Hospital Rochester, NY

Nicholas H. Noyes Memorial Hospital

Nicholas H. Noyes Memorial Hospital in Dansville, NY publishes cash prices for 405 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New York median for 369 of 400 procedures and above it for 30. By typical cash price it ranks #26 of 115 New York hospitals and #2 of 10 hospitals in the Rochester, NY area, cheapest first. Select a procedure to compare it with other hospitals nearby.

111 Clara Barton Street, Dansville, NY 14437 Collected Sep 23, 2026 Source price file Check a bill from this hospital (585) 335-6001

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 330238 · CMS hospital register NPI 1982625661

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Nicholas H. Noyes Memorial Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

New York law (Public Health Law §2807-k(9-a), as amended in October 2024): uninsured patients with income below 200% of the federal poverty level owe nothing for emergency and medically necessary hospital care; up to 400% they pay on a sliding scale of at most 10% or 20% of what Medicaid would pay. Emergency care is covered for New York residents, other care for people living in the hospital's service area; immigration status does not count. Ask for the Uniform Hospital Financial Assistance form. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Abdominal CT scan without and with contrast CPT 74170 HB CT Abdomen W/O & W/Contrast Material	$264.00	—	—	80% below	—
Abdominal X-ray, 2 views CPT 74019 HB Radiologic Exam Abdomen 2 Views	$158.00	—	—	39% below	—
Ankle X-ray, complete, 3 or more views CPT 73610 CHG RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	62% below	40%
Ankle X-ray, complete, 3 or more views CPT 73610 HB Radex Ankle Complete Minimum 3 Views	$130.00	—	—	36% below	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 CHG RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non-Invas Physiologic Std Extremity Art 2 Level	$216.00	—	—	32% below	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$223.02	$374.00	—	30% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL	$223.02	$374.00	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HB CT Upper Extremity W/O Contrast Material	$158.00	—	—	79% below	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Contrast X-Ray Esophagus	$264.00	—	—	23% below	—
Bone scan, whole body (nuclear medicine) CPT 78306 HB Bone &/Joint Imaging Whole Body	$594.00	—	—	40% below	—
Breast ultrasound, complete, one breast CPT 76641 HB Ultrasound Breast Complete	$158.00	—	—	51% below	—
Breast ultrasound, limited (one breast or one area) CPT 76642 HB Ultrasound Breast Limited	$170.00	—	—	33% below	—
Breast ultrasound, limited (one breast or one area) CPT 76642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED	$211.09	$354.00	—	17% below	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 CHG US BREAST UNI REAL TIME WITH IMAGE LIMITED	$211.09	$354.00	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CT Angio Abd&Plvis Cntrst Mtrl W/WO Cntrst Img	$528.00	—	—	70% below	—
CT angiography (CTA) of the head CPT 70496 HB CT Angiography Head W/Contrast/Noncontrast	$264.00	—	—	79% below	—
CT angiography (CTA) of the neck CPT 70498 HB CT Angiography Neck W/Contrast/Noncontrast	$264.00	—	—	79% below	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CT Angiography Chest W/Contrast/Noncontrast	$264.00	—	—	80% below	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT Abdomen & Pelvis W/O Contrast Material	$358.00	—	—	69% below	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT Abdomen & Pelvis W/Contrast Material	$528.00	—	—	66% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HB CT Abdomen & Pelvis W/O Contrst 1/> Body Re	$528.00	—	—	75% below	—
CT scan of the abdomen with contrast CPT 74160 HB CT Abdomen W/Contrast Material	$264.00	—	—	77% below	—
CT scan of the abdomen without contrast CPT 74150 HB CT Abdomen W/O Contrast Material	$158.00	—	—	83% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT Maxillofacial W/O Contrast Material	$158.00	—	—	80% below	—
CT scan of the head or brain, no contrast dye CPT 70450 HB CT Head/Brain W/O Contrast Material	$158.00	—	—	81% below	—
CT scan of the head with contrast CPT 70460 HB CT Head/Brain W/Contrast Material	$264.00	—	—	73% below	—
CT scan of the head without and with contrast CPT 70470 HB CT Head/Brain W/O & W/Contrast Material	$264.00	—	—	75% below	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HB CT Lumbar Spine W/O Contrast Material	$158.00	—	—	82% below	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT Cervical Spine W/O Contrast Material	$158.00	—	—	83% below	—
CT scan of the pelvis, with contrast dye CPT 72193 HB CT Pelvis W/Contrast Material	$264.00	—	—	74% below	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Scan Extracranial Art Compl Bi Study	$358.00	—	—	—	—
Chest X-ray, 2 views CPT 71046 HB Radiologic Exam Chest 2 Views	$130.00	—	—	36% below	—
Chest X-ray, single view CPT 71045 HB Radiologic Exam Chest Single View	$130.00	—	—	34% below	—
Collarbone (clavicle) X-ray, complete CPT 73000 CHG RADEX CLAVICLE COMPLETE	$76.33	$128.00	—	62% below	40%
Collarbone (clavicle) X-ray, complete CPT 73000 HB Radex Clavicle Complete	$130.00	—	—	36% below	—
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 CHG RADEX CLAVICLE COMPLETE	$76.33	$128.00	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HB US Retroperitoneal Real Time W/Image Complete	$456.00	—	—	8% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 CHG DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$102.56	$172.00	—	63% below	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HB DXA Bone Density Study 1/> Sites Axial Skel	$158.00	—	—	43% below	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 CHG DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$102.56	$172.00	—	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 CHG DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$76.33	$128.00	—	47% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HB DXA Bone Density Study 1/>Sites Appendiclr Skel	$130.00	—	—	10% below	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 CHG DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL	$76.33	$128.00	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB US Preg Uterus W/Detail Fetal Anat 1st Gestation	$358.00	—	—	37% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT Thorax W/O Contrast Material	$158.00	—	—	82% below	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HB CT Thorax W/Contrast Material	$264.00	—	—	80% below	—
Diagnostic mammogram, both breasts both sides CPT 77066 HB Diagnostic Mammography Computer-Aided Detcj Bi	$208.00	—	—	—	—
Diagnostic mammogram, one breast CPT 77065 HB Diagnostic Mammography Computer-Aided Detcj Uni	$176.00	—	—	37% below	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study	$358.00	—	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HB Dup-Scan Xtr Veins Complete Bilateral Study	$358.00	—	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W or WO Fol Wcon,Doppler	$811.00	—	—	27% below	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Tthrc R-T 2d W/Wom-Mode Compl Spec&Colr D	$811.00	—	—	27% below	—
Elbow X-ray, 2 views CPT 73070 CHG RADEX ELBOW 2 VIEWS	$76.33	$128.00	—	62% below	40%
Elbow X-ray, 2 views CPT 73070 HB Radex Elbow 2 Views	$130.00	—	—	35% below	—
Elbow X-ray, 2 views inpatient CPT 73070 CHG RADEX ELBOW 2 VIEWS	$76.33	$128.00	—	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 CHG RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	62% below	40%
Elbow X-ray, complete, 3 or more views CPT 73080 HB Radex Elbow Complete Minimum 3 Views	$130.00	—	—	36% below	—
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 CHG RADEX ELBOW COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 HB CT Orbit Sella/Post Fossa/Ear W/O Contrast Matrl	$158.00	—	—	79% below	—
Facial bones X-ray, complete, 3 or more views CPT 70150 HB Radex Facial Bones Complete Minimum 3 Views	$158.00	—	—	42% below	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 CHG RADEX FOREARM 2 VIEWS	$76.33	$128.00	—	62% below	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HB Radex Forearm 2 Views	$130.00	—	—	36% below	—
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 CHG RADEX FOREARM 2 VIEWS	$76.33	$128.00	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HB Hepatobiliary Syst Imaging Including Gallbladder	$594.00	—	—	42% below	—
Hand X-ray, 2 views CPT 73120 CHG RADEX HAND 2 VIEWS	$102.56	$172.00	—	51% below	40%
Hand X-ray, 2 views CPT 73120 HB Radex Hand 2 Views	$158.00	—	—	24% below	—
Hand X-ray, 2 views inpatient CPT 73120 CHG RADEX HAND 2 VIEWS	$102.56	$172.00	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CHG RADEX CALCANEUS MINIMUM 2 VIEWS	$76.33	$128.00	—	60% below	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HB Radex Calcaneus Minimum 2 Views	$130.00	—	—	32% below	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 CHG RADEX CALCANEUS MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HB Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd	$1,776.00	—	—	17% below	—
Knee X-ray, 3 views CPT 73562 CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$76.33	$128.00	—	63% below	40%
Knee X-ray, 3 views CPT 73562 HB Radiologic Examination Knee 3 Views	$130.00	—	—	37% below	—
Knee X-ray, 3 views inpatient CPT 73562 CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$76.33	$128.00	—	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$102.56	$172.00	—	63% below	40%
Knee X-ray, complete, 4 or more views CPT 73564 HB Radiologic Exam Knee Complete 4/More Views	$158.00	—	—	43% below	—
