Hospital Rochester, MN

Saint Elizabeth’s Hospital of Wabasha

Saint Elizabeth’s Hospital of Wabasha in Wabasha, MN publishes cash prices for 377 common procedures listed here, from its own machine-readable price file updated Jun 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 202 of 364 procedures and below it for 157. By typical cash price it ranks #47 of 85 Minnesota hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1200 Grant Blvd W, Wabasha, MN 55981 Collected Sep 23, 2026 Source price file Check a bill from this hospital (651) 565-4531

Critical access hospital (rural, 25 beds or fewer) For-profit hospital Emergency department CCN 241335 · CMS hospital register NPI 1659355600

State law

This state limits hospital bills for lower-income patients

Minnesota law (Minn. Stat. §144.589): a hospital may not charge an uninsured patient whose household income is under $125,000 more than the lowest amount it would be paid for the same service by a private insurer, counting the insured patient's share. If the cash price below is higher, ask the billing office to apply this limit. Each hospital's page here shows the range of insurer rates in its own file (the "Insurers pay" column), a starting point when you ask. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Abdominal CT scan without and with contrast CPT 74170 HCHG 74170 CT ABD W&W/O IV CONT	$1,760.62	$2,891.00	$715.52–$2,775.36	1% above	39%
Abdominal CT scan without and with contrast inpatient CPT 74170 HCHG 74170 CT ABD W&W/O IV CONT	$1,760.62	$2,891.00	$715.52–$2,775.36	—	39%
Abdominal X-ray, 2 views CPT 74019 HCHG 74019 RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS	$329.47	$541.00	$133.90–$519.36	20% above	39%
Abdominal X-ray, 2 views inpatient CPT 74019 HCHG 74019 RADIOLOGIC EXAM, ABDOMEN; 2 VIEWS	$329.47	$541.00	$133.90–$519.36	—	39%
Ankle X-ray, complete, 3 or more views CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	24% above	39%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	—	39%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HCHG 73200 CT UPR EXT W/O IV CONT	$1,387.91	$2,279.00	$564.05–$2,187.84	10% above	39%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HCHG 73200 CT UPR EXT W/O IV CONT	$1,387.91	$2,279.00	$564.05–$2,187.84	—	39%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST	$443.96	$729.00	$180.43–$699.84	43% above	39%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST	$443.96	$729.00	$180.43–$699.84	—	39%
Bone scan, whole body (nuclear medicine) CPT 78306 HCHG 78306 BONE SCAN-ROUTINE	$1,272.81	$2,090.00	$517.28–$2,006.40	4% above	39%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HCHG 78306 BONE SCAN-ROUTINE	$1,272.81	$2,090.00	$517.28–$2,006.40	—	39%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HCHG 76642 US BREAST UNILATERAL LIMITED	$505.47	$830.00	$205.43–$796.80	61% above	39%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HCHG 76642 US BREAST UNILATERAL LIMITED	$505.47	$830.00	$205.43–$796.80	—	39%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HCHG 74174 CTA ABD & PELVIS W/CONTRAST,INCL NONCONT	$1,909.22	$3,135.00	$775.91–$3,009.60	25% below	39%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HCHG 74174 CTA ABD & PELVIS W/CONTRAST,INCL NONCONT	$1,909.22	$3,135.00	$775.91–$3,009.60	—	39%
CT angiography (CTA) of the head CPT 70496 HCHG 70496 CT ANGIO HEAD W/O&W IV CONT	$1,571.22	$2,580.00	$638.55–$2,476.80	13% below	39%
CT angiography (CTA) of the head inpatient CPT 70496 HCHG 70496 CT ANGIO HEAD W/O&W IV CONT	$1,571.22	$2,580.00	$638.55–$2,476.80	—	39%
CT angiography (CTA) of the neck CPT 70498 HCHG 70498 CT ANGIO NECK W/O&W IV CONT	$1,543.21	$2,534.00	$627.17–$2,432.64	12% below	39%
CT angiography (CTA) of the neck inpatient CPT 70498 HCHG 70498 CT ANGIO NECK W/O&W IV CONT	$1,543.21	$2,534.00	$627.17–$2,432.64	—	39%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT	$1,920.18	$3,153.00	$780.37–$3,026.88	5% above	39%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT	$1,920.18	$3,153.00	$780.37–$3,026.88	—	39%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST	$1,895.21	$3,112.00	$770.22–$2,987.52	9% below	39%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST	$1,895.21	$3,112.00	$770.22–$2,987.52	—	39%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST	$1,895.21	$3,112.00	$770.22–$2,987.52	25% below	39%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST	$1,895.21	$3,112.00	$770.22–$2,987.52	—	39%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST	$2,217.37	$3,641.00	$901.15–$3,495.36	18% below	39%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST	$2,217.37	$3,641.00	$901.15–$3,495.36	—	39%
CT scan of the abdomen with contrast CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT	$1,579.75	$2,594.00	$642.02–$2,490.24	14% above	39%
CT scan of the abdomen with contrast inpatient CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT	$1,579.75	$2,594.00	$642.02–$2,490.24	—	39%
CT scan of the abdomen without contrast CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT	$1,420.80	$2,333.00	$577.42–$2,239.68	21% above	39%
CT scan of the abdomen without contrast inpatient CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT	$1,420.80	$2,333.00	$577.42–$2,239.68	—	39%
CT scan of the face and sinuses, no contrast dye CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT	$1,300.82	$2,136.00	$528.66–$2,050.56	3% above	39%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT	$1,300.82	$2,136.00	$528.66–$2,050.56	—	39%
CT scan of the head or brain, no contrast dye CPT 70450 HCHG 70450 CT HEAD W/O IV CONT	$1,186.33	$1,948.00	$482.13–$1,870.08	6% below	39%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HCHG 70450 CT HEAD W/O IV CONT	$1,186.33	$1,948.00	$482.13–$1,870.08	—	39%
CT scan of the head with contrast CPT 70460 HCHG 70460 CT HEAD W/IV CONT	$1,214.96	$1,995.00	$493.76–$1,915.20	6% below	39%
CT scan of the head with contrast inpatient CPT 70460 HCHG 70460 CT HEAD W/IV CONT	$1,214.96	$1,995.00	$493.76–$1,915.20	—	39%
CT scan of the head without and with contrast CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT	$1,529.20	$2,511.00	$621.47–$2,410.56	4% below	39%
CT scan of the head without and with contrast inpatient CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT	$1,529.20	$2,511.00	$621.47–$2,410.56	—	39%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT	$1,502.40	$2,467.00	$610.58–$2,368.32	10% above	39%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT	$1,502.40	$2,467.00	$610.58–$2,368.32	—	39%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT	$1,342.85	$2,205.00	$545.74–$2,116.80	6% below	39%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT	$1,342.85	$2,205.00	$545.74–$2,116.80	—	39%
CT scan of the pelvis, with contrast dye CPT 72193 HCHG 72193 CT PELVIS W/IV CONT	$1,562.09	$2,565.00	$634.84–$2,462.40	10% above	39%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HCHG 72193 CT PELVIS W/IV CONT	$1,562.09	$2,565.00	$634.84–$2,462.40	—	39%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HCHG 93880 US CAROTID/DOPPLER	$810.58	$1,331.00	$329.42–$1,277.76	2% below	39%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HCHG 93880 US CAROTID/DOPPLER	$810.58	$1,331.00	$329.42–$1,277.76	—	39%
Chest CT scan without and with contrast CPT 71270 HCHG 71270 CT THORAX, DIAGNOSTIC; W/O & W/IV CONTRAST	$1,696.67	$2,786.00	$689.54–$2,674.56	7% above	39%
Chest CT scan without and with contrast inpatient CPT 71270 HCHG 71270 CT THORAX, DIAGNOSTIC; W/O & W/IV CONTRAST	$1,696.67	$2,786.00	$689.54–$2,674.56	—	39%
Chest X-ray, 2 views CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS	$309.98	$509.00	$125.98–$488.64	37% above	39%
Chest X-ray, 2 views inpatient CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS	$309.98	$509.00	$125.98–$488.64	—	39%
Chest X-ray, single view CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW	$279.53	$459.00	$113.60–$440.64	38% above	39%
Chest X-ray, single view inpatient CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW	$279.53	$459.00	$113.60–$440.64	—	39%
Collarbone (clavicle) X-ray, complete CPT 73000 HCHG 73000 CLAVICLE COMPLETE 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	34% above	39%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HCHG 73000 CLAVICLE COMPLETE 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	—	39%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HCHG 76770 US RENAL	$735.06	$1,207.00	$298.73–$1,158.72	42% above	39%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HCHG 76770 US RENAL	$735.06	$1,207.00	$298.73–$1,158.72	—	39%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HCHG 77080 BONE DENSTOMETRY	$246.04	$404.00	$99.99–$387.84	34% below	39%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HCHG 77080 BONE DENSTOMETRY	$246.04	$404.00	$99.99–$387.84	—	39%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL	$187.57	$308.00	$76.23–$295.68	6% below	39%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL	$187.57	$308.00	$76.23–$295.68	—	39%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST	$1,406.18	$2,309.00	$571.48–$2,216.64	10% above	39%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST	$1,406.18	$2,309.00	$571.48–$2,216.64	—	39%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST	$1,633.34	$2,682.00	$663.80–$2,574.72	12% above	39%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST	$1,633.34	$2,682.00	$663.80–$2,574.72	—	39%
Diagnostic mammogram, both breasts both sides CPT 77066 HCHG 77066 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, BILATERAL	$293.54	$482.00	$119.30–$462.72	—	39%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HCHG 77066 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, BILATERAL	$293.54	$482.00	$119.30–$462.72	—	39%
Diagnostic mammogram, one breast one side CPT 77065 HCHG 77065 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, UNILATERAL	$233.86	$384.00	$95.04–$368.64	25% below	39%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HCHG 77065 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, UNILATERAL	$233.86	$384.00	$95.04–$368.64	—	39%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT	$403.77	$663.00	$164.09–$636.48	—	39%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT	$403.77	$663.00	$164.09–$636.48	—	39%
Duplex ultrasound of the leg veins, both legs CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL	$887.31	$1,457.00	$360.61–$1,398.72	at median	39%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL	$887.31	$1,457.00	$360.61–$1,398.72	—	39%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST	$1,252.71	$2,057.00	$509.11–$1,974.72	13% below	39%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE	$1,252.71	$2,057.00	$509.11–$1,974.72	13% below	39%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST	$1,252.71	$2,057.00	$509.11–$1,974.72	—	39%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE	$1,252.71	$2,057.00	$509.11–$1,974.72	—	39%
Elbow X-ray, 2 views CPT 73070 HCHG 73070 ELBOW 2VW L/R	$250.30	$411.00	$101.72–$394.56	23% above	39%
Elbow X-ray, 2 views inpatient CPT 73070 HCHG 73070 ELBOW 2VW L/R	$250.30	$411.00	$101.72–$394.56	—	39%
Elbow X-ray, complete, 3 or more views CPT 73080 HCHG 73080 ELBOW TRAUMA 3VW L/R	$329.47	$541.00	$133.90–$519.36	42% above	39%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HCHG 73080 ELBOW TRAUMA 3VW L/R	$329.47	$541.00	$133.90–$519.36	—	39%
Eye socket (orbit) CT scan without contrast CPT 70480 HCHG 70480 CT ORB TEMP B IAC W/O IV CONT	$632.75	$1,039.00	$257.15–$997.44	47% below	39%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HCHG 70480 CT ORB TEMP B IAC W/O IV CONT	$632.75	$1,039.00	$257.15–$997.44	—	39%
Facial bones X-ray, complete, 3 or more views CPT 70150 HCHG 70150 FACIAL BONES	$329.47	$541.00	$133.90–$519.36	29% above	39%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HCHG 70150 FACIAL BONES	$329.47	$541.00	$133.90–$519.36	—	39%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HCHG 73090 FOREARM L/R	$279.53	$459.00	$113.60–$440.64	38% above	39%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HCHG 73090 FOREARM L/R	$279.53	$459.00	$113.60–$440.64	—	39%
Hand X-ray, 2 views CPT 73120 HCHG 73120 HAND 1-2 VIEWS	$236.29	$388.00	$96.03–$372.48	24% above	39%
Hand X-ray, 2 views inpatient CPT 73120 HCHG 73120 HAND 1-2 VIEWS	$236.29	$388.00	$96.03–$372.48	—	39%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HCHG 73650 HEEL 1-2VW L/R	$236.29	$388.00	$96.03–$372.48	32% above	39%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HCHG 73650 HEEL 1-2VW L/R	$236.29	$388.00	$96.03–$372.48	—	39%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING	$356.87	$586.00	$145.04–$562.56	35% below	39%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING	$356.87	$586.00	$145.04–$562.56	—	39%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP	$3,328.79	$5,466.00	$1,352.84–$5,247.36	4% below	39%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP	$3,328.79	$5,466.00	$1,352.84–$5,247.36	—	39%
Knee X-ray, 3 views CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R	$261.87	$430.00	$106.43–$412.80	11% above	39%
Knee X-ray, 3 views inpatient CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R	$261.87	$430.00	$106.43–$412.80	—	39%
