York Hospital
York Hospital in York, ME publishes cash prices for 65 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
15 Hospital Drive, York ME 03902 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/ CON 74177 | $1,996.20 | $3,327.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 W-CT ABDOMEN & PELVIS W/CON 74177 | $1,996.20 | $3,327.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/ CON 74177 | $1,996.20 | $3,327.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 W-CT ABDOMEN & PELVIS W/CON 74177 | $1,996.20 | $3,327.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CON 70450 | $860.40 | $1,434.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 W-CT HEAD W/O CON 70450 | $860.40 | $1,434.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 W-CT HEAD W/O CON 70450 | $860.40 | $1,434.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CON 70450 | $860.40 | $1,434.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 W-CT PELVIS W/C 72193 | $834.00 | $1,390.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CON 72193 | $834.00 | $1,390.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 W-CT PELVIS W/C 72193 | $834.00 | $1,390.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CON 72193 | $834.00 | $1,390.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL BILAT DIAG 77066 | $345.60 | $576.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL DIAG BILAT ADDL VS 77066 | $345.60 | $576.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL DIAG BILAT ADDL VS 77066 | $345.60 | $576.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL BILAT DIAG 77066 | $345.60 | $576.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO DIGITAL AVS UNI DIAG 77065 | $280.80 | $468.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO DIGITAL UNI DIAG 77065 | $280.80 | $468.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAM DIAG UNILAT W CAD 77065 | $313.80 | $523.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIGITAL AVS UNI DIAG 77065 | $280.80 | $468.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DIGITAL UNI DIAG 77065 | $280.80 | $468.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAM DIAG UNILAT W CAD 77065 | $313.80 | $523.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW JOINT W/O 73721 | $1,656.60 | $2,761.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW JOINT W/O 73721 | $1,656.60 | $2,761.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW JOINT W/WO 73723 | $3,685.20 | $6,142.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW JOINT W/WO 73723 | $3,685.20 | $6,142.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O GAD 70551 | $1,691.40 | $2,819.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O GAD 70551 | $1,691.40 | $2,819.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO GAD 70553 | $3,750.60 | $6,251.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO GAD 70553 | $3,750.60 | $6,251.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L/SPINE W/O GAD 72148 | $1,874.40 | $3,124.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L/SPINE W/O GAD 72148 | $1,874.40 | $3,124.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB>14 WK SINGLE 76805 | $497.40 | $829.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 W-US OB>14 WK(S)1ST GEST 76805 | $497.40 | $829.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 W-US OB>14 WK(S)1ST GEST 76805 | $497.40 | $829.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB>14 WK SINGLE 76805 | $497.40 | $829.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 7706726 | $138.00 | $230.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 77067 | $301.80 | $503.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 77067 | $343.80 | $573.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 7706726 | $138.00 | $230.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 77067 | $301.80 | $503.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGITAL BILAT SCREEN 77067 | $343.80 | $573.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP LAB - PSG | $1,830.60 | $3,051.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP LAB - PSG | $1,830.60 | $3,051.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 W-US TRANSVAGINAL 76830 | $474.60 | $791.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL 76830 | $474.60 | $791.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL 76830 | $474.60 | $791.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 W-US TRANSVAGINAL 76830 | $474.60 | $791.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 ULTRASOUND ABDOMEN COMPLETE | $228.00 | $380.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 W-US ABDOMEN COMPLETE 76700 | $447.60 | $746.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE 76700 | $447.60 | $746.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ULTRASOUND ABDOMEN COMPLETE | $228.00 | $380.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 W-US ABDOMEN COMPLETE 76700 | $447.60 | $746.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE 76700 | $447.60 | $746.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 W-LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 B-LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 W-LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 B-LUMBAR W/OBLIQUES MIN 4 VIEWS 72110 | $322.20 | $537.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL-PICCOLO (KITTERY) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 SB PICCOLO BASIC METABOLIC PANEL | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 W BASIC METABOLIC PANEL (WELLS) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 M BMP-PICCOLO (MY HEALTH KITTERY) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 M BMP-PICCOLO (MY HEALTH KITTERY) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 W BASIC METABOLIC PANEL (WELLS) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL-PICCOLO (KITTERY) | $152.40 | $254.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 SB PICCOLO BASIC METABOLIC PANEL | $152.40 | $254.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 (LABCORP) NMR LIPOPROFILELIP WITH GRAPH | $52.80 | $88.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE (CARDIAC RISK 1) | $148.20 | $247.