Knee X-ray, complete, 4 or more views inpatient CPT 73564 CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS	$102.56	$172.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HB CT Lower Extremity W/O Contrast Material	$158.00	—	—	79% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB Ultrasound Abdominal Real Time W/Image Limited	$196.00	—	—	48% below	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$55.46	$93.00	—	79% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HB US Extremity Non-Vasc Real-Time Img Lmtd	$158.00	—	—	41% below	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG	$55.46	$93.00	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HB Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$158.00	—	—	64% below	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$76.33	$128.00	—	62% below	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HB Radiologic Examination Tibia & Fibula 2 Views	$130.00	—	—	36% below	—
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS	$76.33	$128.00	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 HB Mra Head W/O Contrst Material	$358.00	—	—	72% below	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HB MRI Any Jt Lower Extrem W/O Contrast Matrl	$358.00	—	—	70% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HB MRI Any Jt Lower Extrem W/O & W/Contrast Matrl	$528.00	—	—	74% below	—
MRI of the abdomen without contrast CPT 74181 HB MRI Abdomen W/O Contrast Material	$358.00	—	—	67% below	—
MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI Abdomen W/O & W/Contrast Material	$528.00	—	—	69% below	—
MRI of the brain, no contrast dye CPT 70551 HB MRI Brain Brain Stem W/O Contrast Material	$358.00	—	—	69% below	—
MRI of the brain, with and without contrast dye CPT 70553 HB MRI Brain Brain Stem W/O W/Contrast Material	$528.00	—	—	70% below	—
MRI of the lower back, no contrast dye CPT 72148 HB MRI Spinal Canal Lumbar W/O Contrast Material	$358.00	—	—	73% below	—
MRI of the lower back, without and then with contrast dye CPT 72158 HB MRI Spinal Canal Lumbar W/O & W/Contr Matrl	$528.00	—	—	70% below	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HB MRI Spinal Canal Thoracic W/O Contrast Matrl	$358.00	—	—	72% below	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 HB MRI Spinal Canal Cervical W/O & W/Contr Matrl	$528.00	—	—	68% below	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 HB MRI Spinal Canal Cervical W/O Contrast Matrl	$358.00	—	—	73% below	—
MRI of the pelvis without and with contrast CPT 72197 HB MRI Pelvis W/O & W/Contrast Material	$528.00	—	—	67% below	—
MRI of the pelvis, no contrast dye CPT 72195 HB MRI Pelvis W/O Contrast Material	$358.00	—	—	67% below	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HB MRI Any Jt Upper Extremity W/O Contrast Matrl	$358.00	—	—	72% below	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS	$102.56	$172.00	—	64% below	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HB Radex Spine Cervical 4 or 5 Views	$158.00	—	—	44% below	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS	$102.56	$172.00	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 HB CT Soft Tissue Neck W/Contrast Material	$264.00	—	—	74% below	—
Neck soft tissue CT scan without contrast CPT 70490 HB CT Soft Tissue Neck W/O Contrast Material	$158.00	—	—	80% below	—
Neck soft tissue X-ray CPT 70360 HB Radiologic Examination Neck Soft Tissue	$130.00	—	—	36% below	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial Spect Multiple Studies	$1,931.00	—	—	28% below	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB Pet Imaging CT Attenuation Skull Base Mid-Thigh	$2,158.00	—	—	46% below	—
Pelvic CT scan without contrast CPT 72192 HB CT Pelvis W/O Contrast Material	$158.00	—	—	81% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$39.95	$67.00	—	87% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US Pelvic Nonobstetric Image Dcmtn Limited/F/U	$158.00	—	—	48% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$39.95	$67.00	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HB US Pelvic Nonobstetric Real-Time Image Complete	$162.00	—	—	59% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB US Preg Uterus After 1st Trimest 1/1st Gestation	$377.00	—	—	at median	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat	$158.00	—	—	55% below	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 CHG US PREGNANT UTERUS LIMITED 1/> FETUSES	$51.88	$87.00	—	82% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HB US Pregnant Uterus Limited 1/> Fetuses	$158.00	—	—	45% below	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 CHG US PREGNANT UTERUS LIMITED 1/> FETUSES	$51.88	$87.00	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 CHG RADEX RIBS UNILATERAL 2 VIEWS	$76.33	$128.00	—	64% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 HB Radex Ribs Unilateral 2 Views	$130.00	—	—	38% below	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CHG RADEX RIBS UNILATERAL 2 VIEWS	$76.33	$128.00	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HB Radex Ribs Uni W/Posteroant Ch Minimum 3 Views	$158.00	—	—	39% below	—
Screening mammogram, both breasts both sides CPT 77067 HB Screening Mammography Bi 2-View Breast Inc Cad	$166.00	—	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 CHG RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$76.33	$128.00	—	64% below	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 HB Radex Shoulder Complete Minimum 2 Views	$130.00	—	—	38% below	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 CHG RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 HB Radex Sinuses Paranasal Compl Minimum 3 Views	$178.00	—	—	15% below	—
Skull X-ray, fewer than 4 views CPT 70250 HB Radiologic Examination Skull <4 Views	$158.00	—	—	32% below	—
Sleep study in a lab (polysomnography) CPT 95810 HB Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$1,678.00	—	—	20% below	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 HB Swallowing Funcj W/Cineradiograpy/Vidradiog	$264.00	—	—	27% below	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$76.33	$128.00	—	61% below	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HB X-Ray Exam of Femur Min 2 Views	$130.00	—	—	34% below	—
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HB CT Thoracic Spine W/O Contrast Material	$158.00	—	—	82% below	—
Toe X-ray, 2 or more views CPT 73660 CHG RADEX TOE MINIMUM 2 VIEWS	$76.33	$128.00	—	55% below	40%
Toe X-ray, 2 or more views CPT 73660 HB Radex Toe Minimum 2 Views	$130.00	—	—	23% below	—
Toe X-ray, 2 or more views inpatient CPT 73660 CHG RADEX TOE MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 CHG US TRANSVAGINAL	$55.46	$93.00	—	85% below	40%
Transvaginal pelvic ultrasound CPT 76830 HB Ultrasound Transvaginal	$158.00	—	—	59% below	—
Transvaginal pelvic ultrasound inpatient CPT 76830 CHG US TRANSVAGINAL	$55.46	$93.00	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$60.23	$101.00	—	79% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 HB US Preg Uterus Real Time W/Image Dcmtn Transvag	$158.00	—	—	46% below	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$60.23	$101.00	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$191.41	$321.00	—	59% below	40%
Ultrasound of the abdomen, complete CPT 76700 HB US Abdominal Real Time W/Image Documentation	$328.00	—	—	30% below	—
Ultrasound of the abdomen, complete inpatient CPT 76700 CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$191.41	$321.00	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 HB Ultrasound Scrotum & Contents	$158.00	—	—	57% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US Soft Tissue Head & Neck Real Time Imge Docm	$322.00	—	—	12% below	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB Radex GI Tract Upper W/WO Delayed Films W/O Kub	$264.00	—	—	37% below	—
Upper arm X-ray (humerus), 2 views CPT 73060 CHG RADEX HUMERUS MINIMUM 2 VIEWS	$76.33	$128.00	—	62% below	40%
Upper arm X-ray (humerus), 2 views CPT 73060 HB Radex Humerus Minimum 2 Views	$130.00	—	—	36% below	—
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 CHG RADEX HUMERUS MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HB Dup-Scan Xtr Veins Unilateral/Limited Study	$158.00	—	—	57% below	—
Wrist X-ray, 2 views CPT 73100 CHG RADEX WRIST 2 VIEWS	$76.33	$128.00	—	61% below	40%
Wrist X-ray, 2 views CPT 73100 HB Radex Wrist 2 Views	$130.00	—	—	33% below	—
Wrist X-ray, 2 views inpatient CPT 73100 CHG RADEX WRIST 2 VIEWS	$76.33	$128.00	—	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 CHG RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	62% below	40%
Wrist X-ray, complete, 3 or more views CPT 73110 HB Radex Wrist Complete Minimum 3 Views	$130.00	—	—	36% below	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 CHG RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HB X-Ray Exam Hip Uni 2-3 Views	$130.00	—	—	43% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$78.71	$132.00	—	66% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$78.71	$132.00	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 HB Radiologic Exam Abdomen 1 View	$130.00	—	—	38% below	—
X-ray of the ankle, 2 views CPT 73600 CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$76.33	$128.00	—	60% below	40%
X-ray of the ankle, 2 views CPT 73600 HB Radiologic Examination Ankle 2 Views	$130.00	—	—	32% below	—
X-ray of the ankle, 2 views inpatient CPT 73600 CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 CHG RADEX FINGR MINIMUM 2 VIEWS	$76.33	$128.00	—	58% below	40%
X-ray of the finger(s), 2 or more views CPT 73140 HB Radex Fingr Minimum 2 Views	$130.00	—	—	28% below	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 CHG RADEX FINGR MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the foot, 2 views CPT 73620 CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$76.33	$128.00	—	61% below	40%
X-ray of the foot, 2 views CPT 73620 HB Radiologic Examination Foot 2 Views	$130.00	—	—	34% below	—
