Dukes Health System LLC
Dukes Health System LLC in Peru, IN publishes cash prices for 73 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
275 W. 12th St, Peru, IN 46970 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis W Pancreatic Protocol | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis with Rectal W | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT-ABD PELVIS W | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abdomen Pelvis | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Trauma Abdomen Pelvis W | $3,753.50 | $7,507.00 | 50% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Trauma Abdomen Pelvis W | $4,128.85 | $7,507.00 | 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 | 45% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT-ABD PELVIS W | $4,128.85 | $7,507.00 | 45% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W | $4,128.85 | $7,507.00 | 45% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis with Rectal W | $4,128.85 | $7,507.00 | 45% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abdomen Pelvis | $4,128.85 | $7,507.00 | 45% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert | $1,237.50 | $2,475.00 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO | $1,237.50 | $2,475.00 | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Trauma Head WO | $1,237.50 | $2,475.00 | 50% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert | $1,361.25 | $2,475.00 | 45% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Trauma Head WO | $1,361.25 | $2,475.00 | 45% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO | $1,361.25 | $2,475.00 | 45% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W | $2,108.00 | $4,216.00 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Trauma Pelvis W | $2,108.00 | $4,216.00 | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis with Rectal W | $2,108.00 | $4,216.00 | 50% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis with Rectal W | $2,318.80 | $4,216.00 | 45% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W | $2,318.80 | $4,216.00 | 45% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Trauma Pelvis W | $2,318.80 | $4,216.00 | 45% |
| Diagnostic mammogram, both breasts both sides CPT 77066 77066 BR-DIG MAMMO BILAT | $346.00 | $692.00 | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD | $356.50 | $713.00 | 50% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 BR-DIG MAMMO BILAT | $380.60 | $692.00 | 45% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD | $392.15 | $713.00 | 45% |
| Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT | $253.50 | $507.00 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT | $261.00 | $522.00 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD | $261.00 | $522.00 | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD | $261.00 | $522.00 | 50% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT | $278.85 | $507.00 | 45% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD | $287.10 | $522.00 | 45% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT | $287.10 | $522.00 | 45% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD | $287.10 | $522.00 | 45% |
| 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 | 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 | 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 | 50% |
| 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 | 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 | 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 | 50% |
| 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 | 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 | 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 | 45% |
| 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 50% |
| 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 | 45% |
| 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 | 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 | 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 | 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 | 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 | 45% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Stroke Alert | $2,035.50 | $4,071.00 | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain WO | $2,035.50 | $4,071.00 | 50% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO Stroke Alert | $2,239.05 | $4,071.00 | 45% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO | $2,239.05 | $4,071.00 | 45% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO | $3,114.00 | $6,228.00 | 50% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO | $3,425.40 | $6,228.00 | 45% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO | $2,112.00 | $4,224.00 | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar Limited WO | $2,175.50 | $4,351.00 | 50% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO | $2,323.20 | $4,224.00 | 45% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar Limited WO | $2,393.05 | $4,351.00 | 45% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US Pregnancy After 1st Trimester Transabdomi | $254.00 | $508.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 Preg Compl. >14 Wks AMB | $254.00 | $508.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US-PELVIS PREG | $785.50 | $1,571.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal | $785.50 | $1,571.00 | 50% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US Pregnancy After 1st Trimester Transabdomi | $279.40 | $508.00 | 45% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 Preg Compl. >14 Wks AMB | $279.40 | $508.00 | 45% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US-PELVIS PREG | $864.05 | $1,571.00 | 45% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal | $864.05 | $1,571.00 | 45% |
| Screening mammogram, both breasts both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI | $208.00 | $416.00 | 50% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD | $214.00 | $428.00 | 50% |
| Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT | $208.00 | $416.00 | 50% |
| Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT | $208.00 | $416.00 | 50% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD | $214.00 | $428.00 | 50% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD | $214.00 | $428.00 | 50% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI | $228.80 | $416.00 | 45% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD | $235.40 | $428.00 | 45% |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT | $228.80 | $416.00 | 45% |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT | $228.80 | $416.00 | 45% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD | $235.40 | $428.00 | 45% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD | $235.40 | $428.00 | 45% |
| Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOM 6/> YRS 4/> PARAM | $735.50 | $1,471.00 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 SL Polysomnography Sleep Study | $4,329.00 | $8,658.00 | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 CHRG - POLYSOMNO GT4 GE6YO | $4,329.00 | $8,658.00 | 50% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOM 6/> YRS 4/> PARAM | $809.05 | $1,471.00 | 45% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 CHRG - POLYSOMNO GT4 GE6YO | $4,761.90 | $8,658.00 | 45% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SL Polysomnography Sleep Study | $4,761.90 | $8,658.00 | 45% |
| Transvaginal pelvic ultrasound CPT 76830 76830,26 TRANSVAGINAL US NON-OB | $46.00 | $92.00 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 76830 US Transvaginal Non OB AMB | $143.50 | $287.00 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 76830 TRANSVAGINAL US NON-OB | $143.50 | $287.00 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 76830 Vaginal, Non AMB | $143.50 | $287.00 | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $427.50 | $855.00 | 50% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830,26 TRANSVAGINAL US NON-OB | $50.60 | $92.00 | 45% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US Transvaginal Non OB AMB | $157.85 | $287.00 | 45% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 TRANSVAGINAL US NON-OB | $157.85 | $287.00 | 45% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 Vaginal, Non AMB | $157.85 | $287.00 | 45% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $470.25 | $855.00 | 45% |
| Ultrasound of the abdomen, complete CPT 76700 76700 US Abdomen Complete AMB | $172.00 | $344.00 | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $1,012.50 | $2,025.00 | 50% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 76700 US Abdomen Complete AMB | $189.20 | $344.00 | 45% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $1,113.75 | $2,025.00 | 45% |
| X-ray of the lower back, 4 or more views CPT 72110 72110 TC XR Spine Lumbosacral Minimum 4 V CR | $50.50 | $101.00 | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR | $482.50 | $965.00 | 50% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 72110 TC XR Spine Lumbosacral Minimum 4 V CR | $55.55 | $101.00 | 45% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR | $530.75 | $965.00 | 45% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 80048 METABOLIC PANEL TOTAL CA | $13.50 | $27.00 | 50% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel w/Total Calcium | $121.50 | $243.00 | 50% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel (8) (RL) | $121.50 | $243.00 | 50% |
| Basic metabolic panel (blood test) inpatient CPT 80048 80048 METABOLIC PANEL TOTAL CA | $14.85 | $27.00 | 45% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel (8) (RL) | $133.65 | $243.00 | 45% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel w/Total Calcium | $133.65 | $243.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile POC AMB | $22.50 | $45.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 Lipid Profile POC AMB -BCE | $22.50 | $45.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .Lipid Panel POC | $22.50 | $45.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC) | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (RL) | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel With LDL/HDL Ratio (LC) | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 LIPID PANEL | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L33886 LIPID PANEL 889 | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L235036 LIPID PANEL 889 | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with Reflex LDL Direct | $156.00 | $312.00 | 50% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .Lipid Panel POC | $24.75 | $45.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 Lipid Profile POC AMB -BCE | $24.75 | $45.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile POC AMB | $24.75 | $45.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC) | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with Reflex LDL Direct | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (RL) | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L33886 LIPID PANEL 889 | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L235036 LIPID PANEL 889 | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 LIPID PANEL | $171.60 | $312.00 | 45% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel With LDL/HDL Ratio (LC) | $171.60 | $312.00 | 45% |
| Complete blood count (CBC) with differential CPT 85025 85025 COMPLETE CBC W/AUTO DIFF WBC | $13.00 | $26.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 CBCWPLTA | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff + Platelets (RL) | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW B | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential CPT 85025 85025 CBC W-PLT AUTO COMPD | $103.50 | $207.00 | 50% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 COMPLETE CBC W/AUTO DIFF WBC | $14.30 | $26.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW | $113.85 | $207.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBCWPLTA | $113.85 | $207.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto | $113.85 | $207.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW B | $113.85 | $207.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff + Platelets (RL) | $113.85 | $207.00 | 45% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 CBC W-PLT AUTO COMPD | $113.85 | $207.00 | 45% |
