Hospital San Diego-Chula Vista-Carlsbad, CA

Tri-City Medical Center

Tri-City Medical Center in Oceanside, CA publishes cash prices for 257 common procedures listed here, from its own machine-readable price file updated May 29, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 156 of 254 procedures and above it for 96. By typical cash price it ranks #93 of 226 California hospitals and #7 of 18 hospitals in the San Diego, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

4002 Vista Way, Oceanside, CA 92056-4506 Collected Sep 23, 2026 Source price file Check a bill from this hospital (760) 724-8411

Acute care hospital Government-owned hospital Emergency department CMS star rating 1 of 5 CCN 050128 · CMS hospital register NPI 1801861190

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Tri-City Medical Center is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

State law

This state limits hospital bills for lower-income patients

California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 6 actions for a hospital named Tri-City Medical Center in Oceanside, CA:

May 18, 2021 Warning notice
Oct 27, 2021 Corrective action plan requested
Nov 7, 2022 Case closed
Sep 30, 2025 Warning notice
Jan 2, 2026 Case closed
Jun 5, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Triphasic Liver	$2,459.78	$4,099.64	$240.02–$3,234.62	13% below	40%
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast	$2,459.78	$4,099.64	$240.02–$3,234.62	13% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast	$2,459.78	$4,099.64	$2,869.75–$3,193.62	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Triphasic Liver	$2,459.78	$4,099.64	$2,869.75–$3,193.62	—	40%
Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views	$322.30	$537.17	$30.36–$423.83	25% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views	$322.30	$537.17	$376.02–$418.46	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US Segmental Pressures LE 1-2 Lvls Bilat	$308.64	$514.40	$52.62–$405.86	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI	$51.55	$85.91	$17.18–$276.57	91% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Segmental Pressures	$308.64	$514.40	$52.62–$405.86	45% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 TCPO2 LASER DOPPLER ONE LEVEL	$308.64	$514.40	$52.62–$405.86	45% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US Segmental Pressures LE 1-2 Lvls Bilat	$308.64	$514.40	$360.08–$400.72	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI	$51.55	$85.91	$60.14–$66.92	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Segmental Pressures	$308.64	$514.40	$360.08–$400.72	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 TCPO2 LASER DOPPLER ONE LEVEL	$308.64	$514.40	$360.08–$400.72	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$416.69	$694.49	$38.47–$547.95	31% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$416.69	$694.49	$486.14–$541.01	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body Injection	$783.08	$1,305.14	$142.44–$1,029.76	63% below	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body Injection	$783.08	$1,305.14	$913.60–$1,016.70	—	40%
Breast ultrasound, complete, one breast CPT 76641 76641 US BREAST INCL AXILLA LIMITED	$287.53	$479.21	$95.84–$378.10	59% below	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 76641 US BREAST INCL AXILLA LIMITED	$287.53	$479.21	$335.45–$373.30	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis	$3,532.87	$5,888.12	$355.30–$4,645.73	35% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis	$3,532.87	$5,888.12	$4,121.68–$4,586.85	—	40%
CT angiography (CTA) of the head CPT 70496 CT Angio Circle Of Willis	$3,281.36	$5,468.94	$268.68–$4,314.99	10% above	40%
CT angiography (CTA) of the head CPT 70496 CT Angio Brain and Neck	$3,281.36	$5,468.94	$268.68–$4,314.99	10% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain and Neck	$3,281.36	$5,468.94	$3,828.26–$4,260.30	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Circle Of Willis	$3,281.36	$5,468.94	$3,828.26–$4,260.30	—	40%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck	$3,281.36	$5,468.94	$267.83–$4,314.99	11% above	40%
CT angiography (CTA) of the neck CPT 70498 Computed tomographic angiography, neck, with contrast materi	$3,281.36	$5,468.94	$267.83–$4,314.99	11% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 Computed tomographic angiography, neck, with contrast materi	$3,281.36	$5,468.94	$3,828.26–$4,260.30	—	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck	$3,281.36	$5,468.94	$3,828.26–$4,260.30	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary	$2,695.76	$4,492.94	$273.62–$3,544.93	21% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$2,695.76	$4,492.94	$273.62–$3,544.93	21% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Pulmonary	$2,695.76	$4,492.94	$3,145.06–$3,500.00	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$2,695.76	$4,492.94	$3,145.06–$3,500.00	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt	$832.14	$1,386.90	$277.38–$2,303.00	69% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt	$832.14	$1,386.90	$970.83–$1,080.40	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Coronary Calcium Screening	$204.31	$340.52	$68.10–$2,303.00	46% below	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring	$511.70	$852.84	$82.14–$2,303.00	36% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Coronary Calcium Screening	$204.31	$340.52	$238.36–$265.27	—	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring	$511.70	$852.84	$596.99–$664.36	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast	$2,752.27	$4,587.12	$172.20–$3,619.24	14% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT Abdomen/Pelvis w/o Contrast	$2,752.27	$4,587.12	$172.20–$3,619.24	14% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast	$2,752.27	$4,587.12	$3,210.98–$3,573.37	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 74176 CT Abdomen/Pelvis w/o Contrast	$2,752.27	$4,587.12	$3,210.98–$3,573.37	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast	$3,842.75	$6,404.58	$284.62–$5,053.21	7% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Oral Contrast	$3,842.75	$6,404.58	$284.62–$5,053.21	7% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis w Contrast	$3,842.75	$6,404.58	$284.62–$5,053.21	7% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography w/ Contrast	$4,184.30	$6,973.83	$284.62–$5,502.35	1% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Oral Contrast	$3,842.75	$6,404.58	$4,483.21–$4,989.17	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast	$3,842.75	$6,404.58	$4,483.21–$4,989.17	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis w Contrast	$3,842.75	$6,404.58	$4,483.21–$4,989.17	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography w/ Contrast	$4,184.30	$6,973.83	$4,881.68–$5,432.61	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 Abd/Pelvis	$4,579.25	$7,632.09	$322.43–$6,021.72	3% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram	$4,579.25	$7,632.09	$322.43–$6,021.72	3% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 74178 Abd/Pelvis	$4,579.25	$7,632.09	$5,342.46–$5,945.40	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram	$4,579.25	$7,632.09	$5,342.46–$5,945.40	—	40%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$2,137.48	$3,562.47	$210.85–$2,810.79	15% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$2,137.48	$3,562.47	$2,493.73–$2,775.16	—	40%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$1,065.02	$1,775.03	$132.49–$2,303.00	44% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$1,065.02	$1,775.03	$1,242.52–$1,382.75	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast Ltd	$1,828.85	$3,048.08	$124.58–$2,404.94	16% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Mandible w/o Contrast	$2,061.72	$3,436.20	$124.58–$2,711.16	6% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast	$2,061.72	$3,436.20	$124.58–$2,711.16	6% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$2,061.72	$3,436.20	$124.58–$2,711.16	6% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast Ltd	$1,828.85	$3,048.08	$2,133.66–$2,374.45	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Mandible w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast	$2,061.72	$3,436.20	$102.28–$2,711.16	10% below	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head Stroke Alert	$2,061.72	$3,436.20	$102.28–$2,711.16	10% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head Stroke Alert	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast	$2,501.39	$4,168.98	$144.26–$3,289.33	7% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast	$2,501.39	$4,168.98	$2,918.29–$3,247.64	—	40%
CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast	$3,007.51	$5,012.51	$169.72–$3,954.87	3% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast	$3,007.51	$5,012.51	$3,508.76–$3,904.75	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$1,686.64	$2,811.06	$125.58–$2,303.00	41% below	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Sacrum/Coccyx	$1,686.64	$2,811.06	$125.58–$2,303.00	41% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Sacrum/Coccyx	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$1,686.64	$2,811.06	$126.24–$2,303.00	42% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$2,046.82	$3,411.36	$206.49–$2,691.56	20% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$2,046.82	$3,411.36	$2,387.95–$2,657.45	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$370.12	$616.86	$123.37–$495.97	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$370.12	$616.86	$431.80–$480.53	—	40%
Chest CT scan without and with contrast CPT 71270 CT Chest/Abdomen/Pelvis w/ + w/o Contrast	$2,459.78	$4,099.64	$193.53–$3,234.62	25% below	40%
Chest CT scan without and with contrast CPT 71270 CT Chest w Abdomen/Pelvis w/ + w/o Contrast	$2,459.78	$4,099.64	$193.53–$3,234.62	25% below	40%
Chest CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast	$2,459.78	$4,099.64	$193.53–$3,234.62	25% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest/Abdomen/Pelvis w/ + w/o Contrast	$2,459.78	$4,099.64	$2,869.75–$3,193.62	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w Abdomen/Pelvis w/ + w/o Contrast	$2,459.78	$4,099.64	$2,869.75–$3,193.62	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast	$2,459.78	$4,099.64	$2,869.75–$3,193.62	—	40%
Chest X-ray, 2 views CPT 71046 XR Chest Decubitus	$337.21	$562.01	$27.74–$443.43	17% below	40%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$387.50	$645.84	$27.74–$509.57	5% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Decubitus	$337.21	$562.01	$393.41–$437.81	—	40%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$387.50	$645.84	$452.09–$503.11	—	40%