X-ray of the foot, 2 views inpatient CPT 73620 CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	62% below	40%
X-ray of the foot, complete, 3 or more views CPT 73630 HB Radex Foot Complete Minimum 3 Views	$130.00	—	—	36% below	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the hand, 3 or more views CPT 73130 CHG RADEX HAND MINIMUM 3 VIEWS	$76.33	$128.00	—	64% below	40%
X-ray of the hand, 3 or more views CPT 73130 HB Radex Hand Minimum 3 Views	$130.00	—	—	38% below	—
X-ray of the hand, 3 or more views inpatient CPT 73130 CHG RADEX HAND MINIMUM 3 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$76.33	$128.00	—	63% below	40%
X-ray of the knee, 1 or 2 views CPT 73560 HB Radiologic Examination Knee 1/2 Views	$130.00	—	—	36% below	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 CHG RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$102.56	$172.00	—	63% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HB Radex Spine Lumbosacral 2/3 Views	$158.00	—	—	43% below	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 CHG RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$102.56	$172.00	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$102.56	$172.00	—	66% below	40%
X-ray of the lower back, 4 or more views CPT 72110 HB Radex Spine Lumbosacral Minimum 4 Views	$158.00	—	—	48% below	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$102.56	$172.00	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 CHG RADEX SPINE THORACIC 2 VIEWS	$102.56	$172.00	—	54% below	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB Radex Spine Thoracic 2 Views	$158.00	—	—	29% below	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 CHG RADEX SPINE THORACIC 2 VIEWS	$102.56	$172.00	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HB Radex Nasal Bones Complete Minimum 3 Views	$134.00	—	—	34% below	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS	$76.33	$128.00	—	64% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB Radex Spine Cervical 2 or 3 Views	$130.00	—	—	39% below	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS	$76.33	$128.00	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$102.56	$172.00	—	55% below	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 HB Radiologic Examination Pelvis 1/2 Views	$158.00	—	—	30% below	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$102.56	$172.00	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$76.33	$128.00	—	62% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HB Radex Sacrum & Coccyx Minimum 2 Views	$178.00	—	—	12% below	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$76.33	$128.00	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
ACTH blood test CPT 82024 HB Adrenocorticotropic Hormone Acth	$92.00	—	—	35% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB Transferase Alanine Amino Alt Sgpt	$12.00	—	—	48% below	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 CHG TRANSFERASE ALANINE AMINO ALT SGPT	$37.57	$63.00	—	62% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 CHG TRANSFERASE ALANINE AMINO ALT SGPT	$37.57	$63.00	—	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 HB Transferase Aspartate Amino Ast Sgot	$12.00	—	—	50% below	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB Acute Hepatitis Panel	$148.00	—	—	15% below	—
Albumin blood test CPT 82040 HB Albumin Serum Plasma/Whole Blood	$12.00	—	—	34% below	—
Albumin blood test CPT 82040 CHG ALBUMIN SERUM PLASMA/WHOLE BLOOD	$14.91	$25.00	—	18% below	40%
Albumin blood test inpatient CPT 82040 CHG ALBUMIN SERUM PLASMA/WHOLE BLOOD	$14.91	$25.00	—	—	40%
Aldosterone blood test CPT 82088 HB Assay of Aldosterone	$126.00	—	—	at median	—
Alkaline phosphatase (ALP) blood test CPT 84075 HB Assay of Phosphatase Alkaline	$14.00	—	—	31% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 HB Allergen Specific Ige Quan/Semiquan Ea Allergen	$31.00	—	—	94% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 CHG ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$36.97	$62.00	—	131% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$36.97	$62.00	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 HB Maternal Serum Screen, Afp	$51.00	—	—	18% below	—
Alpha-fetoprotein (AFP) blood test CPT 82105 HB Alpha-Fetoprotein Serum	$51.00	—	—	18% below	—
Ammonia blood test CPT 82140 HB Assay of Ammonia	$38.00	—	—	29% below	—
Amylase blood test CPT 82150 HB Assay of Amylase	$18.00	—	—	40% below	—
Amylase blood test CPT 82150 CHG ASSAY OF AMYLASE	$22.06	$37.00	—	27% below	40%
Amylase blood test inpatient CPT 82150 CHG ASSAY OF AMYLASE	$22.06	$37.00	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB Cyclic Citrullinated Peptide Antibody	$20.00	—	—	58% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 HB Antinuclear Antibodies Ana	$28.00	—	—	37% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 CHG ANTINUCLEAR ANTIBODIES ANA	$33.39	$56.00	—	25% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CHG ANTINUCLEAR ANTIBODIES ANA	$33.39	$56.00	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HB Natriuretic Peptide	$48.00	—	—	61% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB Cul Bact Xcpt Urine Blood/Stool Aerobic Isol	$32.00	—	—	1% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CHG CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$38.16	$64.00	—	20% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CHG CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL	$38.16	$64.00	—	—	40%
Basic metabolic panel (blood test) CPT 80048 HB Basic Metabolic Panel Calcium Total	$22.00	—	—	62% below	—
Bilirubin blood test, total CPT 82247 HB Bilirubin Total	$12.00	—	—	47% below	—
Bilirubin blood test, total CPT 82247 CHG BILIRUBIN TOTAL	$14.91	$25.00	—	34% below	40%
Bilirubin blood test, total inpatient CPT 82247 CHG BILIRUBIN TOTAL	$14.91	$25.00	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CHG LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$61.42	$103.00	—	60% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB Level IV Surg Pathology Gross&Microscopic Exam	$147.00	—	—	4% below	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB Level IV Surg Pathology Gross&Microscopic Exam	$198.00	—	—	30% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CHG LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM	$61.42	$103.00	—	—	40%
Blood culture for bacteria CPT 87040 HB Culture Bacterial Blood Aerobic W/ID Isolates	$32.00	—	—	49% below	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB Collection Venous Blood Venipuncture	$10.00	—	—	33% below	—
Blood glucose (sugar) test CPT 82947 Glucose Quantitative Blood Xcpt Reagent Strip	$11.00	—	—	39% below	—
Blood lead test CPT 83655 CHG ASSAY OF LEAD	$22.06	$37.00	—	50% below	40%
Blood lead test CPT 83655 HB Assay of Lead	$32.00	—	—	27% below	—
Blood lead test inpatient CPT 83655 CHG ASSAY OF LEAD	$22.06	$37.00	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HB Gonadotropin Chorionic Qualitative	$18.00	—	—	44% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 CHG BLOOD TYPING SEROLOGIC ABO	$19.08	$32.00	—	87% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB Blood Typing Abo	$190.00	—	—	25% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB Blood Typing, Serologic; Abo	$190.00	—	—	25% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 CHG BLOOD TYPING SEROLOGIC ABO	$19.08	$32.00	—	—	40%
Blood urea nitrogen (BUN) test CPT 84520 HB Assay of Urea Nitrogen Quantitative	$11.00	—	—	51% below	—
Blood urea nitrogen (BUN) test CPT 84520 CHG ASSAY OF UREA NITROGEN QUANTITATIVE	$13.12	$22.00	—	41% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 CHG ASSAY OF UREA NITROGEN QUANTITATIVE	$13.12	$22.00	—	—	40%
C-peptide blood test CPT 84681 HB Assay of C-Peptide	$42.00	—	—	51% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB C-Reactive Protein	$10.00	—	—	62% below	—
C. difficile toxin gene test (stool PCR) CPT 87493 HB Inf Agent Det Nucleic Acid Clostridium Amp Probe	$42.00	—	—	67% below	—
CA 19-9 blood test (tumor marker) CPT 86301 HB Immunoassay Tumor Antigen Quantitative Ca 19-9	$62.00	—	—	18% below	—
CA-125 blood test (ovarian cancer marker) CPT 86304 HB Immunoassay Tumor Antigen Quantitative Ca 125	$62.00	—	—	19% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB Coronavirus Ql Pcr Low	$42.00	—	—	57% below	—
Calcium blood test, total CPT 82310 HB Calcium Total	$12.00	—	—	53% below	—
Calcium blood test, total CPT 82310 CHG CALCIUM TOTAL	$14.91	$25.00	—	41% below	40%
Calcium blood test, total inpatient CPT 82310 CHG CALCIUM TOTAL	$14.91	$25.00	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 HB Carcinoembryonic Antigen Cea	$44.00	—	—	46% below	—
Chickenpox (varicella) immunity blood test CPT 86787 HB Antibody Varicella-Zoster	$40.00	—	—	11% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB Iadna Chlamydia Trachomatis Amplified Probe Tq	$48.00	—	—	52% below	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL	$23.26	$39.00	—	66% below	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB Lipid Panel	$31.00	—	—	54% below	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL	$23.26	$39.00	—	—	40%
Complete blood count (CBC) with differential CPT 85025 HB Blood Count Complete Auto&Auto Difrntl Wbc	$14.00	—	—	66% below	—
Complete blood count (CBC), no differential CPT 85027 HB Blood Count Complete Automated	$15.00	—	—	48% below	—
Comprehensive metabolic panel (blood test) CPT 80053 HB Comprehensive Metabolic Panel	$40.00	—	—	31% below	—
Cortisol blood test, total CPT 82533 CHG CORTISOL TOTAL	$35.18	$59.00	—	28% below	40%
Cortisol blood test, total CPT 82533 HB Cortisol Total	$38.00	—	—	22% below	—
Cortisol blood test, total inpatient CPT 82533 CHG CORTISOL TOTAL	$35.18	$59.00	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 HB Creatine Kinase Total	$16.00	—	—	36% below	—