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 W CARDIAC RISK 1 (WELLS) | $148.20 | $247.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 (LABCORP) NMR LIPOPROFILELIP WITH GRAPH | $52.80 | $88.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 W CARDIAC RISK 1 (WELLS) | $148.20 | $247.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE (CARDIAC RISK 1) | $148.20 | $247.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC W AUTO DIFF WBC | $15.60 | $26.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 W CBC (WELLS) | $57.00 | $95.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HEMOGRAM | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD COUNT, CHG.ONLY | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFFERENTIAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 W HEMOGRAM (WELLS) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 M HEMOGRAM (MY HEALTH KITTERY) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 M CBC AUTO DIFF (REFLEX TO MANUAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 SB HEMOGRAM | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 SB CBC AUTO DIFF (REFLEX MANUAL) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 K HEMOGRAM (KITTERY) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 K CBC AUTO DIFF (REFLEX TO MANUAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HEMOGRAM, PRENATAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W AUTO DIFF WBC | $15.60 | $26.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 W CBC (WELLS) | $57.00 | $95.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HEMOGRAM | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 W HEMOGRAM (WELLS) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 M HEMOGRAM (MY HEALTH KITTERY) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 M CBC AUTO DIFF (REFLEX TO MANUAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 SB HEMOGRAM | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 SB CBC AUTO DIFF (REFLEX MANUAL) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 K HEMOGRAM (KITTERY) | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 K CBC AUTO DIFF (REFLEX TO MANUAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HEMOGRAM, PRENATAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD COUNT, CHG.ONLY | $89.40 | $149.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFFERENTIAL | $89.40 | $149.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $15.60 | $26.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTOMATED | $15.60 | $26.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 M CMP-PICCOLO (MY HEALTH KITTERY) | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 PICCOLO COMP. METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 K CMP-PICCOLO (KITTERY) | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 SB PICCOLO COMP. METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 W COMP.METABOLIC PANEL (WELLS) | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 SB PICCOLO COMP. METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 W COMP.METABOLIC PANEL (WELLS) | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 K CMP-PICCOLO (KITTERY) | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 PICCOLO COMP. METABOLIC PANEL | $192.60 | $321.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 M CMP-PICCOLO (MY HEALTH KITTERY) | $192.60 | $321.00 | 40% |
| Kidney function blood test panel CPT 80069 W RENAL FUNCTION PANEL (WELLS) | $36.60 | $61.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $139.20 | $232.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 W RENAL FUNCTION PANEL (WELLS) | $36.60 | $61.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $139.20 | $232.00 | 40% |
| Liver function blood test panel CPT 80076 W HEPATIC FUNCTION PANEL (WELLS) | $43.80 | $73.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $152.40 | $254.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 W HEPATIC FUNCTION PANEL (WELLS) | $43.80 | $73.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $152.40 | $254.00 | 40% |
| Obstetric blood test panel CPT 80055 PRENATAL FIRST VISIT PANEL | $495.00 | $825.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 PRENATAL FIRST VISIT PANEL | $495.00 | $825.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE | $136.80 | $228.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE | $136.80 | $228.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL (Q) (70136476 EXP) | $73.80 | $123.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL | $127.80 | $213.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX (PHI11) | $156.00 | $260.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL (Q) (70136476 EXP) | $73.80 | $123.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL | $127.80 | $213.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX (PHI11) | $156.00 | $260.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $35.40 | $59.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (LAC) SCREEN (CHG) | $42.60 | $71.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE | $46.80 | $78.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 W PTT (WELLS) | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PROLONGED APTT BLEEDING EVALUATION | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LABCORP THROMBOPLASTINE TIME PARTIAL | $125.40 | $209.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL | $35.40 | $59.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (LAC) SCREEN (CHG) | $42.60 | $71.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE | $46.80 | $78.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PROLONGED APTT BLEEDING EVALUATION | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 W PTT (WELLS) | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $69.60 | $116.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LABCORP THROMBOPLASTINE TIME PARTIAL | $125.40 | $209.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT(INR) TEST | $11.40 | $19.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC INR | $21.60 | $36.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT (PROTIME with INR) | $57.00 | $95.