Chest X-ray, single view CPT 71045 XR Chest 1 View Portable	$307.40	$512.33	$17.83–$404.23	16% below	40%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$307.40	$512.33	$17.83–$404.23	16% below	40%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Portable	$307.40	$512.33	$358.63–$399.11	—	40%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$307.40	$512.33	$358.63–$399.11	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Infant/Peds	$401.17	$668.61	$81.53–$527.53	53% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Aorta	$401.17	$668.61	$81.53–$527.53	53% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Kidney Bladder	$401.17	$668.61	$81.53–$527.53	53% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Vascular	$401.17	$668.61	$81.53–$527.53	53% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Aorta	$401.17	$668.61	$468.03–$520.85	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Infant/Peds	$401.17	$668.61	$468.03–$520.85	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Kidney Bladder	$401.17	$668.61	$468.03–$520.85	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Vascular	$401.17	$668.61	$468.03–$520.85	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$530.96	$884.93	$34.61–$698.21	5% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton EO	$530.96	$884.93	$34.61–$698.21	5% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$530.96	$884.93	$619.45–$689.36	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton EO	$530.96	$884.93	$619.45–$689.36	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD DXA BONE DENSITY 1 OR MORE SITES PERIPHERAL, RADIUS, WRIS	$281.93	$469.89	$25.35–$370.74	2% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD DXA BONE DENSITY 1 OR MORE SITES PERIPHERAL, RADIUS, WRIS	$281.93	$469.89	$328.92–$366.04	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$1,686.64	$2,811.06	$128.59–$2,303.00	17% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/ w/o Contrast	$1,686.64	$2,811.06	$128.59–$2,303.00	17% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w Abdomen/Pelvis w/o Contrast	$1,860.52	$3,100.86	$128.59–$2,446.58	8% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/ w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w Abdomen/Pelvis w/o Contrast	$1,860.52	$3,100.86	$2,170.60–$2,415.57	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$2,046.82	$3,411.36	$162.55–$2,691.56	29% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast	$2,046.82	$3,411.36	$162.55–$2,691.56	29% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w Abdomen/Pelvis w/ Contrast	$2,046.82	$3,411.36	$162.55–$2,691.56	29% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest	$2,046.82	$3,411.36	$162.55–$2,691.56	29% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest	$2,046.82	$3,411.36	$2,387.95–$2,657.45	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$2,046.82	$3,411.36	$2,387.95–$2,657.45	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w Abdomen/Pelvis w/ Contrast	$2,046.82	$3,411.36	$2,387.95–$2,657.45	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast	$2,046.82	$3,411.36	$2,387.95–$2,657.45	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat.	$268.27	$447.12	$89.42–$352.78	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Post Clip Placement Bilateral	$268.27	$447.12	$89.42–$352.78	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo.	$268.27	$447.12	$89.42–$352.78	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Implant Diag Bilateral w/ Tomo.	$268.27	$447.12	$89.42–$352.78	—	40%
Diagnostic mammogram, both breasts CPT 77066 MG Mammo Post Clip Placement Bil	$268.27	$447.12	$89.42–$352.78	45% below	40%
Diagnostic mammogram, both breasts CPT 77066 MG Device Plcmnt w/ Mammo Guide Bilatera	$268.27	$447.12	$89.42–$352.78	45% below	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Implant Diag Bilateral w/ Tomo.	$268.27	$447.12	$312.98–$348.31	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat.	$268.27	$447.12	$312.98–$348.31	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo.	$268.27	$447.12	$312.98–$348.31	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Post Clip Placement Bilateral	$268.27	$447.12	$312.98–$348.31	—	40%
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Mammo Post Clip Placement Bil	$268.27	$447.12	$312.98–$348.31	—	40%
Diagnostic mammogram, both breasts inpatient CPT 77066 MG Device Plcmnt w/ Mammo Guide Bilatera	$268.27	$447.12	$312.98–$348.31	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$755.76	$1,259.60	$97.84–$993.82	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$755.76	$1,259.60	$881.72–$981.23	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Vessel Mapping for Dialysis	$663.85	$1,106.42	$169.92–$872.97	44% below	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Vessel Mapping for Dialysis	$663.85	$1,106.42	$774.49–$861.90	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 C8929 ECHO COMP W/COL DOP W INHANCER CHARGE	$2,085.32	$3,475.53	$242.16–$2,742.19	22% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 C8929 ECHO COMP W/COL DOP W INHANCER CHARGE	$2,085.32	$3,475.53	$2,432.87–$2,707.44	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast	$2,061.72	$3,436.20	$153.86–$2,711.16	10% below	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast	$2,061.72	$3,436.20	$153.86–$2,711.16	10% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast	$2,061.72	$3,436.20	$2,405.34–$2,676.80	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views	$511.09	$851.81	$37.65–$672.08	3% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views	$511.09	$851.81	$596.27–$663.56	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging	$892.38	$1,487.30	$293.92–$1,173.48	50% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging	$892.38	$1,487.30	$1,041.11–$1,158.61	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study	$434.08	$723.47	$83.55–$570.82	43% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study	$434.08	$723.47	$506.43–$563.58	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 CITY U/S ABDOMEN, LTD	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pyloric Stenosis Infant	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Appendix	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 ECHO EXAM OF ABDOMEN TechFee	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Abd/Pel	$417.94	$696.56	$61.35–$549.59	50% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 ECHO EXAM OF ABDOMEN TechFee	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Abd/Pel	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Appendix	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 CITY U/S ABDOMEN, LTD	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$417.94	$696.56	$487.59–$542.62	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pyloric Stenosis Infant	$417.94	$696.56	$487.59–$542.62	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 76882 US XTR NON-VASC LMTD	$167.67	$279.45	$26.50–$220.49	69% below	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 76882 US XTR NON-VASC LMTD	$167.67	$279.45	$195.62–$217.69	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast	$895.48	$1,492.47	$213.05–$2,478.00	69% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast	$895.48	$1,492.47	$1,044.73–$1,162.63	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral.	$1,643.17	$2,738.61	$341.22–$2,478.00	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral.	$1,643.17	$2,738.61	$1,917.03–$2,133.38	—	40%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$2,169.16	$3,615.26	$192.87–$2,852.44	22% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,408.86	$4,014.77	$336.86–$3,167.65	45% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$2,169.16	$3,615.26	$192.06–$2,852.44	25% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$2,408.86	$4,014.77	$314.17–$3,167.65	44% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Survey w/o Contrast	$2,169.16	$3,615.26	$187.86–$2,852.44	29% below	40%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$2,169.16	$3,615.26	$187.86–$2,852.44	29% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Survey w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$2,408.86	$4,014.77	$315.41–$3,167.65	47% below	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Survey w/ + w/o Contrast	$2,408.86	$4,014.77	$315.41–$3,167.65	47% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Survey w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$2,169.16	$3,615.26	$187.20–$2,852.44	25% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$2,408.86	$4,014.77	$316.37–$3,167.65	46% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$2,169.16	$3,615.26	$187.51–$2,852.44	28% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,408.86	$4,014.77	$336.24–$3,167.65	42% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,408.86	$4,014.77	$2,810.34–$3,127.51	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$2,169.16	$3,615.26	$228.60–$2,852.44	16% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$2,169.16	$3,615.26	$2,530.68–$2,816.29	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views	$518.54	$864.23	$40.40–$681.88	20% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views	$518.54	$864.23	$604.96–$673.24	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck/Chest w/ Contrast	$2,170.40	$3,617.33	$180.34–$2,854.07	21% below	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast	$2,170.40	$3,617.33	$180.34–$2,854.07	21% below	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck/Chest/Abdomen/Pelvis w/ Contrast	$2,170.40	$3,617.33	$180.34–$2,854.07	21% below	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck w Chest/Abdomen/Pelvis w Contrast	$2,170.40	$3,617.33	$180.34–$2,854.07	21% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck w Chest/Abdomen/Pelvis w Contrast	$2,170.40	$3,617.33	$2,532.13–$2,817.90	—	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast	$2,170.40	$3,617.33	$2,532.13–$2,817.90	—	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck/Chest/Abdomen/Pelvis w/ Contrast	$2,170.40	$3,617.33	$2,532.13–$2,817.90	—	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck/Chest w/ Contrast	$2,170.40	$3,617.33	$2,532.13–$2,817.90	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast	$2,112.64	$3,521.07	$145.45–$2,778.12	at median	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast	$2,112.64	$3,521.07	$2,464.75–$2,742.91	—	40%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$345.90	$576.50	$17.47–$454.86	6% above	40%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$345.90	$576.50	$403.55–$449.09	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Drug Stress Multi	$1,980.37	$3,300.62	$351.60–$2,691.18	51% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Exercise Stress Mult	$1,980.37	$3,300.62	$351.60–$2,691.18	51% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Exercise Stress Mult	$1,980.37	$3,300.62	$2,310.43–$2,571.18	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Drug Stress Multi	$1,980.37	$3,300.62	$2,310.43–$2,571.18	—	40%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,686.64	$2,811.06	$128.87–$2,303.00	14% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 76857 US EXAM PELVIC LIMITED ED TECH FEE	$175.12	$291.87	$42.59–$230.29	67% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 76857 US EXAM PELVIC LIMITED ED TECH FEE	$175.12	$291.87	$204.31–$227.37	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Comp	$486.86	$811.44	$68.33–$640.23	48% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Comp w/Transvag if indicated	$486.86	$811.44	$68.33–$640.23	48% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Comp	$486.86	$811.44	$568.01–$632.11	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Comp w/Transvag if indicated	$486.86	$811.44	$568.01–$632.11	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks	$459.54	$765.90	$129.22–$604.30	47% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks	$459.54	$765.90	$536.13–$596.64	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 76801 OB US < 14 WKS, SINGLE FETUS	$517.91	$863.19	$111.92–$681.06	33% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Weeks	$517.91	$863.19	$111.92–$681.06	33% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 Weeks	$517.91	$863.19	$604.23–$672.43	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 76801 OB US < 14 WKS, SINGLE FETUS	$517.91	$863.19	$604.23–$672.43	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$287.53	$479.21	$77.30–$378.10	52% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 76815 ANTEPARTUM ULTRASOUND CHARGE	$287.53	$479.21	$77.30–$378.10	52% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 76815 US PREGNANT UTERUS REAL TIME	$287.53	$479.21	$77.30–$378.10	52% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 76815 ANTEPARTUM ULTRASOUND CHARGE	$287.53	$479.21	$335.45–$373.30	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$287.53	$479.21	$335.45–$373.30	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 76815 US PREGNANT UTERUS REAL TIME	$287.53	$479.21	$335.45–$373.30	—	40%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral.	$222.32	$370.53	$74.11–$292.35	—	40%