| Complete blood count (CBC), no differential CPT 85027 85027 COMPLETE CBC AUTOMATED | $12.00 | $24.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Manual | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/o Diff | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 CBC, Platelet, No Differential (LC) | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Diff Manual MW A | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Auto | $68.50 | $137.00 | 50% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 COMPLETE CBC AUTOMATED | $13.20 | $24.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT | $75.35 | $137.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/o Diff | $75.35 | $137.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Manual | $75.35 | $137.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC, Platelet, No Differential (LC) | $75.35 | $137.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Auto | $75.35 | $137.00 | 45% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Diff Manual MW A | $75.35 | $137.00 | 45% |
| Comprehensive metabolic panel (blood test) CPT 80053 80053 COMPREHEN METABOLIC PANEL | $19.00 | $38.00 | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $159.00 | $318.00 | 50% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 80053 COMPREHEN METABOLIC PANEL | $20.90 | $38.00 | 45% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $174.90 | $318.00 | 45% |
| Kidney function blood test panel CPT 80069 80069 Renal Function Panel | $16.00 | $32.00 | 50% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $150.00 | $300.00 | 50% |
| Kidney function blood test panel inpatient CPT 80069 80069 Renal Function Panel | $17.60 | $32.00 | 45% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $165.00 | $300.00 | 45% |
| Liver function blood test panel CPT 80076 80076 Liver Profile | $13.00 | $26.00 | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $196.00 | $392.00 | 50% |
| Liver function blood test panel inpatient CPT 80076 80076 Liver Profile | $14.30 | $26.00 | 45% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $215.60 | $392.00 | 45% |
| Obstetric blood test panel CPT 80055 80055 OB Panel | $101.00 | $202.00 | 50% |
| Obstetric blood test panel CPT 80055 Obstetrics Panel A CS | $101.50 | $203.00 | 50% |
| Obstetric blood test panel CPT 80055 Obstetric Panel CS | $101.50 | $203.00 | 50% |
| Obstetric blood test panel CPT 80055 Obstetric Panel CS INDH | $101.50 | $203.00 | 50% |
| Obstetric blood test panel inpatient CPT 80055 80055 OB Panel | $111.10 | $202.00 | 45% |
| Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS INDH | $111.65 | $203.00 | 45% |
| Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS | $111.65 | $203.00 | 45% |
| Obstetric blood test panel inpatient CPT 80055 Obstetrics Panel A CS | $111.65 | $203.00 | 45% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480780 PSA, FREE 889 | $152.50 | $305.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480947 PSA, FREE | $152.50 | $305.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 %fPSA Reflex (LC) | $152.50 | $305.00 | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 PSA, FREE | $152.50 | $305.00 | 50% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 %fPSA Reflex (LC) | $167.75 | $305.00 | 45% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 PSA, FREE | $167.75 | $305.00 | 45% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480780 PSA, FREE 889 | $167.75 | $305.00 | 45% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480947 PSA, FREE | $167.75 | $305.00 | 45% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 ASSAY OF PSA TOTAL | $31.00 | $62.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Serum (Serial Monitor) LC | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (Reflex To Free) (LC) | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480780 PSA, TOTAL 889 | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480947 PSA, TOTAL | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 PSA, TOTAL | $118.50 | $237.00 | 50% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 ASSAY OF PSA TOTAL | $34.10 | $62.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 PSA, TOTAL | $130.35 | $237.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free) (LC) | $130.35 | $237.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480947 PSA, TOTAL | $130.35 | $237.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480780 PSA, TOTAL 889 | $130.35 | $237.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total | $130.35 | $237.00 | 45% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Serum (Serial Monitor) LC | $130.35 | $237.00 | 45% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 Thromboplastin Time Partial | $11.00 | $22.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L500070 APTT 889 | $96.00 | $192.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L503426 APTT 889 | $96.00 | $192.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $96.00 | $192.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLAST TIMEPTT | $96.00 | $192.00 | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L117079 APTT 889 | $97.00 | $194.00 | 50% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 Thromboplastin Time Partial | $12.10 | $22.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $105.60 | $192.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L503426 APTT 889 | $105.60 | $192.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLAST TIMEPTT | $105.60 | $192.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L500070 APTT 889 | $105.60 | $192.00 | 45% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L117079 APTT 889 | $106.70 | $194.00 | 45% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin and INR POC AMB | $7.50 | $15.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin and INR POC AMB -BCE | $7.50 | $15.