Fairview Hospital
Fairview Hospital in Great Barrington, MA publishes cash prices for 55 common procedures listed here, from its own machine-readable price file updated Mar 25, 2026. Click a procedure to compare it with other hospitals nearby.
29 Lewis Ave, Great Barrington, MA 01230 | 29 Lewis Ave, Great Barrington, MA 01230 | 780 Main Street, Great Barrington, MA 01230 | 197 Adams Road, Williamstown, MA 01267 | 71 Hospital Ave, North Adams, MA 01247 | 710 Stockbridge Road, Suite 2, Lee, MA 01238 | 10 Maple Avenue, Suite 300, Great Barrington, MA 01230 | 10 Maple Avenue, Suite 100, Great Barrington, MA 01230 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pel w/Cntrst | $3,169.78 | $3,336.61 | 5% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pel w/Cntrst - Emergency Room | $5,160.90 | $5,432.53 | 5% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pel w/Cntrst | $5,160.90 | $5,432.53 | 5% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Brain w/o Contrst | $1,020.14 | $1,073.83 | 5% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Brain w/o Contrst - Emergency Room | $1,515.29 | $1,595.04 | 5% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Brain w/o Contrst | $1,515.29 | $1,595.04 | 5% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/Cntrst | $1,655.92 | $1,743.07 | 5% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/Cntrst - Emergency Room | $2,343.55 | $2,466.89 | 5% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/Cntrst | $2,343.55 | $2,466.89 | 5% |
| Diagnostic mammogram, both breasts CPT 77066 MM Mammo Post Plcmnt Bltrl | $385.17 | $405.44 | 5% |
| Diagnostic mammogram, both breasts CPT 77066 Dx Mammo Incl Cad Bilatrl | $597.65 | $629.11 | 5% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MM Mammo Post Plcmnt Bltrl | $385.17 | $405.44 | 5% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 Dx Mammo Incl Cad Bilatrl | $597.65 | $629.11 | 5% |
| Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Uniltrl | $534.84 | $562.99 | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 MM Mammo Post Plcmnt Lt | $303.87 | $319.86 | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 MM Mammo Post Plcmnt Rt | $303.87 | $319.86 | 5% |
| Diagnostic mammogram, one breast inpatient CPT 77065 Dx Mammo Incl Cad Uniltrl | $534.84 | $562.99 | 5% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM Mammo Post Plcmnt Rt | $303.87 | $319.86 | 5% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MM Mammo Post Plcmnt Lt | $303.87 | $319.86 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Lt | $2,391.07 | $2,516.92 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Rt | $2,391.07 | $2,516.92 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Lt - Emergency Room | $3,384.00 | $3,562.11 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Rt - Emergency Room | $3,384.00 | $3,562.11 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Lt | $3,384.00 | $3,562.11 | 5% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Lwr Ext Jt w/o Cntrst Rt | $3,384.00 | $3,562.11 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Rt | $3,265.63 | $3,437.51 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Lt | $3,265.63 | $3,437.51 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Lt - Emergency Room | $4,621.73 | $4,864.98 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Rt - Emergency Room | $4,621.73 | $4,864.98 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Lt | $4,621.73 | $4,864.98 | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Lwr Ext Jt w/wo Cntrst Rt | $4,621.73 | $4,864.98 | 5% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Stem w/o Cntrst | $2,312.47 | $2,434.18 | 5% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Stem w/o Cntrst - Emergency Room | $3,384.00 | $3,562.11 | 5% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Stem w/o Cntrst | $3,384.00 | $3,562.11 | 5% |
| MRI of the brain, with and without contrast dye CPT 70553 MRA Brain Stem W w/o Cntrst | $3,158.25 | $3,324.47 | 5% |
| MRI of the brain, with and without contrast dye CPT 70553 MRA Brain Stem W w/o Cntrst - Emergency Room | $4,621.73 | $4,864.98 | 5% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRA Brain Stem W w/o Cntrst | $4,621.73 | $4,864.98 | 5% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L Spine w/o Cntrst | $2,312.47 | $2,434.18 | 5% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L Spine w/o Cntrst - Emergency Room | $3,384.00 | $3,562.11 | 5% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L Spine w/o Cntrst | $3,384.00 | $3,562.11 | 5% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >/14 Wks Single Fetus | $845.79 | $890.31 | 5% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >/14 Wks Single Fetus - Emergency Room | $1,045.20 | $1,100.21 | 5% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >/14 Wks Single Fetus | $1,045.20 | $1,100.21 | 5% |