Screening mammogram, both breasts CPT 77067 MG Breast Tomo 3D Digital Screening.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts CPT 77067 MG Mammo Implant Digital Screening Bil.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts CPT 77067 77067 Tomo	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Left.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Lt.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Screening Lt w/ Tomo.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Right.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Rt.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Screening Rt w/ Tomo.	$222.32	$370.53	$74.11–$292.35	29% below	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient CPT 77067 77067 Tomo	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient CPT 77067 MG Breast Tomo 3D Digital Screening.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient CPT 77067 MG Mammo Implant Digital Screening Bil.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Digital Screening Rt.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Digital Screening Lt.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Left.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Right.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Screening Rt w/ Tomo.	$222.32	$370.53	$259.37–$288.64	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Screening Lt w/ Tomo.	$222.32	$370.53	$259.37–$288.64	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete	$457.06	$761.76	$33.68–$601.03	at median	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete	$457.06	$761.76	$533.23–$593.41	—	40%
Skull X-ray, fewer than 4 views CPT 70250 XR Shunt Series	$511.09	$851.81	$26.24–$672.08	26% above	40%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views	$511.09	$851.81	$26.24–$672.08	26% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Shunt Series	$511.09	$851.81	$596.27–$663.56	—	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views	$511.09	$851.81	$596.27–$663.56	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech	$416.69	$694.49	$52.43–$547.95	37% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech	$416.69	$694.49	$486.14–$541.01	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast	$1,686.64	$2,811.06	$125.93–$2,303.00	40% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast	$1,686.64	$2,811.06	$1,967.74–$2,189.82	—	40%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB	$674.41	$1,124.01	$68.33–$886.84	6% below	40%
Transvaginal pelvic ultrasound CPT 76830 CITY US TRANSVAGINAL NON-OB	$674.41	$1,124.01	$68.33–$886.84	6% below	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB	$674.41	$1,124.01	$786.81–$875.60	—	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 CITY US TRANSVAGINAL NON-OB	$674.41	$1,124.01	$786.81–$875.60	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 CITY US TRANSVAGINAL OB	$568.84	$948.06	$88.10–$748.02	15% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 76817 US PREGNANT UTERUS REAL TIME	$568.84	$948.06	$88.10–$748.02	15% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$568.84	$948.06	$88.10–$748.02	15% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$568.84	$948.06	$663.64–$738.54	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 CITY US TRANSVAGINAL OB	$568.84	$948.06	$663.64–$738.54	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 76817 US PREGNANT UTERUS REAL TIME	$568.84	$948.06	$663.64–$738.54	—	40%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$408.62	$681.03	$84.03–$537.33	63% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$408.62	$681.03	$476.72–$530.52	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents)	$360.80	$601.34	$60.38–$474.46	59% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents)	$360.80	$601.34	$420.94–$468.44	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 76536 US EXAM OF HEAD AND NECK ED TECH FEE	$224.80	$374.67	$60.34–$295.61	73% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$360.80	$601.34	$60.34–$474.46	57% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$360.80	$601.34	$60.34–$474.46	57% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 76536 US EXAM OF HEAD AND NECK ED TECH FEE	$224.80	$374.67	$262.27–$291.87	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$360.80	$601.34	$420.94–$468.44	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$360.80	$601.34	$420.94–$468.44	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI	$558.90	$931.50	$103.05–$734.95	9% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI	$558.90	$931.50	$652.05–$725.64	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR NG Tube Place w/ Fluoro	$258.34	$430.56	$24.85–$339.71	15% below	40%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View Portable	$258.34	$430.56	$24.85–$339.71	15% below	40%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View	$258.34	$430.56	$24.85–$339.71	15% below	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View Portable	$258.34	$430.56	$301.39–$335.41	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR NG Tube Place w/ Fluoro	$258.34	$430.56	$301.39–$335.41	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View	$258.34	$430.56	$301.39–$335.41	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$441.53	$735.89	$30.59–$580.62	6% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$441.53	$735.89	$515.12–$573.26	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Bending 4 + Views	$687.45	$1,145.75	$44.29–$904.00	5% above	40%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4 Plus Views	$687.45	$1,145.75	$44.29–$904.00	5% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Bending 4 + Views	$687.45	$1,145.75	$802.02–$892.54	—	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4 Plus Views	$687.45	$1,145.75	$802.02–$892.54	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$462.02	$770.04	$28.32–$607.56	at median	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$462.02	$770.04	$539.03–$599.86	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views	$457.06	$761.76	$25.04–$601.03	6% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views	$457.06	$761.76	$533.23–$593.41	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical Flexion + Extension	$418.55	$697.59	$26.24–$550.40	7% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$418.55	$697.59	$26.24–$550.40	7% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$418.55	$697.59	$488.31–$543.42	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical Flexion + Extension	$418.55	$697.59	$488.31–$543.42	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$337.21	$562.01	$21.84–$443.43	12% below	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$337.21	$562.01	$393.41–$437.81	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views	$427.25	$712.08	$25.27–$561.83	9% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views	$427.25	$712.08	$498.46–$554.71	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase	$106.81	$178.02	$4.63–$140.46	148% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase	$106.81	$178.02	$124.61–$138.68	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase	$106.81	$178.02	$4.45–$140.46	135% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase	$106.81	$178.02	$124.61–$138.68	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Rubella IgG Antibody	$232.88	$388.13	$35.21–$306.23	14% below	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Acute Pnl	$464.51	$774.18	$35.21–$610.83	71% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Rubella IgG Antibody	$232.88	$388.13	$271.69–$302.35	—	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Acute Pnl	$464.51	$774.18	$541.93–$603.09	—	40%
Albumin blood test CPT 82040 Albumin Level	$106.81	$178.02	$4.06–$140.46	328% above	40%
Albumin blood test inpatient CPT 82040 Albumin Level	$106.81	$178.02	$124.61–$138.68	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$106.81	$178.02	$4.17–$140.46	189% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$106.81	$178.02	$124.61–$138.68	—	40%
Ammonia blood test CPT 82140 Ammonia Level	$122.34	$203.90	$12.75–$160.88	32% below	40%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$122.34	$203.90	$142.73–$158.84	—	40%
Amylase blood test CPT 82150 Amylase Level Urine	$106.81	$178.02	$5.67–$140.46	109% above	40%
Amylase blood test CPT 82150 Amylase Level 24 Hour Urine	$106.81	$178.02	$5.67–$140.46	109% above	40%
Amylase blood test CPT 82150 Amylase Level Body Fluid	$115.51	$192.51	$5.67–$151.89	126% above	40%
Amylase blood test CPT 82150 Amylase Level	$115.51	$192.51	$5.67–$151.89	126% above	40%
Amylase blood test inpatient CPT 82150 Amylase Level 24 Hour Urine	$106.81	$178.02	$124.61–$138.68	—	40%
Amylase blood test inpatient CPT 82150 Amylase Level Urine	$106.81	$178.02	$124.61–$138.68	—	40%
Amylase blood test inpatient CPT 82150 Amylase Level	$115.51	$192.51	$134.76–$149.97	—	40%
Amylase blood test inpatient CPT 82150 Amylase Level Body Fluid	$115.51	$192.51	$134.76–$149.97	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide LC	$19.25	$32.09	$18.74–$78.95	90% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$280.07	$466.79	$30.45–$368.30	51% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide LC	$19.25	$32.09	$22.46–$25.00	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$280.07	$466.79	$326.75–$363.63	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture and Gram Stain MB ARUP	$22.36	$37.26	$7.54–$29.40	81% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Medical Device Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Legionella Culture	$206.17	$343.62	$7.54–$271.12	71% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Surgical Culture	$383.16	$638.60	$7.54–$503.86	218% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture and Gram Stain MB ARUP	$22.36	$37.26	$26.08–$29.03	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Legionella Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Medical Device Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Surgical Culture	$383.16	$638.60	$447.02–$497.47	—	40%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$238.46	$397.44	$7.34–$313.58	21% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$238.46	$397.44	$278.21–$309.61	—	40%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$106.81	$178.02	$4.13–$140.46	136% above	40%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$106.81	$178.02	$124.61–$138.68	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$155.25	$258.75	$41.40–$204.15	19% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy	$182.57	$304.29	$41.40–$240.08	40% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$248.40	$414.00	$41.40–$326.65	91% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Non-Gyn Cytology Cell Block	$155.25	$258.75	$181.12–$201.57	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy	$182.57	$304.29	$213.00–$237.04	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity	$248.40	$414.00	$289.80–$322.51	—	40%
Blood culture for bacteria CPT 87040 Body Fluid Culture	$206.17	$343.62	$9.03–$271.12	24% below	40%
Blood culture for bacteria CPT 87040 Blood Unit Culture	$265.17	$441.95	$9.03–$348.70	3% below	40%
Blood culture for bacteria CPT 87040 Brucella Blood Culture	$265.17	$441.95	$9.03–$348.70	3% below	40%
Blood culture for bacteria inpatient CPT 87040 Body Fluid Culture	$206.17	$343.62	$240.53–$267.68	—	40%
Blood culture for bacteria inpatient CPT 87040 Blood Unit Culture	$265.17	$441.95	$309.37–$344.28	—	40%
