Hospital

Sistersville General Hospital

Sistersville General Hospital in Sistersville, WV publishes cash prices for 317 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the West Virginia median for 162 of 312 procedures and below it for 148. By typical cash price it ranks #24 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

314 South Wells Street, Sistersville, WV 26175 Collected Sep 23, 2026 Source price file Check a bill from this hospital (304) 652-2611

Critical access hospital (rural, 25 beds or fewer) For-profit hospital Emergency department CCN 511304 · CMS hospital register NPI 1811595192

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct 3 Phase Liver	$1,621.69	$2,702.81	—	31% above	40%
Abdominal CT scan without and with contrast CPT 74170 Ct Abd, W & W/O	$1,621.69	$2,702.81	—	31% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct 3 Phase Liver	$1,621.69	$2,702.81	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct Abd, W & W/O	$1,621.69	$2,702.81	—	—	40%
Abdominal X-ray, 2 views CPT 74019 Xr Abd (Kub)(Greenfield Cath.)	$168.54	$280.90	—	23% below	40%
Abdominal X-ray, 2 views CPT 74019 Xr Abd Kub, Upright &/Or Decub	$198.61	$331.01	—	9% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 Xr Abd (Kub)(Greenfield Cath.)	$168.54	$280.90	—	—	40%
Abdominal X-ray, 2 views inpatient CPT 74019 Xr Abd Kub, Upright &/Or Decub	$198.61	$331.01	—	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle, Right, 3V	$223.15	$371.92	—	24% above	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle, Left, 3V	$223.15	$371.92	—	24% above	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Xr Ankle, Right, 3V	$223.15	$371.92	—	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Xr Ankle, Left, 3V	$223.15	$371.92	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Us Segmentals Abi Only	$403.13	$671.88	—	39% above	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Us Segmentals Abi Only	$403.13	$671.88	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder, Right, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist, Right, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand, Right, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder, Left, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow, Right, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm, Right, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow, Left, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Clavicle, Left, W/O	$1,621.69	$2,702.81	—	130% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Forearm, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Clavicle, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Wrist, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Hand, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Barium Swallow	$283.41	$472.35	—	23% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Xr Barium Swallow	$283.41	$472.35	—	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Usg.Breast Right W/O Axilla L	$355.09	$591.82	—	35% above	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Usg.Breast Left W/O Axilla L	$355.09	$591.82	—	35% above	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Usg.Breast Left W/O Axilla L	$355.09	$591.82	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Usg.Breast Right W/O Axilla L	$355.09	$591.82	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Cta Abd & Pelvis Wo/W Contr	$1,681.76	$2,802.93	—	2% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Cta Abd & Pelvis Wo/W Contr	$1,681.76	$2,802.93	—	—	40%
CT angiography (CTA) of the head CPT 70496 Cta Head W & W/O	$1,173.13	$1,955.22	—	3% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 Cta Head W & W/O	$1,173.13	$1,955.22	—	—	40%
CT angiography (CTA) of the neck CPT 70498 Cta Neck	$1,173.13	$1,955.22	—	2% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 Cta Neck	$1,173.13	$1,955.22	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Thoracic+Aorta W/O + W	$1,621.69	$2,702.81	—	29% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Cta Thoracic+Aorta W/O + W	$1,621.69	$2,702.81	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Stone Study	$1,621.69	$2,702.81	—	19% above	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abd & Pelvis, W/O	$1,621.69	$2,702.81	—	19% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Stone Study	$1,621.69	$2,702.81	—	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Abd & Pelvis, W/O	$1,621.69	$2,702.81	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Abd & Pelvis, W	$1,621.69	$2,702.81	—	at median	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Abd & Pelvis, W	$1,621.69	$2,702.81	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Urogram	$1,621.69	$2,702.81	—	5% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd, Pelvis, W & W/O	$1,621.69	$2,702.81	—	5% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Urogram	$1,621.69	$2,702.81	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abd, Pelvis, W & W/O	$1,621.69	$2,702.81	—	—	40%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen, W	$1,621.69	$2,702.81	—	53% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 Ct Abdomen, W	$1,621.69	$2,702.81	—	—	40%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen, W/O	$1,621.69	$2,702.81	—	120% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 Ct Abdomen, W/O	$1,621.69	$2,702.81	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinuses, W/O Routine	$976.57	$1,627.62	—	41% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Facial Bones, W/O	$976.57	$1,627.62	—	41% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Sinuses, W/O Routine	$976.57	$1,627.62	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Facial Bones, W/O	$976.57	$1,627.62	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 Ct Head Brain W/O Stroke Alert	$976.57	$1,627.62	—	38% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct Head Brain W/O Stroke Alert	$976.57	$1,627.62	—	—	40%
CT scan of the head with contrast CPT 70460 Ct Head Brain, W	$1,173.13	$1,955.22	—	15% above	40%
CT scan of the head with contrast inpatient CPT 70460 Ct Head Brain, W	$1,173.13	$1,955.22	—	—	40%
CT scan of the head without and with contrast CPT 70470 Ct Head Brain, W & W/O	$1,173.13	$1,955.22	—	at median	40%