Creatinine blood test CPT 82565 HB Creatinine Blood	$12.00	—	—	51% below	—
Cytomegalovirus (CMV) antibody test CPT 86644 HB Antibody Cytomegalovirus Cmv	$50.00	—	—	4% below	—
Cytomegalovirus (CMV) antibody test CPT 86644 CHG ANTIBODY CYTOMEGALOVIRUS CMV	$59.03	$99.00	—	13% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CHG ANTIBODY CYTOMEGALOVIRUS CMV	$59.03	$99.00	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 HB Dehydroepiandrosterone-Sulfate	$72.00	—	—	15% below	—
DHEA sulfate (DHEA-S) blood test CPT 82627 CHG DEHYDROEPIANDROSTERONE-SULFATE	$86.46	$145.00	—	2% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 CHG DEHYDROEPIANDROSTERONE-SULFATE	$86.46	$145.00	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Semi Quant Thc UR	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Ethyl Glucuronide Scr W/Rfx Cn UR	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Drug Presumptive Analyzer	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Ethanol	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Drug Svreen Serum W/ Conf	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 HB Additional Drug(S) (Dtp)	$74.00	—	—	39% below	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 CHG DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$76.33	$128.00	—	37% below	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CHG DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE	$76.33	$128.00	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HB Electrolyte Panel	$27.00	—	—	14% below	—
Epstein-Barr virus (EBV) antibody test CPT 86665 HB Antibody Epstein-Barr Eb Virus Viral Capsid Vca	$41.00	—	—	10% below	—
Epstein-Barr virus (EBV) antibody test CPT 86665 CHG ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$48.90	$82.00	—	7% above	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 CHG ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA	$48.90	$82.00	—	—	40%
Estradiol blood test CPT 82670 HB Assay of Estradiol	$82.00	—	—	20% below	—
Estradiol blood test CPT 82670 CHG ASSAY OF TOTAL ESTRADIOL	$114.49	$192.00	—	12% above	40%
Estradiol blood test inpatient CPT 82670 CHG ASSAY OF TOTAL ESTRADIOL	$114.49	$192.00	—	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 HB Gonadotropin Follicle Stimulating Hormone	$76.00	—	—	1% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 HB Calprotectin, Fecal	$49.00	—	—	46% below	—
Fecal calprotectin (stool inflammation test) CPT 83993 HB Assay of Calprotectin Fecal	$158.00	—	—	74% above	—
Ferritin blood test (iron stores) CPT 82728 HB Assay of Ferritin	$32.00	—	—	47% below	—
Fibrinogen blood test CPT 85384 HB Fibrinogen Activity	$22.00	—	—	42% below	—
Folate (folic acid) blood test CPT 82746 HB Assay of Folic Acid Serum	$20.00	—	—	64% below	—
Folate (folic acid) blood test CPT 82746 CHG ASSAY OF FOLIC ACID SERUM	$47.11	$79.00	—	14% below	40%
Folate (folic acid) blood test inpatient CPT 82746 CHG ASSAY OF FOLIC ACID SERUM	$47.11	$79.00	—	—	40%
Free T3 thyroid hormone test CPT 84481 HB Assay of Triiodothyronine T3 Free	$34.00	—	—	46% below	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 HB Assay of Free Thyroxine	$27.00	—	—	44% below	—
Free testosterone test CPT 84402 HB Assay of Testosterone Free	$38.00	—	—	59% below	—
Free testosterone test CPT 84402 HB Testosterone, Free	$38.00	—	—	59% below	—
Free testosterone test CPT 84402 HB Testosterone; Free	$38.00	—	—	59% below	—
Free testosterone test CPT 84402 CHG ASSAY OF TESTOSTERONE FREE	$75.73	$127.00	—	18% below	40%
Free testosterone test inpatient CPT 84402 CHG ASSAY OF TESTOSTERONE FREE	$75.73	$127.00	—	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB Assay of Glutamyltrase Gamma	$52.00	—	—	93% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HB General Health Panel	$30.00	—	—	81% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB Glucose Post Glucose Dose	$11.00	—	—	48% below	—
Glucose tolerance test, 3 samples CPT 82951 HB Glucose Tolerance Test Gtt 3 Specimens	$27.00	—	—	53% below	—
Glucose tolerance test, 3 samples CPT 82951 CHG GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$32.20	$54.00	—	44% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 CHG GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$32.20	$54.00	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB Iadna Neisseria Gonorrhoeae Amplified Probe Tq	$62.00	—	—	38% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHG IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$63.21	$106.00	—	37% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHG IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ	$63.21	$106.00	—	—	40%
H. pylori antibody blood test CPT 86677 HB Antibody Helicobacter Pylori	$48.00	—	—	9% below	—
H. pylori antibody blood test CPT 86677 CHG ANTIBODY HELICOBACTER PYLORI	$57.84	$97.00	—	10% above	40%
H. pylori antibody blood test inpatient CPT 86677 CHG ANTIBODY HELICOBACTER PYLORI	$57.84	$97.00	—	—	40%
H. pylori stool antigen test CPT 87338 HB Iaad Eia Hpylori Stool	$49.00	—	—	8% below	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB Iadna Hiv-1 Quant & Reverse Transcription	$126.00	—	—	46% below	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB Iaad Eia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single	$26.00	—	—	64% below	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HB Hpv High Risk Nucleic Acd	$60.00	—	—	37% below	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HB Iadna Human Papillomavirus High-Risk Types	$60.00	—	—	37% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB Hemoglobin Glycosylated A1c	$22.00	—	—	39% below	—
Hemoglobin blood test CPT 85018 HB Blood Count Hemoglobin	$8.00	—	—	45% below	—
Hepatitis B core antibody test (total) CPT 86704 HB Hepatitis B Core Antibody Hbcab Total	$30.00	—	—	31% below	—
Hepatitis B core antibody test (total) CPT 86704 CHG HEPATITIS B CORE ANTIBODY HBCAB TOTAL	$35.78	$60.00	—	18% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 CHG HEPATITIS B CORE ANTIBODY HBCAB TOTAL	$35.78	$60.00	—	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB Hepatitis B Surf Antibody Hbsab	$30.00	—	—	24% below	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HB Iaad Eia Hepatitis B Surface Antigen	$32.00	—	—	14% below	—
Hepatitis C antibody blood test (screening) CPT 86803 HB Hepatitis C Antibody	$46.00	—	—	13% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HB Iadna Hepatitis C Quant & Reverse Transcription	$132.00	—	—	3% below	—
Herpes blood test, HSV-1 antibody CPT 86695 HB Antibody Herpes Smplx Type 1	$27.00	—	—	33% below	—
Herpes blood test, HSV-1 antibody CPT 86695 CHG ANTIBODY HERPES SMPLX TYPE 1	$63.80	$107.00	—	58% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 CHG ANTIBODY HERPES SMPLX TYPE 1	$63.80	$107.00	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HB Antibody Herpes Smplx Type 2	$27.00	—	—	53% below	—
High-sensitivity CRP (hs-CRP) test CPT 86141 HB C-Reactive Protein High Sensitivity	$15.00	—	—	69% below	—
Homocysteine blood test CPT 83090 CHG ASSAY OF HOMOCYSTEINE	$63.80	$107.00	—	13% below	40%
Homocysteine blood test CPT 83090 HB Assay of Homocysteine	$168.00	—	—	130% above	—
Homocysteine blood test inpatient CPT 83090 CHG ASSAY OF HOMOCYSTEINE	$63.80	$107.00	—	—	40%
Insulin blood test CPT 83525 CHG ASSAY OF INSULIN TOTAL	$29.22	$49.00	—	31% below	40%
Insulin blood test CPT 83525 HB Assay of Insulin Total	$44.00	—	—	4% above	—
Insulin blood test inpatient CPT 83525 CHG ASSAY OF INSULIN TOTAL	$29.22	$49.00	—	—	40%
Iron blood test (serum iron) CPT 83540 HB Assay of Iron	$16.00	—	—	38% below	—
Iron-binding capacity (TIBC) test CPT 83550 HB Iron Binding Capacity	$27.00	—	—	33% below	—
Iron-binding capacity (TIBC) test CPT 83550 CHG IRON BINDING CAPACITY	$32.20	$54.00	—	20% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 CHG IRON BINDING CAPACITY	$32.20	$54.00	—	—	40%
Kidney function blood test panel CPT 80069 HB Renal Function Panel	$10.00	—	—	85% below	—
LH (luteinizing hormone) test CPT 83002 HB Gonadotropin Luteinizing Hormone	$76.00	—	—	2% below	—
Lactate (lactic acid) blood test CPT 83605 Assay of Lactate	$40.00	—	—	1% below	—
Lactate dehydrogenase (LDH) blood test CPT 83615 HB Lactate Dehydrogenase Ldh	$27.00	—	—	21% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 CHG LACTATE DEHYDROGENASE LDH	$32.20	$54.00	—	45% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CHG LACTATE DEHYDROGENASE LDH	$32.20	$54.00	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 HB Assay of Lipase	$22.00	—	—	22% below	—
Lipase blood test (pancreas enzyme) CPT 83690 HB Lipase Fluid	$22.00	—	—	22% below	—
Liver function blood test panel CPT 80076 HB Hepatic Function Panel	$28.00	—	—	51% below	—
Lyme disease antibody test CPT 86618 HB Antibody Borrelia Burgdorferi Lyme Disease	$54.00	—	—	11% above	—
Magnesium blood test CPT 83735 HB Assay of Magnesium	$22.00	—	—	11% below	—
Magnesium blood test CPT 83735 CHG ASSAY OF MAGNESIUM	$26.83	$45.00	—	8% above	40%
Magnesium blood test inpatient CPT 83735 CHG ASSAY OF MAGNESIUM	$26.83	$45.00	—	—	40%
Measles (rubeola) antibody test CPT 86765 CHG ANTIBODY RUBEOLA	$29.82	$50.00	—	36% below	40%
Measles (rubeola) antibody test CPT 86765 HB Antibody Rubeola	$48.00	—	—	4% above	—
Measles (rubeola) antibody test inpatient CPT 86765 CHG ANTIBODY RUBEOLA	$29.82	$50.00	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HB Heterophile Antibodies Screen	$12.00	—	—	65% below	—
Mumps immunity blood test CPT 86735 CHG ANTIBODY MUMPS	$23.85	$40.00	—	44% below	40%
Mumps immunity blood test CPT 86735 HB Antibody Mumps	$45.00	—	—	6% above	—
Mumps immunity blood test inpatient CPT 86735 CHG ANTIBODY MUMPS	$23.85	$40.00	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 HB Assay of Prostate Specific Antigen Free	$42.00	—	—	37% below	—
PSA (prostate-specific antigen) blood test, free CPT 84154 HB Prostate Specific Antigen Free	$42.00	—	—	37% below	—