Blood culture for bacteria inpatient CPT 87040 Brucella Blood Culture	$265.17	$441.95	$309.37–$344.28	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Veni	$17.39	$28.98	$2.70–$22.87	17% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$17.39	$28.98	$2.70–$22.87	17% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 VENIPUNCTURE, ROUTINE CHARGE	$17.39	$28.98	$2.70–$22.87	17% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 Veni	$17.39	$28.98	$20.29–$22.58	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 VENIPUNCTURE, ROUTINE CHARGE	$17.39	$28.98	$20.29–$22.58	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$17.39	$28.98	$20.29–$22.58	—	40%
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$106.81	$178.02	$3.33–$140.46	185% above	40%
Blood glucose (sugar) test CPT 82947 Glucose Level	$106.81	$178.02	$3.33–$140.46	185% above	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$106.81	$178.02	$124.61–$138.68	—	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$106.81	$178.02	$124.61–$138.68	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG,Beta Subunit,Qual,Serum LC	$6.83	$11.39	$6.52–$17.47	96% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Qualitative	$136.62	$227.70	$6.52–$179.66	15% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG,Beta Subunit,Qual,Serum LC	$6.83	$11.39	$7.97–$8.87	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Qualitative	$136.62	$227.70	$159.39–$177.38	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood ABORh	$124.20	$207.00	$2.40–$276.57	21% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Neonatal ABO/Rh.	$136.62	$227.70	$2.40–$276.57	33% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type ABO/Rh Typing	$136.62	$227.70	$2.40–$276.57	33% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Echo	$136.62	$227.70	$2.40–$276.57	33% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood ABORh	$124.20	$207.00	$144.90–$161.25	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type ABO/Rh Typing	$136.62	$227.70	$159.39–$177.38	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Echo	$136.62	$227.70	$159.39–$177.38	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Neonatal ABO/Rh.	$136.62	$227.70	$159.39–$177.38	—	40%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Level 24 Hour Urine	$106.81	$178.02	$3.18–$140.46	222% above	40%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$106.81	$178.02	$3.18–$140.46	222% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$106.81	$178.02	$124.61–$138.68	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Level 24 Hour Urine	$106.81	$178.02	$124.61–$138.68	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$117.99	$196.65	$4.53–$155.16	119% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$117.99	$196.65	$137.66–$153.19	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C difficile/Epi (GeneXpert)	$130.41	$217.35	$28.93–$171.49	15% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile/Epi (GeneXpert)	$130.41	$217.35	$152.15–$169.32	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) RNA (BD MAX)	$27.95	$46.58	$27.20–$82.10	70% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 Sharp by PCR	$51.55	$85.91	$44.90–$82.10	46% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) PCR (GeneXpert)	$72.66	$121.10	$44.90–$95.55	23% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (COVID-19) RNA (BD MAX)	$27.95	$46.58	$32.61–$36.29	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 Sharp by PCR	$51.55	$85.91	$60.14–$66.92	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (COVID-19) PCR (GeneXpert)	$72.66	$121.10	$84.77–$94.34	—	40%
Calcium blood test, total CPT 82310 Calcium Level Total	$106.81	$178.02	$4.14–$140.46	73% above	40%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total	$106.81	$178.02	$124.61–$138.68	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$192.51	$320.85	$16.59–$253.15	130% above	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$192.51	$320.85	$224.59–$249.94	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Pnl	$186.92	$311.54	$11.66–$245.81	84% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with Direct LDL	$186.92	$311.54	$11.66–$245.81	84% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Pnl	$186.92	$311.54	$218.08–$242.69	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with Direct LDL	$186.92	$311.54	$218.08–$242.69	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential	$115.51	$192.51	$6.80–$151.89	4% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential	$115.51	$192.51	$134.76–$149.97	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC without Differential	$92.53	$154.22	$5.66–$121.68	5% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Differential	$92.53	$154.22	$107.95–$120.14	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$238.46	$397.44	$9.24–$313.58	7% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$238.46	$397.44	$278.21–$309.61	—	40%
Cortisol blood test, total CPT 82533 Cortisol 60 Min	$182.57	$304.29	$14.26–$240.08	91% above	40%
Cortisol blood test, total CPT 82533 Cortisol 30 Min	$182.57	$304.29	$14.26–$240.08	91% above	40%
Cortisol blood test, total CPT 82533 Cortisol	$182.57	$304.29	$14.26–$240.08	91% above	40%
Cortisol blood test, total CPT 82533 Cortisol Baseline	$182.57	$304.29	$14.26–$240.08	91% above	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol 60 Min	$182.57	$304.29	$213.00–$237.04	—	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol	$182.57	$304.29	$213.00–$237.04	—	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol Baseline	$182.57	$304.29	$213.00–$237.04	—	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol 30 Min	$182.57	$304.29	$213.00–$237.04	—	40%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$122.34	$203.90	$5.70–$160.88	40% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$122.34	$203.90	$142.73–$158.84	—	40%
Creatinine blood test CPT 82565 Creatinine	$106.81	$178.02	$4.35–$140.46	131% above	40%
Creatinine blood test CPT 82565 BUN/Creatinine Ratio	$106.81	$178.02	$4.35–$140.46	131% above	40%
Creatinine blood test inpatient CPT 82565 BUN/Creatinine Ratio	$106.81	$178.02	$124.61–$138.68	—	40%
Creatinine blood test inpatient CPT 82565 Creatinine	$106.81	$178.02	$124.61–$138.68	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$178.85	$298.08	$8.91–$235.19	25% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$178.85	$298.08	$208.66–$232.20	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tricyclic Antidepressant, Ur LC	$10.56	$17.60	$10.28–$131.05	83% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone Level Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCP Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiate Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamine Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturate Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 THC Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TCA Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PPX Screen Urine	$168.91	$281.52	$43.94–$222.12	172% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen	$464.51	$774.18	$43.94–$610.83	649% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tricyclic Antidepressant, Ur LC	$10.56	$17.60	$12.32–$13.71	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamine Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TCA Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone Level Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cocaine Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturate Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PPX Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiate Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCP Screen Urine	$168.91	$281.52	$197.06–$219.30	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen	$464.51	$774.18	$541.93–$603.09	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$238.46	$397.44	$6.13–$313.58	183% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$238.46	$397.44	$278.21–$309.61	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal SO	$158.36	$263.93	$17.18–$208.24	118% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal SO	$158.36	$263.93	$184.75–$205.60	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$168.29	$280.49	$11.93–$221.31	58% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$168.29	$280.49	$196.34–$218.50	—	40%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$179.47	$299.12	$7.71–$236.01	34% above	40%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$179.47	$299.12	$209.38–$233.01	—	40%
Folate (folic acid) blood test CPT 82746 Folate Level	$94.39	$157.32	$12.86–$124.13	14% below	40%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$94.39	$157.32	$110.12–$122.55	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level	$114.26	$190.44	$7.89–$150.26	68% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level	$114.26	$190.44	$133.31–$148.35	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$106.81	$178.02	$6.30–$140.46	135% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$106.81	$178.02	$124.61–$138.68	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Post Prandial	$103.71	$172.85	$4.16–$136.38	99% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gestational Diabetes Screen (Glucose)	$106.81	$178.02	$4.16–$140.46	105% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Post Prandial	$103.71	$172.85	$121.00–$134.65	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Gestational Diabetes Screen (Glucose)	$106.81	$178.02	$124.61–$138.68	—	40%
H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody IgG	$149.66	$249.44	$13.08–$196.81	31% above	40%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody IgG	$149.66	$249.44	$174.61–$194.31	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$98.12	$163.53	$8.50–$129.03	50% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$98.12	$163.53	$114.47–$127.39	—	40%
Hemoglobin blood test CPT 85018 85018 Hb	$40.37	$67.28	$2.07–$53.08	at median	40%
Hemoglobin blood test inpatient CPT 85018 85018 Hb	$40.37	$67.28	$47.10–$52.41	—	40%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total IgG and IgM	$129.17	$215.28	$10.54–$169.86	268% above	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody Total IgG and IgM	$129.17	$215.28	$150.70–$167.70	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$142.21	$237.02	$9.04–$187.01	98% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$142.21	$237.02	$165.91–$184.64	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab	$134.14	$223.56	$12.49–$176.39	145% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Ab	$134.14	$223.56	$156.49–$174.15	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity	$22.36	$37.26	$11.17–$30.11	63% below	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, High Sensitivity SB	$117.99	$196.65	$11.17–$155.16	93% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity	$22.36	$37.26	$26.08–$29.03	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, High Sensitivity SB	$117.99	$196.65	$137.66–$153.19	—	40%
Iron blood test (serum iron) CPT 83540 Iron Level	$106.81	$178.02	$5.66–$140.46	84% above	40%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$106.81	$178.02	$124.61–$138.68	—	40%
Iron-binding capacity (TIBC) test CPT 83550 Iron Panel	$106.81	$178.02	$6.96–$140.46	46% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Panel	$106.81	$178.02	$124.61–$138.68	—	40%
Kidney function blood test panel CPT 80069 Renal Function Panel	$238.46	$397.44	$7.59–$313.58	68% above	40%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$238.46	$397.44	$278.21–$309.61	—	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Venous)	$168.29	$280.49	$9.50–$221.31	26% above	40%