CT scan of the head without and with contrast inpatient CPT 70470 Ct Head Brain, W & W/O	$1,173.13	$1,955.22	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar Spine, W/O	$1,621.69	$2,702.81	—	93% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct Lumbar Spine, W/O	$1,621.69	$2,702.81	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Cervical Spine, W/O	$976.57	$1,627.62	—	19% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct Cervical Spine, W/O	$976.57	$1,627.62	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis, W	$1,621.69	$2,702.81	—	71% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis, W	$1,621.69	$2,702.81	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Usv Carotid Doppler Bilateral	$595.08	$991.80	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Usg Carotid Doppler Bilat	$595.08	$991.80	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Usg Carotid Doppler Bilat	$595.08	$991.80	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Usv Carotid Doppler Bilateral	$595.08	$991.80	—	—	40%
Chest CT scan without and with contrast CPT 71270 Ct Chest, W & W/O	$1,621.69	$2,702.81	—	29% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 Ct Chest, W & W/O	$1,621.69	$2,702.81	—	—	40%
Chest X-ray, 2 views CPT 71046 Xr Chest, B-Reader, 2V	$189.46	$315.76	—	at median	40%
Chest X-ray, 2 views inpatient CPT 71046 Xr Chest, B-Reader, 2V	$189.46	$315.76	—	—	40%
Chest X-ray, single view CPT 71045 Xr Chest, Pa B-Reader, 1V	$206.45	$344.08	—	17% above	40%
Chest X-ray, single view CPT 71045 Xr Chest, 1V	$216.77	$361.28	—	23% above	40%
Chest X-ray, single view inpatient CPT 71045 Xr Chest, Pa B-Reader, 1V	$206.45	$344.08	—	—	40%
Chest X-ray, single view inpatient CPT 71045 Xr Chest, 1V	$216.77	$361.28	—	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle, Lt, 1V	$98.59	$164.32	—	44% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle, Lt, 2V	$204.18	$340.30	—	17% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle, Rt, 2V	$204.18	$340.30	—	17% above	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Xr Clavicle, Lt, 1V	$98.59	$164.32	—	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Xr Clavicle, Rt, 2V	$204.18	$340.30	—	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Xr Clavicle, Lt, 2V	$204.18	$340.30	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Abd Retro Per (Complete)	$366.23	$610.38	—	16% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us Abd Retro Per (Complete)	$366.23	$610.38	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/O Contrast	$1,621.69	$2,702.81	—	106% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest W/O Contrast	$1,621.69	$2,702.81	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Axilla, W	$1,621.69	$2,702.81	—	48% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct Axilla, W	$1,621.69	$2,702.81	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 Mam Diag W Wo Cad Bilat	$296.08	$493.47	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mam Diag W Wo Cad Bilat	$296.08	$493.47	—	—	40%
Diagnostic mammogram, one breast one side CPT 77065 Mam Diag W Wo Cad Rt	$237.04	$395.06	—	8% above	40%
Diagnostic mammogram, one breast one side CPT 77065 Mam Diag W Wo Cad Lt	$237.04	$395.06	—	8% above	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mam Diag W Wo Cad Rt	$237.04	$395.06	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Mam Diag W Wo Cad Lt	$237.04	$395.06	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Arterial By Pass Bilateral	$503.62	$839.36	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Us Arterial By Pass Bilateral	$503.62	$839.36	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Bilateral Low Ext	$662.75	$1,104.59	—	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 Venous Doppler Study Lower Bil	$252.17	$420.29	—	58% below	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Us Venous Bilateral Low Ext	$662.75	$1,104.59	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Venous Doppler Study Lower Bil	$252.17	$420.29	—	—	40%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow, Left, 2V	$198.35	$330.58	—	4% above	40%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow, Right, 2V	$198.35	$330.58	—	4% above	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 Xr Elbow, Left, 2V	$198.35	$330.58	—	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 Xr Elbow, Right, 2V	$198.35	$330.58	—	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow, Right, 3V	$198.35	$330.58	—	10% above	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow, Left, 3V	$198.35	$330.58	—	10% above	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Xr Elbow, Right, 3V	$198.35	$330.58	—	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Xr Elbow, Left, 3V	$198.35	$330.58	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Iac+Tem Bone, W/O	$976.57	$1,627.62	—	41% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Temp Bone, W/O	$976.57	$1,627.62	—	41% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit Temp Bone,W & W/O Iac	$1,173.13	$1,955.22	—	69% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Iac+Tem Bone, W/O	$976.57	$1,627.62	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Temp Bone, W/O	$976.57	$1,627.62	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Orbit Temp Bone,W & W/O Iac	$1,173.13	$1,955.22	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones, 3/+V	$245.04	$408.40	—	4% above	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Zygomatic Arches, 3+V	$287.32	$478.87	—	22% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Xr Facial Bones, 3/+V	$245.04	$408.40	—	—	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Xr Zygomatic Arches, 3+V	$287.32	$478.87	—	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm, Left, 2V	$198.35	$330.58	—	11% above	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm, Right, 2V	$198.35	$330.58	—	11% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Xr Forearm, Left, 2V	$198.35	$330.58	—	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Xr Forearm, Right, 2V	$198.35	$330.58	—	—	40%
Hand X-ray, 2 views one side CPT 73120 Xr Hand, Lt, 2 Views	$177.65	$296.08	—	9% below	40%
Hand X-ray, 2 views one side CPT 73120 Xr Hand, Rt, 2 Views	$177.65	$296.08	—	9% below	40%
Hand X-ray, 2 views inpatient one side CPT 73120 Xr Hand, Rt, 2 Views	$177.65	$296.08	—	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 Xr Hand, Lt, 2 Views	$177.65	$296.08	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Heel, Rt, 2/+V	$198.35	$330.58	—	15% above	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Heel, Lt, 2/+V	$198.35	$330.58	—	15% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Xr Heel, Lt, 2/+V	$198.35	$330.58	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Xr Heel, Rt, 2/+V	$198.35	$330.58	—	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unattended	$485.38	$808.96	—	38% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Unattended	$485.38	$808.96	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography 4/> W/Cpap	$2,133.58	$3,555.96	—	26% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography 4/> W/Cpap	$2,133.58	$3,555.96	—	—	40%