Knee X-ray, complete, 4 or more views CPT 73564 HCHG 73564 KNEE 4 VW SPCFY L/R	$309.98	$509.00	$125.98–$488.64	10% above	39%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HCHG 73564 KNEE 4 VW SPCFY L/R	$309.98	$509.00	$125.98–$488.64	—	39%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HCHG 73700 CT LWR EXT W/O IV CONT	$1,387.91	$2,279.00	$564.05–$2,187.84	6% above	39%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HCHG 73700 CT LWR EXT W/O IV CONT	$1,387.91	$2,279.00	$564.05–$2,187.84	—	39%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HCHG 76705 US ABDOMEN; LIMITED	$475.63	$781.00	$193.30–$749.76	7% above	39%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HCHG 76705 US ABDOMEN; LIMITED	$475.63	$781.00	$193.30–$749.76	—	39%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HCHG 76882 ULTRASOUND, LIMITED, JOINT OR OTHER NONVASC STRUCTURE	$475.63	$781.00	$193.30–$749.76	37% above	39%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HCHG 76882 ULTRASOUND, LIMITED, JOINT OR OTHER NONVASC STRUCTURE	$475.63	$781.00	$193.30–$749.76	—	39%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST	$101.70	$167.00	$41.33–$160.32	87% below	39%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST	$101.70	$167.00	$41.33–$160.32	—	39%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HCHG 73590 TIBIA+FIBULA L/R	$266.74	$438.00	$108.41–$420.48	25% above	39%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HCHG 73590 TIBIA+FIBULA L/R	$266.74	$438.00	$108.41–$420.48	—	39%
MR angiography (MRA) of the head without contrast CPT 70544 HCHG 70544 MRA-HEAD W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	at median	39%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HCHG 70544 MRA-HEAD W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST	$1,668.66	$2,740.00	$678.15–$2,630.40	15% below	39%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST	$1,668.66	$2,740.00	$678.15–$2,630.40	—	39%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT	$2,425.65	$3,983.00	$985.79–$3,823.68	6% below	39%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT	$2,425.65	$3,983.00	$985.79–$3,823.68	—	39%
MRI of the abdomen without contrast CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	at median	39%
MRI of the abdomen without contrast inpatient CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the abdomen, without and then with contrast dye CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST	$2,971.92	$4,880.00	$1,207.80–$4,684.80	1% above	39%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST	$2,971.92	$4,880.00	$1,207.80–$4,684.80	—	39%
MRI of the brain, no contrast dye CPT 70551 HCHG 70551 MRI HEAD (3 SEQ)	$2,140.03	$3,514.00	$869.72–$3,373.44	3% above	39%
MRI of the brain, no contrast dye inpatient CPT 70551 HCHG 70551 MRI HEAD (3 SEQ)	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the brain, with and without contrast dye CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST	$2,971.31	$4,879.00	$1,207.55–$4,683.84	2% above	39%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST	$2,971.31	$4,879.00	$1,207.55–$4,683.84	—	39%
MRI of the lower back, no contrast dye CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	5% above	39%
MRI of the lower back, no contrast dye inpatient CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the lower back, without and then with contrast dye CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	19% below	39%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS	$2,140.03	$3,514.00	$869.72–$3,373.44	4% above	39%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	15% below	39%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS	$2,140.03	$3,514.00	$869.72–$3,373.44	7% above	39%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the pelvis without and with contrast CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST	$2,777.04	$4,560.00	$1,128.60–$4,377.60	4% above	39%
MRI of the pelvis without and with contrast inpatient CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST	$2,777.04	$4,560.00	$1,128.60–$4,377.60	—	39%
MRI of the pelvis, no contrast dye CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	1% above	39%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST	$2,140.03	$3,514.00	$869.72–$3,373.44	—	39%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS	$1,668.66	$2,740.00	$678.15–$2,630.40	21% below	39%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS	$1,668.66	$2,740.00	$678.15–$2,630.40	—	39%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HCHG 72050 SPINE CERVICAL 4-5 VIEWS SPEC	$373.93	$614.00	$151.97–$589.44	20% above	39%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HCHG 72050 SPINE CERVICAL 4-5 VIEWS SPEC	$373.93	$614.00	$151.97–$589.44	—	39%
Neck soft tissue CT scan with contrast CPT 70491 HCHG 70491 CT NECK SOFT TIS W/IV CONT	$1,343.45	$2,206.00	$545.99–$2,117.76	2% below	39%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HCHG 70491 CT NECK SOFT TIS W/IV CONT	$1,343.45	$2,206.00	$545.99–$2,117.76	—	39%
Neck soft tissue CT scan without contrast CPT 70490 HCHG 70490 CT NECK SOFT TIS W/O IV CONT	$1,158.93	$1,903.00	$470.99–$1,826.88	2% above	39%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HCHG 70490 CT NECK SOFT TIS W/O IV CONT	$1,158.93	$1,903.00	$470.99–$1,826.88	—	39%
Neck soft tissue X-ray CPT 70360 HCHG 70360 NECK SOFT TISSUE 1VW	$233.25	$383.00	$94.79–$367.68	33% above	39%
Neck soft tissue X-ray inpatient CPT 70360 HCHG 70360 NECK SOFT TISSUE 1VW	$233.25	$383.00	$94.79–$367.68	—	39%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU	$1,405.57	$2,308.00	$571.23–$2,215.68	48% below	39%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU	$1,405.57	$2,308.00	$571.23–$2,215.68	—	39%
OCT scan of the retina (optical coherence tomography) CPT 92134 HCHG 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING RETINA	$74.91	$123.00	$30.44–$118.08	37% below	39%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HCHG 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING RETINA	$74.91	$123.00	$30.44–$118.08	—	39%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH	$2,946.95	$4,839.00	$1,197.65–$4,645.44	7% above	39%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH	$2,946.95	$4,839.00	$1,197.65–$4,645.44	—	39%
Pelvic CT scan without contrast CPT 72192 HCHG 72192 CT PELVIS W/O IV CONT	$1,406.18	$2,309.00	$571.48–$2,216.64	7% above	39%
Pelvic CT scan without contrast inpatient CPT 72192 HCHG 72192 CT PELVIS W/O IV CONT	$1,406.18	$2,309.00	$571.48–$2,216.64	—	39%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED	$475.63	$781.00	$193.30–$749.76	41% above	39%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED	$475.63	$781.00	$193.30–$749.76	—	39%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HCHG 76856 US PELVIS	$441.53	$725.00	$179.44–$696.00	10% below	39%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HCHG 76856 US PELVIS	$441.53	$725.00	$179.44–$696.00	—	39%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER	$718.01	$1,179.00	$291.80–$1,131.84	43% above	39%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER	$718.01	$1,179.00	$291.80–$1,131.84	—	39%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS	$651.63	$1,070.00	$264.83–$1,027.20	51% above	39%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS	$651.63	$1,070.00	$264.83–$1,027.20	—	39%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE)	$517.65	$850.00	$210.38–$816.00	54% above	39%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE)	$517.65	$850.00	$210.38–$816.00	—	39%
Rib X-ray, one side, 2 views one side CPT 71100 HCHG 71100 RIB UNILAT (1-2 VW) L/R	$219.85	$361.00	$89.35–$346.56	8% above	39%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HCHG 71100 RIB UNILAT (1-2 VW) L/R	$219.85	$361.00	$89.35–$346.56	—	39%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HCHG 71101 X/R-RIBS-W/PA CHEST-MIN 3 VIEW	$329.47	$541.00	$133.90–$519.36	13% above	39%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HCHG 71101 X/R-RIBS-W/PA CHEST-MIN 3 VIEW	$329.47	$541.00	$133.90–$519.36	—	39%
Screening mammogram, both breasts both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD	$236.29	$388.00	$96.03–$372.48	—	39%
Screening mammogram, both breasts inpatient both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD	$236.29	$388.00	$96.03–$372.48	—	39%
Shoulder X-ray, complete, 2 or more views CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT)	$309.98	$509.00	$125.98–$488.64	32% above	39%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT)	$309.98	$509.00	$125.98–$488.64	—	39%
Sinus X-ray, complete, 3 or more views CPT 70220 HCHG 70220 SINUS MORE THAN 3VW (ROUTINE)	$302.67	$497.00	$123.01–$477.12	30% above	39%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HCHG 70220 SINUS MORE THAN 3VW (ROUTINE)	$302.67	$497.00	$123.01–$477.12	—	39%
Skull X-ray, fewer than 4 views CPT 70250 HCHG 70250 SKULL; LESS THAN 4VW	$202.80	$333.00	$82.42–$319.68	10% below	39%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HCHG 70250 SKULL; LESS THAN 4VW	$202.80	$333.00	$82.42–$319.68	—	39%
Sleep study in a lab (polysomnography) CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS	$2,770.34	$4,549.00	$1,125.88–$4,367.04	10% below	39%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS	$2,770.34	$4,549.00	$1,125.88–$4,367.04	—	39%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HCHG 93351 STRESS ECHO W/CONT ECG W/CONTRAST	$890.36	$1,462.00	$361.85–$1,403.52	46% below	39%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HCHG 93351 STRESS ECHO W/CONT ECG W/CONTRAST	$890.36	$1,462.00	$361.85–$1,403.52	—	39%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES,	$390.98	$642.00	$158.90–$616.32	7% above	39%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES,	$390.98	$642.00	$158.90–$616.32	—	39%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HCHG 73552 X/R FEMUR MINIMUM OF 2 VIEWS	$266.13	$437.00	$108.16–$419.52	17% above	39%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HCHG 73552 X/R FEMUR MINIMUM OF 2 VIEWS	$266.13	$437.00	$108.16–$419.52	—	39%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HCHG 72128 CT SPINE T W/O IV CONT	$1,343.45	$2,206.00	$545.99–$2,117.76	at median	39%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HCHG 72128 CT SPINE T W/O IV CONT	$1,343.45	$2,206.00	$545.99–$2,117.76	—	39%
Toe X-ray, 2 or more views CPT 73660 HCHG 73660 TOES SPECIFY L/R	$266.74	$438.00	$108.41–$420.48	44% above	39%
Toe X-ray, 2 or more views inpatient CPT 73660 HCHG 73660 TOES SPECIFY L/R	$266.74	$438.00	$108.41–$420.48	—	39%
Transvaginal pelvic ultrasound CPT 76830 HCHG 76830 US PELVIS TRANSVAG	$311.20	$511.00	$126.47–$490.56	22% below	39%
Transvaginal pelvic ultrasound inpatient CPT 76830 HCHG 76830 US PELVIS TRANSVAG	$311.20	$511.00	$126.47–$490.56	—	39%
Transvaginal ultrasound during pregnancy CPT 76817 HCHG 76817 US OB TRANSVAGINAL	$311.20	$511.00	$126.47–$490.56	12% below	39%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HCHG 76817 US OB TRANSVAGINAL	$311.20	$511.00	$126.47–$490.56	—	39%
Ultrasound of the abdomen, complete CPT 76700 HCHG 76700 US ABDOMEN (SPCFY)	$744.81	$1,223.00	$302.69–$1,174.08	23% above	39%
Ultrasound of the abdomen, complete inpatient CPT 76700 HCHG 76700 US ABDOMEN (SPCFY)	$744.81	$1,223.00	$302.69–$1,174.08	—	39%
Ultrasound of the scrotum and testicles CPT 76870 HCHG 76870 US TESTICULAR	$674.77	$1,108.00	$274.23–$1,063.68	50% above	39%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HCHG 76870 US TESTICULAR	$674.77	$1,108.00	$274.23–$1,063.68	—	39%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK	$603.52	$991.00	$245.27–$951.36	38% above	39%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK	$603.52	$991.00	$245.27–$951.36	—	39%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA	$689.39	$1,132.00	$280.17–$1,086.72	75% above	39%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA	$689.39	$1,132.00	$280.17–$1,086.72	—	39%
Upper arm X-ray (humerus), 2 views CPT 73060 HCHG 73060 HUMERUS L/R	$266.74	$438.00	$108.41–$420.48	25% above	39%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HCHG 73060 HUMERUS L/R	$266.74	$438.00	$108.41–$420.48	—	39%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI	$370.88	$609.00	$150.73–$584.64	31% below	39%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI	$370.88	$609.00	$150.73–$584.64	—	39%
Wrist X-ray, 2 views CPT 73100 HCHG 73100 WRIST 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	35% above	39%
Wrist X-ray, 2 views inpatient CPT 73100 HCHG 73100 WRIST 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	—	39%
Wrist X-ray, complete, 3 or more views CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	24% above	39%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	—	39%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE	$309.37	$508.00	$125.73–$487.68	12% above	39%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE	$309.37	$508.00	$125.73–$487.68	—	39%
X-ray of the abdomen, 1 view CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW	$286.84	$471.00	$116.57–$452.16	36% above	39%
X-ray of the abdomen, 1 view inpatient CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW	$286.84	$471.00	$116.57–$452.16	—	39%
X-ray of the ankle, 2 views CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	30% above	39%
X-ray of the ankle, 2 views inpatient CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	—	39%
X-ray of the finger(s), 2 or more views CPT 73140 HCHG 73140 FINGER (SPCFY) L/R	$266.74	$438.00	$108.41–$420.48	37% above	39%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HCHG 73140 FINGER (SPCFY) L/R	$266.74	$438.00	$108.41–$420.48	—	39%
X-ray of the foot, 2 views CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	39% above	39%
X-ray of the foot, 2 views inpatient CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS	$266.74	$438.00	$108.41–$420.48	—	39%
X-ray of the foot, complete, 3 or more views CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	30% above	39%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	—	39%
X-ray of the hand, 3 or more views CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	30% above	39%
X-ray of the hand, 3 or more views inpatient CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R	$286.84	$471.00	$116.57–$452.16	—	39%
X-ray of the knee, 1 or 2 views CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC	$266.74	$438.00	$108.41–$420.48	23% above	39%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC	$266.74	$438.00	$108.41–$420.48	—	39%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS	$381.23	$626.00	$154.94–$600.96	48% above	39%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS	$381.23	$626.00	$154.94–$600.96	—	39%