Lactate (lactic acid) blood test CPT 83605 LA Ven - Sepsis 2Hr	$168.29	$280.49	$9.50–$221.31	26% above	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Venous) - Sepsis	$168.29	$280.49	$9.50–$221.31	26% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid (Venous)	$168.29	$280.49	$196.34–$218.50	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LA Ven - Sepsis 2Hr	$168.29	$280.49	$196.34–$218.50	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid (Venous) - Sepsis	$168.29	$280.49	$196.34–$218.50	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactic Acid LC	$6.83	$11.39	$5.29–$14.04	81% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactic Acid, Body Fluid LC	$24.22	$40.37	$5.29–$31.85	33% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$106.81	$178.02	$5.29–$140.46	196% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$106.81	$178.02	$5.29–$140.46	196% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactic Acid LC	$6.83	$11.39	$7.97–$8.87	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactic Acid, Body Fluid LC	$24.22	$40.37	$28.26–$31.45	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$106.81	$178.02	$124.61–$138.68	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$106.81	$178.02	$124.61–$138.68	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$122.34	$203.90	$6.03–$160.88	27% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$122.34	$203.90	$142.73–$158.84	—	40%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$238.46	$397.44	$6.44–$313.58	58% above	40%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$238.46	$397.44	$278.21–$309.61	—	40%
Magnesium blood test CPT 83735 Magnesium Level OB	$108.05	$180.09	$5.86–$142.09	71% above	40%
Magnesium blood test CPT 83735 Magnesium Level	$108.05	$180.09	$5.86–$142.09	71% above	40%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$108.05	$180.09	$126.06–$140.29	—	40%
Magnesium blood test inpatient CPT 83735 Magnesium Level OB	$108.05	$180.09	$126.06–$140.29	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$119.86	$199.76	$4.53–$157.61	17% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$119.86	$199.76	$139.83–$155.61	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Total	$190.65	$317.75	$16.09–$250.70	219% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen Total	$190.65	$317.75	$222.43–$247.53	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$86.94	$144.90	$35.19–$114.33	21% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intraoperative	$86.94	$144.90	$28.98–$114.33	21% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$86.94	$144.90	$101.43–$112.88	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intraoperative	$86.94	$144.90	$101.43–$112.88	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated PTT	$126.68	$211.14	$5.26–$166.59	103% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$126.68	$211.14	$5.26–$166.59	103% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$126.68	$211.14	$147.80–$164.48	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated PTT	$126.68	$211.14	$147.80–$164.48	—	40%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$106.81	$178.02	$4.15–$140.46	41% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level	$106.81	$178.02	$124.61–$138.68	—	40%
Potassium blood test CPT 84132 Potassium Level	$106.81	$178.02	$3.47–$140.46	46% above	40%
Potassium blood test inpatient CPT 84132 Potassium Level	$106.81	$178.02	$124.61–$138.68	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR	$99.36	$165.60	$3.52–$130.66	81% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR	$99.36	$165.60	$115.92–$129.00	—	40%
Rapid flu test (influenza antigen) CPT 87804 Flu A + B (BD Veritor)	$168.29	$280.49	$8.94–$221.31	123% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 Flu A + B (BD Veritor)	$168.29	$280.49	$196.34–$218.50	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A, Rapid	$149.66	$249.44	$7.06–$196.81	39% above	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep Confirmation	$149.66	$249.44	$7.06–$196.81	39% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A, Rapid	$149.66	$249.44	$174.61–$194.31	—	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep Confirmation	$149.66	$249.44	$174.61–$194.31	—	40%
Rh blood typing CPT 86901 Rh Only	$72.04	$120.06	$2.48–$94.73	29% above	40%
Rh blood typing inpatient CPT 86901 Rh Only	$72.04	$120.06	$84.04–$93.53	—	40%
Sodium blood test CPT 84295 Sodium Level	$106.81	$178.02	$3.55–$140.46	63% above	40%
Sodium blood test inpatient CPT 84295 Sodium Level	$106.81	$178.02	$124.61–$138.68	—	40%
Stool ova and parasites exam CPT 87177 Ova and Parasites	$195.62	$326.03	$7.25–$257.24	837% above	40%
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasites	$195.62	$326.03	$228.22–$253.98	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Antibodies LC	$4.35	$7.25	$4.23–$30.79	73% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Ab	$22.98	$38.30	$11.51–$30.79	42% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Antibodies LC	$4.35	$7.25	$5.08–$5.65	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum Ab	$22.98	$38.30	$26.81–$29.84	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin	$67.07	$111.78	$3.21–$88.19	400% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin	$67.07	$111.78	$78.25–$87.08	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$24.84	$41.40	$14.70–$39.08	73% below	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$24.84	$41.40	$28.98–$32.25	—	40%
Total cholesterol blood test CPT 82465 Cholesterol Total	$106.81	$178.02	$3.81–$140.46	154% above	40%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total	$106.81	$178.02	$124.61–$138.68	—	40%
Total thyroxine (T4) blood test CPT 84436 T4 Total	$114.26	$190.44	$5.23–$150.26	191% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 Total	$114.26	$190.44	$133.31–$148.35	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3 Total	$114.26	$190.44	$12.41–$150.26	46% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total	$114.26	$190.44	$133.31–$148.35	—	40%
Transferrin blood test CPT 84466 Transferrin	$21.74	$36.23	$11.12–$29.70	60% below	40%
Transferrin blood test inpatient CPT 84466 Transferrin	$21.74	$36.23	$25.36–$28.22	—	40%
Triglycerides blood test CPT 84478 Triglyceride Body Fluid	$106.81	$178.02	$5.02–$140.46	160% above	40%
Triglycerides blood test CPT 84478 Triglyceride	$106.81	$178.02	$5.02–$140.46	160% above	40%
Triglycerides blood test inpatient CPT 84478 Triglyceride Body Fluid	$106.81	$178.02	$124.61–$138.68	—	40%
Triglycerides blood test inpatient CPT 84478 Triglyceride	$106.81	$178.02	$124.61–$138.68	—	40%
Troponin test, quantitative CPT 84484 Troponin T LC	$21.74	$36.23	$8.55–$28.59	88% below	40%
Troponin test, quantitative CPT 84484 Troponin-I High Sensitivity SHARP	$40.99	$68.31	$8.55–$53.90	77% below	40%
Troponin test, quantitative CPT 84484 Troponin-I High Sensitivity	$192.51	$320.85	$8.55–$253.15	7% above	40%
Troponin test, quantitative CPT 84484 Troponin-I	$192.51	$320.85	$8.55–$253.15	7% above	40%
Troponin test, quantitative inpatient CPT 84484 Troponin T LC	$21.74	$36.23	$25.36–$28.22	—	40%
Troponin test, quantitative inpatient CPT 84484 Troponin-I High Sensitivity SHARP	$40.99	$68.31	$47.82–$53.21	—	40%
Troponin test, quantitative inpatient CPT 84484 Troponin-I	$192.51	$320.85	$224.59–$249.94	—	40%
Troponin test, quantitative inpatient CPT 84484 Troponin-I High Sensitivity	$192.51	$320.85	$224.59–$249.94	—	40%
Uric acid blood test CPT 84550 Uric Acid	$106.81	$178.02	$3.96–$140.46	62% above	40%
Uric acid blood test inpatient CPT 84550 Uric Acid	$106.81	$178.02	$124.61–$138.68	—	40%
Urinalysis with microscope exam, automated CPT 81001 81001	$60.24	$100.40	$2.77–$79.22	27% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 81001	$60.24	$100.40	$70.28–$78.21	—	40%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis (POCT)	$96.88	$161.46	$1.97–$127.39	73% above	40%
Urinalysis without microscope exam, automated CPT 81003 Clinitek Status POC Testing	$106.81	$178.02	$1.97–$140.46	91% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis (POCT)	$96.88	$161.46	$113.02–$125.78	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Clinitek Status POC Testing	$106.81	$178.02	$124.61–$138.68	—	40%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$121.10	$201.83	$5.71–$159.24	13% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$121.10	$201.83	$141.28–$157.23	—	40%
Urine microalbumin (albumin) test CPT 82043 Albumin/Creatinine Ratio,Urine LC	$12.42	$20.70	$5.06–$16.33	66% below	40%
Urine microalbumin (albumin) test CPT 82043 Albumin Level Urine	$87.56	$145.94	$5.06–$115.15	138% above	40%
Urine microalbumin (albumin) test CPT 82043 Albumin Level 24 Hour Urine	$87.56	$145.94	$5.06–$115.15	138% above	40%
Urine microalbumin (albumin) test CPT 82043 Albumin/Creatinine Ratio Urine	$106.81	$178.02	$5.06–$140.46	191% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin/Creatinine Ratio,Urine LC	$12.42	$20.70	$14.49–$16.13	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Level Urine	$87.56	$145.94	$102.16–$113.69	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin Level 24 Hour Urine	$87.56	$145.94	$102.16–$113.69	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin/Creatinine Ratio Urine	$106.81	$178.02	$124.61–$138.68	—	40%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test, Urine LC	$6.83	$11.39	$2.83–$13.78	92% below	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Qualitative	$117.99	$196.65	$2.83–$155.16	34% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test, Urine LC	$6.83	$11.39	$7.97–$8.87	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test Qualitative	$117.99	$196.65	$137.66–$153.19	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$94.39	$157.32	$13.20–$124.13	at median	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$94.39	$157.32	$110.12–$122.55	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 25 Hydroxy Level	$62.10	$103.50	$33.51–$81.66	8% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 25 Hydroxy Level	$62.10	$103.50	$72.45–$80.63	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative	$259.58	$432.63	$13.17–$341.35	45% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative	$259.58	$432.63	$302.84–$337.02	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 CITY BX BRST PLCMT DEV 1ST STRTCTC	$1,101.65	$1,836.09	$638.49–$6,640.00	75% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 CITY MG BREAST BX W/NEDLE LOC 1ST LESION	$2,035.64	$3,392.73	$638.49–$6,640.00	53% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,035.64	$3,392.73	$638.49–$6,640.00	53% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,035.64	$3,392.73	$638.49–$6,640.00	53% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 CITY BX BRST PLCMT DEV 1ST STRTCTC	$1,101.65	$1,836.09	$1,285.26–$1,430.31	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 CITY MG BREAST BX W/NEDLE LOC 1ST LESION	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786-Distal Fibular w/o Manipulation	$423.52	$705.87	$175.66–$3,004.00	21% below	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786-Distal Fibular w/o Manipulation	$423.52	$705.87	$494.11–$549.87	—	40%
Cardiac catheterization with coronary angiogram one side CPT 93458 93458 HT Cath Left W LV and Cor Angio	$4,383.02	$7,305.03	$959.51–$9,256.00	66% below	40%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 93458 HT Cath Left W LV and Cor Angio	$4,383.02	$7,305.03	$5,113.52–$5,690.62	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion; Elective	$842.70	$1,404.50	$198.39–$3,004.00	56% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion Cath Lab	$2,262.92	$3,771.54	$123.68–$2,975.75	18% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 ELEC CARDIOVERSION/DEFIBRILATION OP Tech Fee	$2,262.92	$3,771.54	$198.39–$3,004.00	18% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 - Cardioversion; Elective	$842.70	$1,404.50	$983.15–$1,094.11	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 ELEC CARDIOVERSION/DEFIBRILATION OP Tech Fee	$2,262.92	$3,771.54	$2,640.08–$2,938.03	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 Cardioversion Cath Lab	$2,262.92	$3,771.54	$2,640.08–$2,938.03	—	40%