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .ISTAT PT w/INR POC | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 L500070 PT 889 | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Coag Clinic POC PT INR | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 L503426 PT 889 | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME | $55.50 | $111.00 | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 L117079 PT 889 | $56.00 | $112.00 | 50% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Prothrombin and INR POC AMB -BCE | $8.25 | $15.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin and INR POC AMB | $8.25 | $15.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Coag Clinic POC PT INR | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .ISTAT PT w/INR POC | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L500070 PT 889 | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L503426 PT 889 | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR | $61.05 | $111.00 | 45% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L117079 PT 889 | $61.60 | $112.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 ASSAY THYROID STIM HORMONE | $28.50 | $57.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 THYROID STIM TSH | $39.00 | $78.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $39.00 | $78.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (RL) | $39.00 | $78.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4 | $39.00 | $78.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 NBS THYROID STIM TSH | $155.50 | $311.00 | 50% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 ASSAY THYROID STIM HORMONE | $31.35 | $57.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $42.90 | $78.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4 | $42.90 | $78.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (RL) | $42.90 | $78.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 THYROID STIM TSH | $42.90 | $78.00 | 45% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 NBS THYROID STIM TSH | $171.05 | $311.00 | 45% |
| Urinalysis with microscope exam, automated CPT 81001 81001 Urinalysis Dipstick Auto w MicroSc POC AMB - | $8.50 | $17.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Dipstick Auto w MicroSc POC AMB | $8.50 | $17.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Micro Auto Rfx Culture | $68.50 | $137.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Reflex Microscopic Type? - Manual | $68.50 | $137.00 | 50% |
| Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd | $68.50 | $137.00 | 50% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 81001 Urinalysis Dipstick Auto w MicroSc POC AMB - | $9.35 | $17.00 | 45% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Dipstick Auto w MicroSc POC AMB | $9.35 | $17.00 | 45% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Micro Auto Rfx Culture | $75.35 | $137.00 | 45% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Reflex Microscopic Type? - Manual | $75.35 | $137.00 | 45% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd | $75.35 | $137.00 | 45% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Dipstick POC AMB | $8.50 | $17.00 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 81000 Urinalysis Dipstick POC AMB -BCE | $8.50 | $17.00 | 50% |
| Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd | $67.50 | $135.00 | 50% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Dipstick POC AMB | $9.35 | $17.00 | 45% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 81000 Urinalysis Dipstick POC AMB -BCE | $9.35 | $17.00 | 45% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd | $74.25 | $135.00 | 45% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $6.00 | $12.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $6.00 | $12.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Glucose Urine Dipstick Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Bilirubin Urine Dipstick Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Blood Urine Dipstick Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Reflex Microscopic Type? - Not Required | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Ketones Urine Dipstk Qual Automated | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 81003 L306266 UA AUTO WO S | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Protein Urine Dipstick Auto | $38.50 | $77.00 | 50% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $6.60 | $12.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $6.60 | $12.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones Urine Dipstk Qual Automated | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Reflex Microscopic Type? - Not Required | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose Urine Dipstick Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Blood Urine Dipstick Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Protein Urine Dipstick Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Bilirubin Urine Dipstick Auto | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 L306266 UA AUTO WO S | $42.35 | $77.00 | 45% |
| Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Manual w/o MicroSc POC AMB | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 .Urinalysis Manual w/o MicroSc POC | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Manual | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE | $7.00 | $14.00 | 50% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Manual | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 .Urinalysis Manual w/o MicroSc POC | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Manual w/o MicroSc POC AMB | $7.70 | $14.00 | 45% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql | $7.70 | $14.00 | 45% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 66984,52,55,LT CATARACT SURG W/IOL 1 STAGE,POSTOP | $927.00 | $1,854.00 | 50% |
| Cataract surgery with lens implant CPT 66984 66984 CATARACT SURG W/IOL 1 STAGE | $927.00 | $1,854.00 | 50% |