| Screening mammogram, both breasts CPT 77067 Screen Mammo Inc CAD Bltrl | $363.76 | $382.91 | 5% |
| Screening mammogram, both breasts inpatient CPT 77067 Screen Mammo Inc CAD Bltrl | $363.76 | $382.91 | 5% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB - Professional Charge | $130.15 | $137.00 | 5% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $607.57 | $639.55 | 5% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB - Emergency Room | $730.36 | $768.80 | 5% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $730.36 | $768.80 | 5% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen w/Img Docmention | $687.80 | $724.00 | 5% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen w/Img Docmention - Emergency Room | $826.85 | $870.37 | 5% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen w/Img Docmention | $826.85 | $870.37 | 5% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Lmbr Spine 4 vws | $562.81 | $592.43 | 5% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Lmbr Spine 4 vws - Emergency Room | $670.03 | $705.29 | 5% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Lmbr Spine 4 vws | $670.03 | $705.29 | 5% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Chem Basic Metabolic Scrn | $77.58 | $81.66 | 5% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Chem Basic Metabolic Scrn | $77.58 | $81.66 | 5% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel - Professional Charge | $69.35 | $73.00 | 5% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $115.91 | $122.01 | 5% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $115.91 | $122.01 | 5% |
| Complete blood count (CBC) with differential CPT 85025 CBC (Auto Diff) | $71.18 | $74.93 | 5% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC (Auto Diff) | $71.18 | $74.93 | 5% |
| Complete blood count (CBC), no differential CPT 85027 CBC (Manual Diff) | $81.37 | $85.65 | 5% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC (Manual Diff) | $81.37 | $85.65 | 5% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Met Screen | $96.90 | $102.00 | 5% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Met Screen | $96.90 | $102.00 | 5% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $77.59 | $81.67 | 5% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $77.59 | $81.67 | 5% |
| Liver function blood test panel CPT 80076 Hepatic Function | $95.67 | $100.71 | 5% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function | $95.67 | $100.71 | 5% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Free Psa | $143.04 | $150.57 | 5% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free Psa | $143.04 | $150.57 | 5% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screening | $159.13 | $167.50 | 5% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostatic Spec Ant | $159.13 | $167.50 | 5% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screening | $159.13 | $167.50 | 5% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostatic Spec Ant | $159.13 | $167.50 | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA (Lupus Sensitive) | $18.91 | $19.91 | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA Mixing Study s/o | $20.93 | $22.03 | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Plasma Fraction Ea | $51.97 | $54.71 | 5% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA (Lupus Sensitive) | $18.91 | $19.91 | 5% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA Mixing Study s/o | $20.93 | $22.03 | 5% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Plasma Fraction Ea | $51.97 | $54.71 | 5% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Mix Study s/o | $16.67 | $17.55 | 5% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $34.01 | $35.80 | 5% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time Mix Study s/o | $16.67 | $17.55 | 5% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $34.01 | $35.80 | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Untreated s/o | $52.73 | $55.50 | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH HAMA Treatment | $52.73 | $55.50 | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $55.97 | $58.92 | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone | $145.39 | $153.04 | 5% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH HAMA Treatment | $52.73 | $55.50 | 5% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Untreated s/o | $52.73 | $55.50 | 5% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $55.97 | $58.92 | 5% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stim Hormone | $145.39 | $153.04 | 5% |