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 W PT PROTIME (WELLS) | $57.00 | $95.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LABCORP PROTHROMBIN TIME | $125.40 | $209.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT(INR) TEST | $11.40 | $19.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC INR | $21.60 | $36.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT (PROTIME with INR) | $57.00 | $95.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 W PT PROTIME (WELLS) | $57.00 | $95.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LABCORP PROTHROMBIN TIME | $125.40 | $209.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADING REFLEX | $33.00 | $55.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE (TSH) LAB CORP | $95.40 | $159.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE(TSH) | $139.20 | $232.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH REFLEX | $139.20 | $232.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADING REFLEX | $33.00 | $55.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE (TSH) LAB CORP | $95.40 | $159.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE(TSH) | $139.20 | $232.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH REFLEX | $139.20 | $232.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 UA WITH MICROSCOPIC | $80.40 | $134.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 W URINALYSIS W/MICRO (WELLS) | $80.40 | $134.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA WITH MICROSCOPIC | $80.40 | $134.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 W URINALYSIS W/MICRO (WELLS) | $80.40 | $134.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS w/ MICRO (GL 6233) | $18.60 | $31.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 POC - URINALYSIS W MICROSCOPY | $25.80 | $43.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 POC - UA DIPSTICK, NON AUTOMATED | $33.60 | $56.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS w/ MICRO (GL 6233) | $18.60 | $31.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 POC - URINALYSIS W MICROSCOPY | $25.80 | $43.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 POC - UA DIPSTICK, NON AUTOMATED | $33.60 | $56.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS (GL8085) | $11.40 | $19.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS (GL6233) | $13.20 | $22.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 POC URINALYSIS (GL7008) | $16.80 | $28.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY | $37.20 | $62.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 PH | $45.00 | $75.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 OCCULT BLOOD, URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 W URINALYSIS, ROUTINE (WELLS) | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 SB URINALYSIS, ROUTINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, ROUTINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UROBILINOGEN, URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 PROTEIN, URINE QUAL | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 PROTEIN, URINE QUAL (KITTERY) | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 PROTEIN, URINE QUAL (WELLS) | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS (GL8085) | $11.40 | $19.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS (GL6233) | $13.20 | $22.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINALYSIS (GL7008) | $16.80 | $28.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY | $37.20 | $62.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PH | $45.00 | $75.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UROBILINOGEN, URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, ROUTINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 W URINALYSIS, ROUTINE (WELLS) | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 OCCULT BLOOD, URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SB URINALYSIS, ROUTINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN, URINE QUAL (KITTERY) | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN, URINE QUAL (WELLS) | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN, URINE QUAL | $57.00 | $95.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK | $15.60 | $26.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 POC - UA DIPSTICK, NON AUTOMATED | $33.60 | $56.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 REDUCING SUBSTANCES, URINE | $46.80 | $78.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 BILIRUBIN, URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 KETONE,URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK | $15.60 | $26.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 POC - UA DIPSTICK, NON AUTOMATED | $33.60 | $56.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 REDUCING SUBSTANCES, URINE | $46.80 | $78.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 KETONE,URINE | $48.00 | $80.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 BILIRUBIN, URINE | $48.00 | $80.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY | $3,758.40 | $6,264.00 | 40% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CESAREAN DELIVERY | $3,758.40 | $6,264.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY SNARE POLYPECTOMY | $519.60 | $866.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY SNARE POLYPECTOMY | $519.60 | $866.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY | $395.40 | $659.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY | $395.40 | $659.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $381.00 | $635.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY | $381.00 | $635.00 | 40% |
| Gallbladder removal, laparoscopic CPT 47562 LAP CHOLECYSTECTOMY | $1,092.60 | $1,821.00 | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLECYSTECTOMY | $1,092.60 | $1,821.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA INGUINAL | $868.20 | $1,447.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA INGUINAL | $868.20 | $1,447.00 | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHRO KNEE W/MEDISC MED/LAT | $961.20 | $1,602.00 | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRO KNEE W/MEDISC MED/LAT | $961.20 | $1,602.00 | 40% |