| Cataract surgery with lens implant CPT 66984 66984,RT CATARACT SURG W/IOL 1 STAGE | $927.00 | $1,854.00 | 50% |
| Cataract surgery with lens implant CPT 66984 66984,LT CATARACT SURG W/IOL 1 STAGE | $927.00 | $1,854.00 | 50% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,52,55,LT CATARACT SURG W/IOL 1 STAGE,POSTOP | $1,019.70 | $1,854.00 | 45% |
| Cataract surgery with lens implant inpatient CPT 66984 66984 CATARACT SURG W/IOL 1 STAGE | $1,019.70 | $1,854.00 | 45% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,LT CATARACT SURG W/IOL 1 STAGE | $1,019.70 | $1,854.00 | 45% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,RT CATARACT SURG W/IOL 1 STAGE | $1,019.70 | $1,854.00 | 45% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 59510 CESAREAN DELIVERY | $2,671.00 | $5,342.00 | 50% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 59510 CESAREAN DELIVERY | $2,938.10 | $5,342.00 | 45% |
| Colonoscopy with endoscopic ultrasound CPT 45391 45391 COLONOSCOPY W/ENDOSCOPE US | $377.00 | $754.00 | 50% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 45391 COLONOSCOPY W/ENDOSCOPE US | $414.70 | $754.00 | 45% |
| Colonoscopy with polyp removal CPT 45385 45385,53 COLONOSCOPY - SNARE | $435.50 | $871.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,52 COLONOSCOPY - SNARE | $435.50 | $871.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,52,PT LESION REMOVAL COLONOSCOPY,SCREENING | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385 COLONOSCOPY - SNARE | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,53,PT COLONOSCOPY W/LESION REMOVAL,SCREENIN | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,53,33 COLONOSCOPY W/LESION REMOVAL,PREVENTI | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,53 COLONOSCOPY W/LESION REMOVAL | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,52,33 LESION REMOVAL COLONOSCOPY,PREVENTIVE | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 45385,52 LESION REMOVAL COLONOSCOPY | $587.00 | $1,174.00 | 50% |
| Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY | $8,947.94 | $17,895.88 | 50% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53 COLONOSCOPY - SNARE | $479.05 | $871.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52 COLONOSCOPY - SNARE | $479.05 | $871.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53,33 COLONOSCOPY W/LESION REMOVAL,PREVENTI | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53,PT COLONOSCOPY W/LESION REMOVAL,SCREENIN | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52,PT LESION REMOVAL COLONOSCOPY,SCREENING | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52,33 LESION REMOVAL COLONOSCOPY,PREVENTIVE | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385 COLONOSCOPY - SNARE | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52 LESION REMOVAL COLONOSCOPY | $645.70 | $1,174.00 | 45% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53 COLONOSCOPY W/LESION REMOVAL | $645.70 | $1,174.00 | 45% |
| Colonoscopy with tissue sample CPT 45380 45380,53,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,52 COLONOSCOPY AND BIOPSY | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,52,33 COLONOSCOPY AND BIOPSY,PREVENTIVE SER | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,52,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,53 COLONOSCOPY AND BIOPSY | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,53,59,PT COLONOSCOPY AND BIOPSY,DISTINCT PR | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380,53,PT COLONOSCOPY AND BIOPSY,SCREENING TEST | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 45380 COLONOSCOPY AND BIOPSY | $494.50 | $989.00 | 50% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $8,471.96 | $16,943.92 | 50% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380 COLONOSCOPY AND BIOPSY | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,PT COLONOSCOPY AND BIOPSY,SCREENING TEST | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,59,PT COLONOSCOPY AND BIOPSY,DISTINCT PR | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52 COLONOSCOPY AND BIOPSY | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53 COLONOSCOPY AND BIOPSY | $543.95 | $989.00 | 45% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52,33 COLONOSCOPY AND BIOPSY,PREVENTIVE SER | $543.95 | $989.00 | 45% |
| Colonoscopy, diagnostic CPT 45378 45378,53,58 DIAGNOSTIC COLONOSCOPY,STAGED OR RELA | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53 DIAGNOSTIC COLONOSCOPY | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,PT DIAGNOSTIC COLONOSCOPY,SCREENING TEST | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,59 DIAGNOSTIC COLONOSCOPY,DISTINCT PROCE | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378 DIAGNOSTIC COLONOSCOPY | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,52,51 DIAGNOSTIC COLONOSCOPY,MULTIPLE PROCE | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,52 DIAGNOSTIC COLONOSCOPY | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,79 DIAGNOSTIC COLONOSCOPY,UNRELATED PROC | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,33 DIAGNOSTIC COLONOSCOPY,PREVENTIVE SER | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,AQ DIAGNOSTIC COLONOSCOPY,PHYSICIAN SERV | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GY DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 45378,53,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $414.00 | $828.00 | 50% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $6,879.64 | $13,759.28 | 50% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53 DIAGNOSTIC COLONOSCOPY | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,33 DIAGNOSTIC COLONOSCOPY,PREVENTIVE SER | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,58 DIAGNOSTIC COLONOSCOPY,STAGED OR RELA | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,59 DIAGNOSTIC COLONOSCOPY,DISTINCT PROCE | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,79 DIAGNOSTIC COLONOSCOPY,UNRELATED PROC | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,AQ DIAGNOSTIC COLONOSCOPY,PHYSICIAN SERV | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GY DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,PT DIAGNOSTIC COLONOSCOPY,SCREENING TEST | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378 DIAGNOSTIC COLONOSCOPY | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52 DIAGNOSTIC COLONOSCOPY | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,51 DIAGNOSTIC COLONOSCOPY,MULTIPLE PROCE | $455.40 | $828.00 | 45% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $455.40 | $828.00 | 45% |