| Urinalysis with microscope exam, automated CPT 81001 Urnlysis Auto w/Micrscpy | $87.38 | $91.98 | 5% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urnlysis Auto w/Micrscpy | $87.38 | $91.98 | 5% |
| Urinalysis with microscope exam, manual CPT 81000 AMB Urnls DipStck/Tab Non-Auto | $15.20 | $16.00 | 5% |
| Urinalysis with microscope exam, manual CPT 81000 Microscopic Urinalysis | $29.31 | $30.85 | 5% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 AMB Urnls DipStck/Tab Non-Auto | $15.20 | $16.00 | 5% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Microscopic Urinalysis | $29.31 | $30.85 | 5% |
| Urinalysis without microscope exam, automated CPT 81003 Routine Urinalysis POC | $43.90 | $46.21 | 5% |
| Urinalysis without microscope exam, automated CPT 81003 Routine Urinalysis | $43.90 | $46.21 | 5% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Routine Urinalysis | $43.90 | $46.21 | 5% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Routine Urinalysis POC | $43.90 | $46.21 | 5% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis w/o Scope | $23.52 | $24.76 | 5% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis w/o Scope | $23.52 | $24.76 | 5% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with endoscopic ultrasound CPT 45391 Colonoscopy Endo US Exam R/S/C | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colonoscopy Endo US Exam R/S/C | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy Rem T/P/L Snare | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy Rem T/P/L Snare | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy Bx Sing/Mult | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy Bx Sing/Mult | $3,309.67 | $3,483.86 | 5% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Dx Brush/Wash | $2,539.90 | $2,673.58 | 5% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy High Risk | $2,539.90 | $2,673.58 | 5% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Not High Risk | $2,539.90 | $2,673.58 | 5% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Not High Risk | $2,539.90 | $2,673.58 | 5% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Dx Brush/Wash | $2,539.90 | $2,673.58 | 5% |
| Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy High Risk | $2,539.90 | $2,673.58 | 5% |
| Left heart catheterization, diagnostic CPT 93452 Lt Hrt Cath w/Ventriculo S I | $8,844.62 | $9,310.13 | 5% |
| Left heart catheterization, diagnostic inpatient CPT 93452 Lt Hrt Cath w/Ventriculo S I | $8,844.62 | $9,310.13 | 5% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac | $283.20 | $298.10 | 5% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Interlaminar Lmbr/Sac | $283.20 | $298.10 | 5% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Rmve Breast Lesion >/1 | $428.45 | $451.00 | 5% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Upper Gi Endoscopy W/Biopsy | $1,819.21 | $1,914.96 | 5% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD w/Bx Single/Multiple | $2,522.99 | $2,655.78 | 5% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Upper Gi Endoscopy W/Biopsy | $1,819.21 | $1,914.96 | 5% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w/Bx Single/Multiple | $2,522.99 | $2,655.78 | 5% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash | $1,819.21 | $1,914.96 | 5% |
| Upper endoscopy (EGD), diagnostic CPT 43235 EGD w/Brush/Wash Dx | $2,522.99 | $2,655.78 | 5% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd Diagnostic Brush Wash | $1,819.21 | $1,914.96 | 5% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD w/Brush/Wash Dx | $2,522.99 | $2,655.78 | 5% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG Complete min 12ld w/I R - Professional Charge | $96.90 | $102.00 | 5% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG Complete min 12ld w/I R | $96.90 | $102.00 | 5% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG Complete min 12ld w/I R | $96.90 | $102.00 | 5% |
| Family therapy with the patient, 50 minutes CPT 90847 Psy Thrpy w Pt Fmly 50m | $295.60 | $311.16 | 5% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Psy Thrpy w Pt Fmly 50m | $295.60 | $311.16 | 5% |
| Family therapy without the patient, 50 minutes CPT 90846 Psy Thrpy w Fmly No Pt 50m | $269.75 | $283.95 | 5% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Psy Thrpy w Fmly No Pt 50m | $269.75 | $283.95 | 5% |
| Group psychotherapy session CPT 90853 Psy Thrpy Group | $87.89 | $92.52 | 5% |
| Group psychotherapy session inpatient CPT 90853 Psy Thrpy Group | $87.89 | $92.52 | 5% |
| New patient office visit, about 30 minutes CPT 99203 Outpt New Lvl 3 | $79.80 | $84.00 | 5% |
| New patient office visit, about 30 minutes CPT 99203 Outpt New 30-44m | $227.05 | $239.00 | 5% |