PSA (prostate-specific antigen) blood test, free CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$50.09	$84.00	—	25% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHG ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE	$50.09	$84.00	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 HB Prostate Health Index	$62.00	—	—	7% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 HB Assay of Prostate Specific Antigen Total	$62.00	—	—	7% below	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB Cytp Cerv/Vag Auto Thin Layer Prep Mnl Screen	$28.00	—	—	60% below	—
Parathyroid hormone (PTH) blood test CPT 83970 HB Assay of Parathormone	$57.00	—	—	61% below	—
Parathyroid hormone (PTH) blood test CPT 83970 CHG ASSAY OF PARATHORMONE	$131.78	$221.00	—	10% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 CHG ASSAY OF PARATHORMONE	$131.78	$221.00	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 HB Thromboplastin Time Partial Plasma/Whole Blood	$14.00	—	—	41% below	—
Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$19.08	$32.00	—	19% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD	$19.08	$32.00	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 HB Assay of Phosphorus Inorganic	$12.00	—	—	41% below	—
Potassium blood test CPT 84132 Potassium Serum Plasma/Whole Blood	$12.00	—	—	48% below	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HB Fetal Chrom Aneup 13,18,21	$492.00	—	—	57% below	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HB Fetal Chromosomal Aneuploidy Genomic Seq Analys	$492.00	—	—	57% below	—
Progesterone blood test CPT 84144 HB Assay of Progesterone	$95.00	—	—	11% above	—
Prolactin blood test CPT 84146 HB Assay of Prolactin	$91.00	—	—	26% above	—
Prolactin blood test CPT 84146 CHG ASSAY OF PROLACTIN	$106.74	$179.00	—	48% above	40%
Prolactin blood test inpatient CPT 84146 CHG ASSAY OF PROLACTIN	$106.74	$179.00	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME	$3.58	$6.00	—	77% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$12.00	—	—	23% below	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME	$3.58	$6.00	—	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HB Iaadiadoo Streptococcus Group A	$12.00	—	—	70% below	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A	$23.26	$39.00	—	42% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A	$23.26	$39.00	—	—	40%
Renin blood test CPT 84244 CHG ASSAY OF RENIN	$42.34	$71.00	—	48% below	40%
Renin blood test CPT 84244 HB Renin	$64.00	—	—	21% below	—
Renin blood test CPT 84244 HB Assay of Renin	$64.00	—	—	21% below	—
Renin blood test inpatient CPT 84244 CHG ASSAY OF RENIN	$42.34	$71.00	—	—	40%
Rh blood typing CPT 86901 CHG BLOOD TYPING SEROLOGIC RH (D)	$17.89	$30.00	—	67% below	40%
Rh blood typing CPT 86901 HB Blood Typing, Serologic; Rh (D)	$58.00	—	—	5% above	—
Rh blood typing CPT 86901 HB Blood Typing Rh (D)	$58.00	—	—	5% above	—
Rh blood typing inpatient CPT 86901 CHG BLOOD TYPING SEROLOGIC RH (D)	$17.89	$30.00	—	—	40%
Rheumatoid factor (RF) test CPT 86431 HB Rheumatoid Factor Quantitative	$12.00	—	—	43% below	—
Rheumatoid factor (RF) test CPT 86431 CHG RHEUMATOID FACTOR QUANTITATIVE	$13.12	$22.00	—	37% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 CHG RHEUMATOID FACTOR QUANTITATIVE	$13.12	$22.00	—	—	40%
Rubella antibody test (immunity check) CPT 86762 HB Antibody Rubella	$26.00	—	—	42% below	—
Rubella antibody test (immunity check) CPT 86762 CHG ANTIBODY RUBELLA	$30.41	$51.00	—	32% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 CHG ANTIBODY RUBELLA	$30.41	$51.00	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HB Sedimentation Rate RBC Automated	$11.00	—	—	56% below	—
Sodium blood test CPT 84295 Sodium Serum Plasma or Whole Blood	$12.00	—	—	45% below	—
Stool ova and parasites exam CPT 87177 HB Ova&Parasites Direct Smears Concentration & ID	$16.00	—	—	51% below	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 HB Blood Occult Peroxidase Actv Qual Feces 1 Deter	$10.00	—	—	30% below	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3	$24.00	—	—	51% below	—
Syphilis antibody test (Treponema pallidum) CPT 86780 HB Antibody Treponema Pallidum	$56.00	—	—	32% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB Syphilis Test Non-Treponemal Antibody Qual	$10.00	—	—	37% below	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB TB Cell Mediated Antign Respnse Gamma Interferon	$74.00	—	—	55% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 CHG ASSAY OF TESTOSTERONE TOTAL	$39.95	$67.00	—	57% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 HB Testosterone; Total	$88.00	—	—	6% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 HB Assay of Testosterone Total	$88.00	—	—	6% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 HB Testosterone, Total	$88.00	—	—	6% below	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CHG ASSAY OF TESTOSTERONE TOTAL	$39.95	$67.00	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 HB Microsomal Antibodies Each	$22.00	—	—	59% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 CHG MICROSOMAL ANTIBODIES EACH	$59.03	$99.00	—	11% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 CHG MICROSOMAL ANTIBODIES EACH	$59.03	$99.00	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB Assay of Thyroid Stimulating Hormone Tsh	$38.00	—	—	48% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH	$45.92	$77.00	—	37% below	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY OF THYROID STIMULATING HORMONE TSH	$45.92	$77.00	—	—	40%
Total IgE blood test CPT 82785 HB Assay of Gammaglobulin Ige	$64.00	—	—	5% above	—
Total cholesterol blood test CPT 82465 HB Cholesterol Serum/Whole Blood Total	$11.00	—	—	51% below	—
Total thyroxine (T4) blood test CPT 84436 HB Assay of Thyroxine Total	$16.00	—	—	45% below	—
Total triiodothyronine (T3) blood test CPT 84480 HB Assay of Triiodothyronine T3 Total Tt3	$64.00	—	—	1% above	—
Transferrin blood test CPT 84466 HB Assay of L7383transferrin	$37.00	—	—	21% below	—
Trichomonas test (NAAT) CPT 87661 HB Iadna Trichomonas Vaginalis Amplified Probe Tech	$64.00	—	—	16% below	—
Triglycerides blood test CPT 84478 CHG ASSAY OF TRIGLYCERIDES	$16.10	$27.00	—	34% below	40%
Triglycerides blood test CPT 84478 HB Assay of Triglycerides	$27.00	—	—	10% above	—
Triglycerides blood test inpatient CPT 84478 CHG ASSAY OF TRIGLYCERIDES	$16.10	$27.00	—	—	40%
Troponin test, quantitative CPT 84484 HB Assay of Troponin Quantitative	$48.00	—	—	11% above	—
Uric acid blood test CPT 84550 HB Assay of Blood/Uric Acid	$12.00	—	—	40% below	—
Urinalysis with microscope exam, automated CPT 81001 HB Urnls Dip Stick/Tablet Reagent Auto Microscopy	$8.00	—	—	75% below	—
Urinalysis with microscope exam, manual CPT 81000 HB Urinls Dip Stick/Tablet Reagnt Non-Auto Micrscpy	$4.00	—	—	66% below	—
Urinalysis without microscope exam, automated CPT 81003 HB Urnls Dip Stick/Tablet Rgnt Auto W/O Microscopy	$8.00	—	—	53% below	—
Urinalysis without microscope exam, automated CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$9.54	$16.00	—	44% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY	$9.54	$16.00	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$4.17	$7.00	—	60% below	40%
Urinalysis without microscope exam, manual CPT 81002 HB Urnls Dip Stick/Tablet Rgnt Non-Auto W/O Micrscp	$8.00	—	—	23% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$4.17	$7.00	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 HB Culture Bacterial Quanttative Colony Count Urine	$18.00	—	—	53% below	—
Urine microalbumin (albumin) test CPT 82043 HB Albumin Urine Microalbumin Quantiative	$51.00	—	—	71% above	—
Urine pregnancy test, read by color change CPT 81025 HB Urine Pregnancy Test Visual Color Cmprsn Meths	$17.00	—	—	41% below	—
Vitamin B12 (cobalamin) blood test CPT 82607 HB Cyanocobalamin Vitamin B-12	$51.00	—	—	8% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB 25 Hydroxy Includes Fractions if Performed	$76.00	—	—	29% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CHG 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$94.81	$159.00	—	12% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CHG 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED	$94.81	$159.00	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 CHG 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED	$75.73	$127.00	—	29% below	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HB 1 25 Dihydroxy Includes Fractions if Performed	$76.00	—	—	29% below	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 CHG 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED	$75.73	$127.00	—	—	40%
Zinc blood test CPT 84630 HB Assay of Zinc	$106.00	—	—	162% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB Gonadotropin Chorionic Quantitative	$44.00	—	—	21% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB Beta Hcg Quant	$44.00	—	—	21% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHG GONADOTROPIN CHORIONIC QUANTITATIVE	$51.88	$87.00	—	7% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHG GONADOTROPIN CHORIONIC QUANTITATIVE	$51.88	$87.00	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$3,451.98	$5,789.00	—	59% below	40%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 PR ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ	$3,451.98	$5,789.00	—	—	40%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 HB Shldr Arthroscop,Surg,W/Rotat Cuff Repr	$10,567.00	—	—	25% above	—
Botox injections for chronic migraine CPT 64615 HB Chemodervate Facial/Trigem/Cerv Musc Migraine	$436.00	—	—	at median	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HB Closed Tx Metatarsal Fracture W/O Manipulation	$355.00	—	—	22% below	—