X-ray of the lower back, 4 or more views CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS)	$499.99	$821.00	$203.20–$788.16	51% above	39%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS)	$499.99	$821.00	$203.20–$788.16	—	39%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW)	$381.23	$626.00	$154.94–$600.96	63% above	39%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW)	$381.23	$626.00	$154.94–$600.96	—	39%
X-ray of the nasal bones, 3 or more views CPT 70160 HCHG 70160 NASAL BONES ROUTINE	$279.53	$459.00	$113.60–$440.64	28% above	39%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HCHG 70160 NASAL BONES ROUTINE	$279.53	$459.00	$113.60–$440.64	—	39%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS	$309.98	$509.00	$125.98–$488.64	26% above	39%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS	$309.98	$509.00	$125.98–$488.64	—	39%
X-ray of the pelvis, 1 or 2 views CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS	$266.74	$438.00	$108.41–$420.48	20% above	39%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS	$266.74	$438.00	$108.41–$420.48	—	39%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HCHG 72220 SACRUM & COCCYX	$266.74	$438.00	$108.41–$420.48	21% above	39%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HCHG 72220 SACRUM & COCCYX	$266.74	$438.00	$108.41–$420.48	—	39%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$270.40	$444.00	$109.89–$426.24	154% above	39%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$270.40	$444.00	$109.89–$426.24	—	39%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT)	$37.15	$61.00	$15.10–$58.56	24% below	39%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT)	$37.15	$61.00	$15.10–$58.56	—	39%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$36.54	$60.00	$14.85–$57.60	26% below	39%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$36.54	$60.00	$14.85–$57.60	—	39%
Albumin blood test CPT 82040 ALBUMIN; ISERUM, PLASMA OR WHOLE BLOOD	$34.71	$57.00	$14.11–$54.72	22% above	39%
Albumin blood test inpatient CPT 82040 ALBUMIN; ISERUM, PLASMA OR WHOLE BLOOD	$34.71	$57.00	$14.11–$54.72	—	39%
Aldosterone blood test CPT 82088 ALDOSTERONE, BLOOD	$272.83	$448.00	$110.88–$430.08	288% above	39%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE, BLOOD	$272.83	$448.00	$110.88–$430.08	—	39%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE	$36.54	$60.00	$14.85–$57.60	6% below	39%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE, ALKALINE	$36.54	$60.00	$14.85–$57.60	—	39%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANT/SEMI-QUANTITATIVE, CRUDE ALLERGEN E	$36.54	$60.00	$14.85–$57.60	76% above	39%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE; QUANT/SEMI-QUANTITATIVE, CRUDE ALLERGEN E	$36.54	$60.00	$14.85–$57.60	—	39%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM	$117.54	$193.00	$47.77–$185.28	144% above	39%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP); SERUM	$117.54	$193.00	$47.77–$185.28	—	39%
Ammonia blood test CPT 82140 AMMONIA	$102.31	$168.00	$41.58–$161.28	13% above	39%
Ammonia blood test inpatient CPT 82140 AMMONIA	$102.31	$168.00	$41.58–$161.28	—	39%
Amylase blood test CPT 82150 AMYLASE, FLUID	$45.68	$75.00	$18.56–$72.00	31% below	39%
Amylase blood test CPT 82150 AMYLASE, BLOOD	$45.68	$75.00	$18.56–$72.00	31% below	39%
Amylase blood test CPT 82150 AMYLASE	$45.68	$75.00	$18.56–$72.00	31% below	39%
Amylase blood test inpatient CPT 82150 AMYLASE, FLUID	$45.68	$75.00	$18.56–$72.00	—	39%
Amylase blood test inpatient CPT 82150 AMYLASE, BLOOD	$45.68	$75.00	$18.56–$72.00	—	39%
Amylase blood test inpatient CPT 82150 AMYLASE	$45.68	$75.00	$18.56–$72.00	—	39%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE A	$90.74	$149.00	$36.88–$143.04	60% above	39%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE A	$90.74	$149.00	$36.88–$143.04	—	39%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$84.65	$139.00	$34.40–$133.44	64% above	39%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$84.65	$139.00	$34.40–$133.44	—	39%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (BNP)	$274.66	$451.00	$111.62–$432.96	72% above	39%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$274.66	$451.00	$111.62–$432.96	72% above	39%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE (BNP)	$274.66	$451.00	$111.62–$432.96	—	39%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$274.66	$451.00	$111.62–$432.96	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (CSF)	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; BONE MARROW	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; WOUND	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; MISC (NONPT SOURCE)	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; RESPIRATORY CF	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; EYE	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; RESPIRATORY	$60.29	$99.00	$24.50–$95.04	14% below	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE (CSF)	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; WOUND	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; BONE MARROW	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; MISC (NONPT SOURCE)	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; RESPIRATORY	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; RESPIRATORY CF	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; EYE	$60.29	$99.00	$24.50–$95.04	—	39%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BACTERIAL; OTHER SOURCE	$60.29	$99.00	$24.50–$95.04	—	39%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$59.07	$97.00	$24.01–$93.12	41% below	39%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$59.07	$97.00	$24.01–$93.12	—	39%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL (FLUID)	$35.32	$58.00	$14.36–$55.68	28% below	39%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$35.32	$58.00	$14.36–$55.68	28% below	39%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL	$35.32	$58.00	$14.36–$55.68	28% below	39%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$35.32	$58.00	$14.36–$55.68	—	39%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL	$35.32	$58.00	$14.36–$55.68	—	39%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL (FLUID)	$35.32	$58.00	$14.36–$55.68	—	39%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAM, LEVEL 4	$174.17	$286.00	$70.79–$274.56	26% above	39%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAM, LEVEL 4	$174.17	$286.00	$70.79–$274.56	—	39%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD	$72.47	$119.00	$29.45–$114.24	39% below	39%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, LEGIONELLA	$72.47	$119.00	$29.45–$114.24	39% below	39%
Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, ABR	$72.47	$119.00	$29.45–$114.24	39% below	39%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD, LEGIONELLA	$72.47	$119.00	$29.45–$114.24	—	39%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD	$72.47	$119.00	$29.45–$114.24	—	39%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BACTERIAL; BLOOD, ABR	$72.47	$119.00	$29.45–$114.24	—	39%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG 36415 LEGAL BLOOD ALCOHOL-POLICE	$30.45	$50.00	$12.38–$48.00	41% above	39%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HCHG 36415 LEGAL BLOOD ALCOHOL-POLICE	$30.45	$50.00	$12.38–$48.00	—	39%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD	$27.41	$45.00	$11.14–$43.20	40% below	39%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANT, BLOOD POCT	$27.41	$45.00	$11.14–$43.20	40% below	39%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD	$27.41	$45.00	$11.14–$43.20	—	39%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANT, BLOOD POCT	$27.41	$45.00	$11.14–$43.20	—	39%
Blood lead test CPT 83655 LEAD	$81.00	$133.00	$32.92–$127.68	75% above	39%
Blood lead test CPT 83655 LEAD, BLOOD	$84.65	$139.00	$34.40–$133.44	83% above	39%
Blood lead test inpatient CPT 83655 LEAD	$81.00	$133.00	$32.92–$127.68	—	39%
Blood lead test inpatient CPT 83655 LEAD, BLOOD	$84.65	$139.00	$34.40–$133.44	—	39%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE, SERUM	$52.37	$86.00	$21.29–$82.56	27% below	39%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE, SERUM	$52.37	$86.00	$21.29–$82.56	—	39%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, SEROLOGIC; ABO	$20.71	$34.00	$8.42–$32.64	61% below	39%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING, SEROLOGIC; ABO	$20.71	$34.00	$8.42–$32.64	—	39%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN; QUANTITATIVE	$27.41	$45.00	$11.14–$43.20	40% below	39%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN; QUANTITATIVE	$27.41	$45.00	$11.14–$43.20	—	39%
C-peptide blood test CPT 84681 C-PEPTIDE	$145.55	$239.00	$59.15–$229.44	77% above	39%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$145.55	$239.00	$59.15–$229.44	—	39%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN; IBD PANEL	$36.54	$60.00	$14.85–$57.60	41% below	39%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (CRP)	$36.54	$60.00	$14.85–$57.60	41% below	39%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (CRP)	$36.54	$60.00	$14.85–$57.60	—	39%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN; IBD PANEL	$36.54	$60.00	$14.85–$57.60	—	39%
C. difficile toxin gene test (stool PCR) CPT 87493 INFECTIOUS AGENT ANTIGEN DETECT; C DIFF PCR ARUP	$96.22	$158.00	$39.11–$151.68	29% below	39%
C. difficile toxin gene test (stool PCR) CPT 87493 INFECTIOUS AGENT ANTIGEN DETECTION; C DIFF TOXIN GENE(S) AMP PRO	$261.26	$429.00	$106.18–$411.84	92% above	39%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INFECTIOUS AGENT ANTIGEN DETECT; C DIFF PCR ARUP	$96.22	$158.00	$39.11–$151.68	—	39%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INFECTIOUS AGENT ANTIGEN DETECTION; C DIFF TOXIN GENE(S) AMP PRO	$261.26	$429.00	$106.18–$411.84	—	39%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9	$145.55	$239.00	$59.15–$229.44	43% above	39%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9	$145.55	$239.00	$59.15–$229.44	—	39%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125	$145.55	$239.00	$59.15–$229.44	43% above	39%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125	$145.55	$239.00	$59.15–$229.44	—	39%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 NON-CDC 2019-NCOV CORONAVIRUS COVID-19	$190.62	$313.00	$51.31–$194.98	59% above	39%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR	$190.62	$313.00	$51.31–$194.98	59% above	39%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MCLAB	$190.62	$313.00	$51.31–$194.98	59% above	39%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PROBE TECH	$190.62	$313.00	$51.31–$194.98	59% above	39%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CDC 2019-NCOV CORONAVIRUS COVID-19	$190.62	$313.00	$51.31–$194.98	59% above	39%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR	$190.62	$313.00	$77.47–$300.48	—	39%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 NON-CDC 2019-NCOV CORONAVIRUS COVID-19	$190.62	$313.00	$77.47–$300.48	—	39%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PROBE TECH	$190.62	$313.00	$77.47–$300.48	—	39%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MCLAB	$190.62	$313.00	$77.47–$300.48	—	39%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CDC 2019-NCOV CORONAVIRUS COVID-19	$190.62	$313.00	$77.47–$300.48	—	39%
Calcium blood test, total CPT 82310 CALCIUM; TOTAL	$35.93	$59.00	$14.60–$56.64	25% below	39%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$35.93	$59.00	$14.60–$56.64	25% below	39%
Calcium blood test, total inpatient CPT 82310 CALCIUM; TOTAL	$35.93	$59.00	$14.60–$56.64	—	39%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$35.93	$59.00	$14.60–$56.64	—	39%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$132.76	$218.00	$53.96–$209.28	33% above	39%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$132.76	$218.00	$53.96–$209.28	—	39%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$90.13	$148.00	$36.63–$142.08	66% above	39%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA ZOSTER IMM STAT	$90.13	$148.00	$36.63–$142.08	66% above	39%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$90.13	$148.00	$36.63–$142.08	—	39%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA ZOSTER IMM STAT	$90.13	$148.00	$36.63–$142.08	—	39%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA DNA/RNA ASSAY	$246.04	$404.00	$99.99–$387.84	158% above	39%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA ASSAY	$246.04	$404.00	$99.99–$387.84	158% above	39%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA ASSAY	$246.04	$404.00	$99.99–$387.84	—	39%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION; CHLAMYDIA DNA/RNA ASSAY	$246.04	$404.00	$99.99–$387.84	—	39%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$110.23	$181.00	$44.80–$173.76	17% above	39%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL (NMR)	$110.23	$181.00	$44.80–$173.76	17% above	39%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$110.23	$181.00	$44.80–$173.76	—	39%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL (NMR)	$110.23	$181.00	$44.80–$173.76	—	39%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT; COMPLETE CBC	$63.95	$105.00	$25.99–$100.80	25% below	39%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT; COMPLETE (CBC)	$63.95	$105.00	$25.99–$100.80	25% below	39%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT; COMPLETE (CBC)	$63.95	$105.00	$25.99–$100.80	—	39%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT; COMPLETE CBC	$63.95	$105.00	$25.99–$100.80	—	39%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT; COMPLETE (CBC) AUTOMATED	$45.07	$74.00	$18.32–$71.04	37% below	39%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM W/O PLATELETS	$45.07	$74.00	$18.32–$71.04	37% below	39%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT; COMPLETE (CBC) AUTOMATED	$45.07	$74.00	$18.32–$71.04	—	39%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/O PLATELETS	$45.07	$74.00	$18.32–$71.04	—	39%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$87.09	$143.00	$35.39–$137.28	19% below	39%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$87.09	$143.00	$35.39–$137.28	—	39%