| New patient office visit, about 30 minutes CPT 99203 Outpt New 30-44m MCR | $227.05 | $239.00 | 5% |
| New patient office visit, about 30 minutes CPT 99203 Psy Outpt New 30-44m | $261.83 | $275.61 | 5% |
| New patient office visit, about 30 minutes CPT 99203 Outpt New Lvl 3 Wound | $521.57 | $549.02 | 5% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Outpt New 30-44m MCR | $227.05 | $239.00 | 5% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Outpt New 30-44m | $227.05 | $239.00 | 5% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Psy Outpt New 30-44m | $261.83 | $275.61 | 5% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Outpt New Lvl 3 Wound | $521.57 | $549.02 | 5% |
| New patient office visit, about 45 minutes CPT 99204 Outpt New 45-59m MCR | $328.70 | $346.00 | 5% |
| New patient office visit, about 45 minutes CPT 99204 Outpt New 45-59m | $328.70 | $346.00 | 5% |
| New patient office visit, about 45 minutes CPT 99204 Psy Outpt New 45-59m | $397.04 | $417.94 | 5% |
| New patient office visit, about 45 minutes CPT 99204 Eval New Level 4 (45m) Wound | $724.88 | $763.03 | 5% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Outpt New Lvl 4 | $114.95 | $121.00 | 5% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Outpt New 45-59m | $328.70 | $346.00 | 5% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Outpt New 45-59m MCR | $328.70 | $346.00 | 5% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Psy Outpt New 45-59m | $397.04 | $417.94 | 5% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Eval New Level 4 (45m) Wound | $724.88 | $763.03 | 5% |
| New patient office visit, about 60 minutes CPT 99205 Outpt New Lvl 5 | $150.10 | $158.00 | 5% |
| New patient office visit, about 60 minutes CPT 99205 Outpt New 60-74m MCR | $429.40 | $452.00 | 5% |
| New patient office visit, about 60 minutes CPT 99205 Outpt New 60-74m | $429.40 | $452.00 | 5% |
| New patient office visit, about 60 minutes CPT 99205 Psy Outpt New 60-74m | $491.09 | $516.94 | 5% |
| New patient office visit, about 60 minutes CPT 99205 New Wound Visit Complex | $1,129.53 | $1,188.98 | 5% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Outpt New 60-74m MCR | $429.40 | $452.00 | 5% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Outpt New 60-74m | $429.40 | $452.00 | 5% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Psy Outpt New 60-74m | $491.09 | $516.94 | 5% |
| New patient office visit, about 60 minutes inpatient CPT 99205 New Wound Visit Complex | $1,129.53 | $1,188.98 | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Ex ea 15m | $97.17 | $102.28 | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Ex ea 15m | $97.17 | $102.28 | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Ex ea 15m | $97.17 | $102.28 | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Ex ea 15m | $97.17 | $102.28 | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Prvntve Visit New 18-39y | $121.60 | $128.00 | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Prvntve Visit New 18-39y MCR | $347.70 | $366.00 | 5% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prvntve Visit New 18-39y | $347.70 | $366.00 | 5% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prvntve Visit New 18-39y MCR | $347.70 | $366.00 | 5% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Prev Visit New 40-64 yrs | $121.60 | $128.00 | 5% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Prev Visit New 40-64 yrs MCR | $406.60 | $428.00 | 5% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Prev Visit New 40-64 yrs | $406.60 | $428.00 | 5% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Prev Visit New 40-64 yrs MCR | $406.60 | $428.00 | 5% |
| Psychotherapy session, 30 minutes CPT 90832 Psy Thrpy 30m w Pt | $150.48 | $158.40 | 5% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psy Thrpy 30m w Pt | $150.48 | $158.40 | 5% |
| Psychotherapy session, 45 minutes CPT 90834 Psy Thrpy 45m w Pt | $192.62 | $202.76 | 5% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psy Thrpy 45m w Pt | $192.62 | $202.76 | 5% |
| Psychotherapy session, 60 minutes CPT 90837 Psy Thrpy 60m w Pt | $281.59 | $296.41 | 5% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psy Thrpy 60m w Pt | $281.59 | $296.41 | 5% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Anesth MD Outpt Consult 40 Low | $346.04 | $364.25 | 5% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Anesth MD Outpt Consult 40 Low | $346.04 | $364.25 | 5% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Anesth MD Outpt Consult 60 Mod | $443.76 | $467.12 | 5% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Anesth MD Outpt Consult 60 Mod | $443.76 | $467.12 | 5% |
Source file: https://bhs-publicdownload.s3.us-east-1.amazonaws.com/Public/042133860_Fairview-Hospital_StandardCharges.csv