Catheter ablation for atrial fibrillation CPT 93656 PERQ STENT/ANGIO SINGLE VESSEL --LC	$17,518.41	$29,197.35	$889.27–$54,332.46	48% below	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 PERQ STENT/ANGIO SINGLE VESSEL --LC	$17,518.41	$29,197.35	$20,438.15–$22,744.74	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-Distal Radial w/o Manipulation	$423.52	$705.87	$192.75–$3,004.00	24% below	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600-Distal Radial w/o Manipulation	$423.52	$705.87	$494.11–$549.87	—	40%
Coronary stent placement, one artery CPT 92928 92928 Trnscath Plcmnt Metal Single	$12,057.34	$20,095.56	$487.88–$23,996.77	19% below	40%
Coronary stent placement, one artery CPT 92928 92928 PERC CARD STENT/ANGIO 1 VSL	$12,201.41	$20,335.68	$487.88–$23,996.77	18% below	40%
Coronary stent placement, one artery inpatient CPT 92928 92928 Trnscath Plcmnt Metal Single	$12,057.34	$20,095.56	$14,066.89–$15,654.44	—	40%
Coronary stent placement, one artery inpatient CPT 92928 92928 PERC CARD STENT/ANGIO 1 VSL	$12,201.41	$20,335.68	$14,234.98–$15,841.49	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage	$109.92	$183.20	$14.72–$3,004.00	38% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage	$109.92	$183.20	$128.24–$142.71	—	40%
Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation	$108.68	$181.13	$30.84–$3,004.00	42% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation	$108.68	$181.13	$126.79–$141.10	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CITY IR INJ CERV/THORACIC W/IMAG GUID	$809.78	$1,349.64	$225.61–$6,640.00	67% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CITY IR INJ CERV/THORACIC W/IMAG GUID	$809.78	$1,349.64	$944.75–$1,051.37	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CITY INJ PARAVER FAC JNT L/S 1 LEVE	$1,101.65	$1,836.09	$145.89–$6,640.00	47% below	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CITY INJ PARAVER FAC JNT L/S 1 LEVE	$1,101.65	$1,836.09	$1,285.26–$1,430.31	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$347.14	$578.57	$42.86–$3,004.00	26% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I & D OF ABSCESS SIMPLE CHARGE	$514.19	$856.98	$42.86–$599.89	10% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$347.14	$578.57	$405.00–$450.71	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I & D OF ABSCESS SIMPLE CHARGE	$514.19	$856.98	$599.89–$667.59	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 CITY 20550 INJ TENDON SHEATH/LIGAMENT	$582.50	$970.83	$46.25–$6,640.00	12% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 CITY 20550 INJ TENDON SHEATH/LIGAMENT	$582.50	$970.83	$679.58–$756.28	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CITY IR ARTH/ASP/INJ MAJ JT/BURSA	$461.41	$769.01	$46.25–$6,640.00	52% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$486.25	$810.41	$46.25–$3,004.00	49% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CITY IR ARTH/ASP/INJ MAJ JT/BURSA	$461.41	$769.01	$538.31–$599.06	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$486.25	$810.41	$567.29–$631.31	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IR Joint Inj Wrist Elbow Ankle	$461.41	$769.01	$38.35–$6,640.00	24% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$514.19	$856.98	$38.35–$3,004.00	15% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 CITY IR Intermediate Aspiration/Inj w/o US	$519.78	$866.30	$38.35–$6,640.00	15% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IR Joint Inj Wrist Elbow Ankle	$461.41	$769.01	$538.31–$599.06	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Intermediate Aspiration/Inj w/o US	$514.19	$856.98	$599.89–$667.59	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CITY IR Intermediate Aspiration/Inj w/o US	$519.78	$866.30	$606.41–$674.85	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$514.19	$856.98	$32.71–$3,004.00	29% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 CITY DRAIN/INJ JOINT/ BURSA W/O US	$519.78	$866.30	$32.71–$6,640.00	29% below	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-Small Joint Aspirate/Inject w/o US	$514.19	$856.98	$599.89–$667.59	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 CITY DRAIN/INJ JOINT/ BURSA W/O US	$519.78	$866.30	$606.41–$674.85	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$627.83	$1,046.39	$248.70–$3,004.00	28% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CITY INTMD WND REPAIR S/A/T/EXT	$632.80	$1,054.67	$248.70–$6,640.00	27% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm	$627.83	$1,046.39	$732.47–$815.14	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 CITY INTMD WND REPAIR S/A/T/EXT	$632.80	$1,054.67	$738.27–$821.59	—	40%
Left heart catheterization, diagnostic one side CPT 93452 93452 LEFT HRT CATH W/VENTRICLGRPHY	$4,383.02	$7,305.03	$770.49–$9,256.00	56% below	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 93452 LEFT HRT CATH W/VENTRICLGRPHY	$4,383.02	$7,305.03	$5,113.52–$5,690.62	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CITY IR INJ LUMBAR/SACRAL W/IMAG GUID	$809.78	$1,349.64	$222.23–$6,640.00	64% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CITY IR INJ LUMBAR/SACRAL W/IMAG GUID	$809.78	$1,349.64	$944.75–$1,051.37	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CITY IR INJ ANES AGENT/STEROID; L/S	$1,059.43	$1,765.71	$144.77–$6,640.00	48% below	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CITY IR INJ ANES AGENT/STEROID; L/S	$1,059.43	$1,765.71	$1,236.00–$1,375.49	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$791.78	$1,319.63	$58.66–$3,004.00	40% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 CITY EXC TR-EXT B9+MARG 0.5CM/<	$965.66	$1,609.43	$58.66–$6,640.00	27% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400-Excision Lesion Benign Trunk/Extremity <= 0.5 cm	$791.78	$1,319.63	$923.74–$1,027.99	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 CITY EXC TR-EXT B9+MARG 0.5CM/<	$965.66	$1,609.43	$1,126.60–$1,253.75	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$791.78	$1,319.63	$65.05–$3,004.00	46% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440-Excise Lesion Benign Face Less Than/Equal to 0.5 cm	$791.78	$1,319.63	$923.74–$1,027.99	—	40%
Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single	$343.42	$572.36	$32.34–$3,004.00	32% below	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single	$343.42	$572.36	$400.65–$445.87	—	40%
Occipital nerve block (injection for headaches) CPT 64405 CITY IR INJ ANES OCCIPITAL NERVE	$461.41	$769.01	$63.55–$6,640.00	47% below	40%
Occipital nerve block (injection for headaches) CPT 64405 64405-Inject Nerve Block Great Occipital	$514.19	$856.98	$63.55–$3,004.00	41% below	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 CITY IR INJ ANES OCCIPITAL NERVE	$461.41	$769.01	$538.31–$599.06	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405-Inject Nerve Block Great Occipital	$514.19	$856.98	$599.89–$667.59	—	40%
Pacemaker implant (dual chamber) CPT 33208 33208 Insert or Replace Perm Atr and Ven	$12,174.71	$20,291.18	$752.05–$21,726.44	35% below	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 33208 Insert or Replace Perm Atr and Ven	$12,174.71	$20,291.18	$14,203.83–$15,806.83	—	40%
Paracentesis with imaging guidance CPT 49083 CITY IR PARACENTESIS W/IMAGING GUIDANCE	$1,117.80	$1,863.00	$279.66–$6,640.00	39% below	40%
Paracentesis with imaging guidance CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,196.67	$1,994.45	$279.66–$3,004.00	35% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 CITY IR PARACENTESIS W/IMAGING GUIDANCE	$1,117.80	$1,863.00	$1,304.10–$1,451.28	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide	$1,196.67	$1,994.45	$1,396.12–$1,553.68	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750-Excision Nail & Matrix	$627.83	$1,046.39	$149.59–$3,004.00	52% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION OF NAIL PART OR COMP CHARGE	$1,972.92	$3,288.20	$149.59–$2,301.74	52% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750-Excision Nail & Matrix	$627.83	$1,046.39	$732.47–$815.14	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 EXCISION OF NAIL PART OR COMP CHARGE	$1,972.92	$3,288.20	$2,301.74–$2,561.51	—	40%
Prostate biopsy CPT 55700 CITY BIOPSY PROSTATE	$1,969.19	$3,281.99	$492.30–$6,640.00	68% below	40%
Prostate biopsy inpatient CPT 55700 CITY BIOPSY PROSTATE	$1,969.19	$3,281.99	$2,297.39–$2,556.67	—	40%
Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple	$616.66	$1,027.76	$52.27–$3,004.00	37% below	40%
Removal of a foreign object under the skin, simple CPT 10120 CITY INCIS/REM OF FB, SUB TISS	$618.52	$1,030.86	$52.27–$6,640.00	37% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple	$616.66	$1,027.76	$719.43–$800.63	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 CITY INCIS/REM OF FB, SUB TISS	$618.52	$1,030.86	$721.60–$803.04	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 50590 LITHOTRIPSY CHARGE	$25,098.96	$41,831.60	$676.84–$29,282.12	219% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 50590 LITHOTRIPSY CHARGE	$25,098.96	$41,831.60	$12,981.00–$29,282.12	—	40%
Short arm splint (forearm and hand) CPT 29125 29125-Short Arm	$209.90	$349.83	$62.27–$3,004.00	50% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm	$209.90	$349.83	$244.88–$272.52	—	40%
Short leg splint (calf to foot) CPT 29515 29515-Short Leg	$265.17	$441.95	$57.16–$3,004.00	46% below	40%
Short leg splint (calf to foot) CPT 29515 29515 Application of Short Leg Cast	$514.19	$856.98	$57.16–$599.89	4% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg	$265.17	$441.95	$309.37–$344.28	—	40%
Short leg splint (calf to foot) inpatient CPT 29515 29515 Application of Short Leg Cast	$514.19	$856.98	$599.89–$667.59	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$347.14	$578.57	$70.69–$3,004.00	37% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$347.14	$578.57	$405.00–$450.71	—	40%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy of Skin, Single Lesion Charge	$1,972.92	$3,288.20	$113.18–$2,301.74	173% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch Biopsy of Skin, Single Lesion Charge	$1,972.92	$3,288.20	$2,301.74–$2,561.51	—	40%
Skin tag removal, up to 15 tags CPT 11200 11200-Removal Skin Tag up to 15	$343.42	$572.36	$31.97–$3,004.00	13% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200-Removal Skin Tag up to 15	$343.42	$572.36	$400.65–$445.87	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 CITY NM SPINAL PUNCT LUMBAR DX	$488.73	$814.55	$82.73–$6,640.00	63% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 CITY INJ LUMBAR SPINE DIAGNOSTIC	$809.78	$1,349.64	$82.73–$6,640.00	39% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 LUMBAR PUNCTURE CHARGE	$809.78	$1,349.64	$82.73–$6,640.00	39% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar puncture peds/infant	$809.78	$1,349.64	$82.73–$6,640.00	39% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic	$941.44	$1,569.06	$82.73–$3,004.00	29% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CITY NM SPINAL PUNCT LUMBAR DX	$488.73	$814.55	$570.18–$634.53	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 CITY INJ LUMBAR SPINE DIAGNOSTIC	$809.78	$1,349.64	$944.75–$1,051.37	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar puncture peds/infant	$809.78	$1,349.64	$944.75–$1,051.37	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 LUMBAR PUNCTURE CHARGE	$809.78	$1,349.64	$944.75–$1,051.37	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic	$941.44	$1,569.06	$1,098.34–$1,222.30	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$347.14	$578.57	$105.24–$3,004.00	54% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$347.14	$578.57	$405.00–$450.71	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$347.14	$578.57	$73.70–$3,004.00	47% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$347.14	$578.57	$405.00–$450.71	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Trangential Biopsy Skin, Single Lesion Charge	$347.14	$578.57	$90.24–$845.01	37% below	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Trangential Biopsy Skin, Single Lesion Charge	$347.14	$578.57	$405.00–$450.71	—	40%