Cortisol blood test, total CPT 82533 CORTISOL; TOTAL	$113.88	$187.00	$46.28–$179.52	78% above	39%
Cortisol blood test, total inpatient CPT 82533 CORTISOL; TOTAL	$113.88	$187.00	$46.28–$179.52	—	39%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL	$45.68	$75.00	$18.56–$72.00	23% below	39%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL	$45.68	$75.00	$18.56–$72.00	—	39%
Creatinine blood test CPT 82565 CREATININE, BLOOD	$42.02	$69.00	$17.08–$66.24	18% below	39%
Creatinine blood test CPT 82565 CREATININE; BLOOD	$42.02	$69.00	$17.08–$66.24	18% below	39%
Creatinine blood test inpatient CPT 82565 CREATININE; BLOOD	$42.02	$69.00	$17.08–$66.24	—	39%
Creatinine blood test inpatient CPT 82565 CREATININE, BLOOD	$42.02	$69.00	$17.08–$66.24	—	39%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) AB, IGG, S MCLAB	$100.49	$165.00	$40.84–$158.40	58% above	39%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) AB, IGG, S MCLAB	$100.49	$165.00	$40.84–$158.40	—	39%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$71.25	$117.00	$28.96–$112.32	32% below	39%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE	$71.25	$117.00	$28.96–$112.32	—	39%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)	$155.90	$256.00	$63.36–$245.76	170% above	39%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)	$155.90	$256.00	$63.36–$245.76	—	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 MEDTOX/LABCORP - DRUG SCREEN PRSMPTV SGL DR CLASS	$42.63	$70.00	$17.33–$67.20	41% below	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPT; INSTR CHEM ANALYZER	$60.29	$99.00	$24.50–$95.04	16% below	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMPLIANCE DRUG SCREEN BLOOD	$121.80	$200.00	$49.50–$192.00	70% above	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE, ALCOHOL BIOMARKERS MCLAB	$230.81	$379.00	$93.80–$363.84	222% above	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN LIST A - MEDTOX DOA SCREEN	$416.56	$684.00	$169.29–$656.64	481% above	39%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL SCREEN, URINE MCLAB	$435.44	$715.00	$176.96–$686.40	508% above	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MEDTOX/LABCORP - DRUG SCREEN PRSMPTV SGL DR CLASS	$42.63	$70.00	$17.33–$67.20	—	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPT; INSTR CHEM ANALYZER	$60.29	$99.00	$24.50–$95.04	—	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMPLIANCE DRUG SCREEN BLOOD	$121.80	$200.00	$49.50–$192.00	—	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE, ALCOHOL BIOMARKERS MCLAB	$230.81	$379.00	$93.80–$363.84	—	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN LIST A - MEDTOX DOA SCREEN	$416.56	$684.00	$169.29–$656.64	—	39%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL SCREEN, URINE MCLAB	$435.44	$715.00	$176.96–$686.40	—	39%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$49.33	$81.00	$20.05–$77.76	36% below	39%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$49.33	$81.00	$20.05–$77.76	—	39%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR (EB) VIRUS; VIRAL CAPSID (VCA)	$127.28	$209.00	$51.73–$200.64	146% above	39%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR (EB) VIRUS; VIRAL CAPSID (VCA)	$127.28	$209.00	$51.73–$200.64	—	39%
Estradiol blood test CPT 82670 ESTRADIOL; TOTAL	$195.49	$321.00	$79.45–$308.16	195% above	39%
Estradiol blood test inpatient CPT 82670 ESTRADIOL; TOTAL	$195.49	$321.00	$79.45–$308.16	—	39%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH)	$130.33	$214.00	$52.97–$205.44	57% above	39%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN; FOLLCLE STIMULATING HORMONE (FSH)	$130.33	$214.00	$52.97–$205.44	—	39%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$137.63	$226.00	$55.94–$216.96	57% above	39%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$137.63	$226.00	$55.94–$216.96	—	39%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$95.61	$157.00	$38.86–$150.72	at median	39%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$95.61	$157.00	$38.86–$150.72	—	39%
Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY	$65.16	$107.00	$26.48–$102.72	36% above	39%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN; ACTIVITY	$65.16	$107.00	$26.48–$102.72	—	39%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM	$102.92	$169.00	$41.83–$162.24	21% above	39%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID; SERUM	$102.92	$169.00	$41.83–$162.24	—	39%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FREE	$118.76	$195.00	$48.26–$187.20	12% above	39%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3; FREE	$118.76	$195.00	$48.26–$187.20	—	39%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE (FT4)	$63.34	$104.00	$25.74–$99.84	8% below	39%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; FREE (FT4)	$63.34	$104.00	$25.74–$99.84	—	39%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$178.44	$293.00	$72.52–$281.28	182% above	39%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$178.44	$293.00	$72.52–$281.28	—	39%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT)	$50.55	$83.00	$20.54–$79.68	9% above	39%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT)	$50.55	$83.00	$20.54–$79.68	—	39%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$235.07	$386.00	$95.54–$370.56	6% below	39%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$235.07	$386.00	$95.54–$370.56	—	39%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE (GLU2)	$33.50	$55.00	$13.61–$52.80	22% below	39%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE (1HR DEXICOLA)	$33.50	$55.00	$13.61–$52.80	22% below	39%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE (GLU2)	$33.50	$55.00	$13.61–$52.80	—	39%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE (1HR DEXICOLA)	$33.50	$55.00	$13.61–$52.80	—	39%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE; TOLERANCE TEST (GTT)	$86.48	$142.00	$35.15–$136.32	15% below	39%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE; TOLERANCE TEST (GTT)	$86.48	$142.00	$35.15–$136.32	—	39%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA/RNA	$246.04	$404.00	$99.99–$387.84	185% above	39%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA	$246.04	$404.00	$99.99–$387.84	185% above	39%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA	$246.04	$404.00	$99.99–$387.84	—	39%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION; GC-DNA/RNA	$246.04	$404.00	$99.99–$387.84	—	39%
H. pylori antibody blood test CPT 86677 ANTIBODY; H PYLORI	$118.15	$194.00	$48.02–$186.24	10% below	39%
H. pylori antibody blood test inpatient CPT 86677 ANTIBODY; H PYLORI	$118.15	$194.00	$48.02–$186.24	—	39%
H. pylori stool antigen test CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION; H PYLORI ANTIGEN, STOOL	$100.49	$165.00	$40.84–$158.40	8% below	39%
H. pylori stool antigen test inpatient CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION; H PYLORI ANTIGEN, STOOL	$100.49	$165.00	$40.84–$158.40	—	39%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV RNA DETECTION AND QUANT,	$596.21	$979.00	$242.30–$939.84	419% above	39%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT ANTIGEN DETECTION; HIV RNA DETECTION AND QUANT,	$596.21	$979.00	$242.30–$939.84	—	39%
HIV-1 and HIV-2 antibody test CPT 86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE RESULT	$96.22	$158.00	$39.11–$151.68	44% above	39%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE RESULT	$96.22	$158.00	$39.11–$151.68	—	39%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 INFECTIOUS AGENT ANTIGEN DETECTION; HIV-1 W/HIV-1 & HIV-2 ABY	$168.69	$277.00	$68.56–$265.92	119% above	39%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 INFECTIOUS AGENT ANTIGEN DETECTION; HIV-1 W/HIV-1 & HIV-2 ABY	$168.69	$277.00	$68.56–$265.92	—	39%
HPV test for high-risk types, one combined (pooled) result CPT 87624 INFECTIOUS AGENT ANTIGEN DETECTION; HPV HIGH-RISK TYPES, POOLED	$246.04	$404.00	$99.99–$387.84	95% above	39%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 INFECTIOUS AGENT ANTIGEN DETECTION; HPV HIGH-RISK TYPES, POOLED	$246.04	$404.00	$99.99–$387.84	—	39%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C)	$68.21	$112.00	$27.72–$107.52	7% above	39%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLTED (A1C)	$68.21	$112.00	$27.72–$107.52	7% above	39%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C)	$68.21	$112.00	$27.72–$107.52	—	39%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLTED (A1C)	$68.21	$112.00	$27.72–$107.52	—	39%
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)	$16.44	$27.00	$6.68–$25.92	52% below	39%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB)	$16.44	$27.00	$6.68–$25.92	—	39%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY; TOTAL	$84.65	$139.00	$34.40–$133.44	20% above	39%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY; TOTAL	$84.65	$139.00	$34.40–$133.44	—	39%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$75.52	$124.00	$30.69–$119.04	5% above	39%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$75.52	$124.00	$30.69–$119.04	—	39%
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS B SURFACE ANTIGEN	$72.47	$119.00	$29.45–$114.24	22% above	39%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS B SURFACE ANTIGEN	$72.47	$119.00	$29.45–$114.24	—	39%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$99.88	$164.00	$40.59–$157.44	4% above	39%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$99.88	$164.00	$40.59–$157.44	—	39%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS C QUANT, PCR	$286.84	$471.00	$116.57–$452.16	123% above	39%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HCV RNA DET AND QUANT BY RT-	$300.24	$493.00	$122.02–$473.28	134% above	39%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HEPATITIS C QUANT, PCR	$286.84	$471.00	$116.57–$452.16	—	39%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 INFECTIOUS AGENT ANTIGEN DETECTION; HCV RNA DET AND QUANT BY RT-	$300.24	$493.00	$122.02–$473.28	—	39%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY; HERPES SIMPLEX (HSV TYPE 1 AB)	$92.57	$152.00	$37.62–$145.92	94% above	39%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY; HERPES SIMPLEX (HSV TYPE 1 AB)	$92.57	$152.00	$37.62–$145.92	—	39%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY; HERPES SIMPLEX, TYPE 2	$135.81	$223.00	$55.19–$214.08	136% above	39%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY; HERPES SIMPLEX, TYPE 2	$135.81	$223.00	$55.19–$214.08	—	39%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY	$90.74	$149.00	$36.88–$143.04	22% above	39%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY	$90.74	$149.00	$36.88–$143.04	—	39%
Homocysteine blood test CPT 83090 HOMOCYSTINE, BLOOD	$125.45	$206.00	$50.99–$197.76	33% above	39%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE, BLOOD	$125.45	$206.00	$50.99–$197.76	—	39%
Insulin blood test CPT 83525 INSULIN; TOTAL	$79.78	$131.00	$32.42–$125.76	43% above	39%
Insulin blood test inpatient CPT 83525 INSULIN; TOTAL	$79.78	$131.00	$32.42–$125.76	—	39%
Iron blood test (serum iron) CPT 83540 IRON	$45.07	$74.00	$18.32–$71.04	13% below	39%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$45.07	$74.00	$18.32–$71.04	—	39%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$61.51	$101.00	$25.00–$96.96	7% below	39%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$61.51	$101.00	$25.00–$96.96	—	39%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$60.90	$100.00	$24.75–$96.00	42% below	39%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$60.90	$100.00	$24.75–$96.00	—	39%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH)	$129.72	$213.00	$52.72–$204.48	56% above	39%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH)	$129.72	$213.00	$52.72–$204.48	—	39%
Lactate (lactic acid) blood test CPT 83605 D-LACTATE, PLASMA	$81.00	$133.00	$32.92–$127.68	2% below	39%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$81.00	$133.00	$32.92–$127.68	2% below	39%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE, PLASMA	$81.00	$133.00	$32.92–$127.68	—	39%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$81.00	$133.00	$32.92–$127.68	—	39%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); BLOOD	$42.02	$69.00	$17.08–$66.24	13% below	39%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); CSF	$42.02	$69.00	$17.08–$66.24	13% below	39%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); BLOOD	$42.02	$69.00	$17.08–$66.24	—	39%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); CSF	$42.02	$69.00	$17.08–$66.24	—	39%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$48.11	$79.00	$19.55–$75.84	28% below	39%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, URINE	$48.11	$79.00	$19.55–$75.84	28% below	39%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, URINE	$48.11	$79.00	$19.55–$75.84	—	39%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$48.11	$79.00	$19.55–$75.84	—	39%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$57.25	$94.00	$23.27–$90.24	44% below	39%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$57.25	$94.00	$23.27–$90.24	—	39%
Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME IGG/IGM SCREEN)	$119.36	$196.00	$48.51–$188.16	71% above	39%
Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME) MCLAB	$119.36	$196.00	$48.51–$188.16	71% above	39%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME IGG/IGM SCREEN)	$119.36	$196.00	$48.51–$188.16	—	39%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME) MCLAB	$119.36	$196.00	$48.51–$188.16	—	39%
Magnesium blood test CPT 83735 UROCHEM PANEL-MAGNESIUM	$46.89	$77.00	$19.06–$73.92	12% above	39%
Magnesium blood test CPT 83735 MAGNESIUM, RBC ARUP	$46.89	$77.00	$19.06–$73.92	12% above	39%
Magnesium blood test CPT 83735 MAGNESIUM ARUP	$46.89	$77.00	$19.06–$73.92	12% above	39%