| Left heart catheterization, diagnostic CPT 93452 LT HEART CATH W INTRAPROCEDURAL INJECTIO | $1,836.60 | $3,061.00 | 40% |
| Left heart catheterization, diagnostic CPT 93452 C CATH LHC W/ LV 93452 | $4,728.60 | $7,881.00 | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LT HEART CATH W INTRAPROCEDURAL INJECTIO | $1,836.60 | $3,061.00 | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 C CATH LHC W/ LV 93452 | $4,728.60 | $7,881.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SACRAL W IMAGING | $1,038.60 | $1,731.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR LUMBAR INJECTION THERAPEUTIC | $1,059.60 | $1,766.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SACRAL W IMAGING | $1,038.60 | $1,731.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR LUMBAR INJECTION THERAPEUTIC | $1,059.60 | $1,766.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INTRATHECAL INFUSION OF CHEMO 62322 | $158.40 | $264.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SACRAL W/O IMAGING | $1,038.60 | $1,731.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 IR NJX INTERLAMINAR LMBR/SACRAL W/O IMAG | $1,059.60 | $1,766.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INTRATHECAL INFUSION OF CHEMO 62322 | $158.40 | $264.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SACRAL W/O IMAGING | $1,038.60 | $1,731.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 IR NJX INTERLAMINAR LMBR/SACRAL W/O IMAG | $1,059.60 | $1,766.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR CT NERVE ROOT INJ LUMB SAC 64483 | $1,046.40 | $1,744.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR CT NERVE ROOT INJ LUMB SAC 64483 | $1,046.40 | $1,744.00 | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPARO RADICAL PROSTATECTOMY | $2,803.20 | $4,672.00 | 40% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPARO RADICAL PROSTATECTOMY | $2,803.20 | $4,672.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC BREAST CYST FIBROADENOMA | $688.20 | $1,147.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST CYST FIBROADENOMA | $688.20 | $1,147.00 | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHRO SHLDR DECOM W W/O COR REL | $1,096.20 | $1,827.00 | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHRO SHLDR DECOM W W/O COR REL | $1,096.20 | $1,827.00 | 40% |
| Total hip replacement CPT 27130 ARTHROPLASTY TOTAL HIP | $2,526.00 | $4,210.00 | 40% |
| Total hip replacement inpatient CPT 27130 ARTHROPLASTY TOTAL HIP | $2,526.00 | $4,210.00 | 40% |
| Total knee replacement CPT 27447 ARTHROPLASTY TOTAL KNEE | $2,326.80 | $3,878.00 | 40% |
| Total knee replacement inpatient CPT 27447 ARTHROPLASTY TOTAL KNEE | $2,326.80 | $3,878.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $255.60 | $426.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 DR EGD DIAGNOSTIC WITH BIOPSY | $256.20 | $427.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ER EGD DIAGNOSTIC WITH BIOPSY | $1,425.00 | $2,375.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE | $255.60 | $426.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 DR EGD DIAGNOSTIC WITH BIOPSY | $256.20 | $427.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ER EGD DIAGNOSTIC WITH BIOPSY | $1,425.00 | $2,375.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DR EGD DIAGNOSTIC | $228.60 | $381.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $229.80 | $383.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ER EGD DIAGNOSTIC | $1,425.00 | $2,375.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 DR EGD DIAGNOSTIC | $228.60 | $381.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH | $229.80 | $383.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ER EGD DIAGNOSTIC | $1,425.00 | $2,375.00 | 40% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY | $2,650.20 | $4,417.00 | 40% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY | $2,650.20 | $4,417.00 | 40% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 VAGINAL DEL W/ANTEPRTUM & POSTPRTUM CARE | $3,317.40 | $5,529.00 | 40% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 VAGINAL DEL W/ANTEPRTUM & POSTPRTUM CARE | $3,317.40 | $5,529.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG | $85.20 | $142.00 | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG | $85.20 | $142.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSY TX W PATIENT | $83.40 | $139.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W PATIENT | $180.00 | $300.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSY TX W PATIENT | $83.40 | $139.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W PATIENT | $180.00 | $300.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSY TX W/O PATIENT | $65.40 | $109.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSY TX W/O PATIENT | $65.40 | $109.00 | 40% |
| Group psychotherapy session CPT 90853 PHASE II GROUP FOR NON PHASE I PATIENTS | $48.00 | $80.00 | 40% |
| Group psychotherapy session CPT 90853 PHASE II GROUP FOR PHASE I PATIENTS | $48.00 | $80.00 | 40% |
| Group psychotherapy session CPT 90853 PHASE I | $138.00 | $230.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 PHASE II GROUP FOR PHASE I PATIENTS | $48.00 | $80.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 PHASE II GROUP FOR NON PHASE I PATIENTS | $48.00 | $80.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 PHASE I | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VST NEW PT LEVEL III TEL | $88.80 | $148.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 DR NEW LEVEL 3 W FAC | $88.80 | $148.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT NEW PT LEVEL III | $96.60 | $161.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 ONCOLOGY CLINIC NEW PT LEVEL 3 | $118.80 | $198.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OP VISIT III | $183.60 | $306.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 W-EVAL AND MGMT LEVEL III NEW PT | $186.60 | $311.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 EVAL AND MGMT LEVEL III NEW PT | $186.60 | $311.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 WALKIN VST NEW LEVEL III | $187.80 | $313.