Thoracentesis with imaging guidance CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$991.12	$1,651.86	$93.25–$3,004.00	51% below	40%
Thoracentesis with imaging guidance CPT 32555 CITY IR THORCENT/ASP PLEUR SPACE W/IMAG	$1,092.34	$1,820.57	$93.25–$6,640.00	46% below	40%
Thoracentesis with imaging guidance CPT 32555 32555 NEEDLE ASPIRATION CHEST W/ IMAG CHARGE	$1,092.34	$1,820.57	$93.25–$6,640.00	46% below	40%
Thoracentesis with imaging guidance inpatient CPT 32555 32555-Thoracentesis w/ Imaging Guidance	$991.12	$1,651.86	$1,156.30–$1,286.80	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 32555 NEEDLE ASPIRATION CHEST W/ IMAG CHARGE	$1,092.34	$1,820.57	$1,274.40–$1,418.22	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 CITY IR THORCENT/ASP PLEUR SPACE W/IMAG	$1,092.34	$1,820.57	$1,274.40–$1,418.22	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 CITY INJ TRIGGER PT 1-2 MUSCLES	$461.41	$769.01	$53.01–$6,640.00	28% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.25	$810.41	$53.01–$3,004.00	24% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CITY INJ TRIGGER PT 1-2 MUSCLES	$461.41	$769.01	$538.31–$599.06	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles	$486.25	$810.41	$567.29–$631.31	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 CITY BX BRST PLCMT DEV 1ST LES US	$1,974.16	$3,290.27	$620.06–$6,640.00	39% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy Left	$1,974.16	$3,290.27	$620.06–$6,640.00	39% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy Right	$1,974.16	$3,290.27	$620.06–$6,640.00	39% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 CITY BX BRST PLCMT DEV 1ST LES US	$1,974.16	$3,290.27	$2,303.19–$2,563.12	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy Left	$1,974.16	$3,290.27	$2,303.19–$2,563.12	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy Right	$1,974.16	$3,290.27	$2,303.19–$2,563.12	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$627.83	$1,046.39	$104.91–$3,004.00	8% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDE SUBQ TISSUE FIRST 20SQ CM	$901.69	$1,502.82	$104.91–$1,051.97	32% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEB SQ TISSUE-1ST 20SQCM/< CHARGE	$901.69	$1,502.82	$104.91–$1,051.97	32% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-SQ Tissue Less Than/Equal to 1st 20 sq cm	$627.83	$1,046.39	$732.47–$815.14	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEB SQ TISSUE-1ST 20SQCM/< CHARGE	$901.69	$1,502.82	$1,051.97–$1,170.70	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEBRIDE SUBQ TISSUE FIRST 20SQ CM	$901.69	$1,502.82	$1,051.97–$1,170.70	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 36430 OP BLOOD ADMINISTRATION CHARGE	$2,035.64	$3,392.73	$439.94–$2,676.86	133% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE Red Blood Cells Leukoreduced (Bridge)	$2,035.64	$3,392.73	$439.94–$2,676.86	133% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD TRANSFUSION SERVICE TechFee	$2,035.64	$3,392.73	$439.94–$2,676.86	133% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 Administration of Blood (Bridge)	$2,035.64	$3,392.73	$439.94–$2,676.86	133% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD TRANSFUSION SERVICE TechFee	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 OP BLOOD ADMINISTRATION CHARGE	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Administration of Blood (Bridge)	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSE Red Blood Cells Leukoreduced (Bridge)	$2,035.64	$3,392.73	$2,374.91–$2,642.94	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL HHN INITIAL CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL INLINE TX, SUBSEQUENT CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 METERED DOSE INHALER TX SUBSEQ CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL TX,SPUTUM INDUC,SUBS CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 IPPB TX, SUBSEQUENT CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL HHN TX, SUBSEQUENT CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT SUBS	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initial	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PAP/IPPB SYS INSTRUCT	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 ED MDI TX INITIAL CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 ED HHN TX INITIAL CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL TX,SPUTUM INDUCT, INIT CHARGE	$322.92	$538.20	$11.82–$455.19	at median	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL HHN INITIAL CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL TX,SPUTUM INDUCT, INIT CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 ED HHN TX INITIAL CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 ED MDI TX INITIAL CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PAP/IPPB SYS INSTRUCT	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initial	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT SUBS	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL HHN TX, SUBSEQUENT CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 IPPB TX, SUBSEQUENT CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL TX,SPUTUM INDUC,SUBS CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 METERED DOSE INHALER TX SUBSEQ CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL INLINE TX, SUBSEQUENT CHARGE	$322.92	$538.20	$376.74–$419.26	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction	$322.92	$538.20	$376.74–$419.26	—	40%
Critical care, first 30 to 74 minutes CPT 99291 99291 TRAUMA ALERT CLASS 1	$4,500.00	$7,500.00	$196.99–$5,917.50	18% below	40%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291	$4,657.50	$7,762.50	$196.99–$6,124.61	15% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 TRAUMA ALERT CLASS 1	$4,500.00	$7,500.00	$5,250.00–$5,842.50	—	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291	$4,657.50	$7,762.50	$5,433.75–$6,046.99	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005-ED EKG	$108.68	$181.13	$26.57–$3,004.00	68% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition	$221.08	$368.46	$16.56–$290.71	35% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$239.09	$398.48	$16.56–$314.40	29% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005-ED EKG	$108.68	$181.13	$126.79–$141.10	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition	$221.08	$368.46	$257.92–$287.03	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$239.09	$398.48	$278.94–$310.42	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ER LEVEL 1 VISIT TechFee	$450.00	$750.00	$24.59–$3,004.00	7% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Emergency Department Visit. Level 1	$465.75	$776.25	$24.59–$3,004.00	11% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 ER LEVEL 1 VISIT TechFee	$450.00	$750.00	$525.00–$584.25	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 Emergency Department Visit. Level 1	$465.75	$776.25	$543.38–$604.70	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ER LEVEL 2 VISIT Tech Fee	$750.00	$1,250.00	$31.10–$3,004.00	14% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$776.25	$1,293.75	$31.10–$3,004.00	11% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 ER LEVEL 2 VISIT Tech Fee	$750.00	$1,250.00	$875.00–$973.75	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$776.25	$1,293.75	$905.62–$1,007.83	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ER LEVEL 3 VISIT TechFee	$1,380.00	$2,300.00	$72.25–$3,004.00	8% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$1,428.30	$2,380.50	$72.25–$3,004.00	5% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 ER LEVEL 3 VISIT TechFee	$1,380.00	$2,300.00	$1,610.00–$1,791.70	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$1,428.30	$2,380.50	$1,666.35–$1,854.41	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ER LEVEL 4 VISIT TechFee	$2,400.00	$4,000.00	$87.20–$3,156.00	12% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$2,484.00	$4,140.00	$87.20–$3,266.46	8% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 ER LEVEL 4 VISIT TechFee	$2,400.00	$4,000.00	$2,800.00–$3,116.00	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$2,484.00	$4,140.00	$2,898.00–$3,225.06	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ER VISIT LEVEL 5 TechFee	$3,450.00	$5,750.00	$175.09–$4,536.75	3% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$3,570.75	$5,951.25	$175.09–$4,695.54	1% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 ER VISIT LEVEL 5 TechFee	$3,450.00	$5,750.00	$4,025.00–$4,479.25	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$3,570.75	$5,951.25	$4,165.88–$4,636.02	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV Thallium Stress Test.	$764.45	$1,274.09	$53.02–$1,005.26	46% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV Stress Acquisition	$840.83	$1,401.39	$53.02–$1,105.70	40% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 93017 CARDIOVASCULAR STRESS TEST CHARGE	$840.83	$1,401.39	$53.02–$1,105.70	40% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV Thallium Stress Test.	$764.45	$1,274.09	$891.86–$992.52	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV Stress Acquisition	$840.83	$1,401.39	$980.97–$1,091.68	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 CARDIOVASCULAR STRESS TEST CHARGE	$840.83	$1,401.39	$980.97–$1,091.68	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 HYDRATION IV SOL 31-60 MIN INT CHARGE	$215.49	$359.15	$51.81–$442.15	57% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 HYDRATION IV INF INIT 31-60MIN	$215.49	$359.15	$83.11–$3,004.00	57% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$215.49	$359.15	$51.81–$442.15	57% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 HYDRATION IV INF INIT 31-60MIN	$215.49	$359.15	$251.41–$279.78	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$215.49	$359.15	$251.41–$279.78	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 HYDRATION IV SOL 31-60 MIN INT CHARGE	$215.49	$359.15	$251.41–$279.78	—	40%
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION THX/PX/DX FIRST HR	$357.70	$596.16	$63.23–$470.37	39% below	40%
IV infusion of a medicine, first hour CPT 96365 96365 DRUG INFUSION 1 HR INTIAL CHARGE	$357.70	$596.16	$63.23–$470.37	39% below	40%
IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour	$357.70	$596.16	$63.23–$470.37	39% below	40%
IV infusion of a medicine, first hour CPT 96365 96365 THER/PROPH IV INF INIT =<1 HR	$357.70	$596.16	$101.41–$3,004.00	39% below	40%
IV infusion of a medicine, first hour CPT 96365 CITY INFUSION THERAPY UP TO 1 HOUR	$357.70	$596.16	$63.23–$470.37	39% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour	$357.70	$596.16	$417.31–$464.41	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION THX/PX/DX FIRST HR	$357.70	$596.16	$417.31–$464.41	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 CITY INFUSION THERAPY UP TO 1 HOUR	$357.70	$596.16	$417.31–$464.41	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 THER/PROPH IV INF INIT =<1 HR	$357.70	$596.16	$417.31–$464.41	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 DRUG INFUSION 1 HR INTIAL CHARGE	$357.70	$596.16	$417.31–$464.41	—	40%
IV push of a medicine, first drug CPT 96374 96374 THER/PROPH/DIAG INJ IV PUSH	$215.49	$359.15	$63.84–$3,004.00	39% below	40%
IV push of a medicine, first drug CPT 96374 96374 IV PUSH ONE/FIRST DRUG	$215.49	$359.15	$50.32–$442.15	39% below	40%
IV push of a medicine, first drug CPT 96374 96374- IV Injection, single/initial	$215.49	$359.15	$50.32–$442.15	39% below	40%
IV push of a medicine, first drug inpatient CPT 96374 96374- IV Injection, single/initial	$215.49	$359.15	$251.41–$279.78	—	40%
IV push of a medicine, first drug inpatient CPT 96374 96374 IV PUSH ONE/FIRST DRUG	$215.49	$359.15	$251.41–$279.78	—	40%