Magnesium blood test CPT 83735 MAGNESIUM	$46.89	$77.00	$19.06–$73.92	12% above	39%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$46.89	$77.00	$19.06–$73.92	—	39%
Magnesium blood test inpatient CPT 83735 UROCHEM PANEL-MAGNESIUM	$46.89	$77.00	$19.06–$73.92	—	39%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC ARUP	$46.89	$77.00	$19.06–$73.92	—	39%
Magnesium blood test inpatient CPT 83735 MAGNESIUM ARUP	$46.89	$77.00	$19.06–$73.92	—	39%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA, IMMUNE STATUS	$90.13	$148.00	$36.63–$142.08	124% above	39%
Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA	$90.13	$148.00	$36.63–$142.08	124% above	39%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA	$90.13	$148.00	$36.63–$142.08	—	39%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY; RUBEOLA, IMMUNE STATUS	$90.13	$148.00	$36.63–$142.08	—	39%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES;SCREEN	$36.54	$60.00	$14.85–$57.60	32% below	39%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREENING (MONOTEST)	$36.54	$60.00	$14.85–$57.60	32% below	39%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES; SCREENING (MONOTEST)	$36.54	$60.00	$14.85–$57.60	—	39%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODIES;SCREEN	$36.54	$60.00	$14.85–$57.60	—	39%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS, SKIN TEST	$91.35	$150.00	$37.13–$144.00	82% above	39%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS	$91.35	$150.00	$37.13–$144.00	82% above	39%
Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS ARUP	$91.35	$150.00	$37.13–$144.00	82% above	39%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS ARUP	$91.35	$150.00	$37.13–$144.00	—	39%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS, SKIN TEST	$91.35	$150.00	$37.13–$144.00	—	39%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY; MUMPS	$91.35	$150.00	$37.13–$144.00	—	39%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATIC SPECIFIC ANTIGEN (PSA); FREE	$128.50	$211.00	$52.22–$202.56	123% above	39%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATIC SPECIFIC ANTIGEN (PSA); FREE	$128.50	$211.00	$52.22–$202.56	—	39%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA); TOTAL	$128.50	$211.00	$52.22–$202.56	43% above	39%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC ANTIGEN (PSA); TOTAL	$128.50	$211.00	$52.22–$202.56	—	39%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATHOLOGY, CERVICAL/VAGINAL, FLUID BASED; AUTOMATED SCREEN	$186.35	$306.00	$75.74–$293.76	119% above	39%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATHOLOGY, CERVICAL/VAGINAL, FLUID BASED; AUTOMATED SCREEN	$186.35	$306.00	$75.74–$293.76	—	39%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY, CERVICAL/VAGINAL, LIQUID BASED PREP; MANUAL SCREE	$141.90	$233.00	$57.67–$223.68	83% above	39%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATHOLOGY, CERVICAL/VAGINAL, LIQUID BASED PREP; MANUAL SCREE	$141.90	$233.00	$57.67–$223.68	—	39%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$289.28	$475.00	$117.56–$456.00	141% above	39%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$289.28	$475.00	$117.56–$456.00	141% above	39%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PARATHYROID HORMONE)	$289.28	$475.00	$117.56–$456.00	—	39%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$289.28	$475.00	$117.56–$456.00	—	39%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT)	$42.02	$69.00	$17.08–$66.24	35% below	39%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$42.02	$69.00	$17.08–$66.24	35% below	39%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA	$42.02	$69.00	$17.08–$66.24	35% below	39%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA	$42.02	$69.00	$17.08–$66.24	—	39%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT)	$42.02	$69.00	$17.08–$66.24	—	39%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD	$42.02	$69.00	$17.08–$66.24	—	39%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS INORGANIC (PHOSPHATE)	$33.50	$55.00	$13.61–$52.80	13% below	39%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS INORGANIC (PHOSPHATE)	$33.50	$55.00	$13.61–$52.80	—	39%
Potassium blood test CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD	$33.50	$55.00	$13.61–$52.80	24% below	39%
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD	$33.50	$55.00	$13.61–$52.80	—	39%
Progesterone blood test CPT 84144 PROGESTERONE	$146.16	$240.00	$59.40–$230.40	72% above	39%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$146.16	$240.00	$59.40–$230.40	—	39%
Prolactin blood test CPT 84146 PROLACTIN	$135.81	$223.00	$55.19–$214.08	48% above	39%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$135.81	$223.00	$55.19–$214.08	—	39%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$29.84	$49.00	$12.13–$47.04	10% below	39%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME, WHOLE BLOOD	$29.84	$49.00	$12.13–$47.04	10% below	39%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME, WHOLE BLOOD	$29.84	$49.00	$12.13–$47.04	—	39%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$29.84	$49.00	$12.13–$47.04	—	39%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; STREPTOCOCCUS	$115.71	$190.00	$47.03–$182.40	113% above	39%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; SCREEN-B STREP GRP A	$115.71	$190.00	$47.03–$182.40	113% above	39%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; STREPTOCOCCUS	$115.71	$190.00	$47.03–$182.40	—	39%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT ANTIGEN DETECTION; SCREEN-B STREP GRP A	$115.71	$190.00	$47.03–$182.40	—	39%
Renin blood test CPT 84244 RENIN, BLOOD	$154.08	$253.00	$62.62–$242.88	229% above	39%
Renin blood test inpatient CPT 84244 RENIN, BLOOD	$154.08	$253.00	$62.62–$242.88	—	39%
Rh blood typing CPT 86901 BLOOD TYPING, SEROLOGIC; RH (D)	$20.71	$34.00	$8.42–$32.64	52% below	39%
Rh blood typing inpatient CPT 86901 BLOOD TYPING, SEROLOGIC; RH (D)	$20.71	$34.00	$8.42–$32.64	—	39%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE	$39.59	$65.00	$16.09–$62.40	19% below	39%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE	$39.59	$65.00	$16.09–$62.40	—	39%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA, IMMM STATUS	$100.49	$165.00	$40.84–$158.40	109% above	39%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA	$100.49	$165.00	$40.84–$158.40	109% above	39%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA, IMMM STATUS	$100.49	$165.00	$40.84–$158.40	—	39%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY; RUBELLA	$100.49	$165.00	$40.84–$158.40	—	39%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED (ESR)	$18.88	$31.00	$7.67–$29.76	51% below	39%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED (ESR)	$18.88	$31.00	$7.67–$29.76	—	39%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD	$33.50	$55.00	$13.61–$52.80	27% below	39%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD	$33.50	$55.00	$13.61–$52.80	—	39%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND ID	$62.12	$102.00	$25.25–$97.92	36% above	39%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS MCLAB	$62.12	$102.00	$25.25–$97.92	36% above	39%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS ARUP	$62.12	$102.00	$25.25–$97.92	36% above	39%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND ID	$62.12	$102.00	$25.25–$97.92	—	39%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS ARUP	$62.12	$102.00	$25.25–$97.92	—	39%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, DIRECT SMEARS MCLAB	$62.12	$102.00	$25.25–$97.92	—	39%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD, OCCULT, BY PEROXIDASE ACTIVITY; FECES (HEMOCCULT SLIDE)	$30.45	$50.00	$12.38–$48.00	14% below	39%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD, OCCULT, BY PEROXIDASE ACTIVITY; FECES (HEMOCCULT SLIDE)	$30.45	$50.00	$12.38–$48.00	—	39%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD, OCCULT, QUAL, FECES, 1-3 DETERMINATIONS, BY IMMUNOASSAY,	$111.45	$183.00	$45.29–$175.68	93% above	39%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD, OCCULT, QUAL, FECES, 1-3 DETERMINATIONS, BY IMMUNOASSAY,	$111.45	$183.00	$45.29–$175.68	—	39%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$92.57	$152.00	$37.62–$145.92	70% above	39%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM, SYPHILIS AB MCLAB	$92.57	$152.00	$37.62–$145.92	70% above	39%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM, SYPHILIS AB MCLAB	$92.57	$152.00	$37.62–$145.92	—	39%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY; TREPONEMA PALLIDUM	$92.57	$152.00	$37.62–$145.92	—	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL) MCLA	$29.84	$49.00	$12.13–$47.04	9% below	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL)	$29.84	$49.00	$12.13–$47.04	9% below	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (RPR, RESPON	$29.84	$49.00	$12.13–$47.04	9% below	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL)	$29.84	$49.00	$12.13–$47.04	—	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (RPR, RESPON	$29.84	$49.00	$12.13–$47.04	—	39%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (VDRL) MCLA	$29.84	$49.00	$12.13–$47.04	—	39%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASU	$434.22	$713.00	$176.47–$684.48	263% above	39%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASU	$434.22	$713.00	$176.47–$684.48	—	39%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$172.96	$284.00	$70.29–$272.64	170% above	39%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL	$180.87	$297.00	$73.51–$285.12	183% above	39%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$172.96	$284.00	$70.29–$272.64	—	39%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL	$180.87	$297.00	$73.51–$285.12	—	39%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, ANTI-THYROID PEROXIDASE AUTOAB	$101.70	$167.00	$41.33–$160.32	87% above	39%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, THYROPEROXIDASE	$101.70	$167.00	$41.33–$160.32	87% above	39%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES, LIVER/KIDNEY	$101.70	$167.00	$41.33–$160.32	87% above	39%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, THYROPEROXIDASE	$101.70	$167.00	$41.33–$160.32	—	39%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, LIVER/KIDNEY	$101.70	$167.00	$41.33–$160.32	—	39%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES, ANTI-THYROID PEROXIDASE AUTOAB	$101.70	$167.00	$41.33–$160.32	—	39%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$117.54	$193.00	$47.77–$185.28	25% above	39%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$117.54	$193.00	$47.77–$185.28	—	39%
Total IgE blood test CPT 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE, TOTAL	$115.10	$189.00	$46.78–$181.44	124% above	39%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE, TOTAL	$115.10	$189.00	$46.78–$181.44	—	39%
Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$30.45	$50.00	$12.38–$48.00	13% below	39%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL	$30.45	$50.00	$12.38–$48.00	—	39%
Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL	$46.28	$76.00	$18.81–$72.96	7% above	39%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE; TOTAL	$46.28	$76.00	$18.81–$72.96	—	39%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3; TOTAL (TT-3)	$99.27	$163.00	$40.34–$156.48	43% above	39%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3; TOTAL (TT-3)	$99.27	$163.00	$40.34–$156.48	—	39%
Transferrin blood test CPT 84466 TRANSFERRIN	$89.52	$147.00	$36.38–$141.12	20% above	39%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$89.52	$147.00	$36.38–$141.12	—	39%
Trichomonas test (NAAT) CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS RNA	$246.04	$404.00	$99.99–$387.84	391% above	39%
Trichomonas test (NAAT) CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS VAGINALIS	$246.04	$404.00	$99.99–$387.84	391% above	39%
Trichomonas test (NAAT) inpatient CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS RNA	$246.04	$404.00	$99.99–$387.84	—	39%
Trichomonas test (NAAT) inpatient CPT 87661 INFECTIOUS AGENT ANTIGEN DETECTION; TRICHOMONAS VAGINALIS	$246.04	$404.00	$99.99–$387.84	—	39%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$40.19	$66.00	$16.34–$63.36	6% below	39%
Triglycerides blood test CPT 84478 TRIGLYCERIDES, FLUID	$40.19	$66.00	$16.34–$63.36	6% below	39%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$40.19	$66.00	$16.34–$63.36	—	39%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES, FLUID	$40.19	$66.00	$16.34–$63.36	—	39%
Troponin test, quantitative CPT 84484 TROPONIN I	$87.09	$143.00	$35.39–$137.28	15% below	39%
Troponin test, quantitative CPT 84484 TROPONIN, QUANTITATIVE	$87.09	$143.00	$35.39–$137.28	15% below	39%
Troponin test, quantitative inpatient CPT 84484 TROPONIN, QUANTITATIVE	$87.09	$143.00	$35.39–$137.28	—	39%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$87.09	$143.00	$35.39–$137.28	—	39%
Uric acid blood test CPT 84550 URIC ACID; BLOOD	$31.67	$52.00	$12.87–$49.92	31% below	39%