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE VST NEW LEVEL III | $188.40 | $314.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 WHC DOC OFFICE VST NEW LEVEL III | $198.00 | $330.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 DR NEW LEVEL 3 W FAC | $88.80 | $148.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VST NEW PT LEVEL III TEL | $88.80 | $148.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT NEW PT LEVEL III | $96.60 | $161.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 ONCOLOGY CLINIC NEW PT LEVEL 3 | $118.80 | $198.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT OFFICE OP VISIT III | $183.60 | $306.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 W-EVAL AND MGMT LEVEL III NEW PT | $186.60 | $311.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 EVAL AND MGMT LEVEL III NEW PT | $186.60 | $311.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WALKIN VST NEW LEVEL III | $187.80 | $313.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VST NEW LEVEL III | $188.40 | $314.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WHC DOC OFFICE VST NEW LEVEL III | $198.00 | $330.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT LEVEL 4 VISIT NEW TEL | $141.60 | $236.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 DR NEW LEVEL 4 W FAC | $141.60 | $236.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 ONCOLOGY CLINIC NEW PT LEVEL 4 | $148.20 | $247.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT NEW PT LEVEL IV | $159.60 | $266.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OP VISIT IV | $237.60 | $396.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 EVAL AND MGMT LEVEL IV NEW PT | $239.40 | $399.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 W-EVAL AND MGMT LEVEL IV NEW PT | $239.40 | $399.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 WALKIN VST NEW LEVEL IV | $240.60 | $401.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE VST NEW LEVEL IV | $241.20 | $402.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 WHC DOC OFFICE VST NEW LEVEL IV | $281.40 | $469.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 DR NEW LEVEL 4 W FAC | $141.60 | $236.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT LEVEL 4 VISIT NEW TEL | $141.60 | $236.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 ONCOLOGY CLINIC NEW PT LEVEL 4 | $148.20 | $247.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT NEW PT LEVEL IV | $159.60 | $266.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT OFFICE OP VISIT IV | $237.60 | $396.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 W-EVAL AND MGMT LEVEL IV NEW PT | $239.40 | $399.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 EVAL AND MGMT LEVEL IV NEW PT | $239.40 | $399.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WALKIN VST NEW LEVEL IV | $240.60 | $401.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VST NEW LEVEL IV | $241.20 | $402.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WHC DOC OFFICE VST NEW LEVEL IV | $281.40 | $469.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 ONCOLOGY CLINIC NEW PT LEVEL 5 | $189.00 | $315.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 DR NEW LEVEL 5 W FAC | $190.20 | $317.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VST NEW PT LEVEL V TEL | $190.20 | $317.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT NEW PT LEVEL V | $205.80 | $343.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OP VISIT V | $288.00 | $480.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 WALKIN VST NEW LEVEL V | $289.20 | $482.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE VST NEW LEVEL V | $289.80 | $483.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 WHC DOC OFFICE VST NEW LEVEL V | $354.60 | $591.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 ONCOLOGY CLINIC NEW PT LEVEL 5 | $189.00 | $315.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VST NEW PT LEVEL V TEL | $190.20 | $317.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 DR NEW LEVEL 5 W FAC | $190.20 | $317.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT NEW PT LEVEL V | $205.80 | $343.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT OFFICE OP VISIT V | $288.00 | $480.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WALKIN VST NEW LEVEL V | $289.20 | $482.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VST NEW LEVEL V | $289.80 | $483.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WHC DOC OFFICE VST NEW LEVEL V | $354.60 | $591.00 | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV MAINT NEW PT 18-39 YRS | $183.60 | $306.00 | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV MAINT NEW PT 18-39 YRS | $183.60 | $306.00 | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREV MAINT NEW PT 40-64 YRS | $213.60 | $356.00 | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV MAINT NEW PT 40-64 YRS | $213.60 | $356.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MIN W PATIENT +FAMILY | $45.00 | $75.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PYSCHOTHERAPY 30 MIN W/WO FAMILY | $57.60 | $96.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MIN W PATIENT +FAMILY | $45.00 | $75.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PYSCHOTHERAPY 30 MIN W/WO FAMILY | $57.60 | $96.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MIN W PATIENT +FAMILY | $65.40 | $109.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PYSCHOTHERAPY 45 MIN W/WO FAMILY | $84.60 | $141.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MIN W PATIENT +FAMILY | $65.40 | $109.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PYSCHOTHERAPY 45 MIN W/WO FAMILY | $84.60 | $141.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY60 MIN W PATIENT +FAMILY | $108.00 | $180.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PYSCHOTHERAPY 60 MIN W/WO FAMILY | $110.40 | $184.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY60 MIN W PATIENT +FAMILY | $108.00 | $180.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PYSCHOTHERAPY 60 MIN W/WO FAMILY | $110.40 | $184.00 | 40% |
Source file: https://www.yorkhospital.com/download_file/view/b51e4a30-f2e2-4e69-a7d1-2ec25eeaa1d7/286