Bunion correction with removal of part of the big toe joint CPT 28292 PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$917.71	$1,539.00	—	76% below	40%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE	$917.71	$1,539.00	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$317.23	$532.00	—	69% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective Arrhythmia External	$968.00	—	—	6% below	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$317.23	$532.00	—	—	40%
Carpal tunnel release, open surgery CPT 64721 PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$865.83	$1,452.00	—	63% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 PR NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE	$865.83	$1,452.00	—	—	40%
Cataract surgery with lens implant CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$3,221.21	$5,402.00	—	19% above	40%
Cataract surgery with lens implant inpatient CPT 66984 PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP	$3,221.21	$5,402.00	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HB Circumcision W/Clamp/Oth Dev W/Block	$198.00	—	—	92% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HB Cltx Dstl Radial Fx/Epiphysl Sep W/O Manj	$355.00	—	—	37% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$568.87	$954.00	—	1% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$568.87	$954.00	—	—	40%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$546.81	$917.00	—	71% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$546.81	$917.00	—	—	40%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$821.70	$1,378.00	—	41% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$821.70	$1,378.00	—	—	40%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$797.85	$1,338.00	—	59% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$797.85	$1,338.00	—	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HB Destruction Premalignant Lesion 1st	$294.00	—	—	1% above	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HB Remove Impacted Ear Wax Unilat	$88.00	—	—	27% below	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HB Remove Impacted Ear Wax Unilat	$110.00	—	—	9% below	—
Earwax removal with instruments, one ear one side CPT 69210 HB Removal Impacted Cerumen Instrumentation Unilat	$88.00	—	—	32% below	—
Earwax removal with instruments, one ear one side CPT 69210 HB Removal Impacted Cerumen Instrumentation Unilat	$133.00	—	—	2% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB Plc Cath Interlaminar Crv/Thrc W/Img	$1,024.00	—	—	27% below	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$152.65	$256.00	—	92% below	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$152.65	$256.00	—	—	40%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,393.55	$2,337.00	—	81% below	40%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,393.55	$2,337.00	—	—	40%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,912.33	$3,207.00	—	74% below	40%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE	$1,912.33	$3,207.00	—	—	40%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$888.49	$1,490.00	—	79% below	40%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$888.49	$1,490.00	—	—	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$1,930.82	$3,238.00	—	72% below	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 PR LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY	$1,930.82	$3,238.00	—	—	40%
Hammertoe correction surgery CPT 28285 PR CORRECTION HAMMERTOE	$661.30	$1,109.00	—	83% below	40%
Hammertoe correction surgery inpatient CPT 28285 PR CORRECTION HAMMERTOE	$661.30	$1,109.00	—	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 HB Hemorrhoidectomy Internal Rubber Band Ligations	$1,348.00	—	—	18% above	—
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$2,958.24	$4,961.00	—	83% below	40%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT	$2,958.24	$4,961.00	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HB Cath & Saline/Contrast Sonohyster/Hysterosalpi	$290.00	—	—	4% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 HB Incision & Drainage Abscess Simple/Single	$294.00	—	—	27% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 HB Incision & Drainage Abscess Simple/Single	$445.00	—	—	10% above	—
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HB Repair Ing Hernia,5+Y/O,Reducibl	$5,220.00	—	—	25% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB Injection 1 Tendon Sheath/Ligament Aponeurosis	$436.00	—	—	12% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB Arthrocentesis Aspir&/Injection Major Jt/Bursa	$436.00	—	—	14% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB Arthrocentesis Aspir&/Injection Interm Jt/Burs	$438.00	—	—	4% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB Arthrocentesis Aspir&/Injection Small Jt/Bursa	$436.00	—	—	3% below	—
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$2,343.46	$3,930.00	—	39% below	40%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 PR ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL	$2,343.46	$3,930.00	—	—	40%
Knee arthroscopy with meniscus trim CPT 29881 HB PR Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg	$4,800.00	—	—	25% above	—
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HB Arthrs Knee W/Meniscectomy Med&Lat W/Shaving	$4,800.00	—	—	25% above	—
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,379.84	$2,314.00	—	64% below	40%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 PR ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG	$1,379.84	$2,314.00	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HB Repair Intermediate S/a/T/E 2.5 Cm/<	$591.00	—	—	at median	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HB Repair Intermediate S/a/T/E 2.5 Cm/<	$804.00	—	—	36% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 HB Plc Cath Interlaminar Lmbr/Sac W/Img	$1,024.00	—	—	31% below	—
Lower-back epidural injection, without imaging guidance CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$531.90	$892.00	—	63% below	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN	$531.90	$892.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$276.68	$464.00	—	82% below	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL	$276.68	$464.00	—	—	40%
Lumbar laminectomy (spinal decompression), one level CPT 63047 PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$1,843.16	$3,091.00	—	78% below	40%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 PR LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR	$1,843.16	$3,091.00	—	—	40%
Miscarriage treatment with D&C, first trimester CPT 59820 HB Surg Rx Missed Abortn,1st Tri	$4,703.00	—	—	15% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HB Exc B9 Les Mrgn Xcp Sk Tg T/a/L 0.5 Cm/<	$1,041.00	—	—	4% below	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HB Exc B9 Les Mrgn Xcp Sk Tg F/E/E/N/L/M 0.5cm/<	$1,041.00	—	—	1% below	—
Nail removal (partial or complete), one nail CPT 11730 HB Avulsion Nail Plate Partial/Complete Simple 1	$294.00	—	—	12% below	—
Nail removal (partial or complete), one nail CPT 11730 HB Avulsion Nail Plate Partial/Complete Simple 1	$379.00	—	—	14% above	—
Occipital nerve block (injection for headaches) CPT 64405 HB Injection Anesthetic Agent Greater Occipital Nrv	$436.00	—	—	8% below	—
Paracentesis with imaging guidance CPT 49083 PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$729.27	$1,223.00	—	49% below	40%
Paracentesis with imaging guidance CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging Guidance	$1,387.00	—	—	3% below	—
Paracentesis with imaging guidance inpatient CPT 49083 PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$729.27	$1,223.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB Excision Nail Matrix Permanent Removal	$591.00	—	—	19% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$485.39	$814.00	—	86% below	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL	$485.39	$814.00	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 HB Incision & Removal Foreign Body Subq Tiss Simple	$591.00	—	—	8% below	—
Removal of a foreign object under the skin, simple CPT 10120 HB Incision & Removal Foreign Body Subq Tiss Simple	$740.00	—	—	15% above	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$463.33	$777.00	—	70% below	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$463.33	$777.00	—	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$449.61	$754.00	—	58% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$449.61	$754.00	—	—	40%
Short arm cast (elbow to hand) CPT 29075 HB Application Cast Elbow Finger Short Arm	$393.00	—	—	8% below	—
Short arm splint (forearm and hand) CPT 29125 HB Application Short Arm Splint Forearm-Hand Static	$190.00	—	—	10% below	—
Short arm splint (forearm and hand) CPT 29125 HB Application Short Arm Splint Forearm-Hand Static	$248.00	—	—	18% above	—
Short leg cast (below the knee) CPT 29405 HB Application Short Leg Cast Below Knee-Toe	$393.00	—	—	20% below	—
Short leg cast (below the knee) CPT 29405 HB Application Short Leg Cast Below Knee-Toe	$482.00	—	—	2% below	—
Short leg splint (calf to foot) CPT 29515 HB Application Short Leg Splint Calf Foot	$234.00	—	—	18% below	—
Short leg splint (calf to foot) CPT 29515 HB Application Short Leg Splint Calf Foot	$304.00	—	—	6% above	—
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HB Shldr Arthroscop,Surg,Dis Claviculectomy	$4,800.00	—	—	25% above	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HB Shoulder Scope Bone Shaving	$3,344.00	—	—	22% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5cm/<	$294.00	—	—	22% below	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5cm/<	$418.00	—	—	11% above	—
Skin biopsy, punch, one lesion CPT 11104 HB Punch Biopsy Skin Single Lesion	$591.00	—	—	14% below	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$204.53	$343.00	—	76% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$204.53	$343.00	—	—	40%