| Gallbladder removal, laparoscopic CPT 47562 47562,80 LAPAROSCOPIC CHOLECYSTECTOMY | $616.50 | $1,233.00 | 50% |
| Gallbladder removal, laparoscopic CPT 47562 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $1,232.50 | $2,465.00 | 50% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $26,340.87 | $52,681.73 | 50% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 47562,AS LAPAROSCOPIC CHOLECYSTECTOMY | $458.70 | $834.00 | 45% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 47562,80 LAPAROSCOPIC CHOLECYSTECTOMY | $678.15 | $1,233.00 | 45% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $1,355.75 | $2,465.00 | 45% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505,RT PRP I/HERN INIT REDUC>5 YR | $977.00 | $1,954.00 | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 PRP I/HERN INIT REDUC>5 YR | $977.00 | $1,954.00 | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505,LT PRP I/HERN INIT REDUC>5 YR | $977.00 | $1,954.00 | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 50 PRP I/HERN INIT REDUC>5 YR | $1,465.50 | $2,931.00 | 50% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA | $27,054.94 | $54,109.87 | 50% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505,LT PRP I/HERN INIT REDUC>5 YR | $1,074.70 | $1,954.00 | 45% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505,RT PRP I/HERN INIT REDUC>5 YR | $1,074.70 | $1,954.00 | 45% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 PRP I/HERN INIT REDUC>5 YR | $1,074.70 | $1,954.00 | 45% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 50 PRP I/HERN INIT REDUC>5 YR | $1,612.05 | $2,931.00 | 45% |
| Knee arthroscopy with meniscus trim CPT 29881 29881,LT KNEE ARTHROSCOPY/SURGERY | $1,026.00 | $2,052.00 | 50% |
| Knee arthroscopy with meniscus trim CPT 29881 29881 KNEE ARTHROSCOPY/SURGERY | $1,026.00 | $2,052.00 | 50% |
| Knee arthroscopy with meniscus trim CPT 29881 29881,RT KNEE ARTHROSCOPY/SURGERY | $1,026.00 | $2,052.00 | 50% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881 KNEE ARTHROSCOPY/SURGERY | $1,128.60 | $2,052.00 | 45% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881,LT KNEE ARTHROSCOPY/SURGERY | $1,128.60 | $2,052.00 | 45% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881,RT KNEE ARTHROSCOPY/SURGERY | $1,128.60 | $2,052.00 | 45% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821,LT AFTER CATARACT LASER SURGERY | $393.50 | $787.00 | 50% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821,RT AFTER CATARACT LASER SURGERY | $393.50 | $787.00 | 50% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 AFTER CATARACT LASER SURGERY | $393.50 | $787.00 | 50% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 50 AFTER CATARACT LASER SURGERY | $590.50 | $1,181.00 | 50% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821,LT AFTER CATARACT LASER SURGERY | $432.85 | $787.00 | 45% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821,RT AFTER CATARACT LASER SURGERY | $432.85 | $787.00 | 45% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 AFTER CATARACT LASER SURGERY | $432.85 | $787.00 | 45% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 50 AFTER CATARACT LASER SURGERY | $649.55 | $1,181.00 | 45% |
| Left heart catheterization, diagnostic one side CPT 93452 93452 LEFT HEART CATH W/LEFT VENT | $1,057.00 | $2,114.00 | 50% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 93452 LEFT HEART CATH W/LEFT VENT | $1,162.70 | $2,114.00 | 45% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 Lumbar Interlaminar/Caudal | $295.50 | $591.00 | 50% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 Lumbar Interlaminar/Caudal | $325.05 | $591.00 | 45% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $343.00 | $686.00 | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 INJECTION INTERLAMINAR | $343.00 | $686.00 | 50% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 INJECTION INTERLAMINAR | $377.30 | $686.00 | 45% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $377.30 | $686.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 Lumbar Transforaminal, First level | $282.00 | $564.00 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483, 50 Lumbar Transforaminal, First level | $423.00 | $846.00 | 50% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 Lumbar Transforaminal, First level | $310.20 | $564.00 | 45% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483, 50 Lumbar Transforaminal, First level | $465.30 | $846.00 | 45% |
| Prostate biopsy CPT 55700 55700 BIOPSY OF PROSTATE | $180.50 | $361.00 | 50% |
| Prostate biopsy inpatient CPT 55700 55700 BIOPSY OF PROSTATE | $198.55 | $361.00 | 45% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 55866 LAPARO RADICAL PROSTATECTOMY | $1,752.00 | $3,504.00 | 50% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 55866 LAPARO RADICAL PROSTATECTOMY | $1,927.20 | $3,504.00 | 45% |