Uric acid blood test inpatient CPT 84550 URIC ACID; BLOOD	$31.67	$52.00	$12.87–$49.92	—	39%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED WITH MICROSCOPY	$18.27	$30.00	$7.43–$28.80	65% below	39%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY	$18.27	$30.00	$7.43–$28.80	65% below	39%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED WITH MICROSCOPY	$18.27	$30.00	$7.43–$28.80	—	39%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY	$18.27	$30.00	$7.43–$28.80	—	39%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (UA DIP ONLY)	$15.83	$26.00	$6.44–$24.96	39% below	39%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (DIPSTICK ONLY)	$15.83	$26.00	$6.44–$24.96	39% below	39%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY	$15.83	$26.00	$6.44–$24.96	39% below	39%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY	$15.83	$26.00	$6.44–$24.96	—	39%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (DIPSTICK ONLY)	$15.83	$26.00	$6.44–$24.96	—	39%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED WO MICROSCOPY (UA DIP ONLY)	$15.83	$26.00	$6.44–$24.96	—	39%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE	$46.28	$76.00	$18.81–$72.96	22% below	39%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, BACTERIAL; QUANTITATIVE COLONY COUNT, URINE	$46.28	$76.00	$18.81–$72.96	—	39%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE	$40.19	$66.00	$16.34–$63.36	31% below	39%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN 24 HR), QUANTITATIVE	$40.19	$66.00	$16.34–$63.36	31% below	39%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN 24 HR), QUANTITATIVE	$40.19	$66.00	$16.34–$63.36	—	39%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN; URINE (EG, MICROALBUMIN), QUANTITATIVE	$40.19	$66.00	$16.34–$63.36	—	39%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$60.29	$99.00	$24.50–$95.04	45% above	39%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$60.29	$99.00	$24.50–$95.04	—	39%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B12)	$105.36	$173.00	$42.82–$166.08	19% above	39%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN (VITAMIN B12)	$105.36	$173.00	$42.82–$166.08	—	39%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25 HYDROXY	$207.06	$340.00	$84.15–$326.40	95% above	39%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D; 25 HYDROXY	$207.06	$340.00	$84.15–$326.40	—	39%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D, 1,25 DIHYDROXY	$269.79	$443.00	$109.64–$425.28	251% above	39%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D, 1,25 DIHYDROXY	$269.79	$443.00	$109.64–$425.28	—	39%
Zinc blood test CPT 84630 ZINC,BLOOD	$79.78	$131.00	$32.42–$125.76	165% above	39%
Zinc blood test inpatient CPT 84630 ZINC,BLOOD	$79.78	$131.00	$32.42–$125.76	—	39%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE	$105.36	$173.00	$42.82–$166.08	14% above	39%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE	$105.36	$173.00	$42.82–$166.08	—	39%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HCHG 27786 CLSD TX DISTAL FIB FX W/O MAN	$238.12	$391.00	$96.77–$375.36	47% below	39%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HCHG 27786 CLSD TX DISTAL FIB FX W/O MAN	$238.12	$391.00	$96.77–$375.36	—	39%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT	$878.18	$1,442.00	$356.90–$1,384.32	16% below	39%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT	$878.18	$1,442.00	$356.90–$1,384.32	—	39%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN	$443.96	$729.00	$180.43–$699.84	10% below	39%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN	$443.96	$729.00	$180.43–$699.84	—	39%
Colonoscopy with polyp removal CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE	$1,631.51	$2,679.00	$663.05–$2,571.84	1% below	39%
Colonoscopy with polyp removal inpatient CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Colonoscopy with tissue sample CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT	$1,631.51	$2,679.00	$663.05–$2,571.84	2% above	39%
Colonoscopy with tissue sample inpatient CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Colonoscopy, diagnostic CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC	$1,631.51	$2,679.00	$663.05–$2,571.84	22% above	39%
Colonoscopy, diagnostic inpatient CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL	$113.88	$187.00	$46.28–$179.52	47% above	39%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL	$113.88	$187.00	$46.28–$179.52	—	39%
Earwax removal with instruments, one ear one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL	$95.61	$157.00	$38.86–$150.72	23% below	39%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL	$95.61	$157.00	$38.86–$150.72	—	39%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HCHG 62321 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH,	$671.12	$1,102.00	$272.75–$1,057.92	45% below	39%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HCHG 62321 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH,	$671.12	$1,102.00	$272.75–$1,057.92	—	39%
Eye injection into the vitreous (intravitreal injection) CPT 67028 HCHG 67028 INTRAVITREAL INJ PHARM AGENT	$939.69	$1,543.00	$381.89–$1,481.28	90% above	39%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HCHG 67028 INTRAVITREAL INJ PHARM AGENT	$939.69	$1,543.00	$381.89–$1,481.28	—	39%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S	$887.92	$1,458.00	$360.86–$1,399.68	36% below	39%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S	$887.92	$1,458.00	$360.86–$1,399.68	—	39%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC	$1,631.51	$2,679.00	$663.05–$2,571.84	73% above	39%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Hemorrhoid banding (rubber band ligation) CPT 46221 HCHG 46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S	$948.21	$1,557.00	$385.36–$1,494.72	16% above	39%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HCHG 46221 HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S	$948.21	$1,557.00	$385.36–$1,494.72	—	39%
Incision and drainage of a simple or single skin abscess CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE	$207.06	$340.00	$84.15–$326.40	28% below	39%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE	$207.06	$340.00	$84.15–$326.40	—	39%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO	$348.96	$573.00	$141.82–$550.08	6% below	39%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO	$348.96	$573.00	$141.82–$550.08	—	39%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT	$348.96	$573.00	$141.82–$550.08	3% below	39%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT	$348.96	$573.00	$141.82–$550.08	—	39%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT	$348.96	$573.00	$141.82–$550.08	14% above	39%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT	$348.96	$573.00	$141.82–$550.08	—	39%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT	$348.96	$573.00	$141.82–$550.08	8% above	39%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT	$348.96	$573.00	$141.82–$550.08	—	39%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT	$388.54	$638.00	$157.91–$612.48	14% below	39%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT	$388.54	$638.00	$157.91–$612.48	—	39%
Lower-back epidural injection, with imaging guidance CPT 62323 HCHG 62323 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH,	$671.12	$1,102.00	$272.75–$1,057.92	43% below	39%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HCHG 62323 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH,	$671.12	$1,102.00	$272.75–$1,057.92	—	39%
Lower-back epidural injection, without imaging guidance CPT 62322 HCHG 62322 PR INJ DIAG/THER SUBSTANCE W/CATH PLC	$887.92	$1,458.00	$360.86–$1,399.68	20% below	39%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HCHG 62322 PR INJ DIAG/THER SUBSTANCE W/CATH PLC	$887.92	$1,458.00	$360.86–$1,399.68	—	39%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HCHG 64483 INJ ANES AGNT-LUMB/SACR SINGLE	$887.92	$1,458.00	$360.86–$1,399.68	32% below	39%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HCHG 64483 INJ ANES AGNT-LUMB/SACR SINGLE	$887.92	$1,458.00	$360.86–$1,399.68	—	39%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM	$675.99	$1,110.00	$274.73–$1,065.60	14% above	39%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM	$675.99	$1,110.00	$274.73–$1,065.60	—	39%
Nail removal (partial or complete), one nail CPT 11730 HCHG 11730 AVULSION NAIL PLATE	$207.06	$340.00	$84.15–$326.40	23% below	39%
Nail removal (partial or complete), one nail inpatient CPT 11730 HCHG 11730 AVULSION NAIL PLATE	$207.06	$340.00	$84.15–$326.40	—	39%
Paracentesis with imaging guidance CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE	$859.91	$1,412.00	$349.47–$1,355.52	3% below	39%
Paracentesis with imaging guidance inpatient CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE	$859.91	$1,412.00	$349.47–$1,355.52	—	39%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT	$646.76	$1,062.00	$262.85–$1,019.52	27% above	39%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT	$646.76	$1,062.00	$262.85–$1,019.52	—	39%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE	$1,872.68	$3,075.00	$761.06–$2,952.00	12% below	39%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE	$1,872.68	$3,075.00	$761.06–$2,952.00	—	39%
Removal of a foreign object under the skin, simple CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE	$388.54	$638.00	$157.91–$612.48	4% below	39%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE	$388.54	$638.00	$157.91–$612.48	—	39%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE	$1,631.51	$2,679.00	$663.05–$2,571.84	4% above	39%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK	$1,631.51	$2,679.00	$663.05–$2,571.84	7% above	39%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK	$1,631.51	$2,679.00	$663.05–$2,571.84	—	39%
Short arm cast (elbow to hand) CPT 29075 HCHG 29075 APPLY SHORT ARM CAST	$414.73	$681.00	$168.55–$653.76	59% above	39%
Short arm cast (elbow to hand) inpatient CPT 29075 HCHG 29075 APPLY SHORT ARM CAST	$414.73	$681.00	$168.55–$653.76	—	39%
Short arm splint (forearm and hand) CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT	$164.43	$270.00	$66.83–$259.20	17% below	39%
Short arm splint (forearm and hand) inpatient CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT	$164.43	$270.00	$66.83–$259.20	—	39%
Short leg cast (below the knee) CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE)	$408.64	$671.00	$166.07–$644.16	37% above	39%
Short leg cast (below the knee) inpatient CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE)	$408.64	$671.00	$166.07–$644.16	—	39%
Short leg splint (calf to foot) CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT)	$151.64	$249.00	$61.63–$239.04	32% below	39%
Short leg splint (calf to foot) inpatient CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT)	$151.64	$249.00	$61.63–$239.04	—	39%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT	$207.06	$340.00	$84.15–$326.40	25% below	39%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT	$207.06	$340.00	$84.15–$326.40	—	39%
Skin tag removal, up to 15 tags CPT 11200 HCHG 11200 REMOVE SKIN TAGS;UP TO 15	$207.06	$340.00	$84.15–$326.40	3% below	39%
Skin tag removal, up to 15 tags inpatient CPT 11200 HCHG 11200 REMOVE SKIN TAGS;UP TO 15	$207.06	$340.00	$84.15–$326.40	—	39%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC;	$671.12	$1,102.00	$272.75–$1,057.92	9% below	39%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC;	$671.12	$1,102.00	$272.75–$1,057.92	—	39%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM	$207.06	$340.00	$84.15–$326.40	36% below	39%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM	$207.06	$340.00	$84.15–$326.40	—	39%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM	$207.06	$340.00	$84.15–$326.40	28% below	39%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM	$207.06	$340.00	$84.15–$326.40	—	39%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$205.84	$338.00	$83.66–$324.48	19% below	39%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$205.84	$338.00	$83.66–$324.48	—	39%
Thoracentesis with imaging guidance CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID	$559.67	$919.00	$227.45–$882.24	39% below	39%
Thoracentesis with imaging guidance inpatient CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID	$559.67	$919.00	$227.45–$882.24	—	39%
Trigger point injections, 1 or 2 muscles CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC	$348.96	$573.00	$141.82–$550.08	9% above	39%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC	$348.96	$573.00	$141.82–$550.08	—	39%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS	$1,404.35	$2,306.00	$570.74–$2,213.76	25% below	39%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS	$1,404.35	$2,306.00	$570.74–$2,213.76	—	39%
Upper endoscopy (EGD) with biopsy CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT	$1,404.35	$2,306.00	$570.74–$2,213.76	at median	39%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT	$1,404.35	$2,306.00	$570.74–$2,213.76	—	39%
Upper endoscopy (EGD), diagnostic CPT 43235 HCHG 43235P EGD; DIAGNOSTIC	$1,404.35	$2,306.00	$570.74–$2,213.76	16% above	39%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HCHG 43235P EGD; DIAGNOSTIC	$1,404.35	$2,306.00	$570.74–$2,213.76	—	39%
Vein ablation, radiofrequency, first vein CPT 36475 HCHG 36475 ENDOVEN ABLAT THERAPY 1ST VEIN	$3,103.46	$5,096.00	$1,261.26–$4,892.16	18% below	39%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HCHG 36475 ENDOVEN ABLAT THERAPY 1ST VEIN	$3,103.46	$5,096.00	$1,261.26–$4,892.16	—	39%
Wart removal, up to 14 warts CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14	$207.06	$340.00	$84.15–$326.40	6% above	39%
Wart removal, up to 14 warts inpatient CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14	$207.06	$340.00	$84.15–$326.40	—	39%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/<	$388.54	$638.00	$157.91–$612.48	14% below	39%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/<	$388.54	$638.00	$157.91–$612.48	—	39%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 1 PRODUCT	$946.39	$1,554.00	$384.62–$1,491.84	34% above	39%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 1 PRODUCT	$946.39	$1,554.00	$384.62–$1,491.84	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 MDI TREATMENT-SUBSEQUENT	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 PAP THERAPY,SUBSEQUENT TRTMENT	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 PAP THERAPY, INITIAL TREATMENT	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 COMBIVENT TRMT-INITIAL	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 COMBIVENT TRMT-SUBSEQ	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 NEB TREATMENT IP	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 MDI TREATMENT-INITIAL	$199.75	$328.00	$81.18–$314.88	71% above	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 NEB TREATMENT IP	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 MDI TREATMENT-SUBSEQUENT	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 PAP THERAPY, INITIAL TREATMENT	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 PAP THERAPY,SUBSEQUENT TRTMENT	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 MDI TREATMENT-INITIAL	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 COMBIVENT TRMT-INITIAL	$199.75	$328.00	$81.18–$314.88	—	39%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 COMBIVENT TRMT-SUBSEQ	$199.75	$328.00	$81.18–$314.88	—	39%