Skin tag removal, up to 15 tags CPT 11200 HB Removal Skn Tags Mlt Fibrq Tags Any Area Upw/15	$294.00	—	—	19% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 HB Spinal Puncture Lumbar Diagnostic	$1,024.00	—	—	14% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB Smpl Repair Scalp/Neck/Ax/Genit/Trunk 2.6-7.5cm	$294.00	—	—	26% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB Smpl Repair Scalp/Neck/Ax/Genit/Trunk 2.6-7.5cm	$432.00	—	—	9% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB Simple Repair F/E/E/N/L/M 2.5cm/<	$294.00	—	—	22% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB Simple Repair F/E/E/N/L/M 2.5cm/<	$416.00	—	—	10% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HB Tangential Biopsy Skin Single Lesion	$294.00	—	—	41% below	—
Thoracentesis with imaging guidance CPT 32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$180.08	$302.00	—	86% below	40%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis With Image	$914.00	—	—	29% below	—
Thoracentesis with imaging guidance inpatient CPT 32555 PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$180.08	$302.00	—	—	40%
Total hip replacement CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$3,991.04	$6,693.00	—	74% below	40%
Total hip replacement inpatient CPT 27130 PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT	$3,991.04	$6,693.00	—	—	40%
Total knee replacement CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$3,874.76	$6,498.00	—	75% below	40%
Total knee replacement inpatient CPT 27447 PR ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS	$3,874.76	$6,498.00	—	—	40%
Total shoulder replacement CPT 23472 HB Arthroplasty Glenohumeral Joint Total Shoulder	$27,202.00	—	—	25% above	—
Trigger finger release surgery CPT 26055 PR TENDON SHEATH INCISION	$781.15	$1,310.00	—	70% below	40%
Trigger finger release surgery inpatient CPT 26055 PR TENDON SHEATH INCISION	$781.15	$1,310.00	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 HB Injection Single/Mlt Trigger Point 1/2 Muscles	$436.00	—	—	4% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 HB Injection Single/Mlt Trigger Point 1/2 Muscles	$488.00	—	—	16% above	—
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$617.83	$1,036.10	—	63% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$617.83	$1,036.10	—	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$640.43	$1,074.00	—	48% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 PR EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$640.43	$1,074.00	—	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$472.87	$793.00	—	71% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$472.87	$793.00	—	—	40%
Wart removal, up to 14 warts CPT 17110 HB Destruction Benign Lesions Up to 14	$294.00	—	—	15% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HB Debridement Subcutaneous Tissue 20 Sq Cm/<	$591.00	—	—	30% below	—
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HB Open Rx Distal Radius Fx, Extra-Articular	$10,582.00	—	—	25% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Emergent Transfusion 0-4 Hours	$646.00	—	—	12% below	—
Blood transfusion (giving blood or blood components) CPT 36430 HB Transfusion Blood/Blood Components	$646.00	—	—	12% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB Sputum Induction	$173.00	—	—	23% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB Mdi Nonvent Tx, Repeat Same Day	$173.00	—	—	23% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB Med Neb Tx, Repeat Same Day	$173.00	—	—	23% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB Mdi via Vent Tx, Repeat Same Day	$173.00	—	—	23% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$174.00	—	—	22% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$195.00	—	—	13% below	—
Chemotherapy IV infusion, first hour CPT 96413 HB Chemotx Admn IV Nfs Tq Up 1 Hr 1/1st Sbst/Drug	$490.00	—	—	20% below	—
Critical care, first 30 to 74 minutes CPT 99291 HB Critical Care Ill/Injured Patient Init 30-74 Min	$1,246.00	—	—	27% below	—
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$23.85	$40.00	—	61% below	40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PR ECG ROUTINE ECG W/LEAST 12 LDS W/I&R	$23.85	$40.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg Routine Ecg W/Least 12 Lds Trcg Only W/O I&R	$88.00	—	—	38% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg Routine Ecg W/Least 12 Lds Trcg Only W/O I&R	$115.00	—	—	20% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB Medical Visit Fee I	$130.00	—	—	48% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB Medical Visit Fee II	$234.00	—	—	31% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB Medical Visit Fee III	$410.00	—	—	27% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB Medical Visit Fee IV	$630.00	—	—	25% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB Medical Visit Fee V	$907.00	—	—	23% below	—
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiac Stress Test	$460.00	—	—	16% below	—
Family therapy with the patient, 50 minutes CPT 90847 HB Family Psychotherapy W/Patient Present	$110.00	—	—	61% below	—
Family therapy with the patient, 50 minutes CPT 90847 HB Family Psychotherapy W/Patient Present	$191.00	—	—	32% below	—
Family therapy without the patient, 50 minutes CPT 90846 HB Family Psychotherapy W/O Patient Present	$110.00	—	—	58% below	—
Family therapy without the patient, 50 minutes CPT 90846 HB Family Psychotherapy W/O Patient Present	$168.00	—	—	36% below	—
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$174.12	$292.00	—	34% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$174.12	$292.00	—	—	40%
Group psychotherapy session CPT 90853 HB Group Psychotherapy	$123.00	—	—	3% below	—
Group psychotherapy session CPT 90853 HB Group Psychotherapy	$152.00	—	—	20% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$59.63	$100.00	—	84% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration, Up to 1 Hr	$312.00	—	—	16% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PR IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$59.63	$100.00	—	—	40%
IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Prophylaxis /Dx 1st to 1 Hr	$312.00	—	—	25% below	—
IV push of a medicine, first drug CPT 96374 PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$115.68	$194.00	—	55% below	40%
IV push of a medicine, first drug CPT 96374 Ther Proph/Dx Njx IV Push Single/1st Sbst/Drug	$312.00	—	—	22% above	—
IV push of a medicine, first drug inpatient CPT 96374 PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG	$115.68	$194.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB Therapeutic Prophylactic/Dx Injection Subq/Im	$106.00	—	—	5% below	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB Psychiatric Diagnostic Evaluation	$110.00	—	—	57% below	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB Psychiatric Diagnostic Evaluation	$234.00	—	—	8% below	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$252.83	$424.00	—	at median	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$252.83	$424.00	—	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 HB Ot Ther Px 1/> Areas Ea 15 Min Neuromusc Reeduca	$54.00	—	—	34% below	—
Neuromuscular re-education, 15 minutes CPT 97112 HB Ther Px 1/> Areas Each 15 Min Neuromusc Reeduca	$54.00	—	—	34% below	—
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$113.30	$190.00	—	49% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$113.30	$190.00	—	—	40%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$143.11	$240.00	—	52% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$143.11	$240.00	—	—	40%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$172.93	$290.00	—	54% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$172.93	$290.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$83.48	$140.00	—	52% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$83.48	$140.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HB Medical Nutrition Assmt&Ivntj Indiv Each 15 Mi	$29.00	—	—	45% below	—
Occupational therapy evaluation, low complexity CPT 97165 HB Occupational Therapy Eval Low Complex 30 Mins	$98.00	—	—	43% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB Physical Therapy Evaluation High Complex 45 Mins	$98.00	—	—	63% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB Physical Therapy Evaluation Low Complex 20 Mins	$98.00	—	—	46% below	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB Physical Therapy Evaluation Mod Complex 30 Mins	$98.00	—	—	59% below	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB Manual Therapy Tqs 1/> Regions Each 15 Minutes	$44.00	—	—	47% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB Therapeutic Px 1/> Areas Each 15 Min Exercises	$42.00	—	—	44% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB Ot Therapeutic Px 1/> Areas Ea 15 Min Exercises	$42.00	—	—	44% below	—
Preventive checkup, new patient aged 18–39 CPT 99385 HB Initial Preventive Medicine New Pt Age 18-39yrs	$32.00	—	—	84% below	—
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$153.25	$257.00	—	24% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$153.25	$257.00	—	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 HB Initial Preventive Medicine New Patient 40-64yrs	$38.00	—	—	83% below	—
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$191.41	$321.00	—	15% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$191.41	$321.00	—	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 HB Periodic Preventive Med Est Patient 18-39 Yrs	$29.00	—	—	86% below	—
Preventive checkup, returning patient aged 18–39 CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$172.33	$289.00	—	15% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$172.33	$289.00	—	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 HB Periodic Preventive Med Est Patient 40-64yrs	$31.00	—	—	87% below	—