| Removal of a breast lump, open surgery CPT 19120 19120,RT REMOVAL OF BREAST LESION | $774.00 | $1,548.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 19120 REMOVAL OF BREAST LESION | $774.00 | $1,548.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 19120,LT REMOVAL OF BREAST LESION | $774.00 | $1,548.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 19120 50 REMOVAL OF BREAST LESION | $871.00 | $1,742.00 | 50% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $11,642.84 | $23,285.68 | 50% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120,AS REMOVAL OF BREAST LESION | $286.00 | $520.00 | 45% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120,LT REMOVAL OF BREAST LESION | $851.40 | $1,548.00 | 45% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120,RT REMOVAL OF BREAST LESION | $851.40 | $1,548.00 | 45% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120 REMOVAL OF BREAST LESION | $851.40 | $1,548.00 | 45% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120 50 REMOVAL OF BREAST LESION | $958.10 | $1,742.00 | 45% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826,RT SHOULDER ARTHROSCOPY/SURGERY | $329.00 | $658.00 | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826 SHOULDER ARTHROSCOPY/SURGERY | $329.00 | $658.00 | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826,LT SHOULDER ARTHROSCOPY/SURGERY | $329.00 | $658.00 | 50% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826,LT SHOULDER ARTHROSCOPY/SURGERY | $361.90 | $658.00 | 45% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826 SHOULDER ARTHROSCOPY/SURGERY | $361.90 | $658.00 | 45% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826,RT SHOULDER ARTHROSCOPY/SURGERY | $361.90 | $658.00 | 45% |
| Tonsil and adenoid removal, child under 12 CPT 42820 42820 REMOVE TONSILS AND ADENOIDS | $562.50 | $1,125.00 | 50% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 42820 REMOVE TONSILS AND ADENOIDS | $618.75 | $1,125.00 | 45% |
| Total hip replacement CPT 27130 27130,80 TOTAL HIP ARTHROPLASTY | $677.00 | $1,354.00 | 50% |
| Total hip replacement CPT 27130 27130,AS TOTAL HIP ARTHROPLASTY | $677.00 | $1,354.00 | 50% |
| Total hip replacement CPT 27130 27130,LT TOTAL HIP ARTHROPLASTY | $2,708.50 | $5,417.00 | 50% |
| Total hip replacement CPT 27130 27130 TOTAL HIP ARTHROPLASTY | $2,708.50 | $5,417.00 | 50% |
| Total hip replacement CPT 27130 27130,RT TOTAL HIP ARTHROPLASTY | $2,708.50 | $5,417.00 | 50% |
| Total hip replacement inpatient CPT 27130 27130,80 TOTAL HIP ARTHROPLASTY | $744.70 | $1,354.00 | 45% |
| Total hip replacement inpatient CPT 27130 27130,AS TOTAL HIP ARTHROPLASTY | $744.70 | $1,354.00 | 45% |
| Total hip replacement inpatient CPT 27130 27130,LT TOTAL HIP ARTHROPLASTY | $2,979.35 | $5,417.00 | 45% |
| Total hip replacement inpatient CPT 27130 27130 TOTAL HIP ARTHROPLASTY | $2,979.35 | $5,417.00 | 45% |
| Total hip replacement inpatient CPT 27130 27130,RT TOTAL HIP ARTHROPLASTY | $2,979.35 | $5,417.00 | 45% |
| Total knee replacement CPT 27447 27447 TOTAL KNEE ARTHROPLASTY | $1,626.00 | $3,252.00 | 50% |
| Total knee replacement CPT 27447 27447,RT TOTAL KNEE ARTHROPLASTY | $1,626.00 | $3,252.00 | 50% |
| Total knee replacement CPT 27447 27447,LT TOTAL KNEE ARTHROPLASTY | $1,626.00 | $3,252.00 | 50% |
| Total knee replacement CPT 27447 27447 50 TOTAL KNEE ARTHROPLASTY | $2,439.00 | $4,878.00 | 50% |
| Total knee replacement inpatient CPT 27447 27447 TOTAL KNEE ARTHROPLASTY | $1,788.60 | $3,252.00 | 45% |
| Total knee replacement inpatient CPT 27447 27447,RT TOTAL KNEE ARTHROPLASTY | $1,788.60 | $3,252.00 | 45% |
| Total knee replacement inpatient CPT 27447 27447,LT TOTAL KNEE ARTHROPLASTY | $1,788.60 | $3,252.00 | 45% |
| Total knee replacement inpatient CPT 27447 27447 50 TOTAL KNEE ARTHROPLASTY | $2,682.90 | $4,878.00 | 45% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,52 EGD BIOPSY SINGLE/MULTIPLE | $328.50 | $657.00 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 53 EGD BIOPSY SINGLE/MULTIPLE | $328.50 | $657.00 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 EGD BIOPSY SINGLE/MULTIPLE | $328.50 | $657.00 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,53 EGD BIOPSY SINGLE/MULTIPLE | $328.50 | $657.00 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,52,58 EGD BIOPSY SINGLE/MULTIPLE,STAGED OR | $328.50 | $657.00 | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY | $8,966.93 | $17,933.86 | 50% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,52 EGD BIOPSY SINGLE/MULTIPLE | $361.35 | $657.00 | 45% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,52,58 EGD BIOPSY SINGLE/MULTIPLE,STAGED OR | $361.35 | $657.00 | 45% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,53 EGD BIOPSY SINGLE/MULTIPLE | $361.35 | $657.00 | 45% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 EGD BIOPSY SINGLE/MULTIPLE | $361.35 | $657.00 | 45% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 53 EGD BIOPSY SINGLE/MULTIPLE | $361.35 | $657.00 | 45% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235 EGD DIAGNOSTIC BRUSH WASH | $278.00 | $556.00 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,53,59 EGD DIAGNOSTIC BRUSH WASH,DISTINCT PR | $278.00 | $556.00 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,53 EGD DIAGNOSTIC BRUSH WASH | $278.00 | $556.00 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,52 EGD DIAGNOSTIC BRUSH WASH | $278.00 | $556.00 | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS | $8,379.05 | $16,758.10 | 50% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 EGD DIAGNOSTIC BRUSH WASH | $305.80 | $556.00 | 45% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,52 EGD DIAGNOSTIC BRUSH WASH | $305.80 | $556.00 | 45% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,53 EGD DIAGNOSTIC BRUSH WASH | $305.80 | $556.00 | 45% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,53,59 EGD DIAGNOSTIC BRUSH WASH,DISTINCT PR | $305.80 | $556.00 | 45% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 59610 VBAC DELIVERY | $2,769.00 | $5,538.00 | 50% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 59610 VBAC DELIVERY | $3,045.90 | $5,538.00 | 45% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 59400 Obstetric Care Routine | $2,419.00 | $4,838.00 | 50% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 59400 Obstetric Care Routine | $2,660.90 | $4,838.00 | 45% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG POC AMB | $34.50 | $69.00 | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 EKG POC AMB -BCE | $34.50 | $69.00 | 50% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 93000 EKG POC AMB -BCE | $37.95 | $69.00 | 45% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG POC AMB | $37.95 | $69.00 | 45% |