Chemotherapy IV infusion, first hour CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR	$517.04	$849.00	$210.13–$815.04	1% above	39%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR	$517.04	$849.00	$210.13–$815.04	—	39%
Critical care, first 30 to 74 minutes CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN	$1,760.62	$2,891.00	$715.52–$2,775.36	10% above	39%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN	$1,760.62	$2,891.00	$715.52–$2,775.36	—	39%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$133.37	$219.00	$54.20–$210.24	23% below	39%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$199.75	$328.00	$81.18–$314.88	16% above	39%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PR ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$133.37	$219.00	$54.20–$210.24	—	39%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY	$199.75	$328.00	$81.18–$314.88	—	39%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HCHG 99281 EMERGENCY SERVICE I	$193.05	$317.00	$78.46–$304.32	5% below	39%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HCHG 99281 EMERGENCY SERVICE I	$193.05	$317.00	$78.46–$304.32	—	39%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HCHG 99282 EMERGENCY SERVICE II	$289.88	$476.00	$117.81–$456.96	3% below	39%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HCHG 99282 EMERGENCY SERVICE II	$289.88	$476.00	$117.81–$456.96	—	39%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HCHG 99283 EMERGENCY SERVICE III	$488.42	$802.00	$198.50–$769.92	1% above	39%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HCHG 99283 EMERGENCY SERVICE III	$488.42	$802.00	$198.50–$769.92	—	39%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HCHG 99284 EMERGENCY SERVICE IV	$786.83	$1,292.00	$319.77–$1,240.32	1% above	39%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HCHG 99284 EMERGENCY SERVICE IV	$786.83	$1,292.00	$319.77–$1,240.32	—	39%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HCHG 99285 EMERGENCY SERVICE V	$1,149.18	$1,887.00	$467.03–$1,811.52	1% below	39%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HCHG 99285 EMERGENCY SERVICE V	$1,149.18	$1,887.00	$467.03–$1,811.52	—	39%
Exercise stress test, tracing only, the hospital charge CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M	$450.66	$740.00	$183.15–$710.40	37% below	39%
Exercise stress test, tracing only, the hospital charge CPT 93017 PR CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT MONITORIN	$450.66	$740.00	$183.15–$710.40	37% below	39%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M	$450.66	$740.00	$183.15–$710.40	—	39%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PR CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT MONITORIN	$450.66	$740.00	$183.15–$710.40	—	39%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 PR EXTERNAL ECG RECORDING UP TO 48 HRS; RECORDING, SCANNING, AND	$458.58	$753.00	$186.37–$722.88	54% above	39%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 PR EXTERNAL ECG RECORDING UP TO 48 HRS; RECORDING, SCANNING, AND	$458.58	$753.00	$186.37–$722.88	—	39%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR	$328.86	$540.00	$133.65–$518.40	21% above	39%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR	$328.86	$540.00	$133.65–$518.40	—	39%
IV infusion of a medicine, first hour CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR	$328.86	$540.00	$133.65–$518.40	1% above	39%
IV infusion of a medicine, first hour inpatient CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR	$328.86	$540.00	$133.65–$518.40	—	39%
IV push of a medicine, first drug CPT 96374 HCHG 96374 INJ;IV PUSH SNGL/INIT	$328.86	$540.00	$133.65–$518.40	79% above	39%
IV push of a medicine, first drug inpatient CPT 96374 HCHG 96374 INJ;IV PUSH SNGL/INIT	$328.86	$540.00	$133.65–$518.40	—	39%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC	$108.40	$178.00	$44.06–$170.88	40% above	39%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC	$108.40	$178.00	$44.06–$170.88	—	39%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG 97112 NEUROMUSCULAR RE-ED	$91.96	$151.00	$37.37–$144.96	—	39%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HCHG 97802 MED NUTRIT THERAPY-INIT-EA 15M	$40.80	$67.00	$16.58–$64.32	34% below	39%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PR MEDICAL NUTRITION THERAPY; INITIAL EVAL, INDIVIDUAL, EA 15 MI	$40.80	$67.00	$16.58–$64.32	34% below	39%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PR MEDICAL NUTRITION THERAPY; INITIAL EVAL, INDIVIDUAL, EA 15 MI	$40.80	$67.00	$16.58–$64.32	—	39%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HCHG 97802 MED NUTRIT THERAPY-INIT-EA 15M	$40.80	$67.00	$16.58–$64.32	—	39%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG 97165 OT EVALUATION, LOW COMPLEXITY	$174.78	$287.00	$71.03–$275.52	—	39%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG 97163 PT EVALUATION, HIGH COMPLEXITY	$208.28	$342.00	$84.65–$328.32	—	39%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG 97161 PT EVALUATION, LOW COMPLEXITY	$140.68	$231.00	$57.17–$221.76	—	39%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG 97162 PT EVALUATION, MODERATE COMPLEXITY	$168.69	$277.00	$68.56–$265.92	—	39%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY(SOFT TISS) 15MIN	$91.96	$151.00	$37.37–$144.96	—	39%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY TECHNIQUES, 15 MIN	$91.96	$151.00	$37.37–$144.96	—	39%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG 97110 THERAPUTIC PROCEDURE, EACH 15 MIN; THERAPUTIC EXERCIS	$91.96	$151.00	$37.37–$144.96	—	39%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN	$31.06	$51.00	$12.62–$48.96	9% below	39%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN	$31.06	$51.00	$12.62–$48.96	—	39%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HCHG 99215 NURSING LEVEL 5 WOUND CTR	$301.46	$495.00	$122.51–$475.20	73% above	39%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HCHG 99215 NURSING LEVEL 5 WOUND CTR	$301.46	$495.00	$122.51–$475.20	—	39%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 NURSING LEVEL 3 WOUND CTR	$152.86	$251.00	$62.12–$240.96	14% above	39%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 NURSING LEVEL 3 WOUND CTR	$152.86	$251.00	$62.12–$240.96	—	39%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 NURSING LEVEL 4 WOUND CTR	$225.33	$370.00	$91.58–$355.20	102% above	39%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 NURSING LEVEL 4 WOUND CTR	$225.33	$370.00	$91.58–$355.20	—	39%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 NURSING LEVEL 2 WOUND CTR	$91.96	$151.00	$37.37–$144.96	at median	39%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 NURSING LEVEL 2 WOUND CTR	$91.96	$151.00	$37.37–$144.96	—	39%
Speech and language evaluation inpatient CPT 92523 HCHG 92523 EVAL SPEECH SOUND PROD W/EVAL LANG COMP	$227.77	$374.00	$92.57–$359.04	—	39%
Speech therapy session, individual inpatient CPT 92507 HCHG 92507 SPEECH LANGUAGE THERAPY, INDIVIDUAL	$166.87	$274.00	$67.82–$263.04	—	39%
Spirometry (breathing test) CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY	$151.64	$249.00	$61.63–$239.04	7% below	39%
Spirometry (breathing test) CPT 94010 HCHG 94010 SPIRO-ROUT-SCREENING	$151.64	$249.00	$61.63–$239.04	7% below	39%
Spirometry (breathing test) CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT	$151.64	$249.00	$61.63–$239.04	7% below	39%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT	$151.64	$249.00	$61.63–$239.04	—	39%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY	$151.64	$249.00	$61.63–$239.04	—	39%
Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 SPIRO-ROUT-SCREENING	$151.64	$249.00	$61.63–$239.04	—	39%
Spirometry before and after a bronchodilator CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS	$451.27	$741.00	$183.40–$711.36	42% above	39%
Spirometry before and after a bronchodilator inpatient CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS	$451.27	$741.00	$183.40–$711.36	—	39%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG 97530 THERAP FUNCT ACTIV 15MIN	$99.27	$163.00	$40.34–$156.48	—	39%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC	$120.58	$198.00	$49.01–$190.08	41% below	39%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC	$120.58	$198.00	$49.01–$190.08	—	39%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$210.71	$346.00	$85.64–$332.16	15% above	39%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$210.71	$346.00	$85.64–$332.16	15% above	39%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$210.71	$346.00	$85.64–$332.16	—	39%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARS-COV-2 VACC, 50MCG/0.5ML, MRNA LNP, IM	$210.71	$346.00	$85.64–$332.16	—	39%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$209.50	$344.00	$85.14–$330.24	21% above	39%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$209.50	$344.00	$85.14–$330.24	21% above	39%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$209.50	$344.00	$85.14–$330.24	—	39%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR SARS-COV-2 VACC, 30MCG/0.3ML, MRNA LNP, IM	$209.50	$344.00	$85.14–$330.24	—	39%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$131.54	$216.00	$53.46–$207.36	33% below	39%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$131.54	$216.00	$53.46–$207.36	33% below	39%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$131.54	$216.00	$53.46–$207.36	—	39%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VARICELLA VIRUS VACCINE (VAR), LIVE, FOR SUBCUTANEOUS USE	$131.54	$216.00	$53.46–$207.36	—	39%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$57.25	$94.00	$23.27–$90.24	38% below	39%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$57.25	$94.00	$23.27–$90.24	38% below	39%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$57.25	$94.00	$23.27–$90.24	—	39%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 PR DIPHTHERIA TETANUS TOXOIDS ACELLULAR PERTUSSIS & INACT POLIO	$57.25	$94.00	$23.27–$90.24	—	39%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$26.19	$43.00	$10.64–$41.28	50% below	39%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$26.19	$43.00	$10.64–$41.28	50% below	39%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$26.19	$43.00	$10.64–$41.28	—	39%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 PR DIPHTHERIA, TETANUS TOXOIDS, AND ACELLULAR PERTUSSIS VACCINE	$26.19	$43.00	$10.64–$41.28	—	39%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$66.99	$110.00	$27.23–$105.60	21% below	39%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$66.99	$110.00	$27.23–$105.60	21% below	39%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$66.99	$110.00	$27.23–$105.60	—	39%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR	$66.99	$110.00	$27.23–$105.60	—	39%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$100.49	$165.00	$40.84–$158.40	at median	39%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$100.49	$165.00	$40.84–$158.40	at median	39%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$100.49	$165.00	$40.84–$158.40	—	39%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE	$100.49	$165.00	$40.84–$158.40	—	39%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$144.94	$238.00	$58.91–$228.48	35% above	39%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$144.94	$238.00	$58.91–$228.48	35% above	39%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$144.94	$238.00	$58.91–$228.48	—	39%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR	$144.94	$238.00	$58.91–$228.48	—	39%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$88.31	$145.00	$35.89–$139.20	109% above	39%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$88.31	$145.00	$98.16–$196.32	109% above	39%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$88.31	$145.00	$35.89–$139.20	—	39%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 PR RIV3 VACCINE PRESERVATIVE FREE FOR IM USE	$88.31	$145.00	$98.16–$196.32	—	39%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$45.68	$75.00	$18.56–$72.00	106% above	39%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$45.68	$75.00	$23.21–$71.25	106% above	39%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$45.68	$75.00	$18.56–$72.00	—	39%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$45.68	$75.00	$23.21–$71.25	—	39%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$262.48	$431.00	$106.67–$413.76	31% below	39%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$262.48	$431.00	$106.67–$413.76	31% below	39%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$262.48	$431.00	$106.67–$413.76	—	39%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR HUMAN PAPILLOMAVIRUS VACCINE, NONAVALENT (9VHPV), 2 OR 3 DOSE	$262.48	$431.00	$106.67–$413.76	—	39%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$68.21	$112.00	$27.72–$107.52	35% below	39%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$68.21	$112.00	$73.54–$147.08	35% below	39%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$68.21	$112.00	$73.54–$147.08	—	39%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPATITIS A VACCINE (HEPA), ADULT DOSE, FOR INTRAMUSCULAR USE	$68.21	$112.00	$27.72–$107.52	—	39%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$33.50	$55.00	$13.61–$52.80	41% below	39%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$33.50	$55.00	$13.61–$52.80	41% below	39%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$33.50	$55.00	$13.61–$52.80	—	39%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 PR HEPATITIS A VACCINE (HEPA), PED/ADOLESCENT DOSE/2 DOSE SCHEDU	$33.50	