% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$166.90	$333.80	$37.93–$333.80	46% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 17478-0131-01 - tetanus-diphth toxoids (Td) adult/	$125.94	$228.99	$72.82–$206.09	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-01 - tetanus-diphth toxoids (Td) adult/	$125.94	$228.99	$72.82–$206.09	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 00006-4133-41 - tetanus-diphtheria toxoids 2 units	$125.94	$228.99	$72.82–$206.09	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-10 - tetanus-diphtheria toxoids 5 units	$163.72	$297.67	$94.66–$267.90	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-83 - tetanus-diphtheria toxoids 5 units	$163.72	$297.67	$94.66–$267.90	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 13533-0131-01 - tetanus-diphth toxoids (Td) adult/	$163.72	$297.67	$94.66–$267.90	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - tetanus-diphtheria toxoids 5 units	$163.72	$297.67	$94.66–$267.90	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-10 - tetanus-diphtheria toxoids 5 units	$163.72	$297.67	$94.66–$267.90	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0225-10 - diphtheria-tetanus toxoids (DT) pe	$183.59	$333.80	$106.15–$300.42	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-20 - tetanus/diphth/pertuss (Tdap) adul	$188.61	$377.22	$47.88–$377.22	54% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$188.61	$377.22	$47.88–$377.22	54% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis acel	$188.61	$377.22	$47.88–$377.22	54% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$188.61	$377.22	$47.88–$377.22	54% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis acel	$188.61	$377.22	$47.88–$377.22	54% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$228.18	$456.35	$47.88–$456.35	86% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$228.18	$456.35	$47.88–$456.35	86% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$228.18	$456.35	$47.88–$456.35	86% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$228.18	$456.35	$47.88–$456.35	86% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis acel	$207.47	$377.22	$119.96–$339.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-20 - tetanus/diphth/pertuss (Tdap) adul	$207.47	$377.22	$119.96–$339.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-10 - tetanus/diphtheria/pertussis, acel	$207.47	$377.22	$119.96–$339.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis acel	$207.47	$377.22	$119.96–$339.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 49281-0400-15 - tetanus/diphtheria/pertussis, acel	$207.47	$377.22	$119.96–$339.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-46 - tetanus/diphth/pertuss (Tdap) adul	$250.99	$456.35	$145.12–$410.72	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - tetanus/diphtheria/pertussis, acel	$250.99	$456.35	$145.12–$410.72	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - tetanus/diphtheria/pertussis, acel	$250.99	$456.35	$145.12–$410.72	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-43 - tetanus/diphth/pertuss (Tdap) adul	$250.99	$456.35	$145.12–$410.72	—	45%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 58337-0003-01 - typhoid vaccine live Cap-EC	$1,351.30	$2,702.59	$91.84–$2,702.59	574% above	50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 69401-0000-01 - typhoid vaccine live - Cap-DR	$1,351.30	$2,702.59	$91.84–$2,702.59	574% above	50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$1,351.30	$2,702.59	$91.84–$2,702.59	574% above	50%
Typhoid vaccine, oral capsules (Vivotif) CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$1,351.30	$2,702.59	$91.84–$2,702.59	574% above	50%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 69401-0000-01 - typhoid vaccine live - Cap-DR	$1,486.42	$2,702.59	$859.42–$2,432.33	—	45%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 58337-0003-01 - typhoid vaccine, live Cap-EC	$1,486.42	$2,702.59	$859.42–$2,432.33	—	45%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 58337-0003-01 - typhoid vaccine live Cap-EC	$1,486.42	$2,702.59	$859.42–$2,432.33	—	45%
Typhoid vaccine, oral capsules (Vivotif) inpatient CPT 90690 69401-0000-01 - typhoid vaccine, live - Cap-DR	$1,486.42	$2,702.59	$859.42–$2,432.33	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$29.50	$59.00	$10.92–$59.00	52% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$95.50	$191.00	$18.78–$191.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE - BCE	$95.50	$191.00	$18.78–$191.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$95.50	$191.00	$18.78–$191.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Outpatient Infusio	$95.50	$191.00	$18.78–$191.00	55% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$114.00	$228.00	$18.78–$228.00	85% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - In House/Observati	$32.45	$59.00	$18.76–$53.10	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Outpatient Infusio	$105.05	$191.00	$60.74–$171.90	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Infusion Center	$105.05	$191.00	$60.74–$171.90	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - OB/Nursery	$105.05	$191.00	$60.74–$171.90	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE - BCE	$105.05	$191.00	$60.74–$171.90	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pt. Location - Vaccine Charge - Emergency Departme	$125.40	$228.00	$72.50–$205.20	—	45%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Clinic Immunization Administration - 90472 Immuniz	$22.50	$45.00	$8.33–$45.00	43% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$79.00	$158.00	$13.36–$158.00	99% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$79.00	$158.00	$13.36–$158.00	99% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADD VACCINE - BCE	$79.00	$158.00	$13.36–$158.00	99% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Clinic Immunization Administration - 90472 Immuniz	$24.75	$45.00	$14.31–$40.50	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - ED Additional	$86.90	$158.00	$50.24–$142.20	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pt. Location - Vaccine Charge - Obs/OP Additional	$86.90	$158.00	$50.24–$142.20	—	45%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EA ADD VACCINE - BCE	$86.90	$158.00	$50.24–$142.20	—	45%
Yellow fever vaccine, live CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$3,074.61	$6,149.21	$158.20–$6,149.21	49% above	50%
Yellow fever vaccine, live CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$3,074.61	$6,149.21	$158.20–$6,149.21	49% above	50%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-05 - yellow fever vaccine - Powder	$3,382.07	$6,149.21	$1,955.45–$5,534.29	—	45%
Yellow fever vaccine, live inpatient CPT 90717 49281-0915-01 - yellow fever vaccine - Powder	$3,382.07	$6,149.21	$1,955.45–$5,534.29	—	45%

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

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

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

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

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

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

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

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

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

Source file: https://www.dukesmemorialhosp.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/522379885_dukes-memorial-hospital_standardcharges.csv