| Family therapy with the patient, 50 minutes CPT 90847 BH CHRG - FAM THERAPY W/PATIEN | $435.00 | $870.00 | 50% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 BH CHRG - FAM THERAPY W/PATIEN | $478.50 | $870.00 | 45% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $132.50 | $265.00 | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 BH CHRG - Fam Therapy W/O Pt | $414.50 | $829.00 | 50% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $145.75 | $265.00 | 45% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 BH CHRG - Fam Therapy W/O Pt | $455.95 | $829.00 | 45% |
| Group psychotherapy session CPT 90853 BH CHRG - PSYCH GROUP THERAPY | $378.50 | $757.00 | 50% |
| Group psychotherapy session inpatient CPT 90853 BH CHRG - PSYCH GROUP THERAPY | $416.35 | $757.00 | 45% |
| New patient office visit, about 30 minutes CPT 99203 99203,25 OFFICE/OUTPATIENT VISIT NEW | $79.50 | $159.00 | 50% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW | $79.50 | $159.00 | 50% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203,25 OFFICE/OUTPATIENT VISIT NEW | $87.45 | $159.00 | 45% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW | $87.45 | $159.00 | 45% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW | $134.00 | $268.00 | 50% |
| New patient office visit, about 45 minutes CPT 99204 99204,25 OFFICE/OUTPATIENT VISIT NEW | $134.00 | $268.00 | 50% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204,25 OFFICE/OUTPATIENT VISIT NEW | $147.40 | $268.00 | 45% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW | $147.40 | $268.00 | 45% |
| New patient office visit, about 60 minutes CPT 99205 99205,25 OFFICE/OUTPATIENT VISIT NEW | $172.50 | $345.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW | $172.50 | $345.00 | 50% |
| New patient office visit, about 60 minutes CPT 99205 99205,LT OFFICE/OUTPATIENT VISIT NEW | $172.50 | $345.00 | 50% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205,LT OFFICE/OUTPATIENT VISIT NEW | $189.75 | $345.00 | 45% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW | $189.75 | $345.00 | 45% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205,25 OFFICE/OUTPATIENT VISIT NEW | $189.75 | $345.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISES | $41.50 | $83.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - UDS 185 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - UDS 181 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 185 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 181 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185 | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge | $133.00 | $266.00 | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISES | $45.65 | $83.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 181 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 185 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - UDS 181 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - UDS 185 | $146.30 | $266.00 | 45% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge | $146.30 | $266.00 | 45% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 PREV VISIT NEW AGE 18-39 | $83.50 | $167.00 | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385,25 PREV VISIT NEW AGE 18-39 | $83.50 | $167.00 | 50% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385,25 PREV VISIT NEW AGE 18-39 | $91.85 | $167.00 | 45% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 PREV VISIT NEW AGE 18-39 | $91.85 | $167.00 | 45% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 PREV VISIT NEW AGE 40-64 | $102.00 | $204.00 | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386,25 PREV VISIT NEW AGE 40-64 | $102.00 | $204.00 | 50% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386,25 PREV VISIT NEW AGE 40-64 | $112.20 | $204.00 | 45% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 PREV VISIT NEW AGE 40-64 | $112.20 | $204.00 | 45% |
| Psychotherapy session, 30 minutes CPT 90832 90832 PSYTX PT&/FAMILY 30 MINUTES | $44.50 | $89.00 | 50% |
| Psychotherapy session, 30 minutes CPT 90832 BH CHRG - PSYCHOTHERAPY 30 MIN | $314.00 | $628.00 | 50% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 PSYTX PT&/FAMILY 30 MINUTES | $48.95 | $89.00 | 45% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 BH CHRG - PSYCHOTHERAPY 30 MIN | $345.40 | $628.00 | 45% |
| Psychotherapy session, 45 minutes CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUTES | $66.50 | $133.00 | 50% |
| Psychotherapy session, 45 minutes CPT 90834 BH CHRG - PSYCHOTHERAPY 45 MIN | $389.00 | $778.00 | 50% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUTES | $73.15 | $133.00 | 45% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 BH CHRG - PSYCHOTHERAPY 45 MIN | $427.90 | $778.00 | 45% |
| Psychotherapy session, 60 minutes CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUTES | $100.50 | $201.00 | 50% |
| Psychotherapy session, 60 minutes CPT 90837 BH CHRG - PSYCHOTHERAPY 60 MIN | $396.50 | $793.00 | 50% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUTES | $110.55 | $201.00 | 45% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 BH CHRG - PSYCHOTHERAPY 60 MIN | $436.15 | $793.00 | 45% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243,RT OFFICE CONSULTATION | $120.00 | $240.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 OFFICE CONSULTATION | $120.00 | $240.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243,25 OFFICE CONSULTATION | $120.00 | $240.00 | 50% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243 OFFICE CONSULTATION | $132.00 | $240.00 | 45% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243,RT OFFICE CONSULTATION | $132.00 | $240.00 | 45% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243,25 OFFICE CONSULTATION | $132.00 | $240.00 | 45% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244,25 OFFICE CONSULTATION | $159.00 | $318.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244 OFFICE CONSULTATION | $159.00 | $318.00 | 50% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99244,25 OFFICE CONSULTATION | $174.90 | $318.00 | 45% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99244 OFFICE CONSULTATION | $174.90 | $318.00 | 45% |