$55.00	$13.61–$52.80	—	39%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$60.90	$100.00	$75.14–$150.29	46% below	39%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$60.90	$100.00	$24.75–$96.00	46% below	39%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$102.98	$169.10	$75.14–$160.65	8% below	39%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$102.98	$169.10	$41.85–$162.34	8% below	39%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$60.90	$100.00	$24.75–$96.00	—	39%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPATITIS B VACCINE (HEPB), ADULT, 3 DOSE SCHEDULE FOR IM USE	$60.90	$100.00	$75.14–$150.29	—	39%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$102.98	$169.10	$41.85–$162.34	—	39%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML IM SYRG	$102.98	$169.10	$75.14–$160.65	—	39%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$126.06	$207.00	$165.60–$355.11	22% below	39%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$126.06	$207.00	$51.23–$198.72	22% below	39%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$126.06	$207.00	$51.23–$198.72	—	39%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 PR HEPATITIS B VACCINE (HEP B) ADULT 2 DOSE SCHEDULE FOR IM USE	$126.06	$207.00	$165.60–$355.11	—	39%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$20.71	$34.00	$27.20–$66.41	60% below	39%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$20.71	$34.00	$8.42–$32.64	60% below	39%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$20.71	$34.00	$27.20–$66.41	—	39%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 PR HEPATITIS B VACCINE (HEPB) PEDIATRIC/ADOLESCENT, 3 DOSE SCHED	$20.71	$34.00	$8.42–$32.64	—	39%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-OMP CONJUGAT	$28.01	$46.00	$11.39–$44.16	61% below	39%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-OMP CONJUGAT	$28.01	$46.00	$11.39–$44.16	61% below	39%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-OMP CONJUGAT	$28.01	$46.00	$11.39–$44.16	—	39%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-OMP CONJUGAT	$28.01	$46.00	$11.39–$44.16	—	39%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$18.27	$30.00	$7.43–$28.80	53% below	39%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$18.27	$30.00	$7.43–$28.80	53% below	39%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$18.27	$30.00	$7.43–$28.80	—	39%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 PR HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB), PRP-T CONJUGATE,	$18.27	$30.00	$7.43–$28.80	—	39%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$88.31	$145.00	$35.89–$139.20	36% above	39%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$88.31	$145.00	$98.16–$196.32	36% above	39%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$103.32	$169.65	$41.99–$162.86	59% above	39%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$103.32	$169.65	$98.16–$196.32	59% above	39%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$88.31	$145.00	$98.16–$196.32	—	39%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PERSERVATIVE FREE	$88.31	$145.00	$35.89–$139.20	—	39%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$103.32	$169.65	$98.16–$196.32	—	39%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML IM SYRG	$103.32	$169.65	$41.99–$162.86	—	39%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$80.39	$132.00	$32.67–$126.72	32% below	39%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$80.39	$132.00	$32.67–$126.72	32% below	39%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$80.39	$132.00	$32.67–$126.72	—	39%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR), LIVE, FOR SUBCUT	$80.39	$132.00	$32.67–$126.72	—	39%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$219.24	$360.00	$89.10–$345.60	1% above	39%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$219.24	$360.00	$89.10–$345.60	1% above	39%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$219.24	$360.00	$89.10–$345.60	—	39%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 PR MEASLES, MUMPS, RUBELLA, AND VARICELLA VACCINE (MMRV) (PROQUA	$219.24	$360.00	$89.10–$345.60	—	39%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$216.80	$356.00	$88.11–$341.76	11% above	39%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$216.80	$356.00	$88.11–$341.76	11% above	39%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$216.80	$356.00	$88.11–$341.76	—	39%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENINGOCOCCAL CONJUGATE VACCINE, GROUPS ACYW-135, QUADRIVALEN	$216.80	$356.00	$88.11–$341.76	—	39%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$81.61	$134.00	$33.17–$128.64	45% below	39%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$81.61	$134.00	$33.17–$128.64	45% below	39%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$81.61	$134.00	$33.17–$128.64	—	39%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 PR MENINGOCOCCAL CONJUGATE VACCINE (MENACWY-TT), FOR IM USE	$81.61	$134.00	$33.17–$128.64	—	39%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$150.42	$247.00	$61.13–$237.12	50% below	39%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$150.42	$247.00	$61.13–$237.12	50% below	39%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$150.42	$247.00	$61.13–$237.12	—	39%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESICLE VACCI	$150.42	$247.00	$61.13–$237.12	—	39%
Meningococcal B vaccine (Trumenba) CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$187.57	$308.00	$76.23–$295.68	at median	39%
Meningococcal B vaccine (Trumenba) CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$187.57	$308.00	$76.23–$295.68	at median	39%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$187.57	$308.00	$76.23–$295.68	—	39%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 PR MENINGOCOCCAL RECOMBINATE LIPOPROTEIN VACCINE, (MENB), 3 DOSE	$187.57	$308.00	$76.23–$295.68	—	39%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$194.88	$320.00	$79.20–$307.20	28% below	39%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$194.88	$320.00	$79.20–$307.20	28% below	39%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$194.88	$320.00	$79.20–$307.20	—	39%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PR PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13), FOR IM USE	$194.88	$320.00	$79.20–$307.20	—	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$272.83	$448.00	$110.88–$430.08	32% below	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$272.83	$448.00	$312.90–$625.80	32% below	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$414.79	$681.10	$312.90–$647.05	3% above	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$414.79	$681.10	$168.57–$653.86	3% above	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$272.83	$448.00	$110.88–$430.08	—	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PREVNAR) IM	$272.83	$448.00	$312.90–$625.80	—	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$414.79	$681.10	$312.90–$647.05	—	39%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML IM SYRG	$414.79	$681.10	$168.57–$653.86	—	39%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$106.58	$175.00	$43.31–$168.00	16% below	39%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$106.58	$175.00	$133.47–$266.94	16% below	39%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$106.58	$175.00	$133.47–$266.94	—	39%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) > 2 YRS FOR SUBQ	$106.58	$175.00	$43.31–$168.00	—	39%
Polio vaccine, inactivated (IPV) CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$45.68	$75.00	$18.56–$72.00	40% below	39%
Polio vaccine, inactivated (IPV) CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$45.68	$75.00	$18.56–$72.00	40% below	39%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$45.68	$75.00	$18.56–$72.00	—	39%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 PR POLIOVIRUS VACCINE, INACTIVATED (IPV), FOR SUBCUTANEOUS OR IM	$45.68	$75.00	$18.56–$72.00	—	39%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE, FOR IM USE	$232.64	$382.00	$305.60–$639.50	55% below	39%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE, FOR IM USE	$232.64	$382.00	$94.55–$366.72	55% below	39%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$614.02	$1,008.25	$319.74–$957.84	20% above	39%
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$614.02	$1,008.25	$249.54–$967.92	20% above	39%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE, FOR IM USE	$232.64	$382.00	$94.55–$366.72	—	39%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE, FOR IM USE	$232.64	$382.00	$305.60–$639.50	—	39%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$614.02	$1,008.25	$319.74–$957.84	—	39%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSR	$614.02	$1,008.25	$249.54–$967.92	—	39%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$115.71	$190.00	$47.03–$182.40	9% below	39%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$115.71	$190.00	$47.03–$182.40	9% below	39%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$115.71	$190.00	$47.03–$182.40	—	39%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 PR ROTAVIRUS VACCINE, PENTAVALENT (RV5), 3 DOSE SCHEDULE, LIVE,	$115.71	$190.00	$47.03–$182.40	—	39%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$158.34	$260.00	$64.35–$249.60	29% below	39%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$158.34	$260.00	$64.35–$249.60	29% below	39%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$277.95	$456.40	$112.96–$438.14	25% above	39%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$277.95	$456.40	$112.96–$438.14	25% above	39%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$158.34	$260.00	$64.35–$249.60	—	39%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR ZOSTER (SHINGLES) VACCINE (HZV)	$158.34	$260.00	$64.35–$249.60	—	39%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$277.95	$456.40	$112.96–$438.14	—	39%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML IM SUSR	$277.95	$456.40	$112.96–$438.14	—	39%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$37.15	$61.00	$38.97–$77.94	40% below	39%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$37.15	$61.00	$15.10–$58.56	40% below	39%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$37.15	$61.00	$15.10–$58.56	—	39%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TETANUS AND DIPHTHERIA TOXOIDS ABSORBED (TD) VACCINE PRESERVA	$37.15	$61.00	$38.97–$77.94	—	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$46.89	$77.00	$19.06–$73.92	40% below	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$46.89	$77.00	$39.69–$79.38	40% below	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$68.94	$113.20	$39.69–$107.54	12% below	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$68.94	$113.20	$28.02–$108.67	12% below	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$46.89	$77.00	$39.69–$79.38	—	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TETANUS, DIPHTHERIA TOXOIDS AND ACELLULAR PERTUSSIS VACCINE (	$46.89	$77.00	$19.06–$73.92	—	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$68.94	$113.20	$39.69–$107.54	—	39%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$68.94	$113.20	$28.02–$108.67	—	39%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$95.00	$156.00	$38.61–$149.76	32% below	39%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$95.00	$156.00	$38.61–$149.76	32% below	39%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$95.00	$156.00	$38.61–$149.76	—	39%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE, VI CAPSULAR POLYSACCHARIDE (VICPS) FOR IM US	$95.00	$156.00	$38.61–$149.76	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE	$28.62	$47.00	$11.63–$45.12	31% below	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR FLU SHOT ADMINISTRATION	$28.62	$47.00	$11.63–$45.12	31% below	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR PNEUMOVAX ADMINISTRATION	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR HEPATITIS B VAC ADMINISTRATION	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IMMUNIZATION ADMINISTRATION; 1 VACCINE	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471 IMMUNIZATION ADMIN	$99.27	$163.00	$40.34–$156.48	140% above	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR FLU SHOT ADMINISTRATION	$28.62	$47.00	$11.63–$45.12	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE	$28.62	$47.00	$11.63–$45.12	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR PNEUMOVAX ADMINISTRATION	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471 IMMUNIZATION ADMIN	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR HEPATITIS B VAC ADMINISTRATION	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IMMUNIZATION ADMINISTRATION; 1 VACCINE	$99.27	$163.00	$40.34–$156.48	—	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR 90472/G0009 ADMIN PNEUMOCCAL VACCINE	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IMMUNIZATION ADMINISTRATION; EA ADDL VACCINE	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR 90472/G0010 ADMIN HEPATITIS B VACCINE	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472/G0010 ADMIN HEPATITIS B VACCINE, ADDL	$25.58	$42.00	$10.40–$40.32	1% above	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR 90472/G0010 ADMIN HEPATITIS B VACCINE	$25.58	$42.00	$10.40–$40.32	—	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472/G0010 ADMIN HEPATITIS B VACCINE, ADDL	$25.58	$42.00	$10.40–$40.32	—	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL	$25.58	$42.00	$10.40–$40.32	—	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR 90472/G0009 ADMIN PNEUMOCCAL VACCINE	$25.58	$42.00	$10.40–$40.32	—	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL	$25.58	$42.00	$10.40–$40.32	—	39%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IMMUNIZATION ADMINISTRATION; EA ADDL VACCINE	$25.58	$42.00	$10.40–$40.32	—	39%

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://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/gundersen-st-elizabeths