IV push of a medicine, first drug inpatient CPT 96374 96374 THER/PROPH/DIAG INJ IV PUSH	$215.49	$359.15	$251.41–$279.78	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER/PROPH/DIAG INJ, SC/IM CHARGE	$106.19	$176.99	$18.94–$149.67	41% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection	$106.19	$176.99	$18.94–$149.67	41% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER/PROPH/DIAG INJ SC/IM ED TECH FEE	$106.19	$176.99	$30.38–$3,004.00	41% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 IM Sq Injection	$106.19	$176.99	$18.94–$149.67	41% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic; prophylactic, or diagnostic injection, subcutaneous or intramuscular	$106.19	$176.99	$18.94–$149.67	41% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER/PROPH/DIAG INJ SC/IM ED TECH FEE	$106.19	$176.99	$123.89–$137.88	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 IM Sq Injection	$106.19	$176.99	$123.89–$137.88	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER/PROPH/DIAG INJ, SC/IM CHARGE	$106.19	$176.99	$123.89–$137.88	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection	$106.19	$176.99	$123.89–$137.88	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Therapeutic; prophylactic, or diagnostic injection, subcutaneous or intramuscular	$106.19	$176.99	$123.89–$137.88	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 95910 NERVE CONDUCTION STUDIES; 7-8 CHARGE	$589.33	$982.22	$131.12–$775.67	36% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 95910 NERVE CONDUCTION STUDIES; 7-8 CHARGE	$589.33	$982.22	$687.55–$765.15	—	40%
New patient office visit, about 30 minutes CPT 99203 99203 OBCH EVAL LVL 3 NEW PATIENT CHARGE	$214.25	$357.08	$71.42–$281.74	at median	40%
New patient office visit, about 30 minutes CPT 99203 99203 CVHI E&M NEW PT INTERM CHARGE	$214.25	$357.08	$71.42–$249.96	at median	40%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 CVHI E&M NEW PT INTERM CHARGE	$214.25	$357.08	$249.96–$278.17	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 OBCH EVAL LVL 3 NEW PATIENT CHARGE	$214.25	$357.08	$249.96–$278.17	—	40%
New patient office visit, about 45 minutes CPT 99204 99204 OBCH EVAL LVL 4 NEW PT CHARGE	$247.78	$412.97	$69.59–$325.83	1% above	40%
New patient office visit, about 45 minutes CPT 99204 99204 NEW PATIENT EXTENDED CHARGE	$247.78	$412.97	$69.59–$289.08	1% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 NEW PATIENT EXTENDED CHARGE	$247.78	$412.97	$289.08–$321.70	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 OBCH EVAL LVL 4 NEW PT CHARGE	$247.78	$412.97	$289.08–$321.70	—	40%
New patient office visit, about 60 minutes CPT 99205 99205 OBCH EVAL LVL 5 NEW PT CHARGE	$260.20	$433.67	$86.73–$342.17	24% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 OBCH EVAL LVL 5 NEW PT CHARGE	$260.20	$433.67	$303.57–$337.83	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OBCH EVAL LVL 2 NEW PT CHARGE	$154.63	$257.72	$34.64–$203.34	11% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OBCH EVAL LVL 2 NEW PT CHARGE	$154.63	$257.72	$180.40–$200.76	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MNT INITIAL 15 MIN CHARGE	$65.21	$108.68	$21.74–$85.75	35% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MNT INITIAL 15 MIN CHARGE	$65.21	$108.68	$76.08–$84.66	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$317.33	$528.89	$38.39–$1,300.00	7% below	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$317.33	$528.89	$370.22–$412.01	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 SMOKING CESSATION 3-10 MINS CHARGE	$42.85	$71.42	$10.51–$77.88	42% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 - SMOKING CESSATION 3-10 MINS CHARGE	$42.85	$71.42	$10.51–$77.88	42% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MINS	$66.45	$110.75	$10.51–$87.38	9% below	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 - SMOKING CESSATION 3-10 MINS CHARGE	$42.85	$71.42	$49.99–$55.64	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 SMOKING CESSATION 3-10 MINS CHARGE	$42.85	$71.42	$49.99–$55.64	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MINS	$66.45	$110.75	$77.53–$86.27	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OBCH EVAL LVL 5 ESTAB PT CHARGE	$260.20	$433.67	$57.77–$342.17	3% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SURGERY E&M EST PT COMPLEX	$260.20	$433.67	$57.77–$303.57	3% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OBCH EVAL LVL 5 ESTAB PT CHARGE	$260.20	$433.67	$303.57–$337.83	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SURGERY E&M EST PT COMPLEX	$260.20	$433.67	$303.57–$337.83	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 NON COPD INITIAL EVAL CHARGE	$39.13	$65.21	$13.04–$51.45	73% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OBCH EVAL LVL 3 ESTAB PT CHARGE	$214.25	$357.08	$24.24–$281.74	50% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 CVHI E&M ESTAB PT INTERM CHARGE	$214.25	$357.08	$24.24–$249.96	50% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 NON COPD INITIAL EVAL CHARGE	$39.13	$65.21	$45.65–$50.80	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 CVHI E&M ESTAB PT INTERM CHARGE	$214.25	$357.08	$249.96–$278.17	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OBCH EVAL LVL 3 ESTAB PT CHARGE	$214.25	$357.08	$249.96–$278.17	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OBCH EVAL LVL 4 ESTAB PT CHARGE	$247.78	$412.97	$37.88–$325.83	23% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CITY IR E&M ESTABLISHED PT EXTENDED	$247.78	$412.97	$37.88–$289.08	23% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CITY IR E&M ESTABLISHED PT EXTENDED	$247.78	$412.97	$289.08–$321.70	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OBCH EVAL LVL 4 ESTAB PT CHARGE	$247.78	$412.97	$289.08–$321.70	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 CVHI E&M ESTAB PT LTD CHARGE	$154.63	$257.72	$11.52–$180.40	35% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OBCH EVAL LVL 2 ESTAB PT CHARGE	$154.63	$257.72	$11.52–$203.34	35% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NM Follow Up Study EO	$154.63	$257.72	$11.52–$180.40	35% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CITY IR E&M ESTABLISHED PT LIMITED	$154.63	$257.72	$11.52–$180.40	35% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CITY IR E&M ESTABLISHED PT LIMITED	$154.63	$257.72	$180.40–$200.76	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NM Follow Up Study EO	$154.63	$257.72	$180.40–$200.76	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OBCH EVAL LVL 2 ESTAB PT CHARGE	$154.63	$257.72	$180.40–$200.76	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 CVHI E&M ESTAB PT LTD CHARGE	$154.63	$257.72	$180.40–$200.76	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$253.37	$422.28	$25.26–$448.84	34% below	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$253.37	$422.28	$295.60–$328.96	—	40%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM - PRE POST BD	$463.89	$773.15	$45.48–$775.67	42% below	40%
Spirometry before and after a bronchodilator CPT 94060 94060 PFT SPIROMETRY B/A CHARGE	$463.89	$773.15	$45.48–$775.67	42% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM - PRE POST BD	$463.89	$773.15	$541.21–$602.28	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 94060 PFT SPIROMETRY B/A CHARGE	$463.89	$773.15	$541.21–$602.28	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 PHLEBOTOMY THERAP INCOMPLETE CHARGE	$727.81	$1,213.02	$78.24–$957.07	125% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 PHLEBOTOMY THERAPEUTIC CHARGE	$970.63	$1,617.71	$78.24–$1,276.37	201% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 PHLEBOTOMY THERAPEUTIC DIALYSIS CHARGE	$970.63	$1,617.71	$78.24–$1,276.37	201% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 PHLEBOTOMY THERAP INCOMPLETE CHARGE	$727.81	$1,213.02	$849.11–$944.94	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 PHLEBOTOMY THERAPEUTIC DIALYSIS CHARGE	$970.63	$1,617.71	$1,132.40–$1,260.20	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 PHLEBOTOMY THERAPEUTIC CHARGE	$970.63	$1,617.71	$1,132.40–$1,260.20	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine SubQ Inj [CITY]	$461.17	$768.61	$153.72–$538.03	47% above	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine SubQ Inj [CITY]	$461.17	$768.61	$257.56–$598.75	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/pertussis/acel/tetanus pediatric 25units-58 mcg-10 units/0.5mL UD [CITY]	$99.04	$165.06	$32.58–$115.54	38% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/pertussis/acel/tetanus pediatric 25units-58 mcg-10 units/0.5mL UD [CITY]	$99.04	$165.06	$55.31–$128.58	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL [CITY]	$237.43	$395.71	$79.14–$277.00	44% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 diphtheria/hepB/pertussis,acel/polio/tetanus IM Susp 0 mL [CITY]	$237.43	$395.71	$132.60–$308.26	—	40%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp [CITY]	$289.08	$481.81	$79.03–$337.27	107% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units/mL PF IM Susp [CITY]	$289.08	$481.81	$161.45–$375.33	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg/mL Sus [CITY]	$272.21	$453.68	$75.59–$317.58	122% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg/mL Sus [CITY]	$272.21	$453.68	$152.03–$353.42	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B pediatric vaccine 10 mcg/0.5 mL Sus [CITY]	$75.11	$125.18	$25.04–$98.77	30% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B pediatric vaccine 10 mcg/0.5 mL Sus [CITY]	$75.11	$125.18	$87.63–$97.52	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conjugate (PRP-T) vaccine IM Inj [CITY]	$50.67	$84.45	$16.89–$59.12	21% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conjugate (PRP-T) vaccine IM Inj [CITY]	$50.67	$84.45	$28.30–$65.79	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza virus vaccine, inactivated high-dose PF trivalent Sus UD [CITY]	$313.02	$521.71	$50.77–$365.20	150% above	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza virus vaccine, inactivated high-dose PF trivalent Sus UD [CITY]	$313.02	$521.71	$174.83–$406.41	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [CITY]	$239.91	$399.84	$79.97–$279.89	71% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj [CITY]	$239.91	$399.84	$133.99–$311.48	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine IM Sol [CITY]	$356.77	$594.62	$118.92–$416.23	36% above	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine group ACYW IM Sol [CITY]	$394.63	$657.72	$131.54–$460.40	51% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine IM Sol [CITY]	$356.77	$594.62	$199.26–$463.21	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine group ACYW IM Sol [CITY]	$394.63	$657.72	$220.40–$512.36	—	40%
Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal serogroup B vaccine [CITY]	$955.14	$1,591.90	$201.47–$1,114.33	374% above	40%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal serogroup B vaccine [CITY]	$955.14	$1,591.90	$533.45–$1,240.09	—	40%
Rabies vaccine, one dose CPT 90675 rabies vaccine, chick embryo cell 2.5 intl units IM Inj [CITY]	$1,043.05	$1,738.42	$275.82–$1,216.89	48% above	40%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, chick embryo cell 2.5 intl units IM Inj [CITY]	$1,043.05	$1,738.42	$582.54–$1,354.23	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [CITY]	$186.19	$310.31	$44.71–$217.22	61% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus [CITY]	$186.19	$310.31	$103.98–$241.73	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 PO IMMUNIZATION ADM EA ADDTL VAC CHARGE	$99.36	$165.60	$24.84–$130.66	24% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE TechFee	$99.36	$165.60	$24.84–$130.66	24% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 PO IMMUNIZATION ADM EA ADDTL VAC CHARGE	$99.36	$165.60	$115.92–$129.00	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE TechFee	$99.36	$165.60	$115.92–$129.00	—	40%

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://downloads.ctfassets.net/pxcfulgsd9e2/4gjlqHWnZQNgtiSy8ZJLrL/462e87c011e61ee6d9262dedaaddd95d/952126937_tricity-medical-center_standardcharges.csv