Preventive checkup, returning patient aged 40–64 CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$178.29	$299.00	—	24% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$178.29	$299.00	—	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 HB Periodic Preventive Med Est Patient 65yrs& Older	$33.00	—	—	84% below	—
Preventive checkup, returning patient aged 65 or older CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$158.62	$266.00	—	22% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$158.62	$266.00	—	—	40%
Psychiatric evaluation with medical services CPT 90792 HB Psychiatric Diagnostic Eval W/Medical Services	$110.00	—	—	63% below	—
Psychiatric evaluation with medical services CPT 90792 HB Psychiatric Diagnostic Eval W/Medical Services	$233.00	—	—	22% below	—
Psychiatric evaluation with medical services CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$288.01	$483.00	—	3% below	40%
Psychiatric evaluation with medical services inpatient CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$288.01	$483.00	—	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 HB Psychotherapy for Crisis Initial 60 Min	$157.00	—	—	41% below	—
Psychotherapy for crisis, first 60 minutes CPT 90839 HB Psychotherapy for Crisis Initial 60 Min	$272.00	—	—	2% above	—
Psychotherapy session, 30 minutes CPT 90832 HB Psychotherapy Patient 30 Minutes	$110.00	—	—	44% below	—
Psychotherapy session, 30 minutes CPT 90832 HB Psychotherapy Patient 30 Minutes	$162.00	—	—	18% below	—
Psychotherapy session, 45 minutes CPT 90834 HB Psychotherapy Patient 45 Minutes	$110.00	—	—	58% below	—
Psychotherapy session, 45 minutes CPT 90834 HB Psychotherapy Patient 45 Minutes	$192.00	—	—	27% below	—
Psychotherapy session, 60 minutes CPT 90837 HB Psychotherapy Patient 60 Minutes	$110.00	—	—	63% below	—
Psychotherapy session, 60 minutes CPT 90837 HB Psychotherapy Patient 60 Minutes	$216.00	—	—	28% below	—
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$237.92	$399.00	—	20% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$237.92	$399.00	—	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB Tobacco Use Cessation Intermediate 3-10 Minutes	$44.00	—	—	6% below	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB Tobacco Use Cessation Intermediate 3-10 Minutes	$54.00	—	—	15% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpt Visit, New, Level V	$100.00	—	—	57% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpt Visit, Est, Level V	$116.00	—	—	51% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$184.85	$310.00	—	21% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpt Visit, Est, Level V	$230.00	—	—	2% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpt Visit, New, Level V	$270.00	—	—	15% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$184.85	$310.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpt Visit, Est, Level III	$100.00	—	—	45% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$101.37	$170.00	—	45% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpt Visit, New, Level lII	$125.00	—	—	32% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpt Visit, New, Level lII	$195.00	—	—	7% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpt Visit, Est, Level III	$210.00	—	—	15% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$101.37	$170.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpt Visit, Est, Level IV	$100.00	—	—	49% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpt Visit, New, Level lV	$100.00	—	—	49% below	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$143.11	$240.00	—	28% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpt Visit, Est, Level IV	$205.00	—	—	4% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpt Visit, New, Level lV	$220.00	—	—	11% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$143.11	$240.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$71.56	$120.00	—	57% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpt Visit, New, Level ll	$100.00	—	—	40% below	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpt Visit, Est, Level II	$125.00	—	—	25% below	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpt Visit, Est, Level II	$155.00	—	—	7% below	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpt Visit, New, Level ll	$170.00	—	—	1% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$71.56	$120.00	—	—	40%
Speech and language evaluation CPT 92523 HB Compr Lang/Cogn Lngstc Eval46-60min	$162.00	—	—	59% below	—
Speech and language evaluation CPT 92523 HB Compr Lang/Cogn Lngstc Eval to 15 Min	$162.00	—	—	59% below	—
Speech and language evaluation CPT 92523 HB Eval Speech Sound Product Language Comprehension	$162.00	—	—	59% below	—
Speech therapy session, individual CPT 92507 HB Speech Lang Treatmnt 0-15min	$50.00	—	—	70% below	—
Speech therapy session, individual CPT 92507 HB Speech Therapy Individual	$50.00	—	—	70% below	—
Spirometry (breathing test) CPT 94010 HB Spmtry W/Vc Expiratory Flo W/WO Mxml Vol Vntj	$232.00	—	—	4% above	—
Spirometry (breathing test) CPT 94010 HB Peak Flow Rate	$232.00	—	—	4% above	—
Spirometry (breathing test) CPT 94010 HB Spmtry W/Vc Expiratory Flo W/WO Mxml Vol Vntj	$270.00	—	—	22% above	—
Spirometry (breathing test) CPT 94010 HB Peak Flow Rate	$270.00	—	—	22% above	—
Spirometry before and after a bronchodilator CPT 94060 HB Brncdilat Rspse Spmtry Pre&Post-Brncdilat Admn	$460.00	—	—	19% above	—
Spirometry before and after a bronchodilator CPT 94060 HB Brncdilat Rspse Spmtry Pre&Post-Brncdilat Admn	$481.00	—	—	24% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 HB Ot Therapeut Activity Direct Pt Contact Ea 15 Min	$27.00	—	—	69% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 HB Therapeut Actvity Direct Pt Contact Each 15 Min	$27.00	—	—	69% below	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB Phlebotomy Therapeutic Separate Procedure	$190.00	—	—	11% below	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New York	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HB Influenza Vaccine Inact Subunit Adjuvant Im	$64.00	—	—	40% below	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC A&B SURF ANT (FLUAD) ADJ 0.5 ML IM SUSY I	$71.14	—	—	33% below	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 PR IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$76.33	$128.00	—	28% below	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 PR IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE	$76.33	$128.00	—	—	40%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 MRNA VACCINE (MODERNA) 50 MCG/0.5ML IM SYRINGE (>/= 12Y) I	$116.98	—	—	43% below	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR I	$150.98	—	—	43% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Iiv3 Vacc Preservative Free 0.5 Ml Dosage Im Use	$17.00	—	—	40% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC TRIVALENT PF (AFLURIA) 0.5 ML IM SYR (36M-64 YR) I	$18.50	—	—	35% below	—
Hepatitis A vaccine, adult dose CPT 90632 HB Hepatitis a Vaccine Adult for Intramuscular Use	$44.00	—	—	57% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HB Hepatitis B Vaccine Adult 3 Dose Im	$48.00	—	—	46% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$57.24	$96.00	—	36% below	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ VIAL/SYR WRAPPED	$59.60	—	—	33% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$57.24	$96.00	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC SC INJ I	$79.19	—	—	41% below	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 HB Pneumococcal Conj Vaccine 13 Valent Im	$114.00	—	—	65% below	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PR PCV13 VACCINE FOR INTRAMUSCULAR USE	$135.36	$227.00	—	59% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PR PCV13 VACCINE FOR INTRAMUSCULAR USE	$135.36	$227.00	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY I	$215.78	—	—	50% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pcv20 Vaccine Im	$316.00	—	—	26% below	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$376.27	$631.00	—	12% below	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$376.27	$631.00	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HB Pneumococcal Polysac Vaccine 23-V 2 Yrs/>Subq/Im	$50.00	—	—	71% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$50.09	$84.00	—	70% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$50.09	$84.00	—	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR I	$351.59	—	—	25% below	—
Rabies vaccine, one dose CPT 90675 HB Rabies Vaccine Intramuscular	$464.00	—	—	1% below	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HB Shingrix 0.5mg - Single Dose	$174.00	—	—	56% below	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE	$200.36	$336.00	—	49% below	40%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE	$200.36	$336.00	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD TETANUS DIPHTHERIA TOXOIDS VACCINE WRAPPED	$33.26	—	—	37% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HB Td Toxoids Adsorbed Prsrv Fr 7 Yr/> Im	$38.00	—	—	28% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$45.92	$77.00	—	13% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$45.92	$77.00	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HB Tdap Vaccine 7 Yrs/> Im	$38.00	—	—	32% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERT 5-2.5-18.5 LF-MCG/0.5 IM SUSP WRAPPED	$40.10	—	—	28% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$44.72	$75.00	—	19% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$44.72	$75.00	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB Imadm Prq ID Subq/Im Njxs 1 Vaccine	$13.00	—	—	85% below	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB Imadm Prq ID Subq/Im Njxs Ea Vaccine	$13.00	—	—	71% below	—

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.urmc.rochester.edu/getmedia/016bb4df-9b94-41b6-a803-c44ad94a879c/160743979-NICHOLAS-H-NOYES-MEMORIAL-HOSPITAL-standardcharges.csv