Knee X-ray, 3 views one side CPT 73562 Xr Knee, Left, 3 Views	$245.04	$408.40	—	23% above	40%
Knee X-ray, 3 views one side CPT 73562 Xr Knee, Right, 3 Views	$245.04	$408.40	—	23% above	40%
Knee X-ray, 3 views inpatient one side CPT 73562 Xr Knee, Left, 3 Views	$245.04	$408.40	—	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 Xr Knee, Right, 3 Views	$245.04	$408.40	—	—	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee, Left, 4 Views	$294.62	$491.03	—	10% above	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee, Right, 4 Views	$294.62	$491.03	—	10% above	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Xr Knee, Right, 4 Views	$294.62	$491.03	—	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Xr Knee, Left, 4 Views	$294.62	$491.03	—	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Leg, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot, Left, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot, Right, W/O	$1,621.69	$2,702.81	—	125% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Lower Leg, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot, Right, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Lower Leg, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot, Left, W/O	$1,621.69	$2,702.81	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Volvulus Peds	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen, (Limited)	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg. Soft Tissue Lower Back	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Gallbladder	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Pyloric Stenosis	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Intussusception	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Abdomen Ltd Bariatric	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Usg Appendicitis	$604.46	$1,007.44	—	50% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdomen, (Limited)	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Appendicitis	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Abdomen Ltd Bariatric	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg. Soft Tissue Lower Back	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Pyloric Stenosis	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Volvulus Peds	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Intussusception	$604.46	$1,007.44	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Usg Gallbladder	$604.46	$1,007.44	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg Soft Tissue Abdomen	$611.83	$1,019.71	—	107% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg. Soft Tissue Axilla	$616.61	$1,027.69	—	108% above	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Usg. Soft Tissue Groin	$616.61	$1,027.69	—	108% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Usg Extr Soft Tissue Lmtd Rt	$294.74	$491.24	—	at median	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Usg Extr Soft Tissue Lmtd Lt	$294.74	$491.24	—	at median	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg Soft Tissue Abdomen	$611.83	$1,019.71	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg. Soft Tissue Axilla	$616.61	$1,027.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Usg. Soft Tissue Groin	$616.61	$1,027.69	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Usg Extr Soft Tissue Lmtd Lt	$294.74	$491.24	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Usg Extr Soft Tissue Lmtd Rt	$294.74	$491.24	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula, Rt, 2V	$198.35	$330.58	—	3% above	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula, Lt, 2V	$198.35	$330.58	—	3% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Xr Tibia Fibula, Lt, 2V	$198.35	$330.58	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Xr Tibia Fibula, Rt, 2V	$198.35	$330.58	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head Wo Contrast	$1,787.35	$2,978.91	—	27% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mra Head Wo Contrast	$1,787.35	$2,978.91	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Right, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Left, (Zimmer)	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip, Right, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Right, (Zimmer)	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee, Left, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle, Right, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle, Left, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip, Left, W/O	$2,124.36	$3,540.60	—	63% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Left, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip, Right, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Right, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle, Right, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip, Left, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Right, (Zimmer)	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee, Left, (Zimmer)	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle, Left, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee, Right, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle, Left, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle, Right, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee, Left, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip, Right, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip, Left, W & W/O	$2,124.36	$3,540.60	—	15% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle, Right, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee, Left, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip, Right, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip, Left, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle, Left, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee, Right, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen, W/O	$1,913.34	$3,188.90	—	52% above	40%
MRI of the abdomen without contrast CPT 74181 Mri Liver, W/O	$2,336.36	$3,893.94	—	85% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Abdomen, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 Mri Liver, W/O	$2,336.36	$3,893.94	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen, W & W/O	$2,124.36	$3,540.60	—	9% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri Abdomen, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the brain, no contrast dye CPT 70551 Mri Brain, W/O	$1,787.35	$2,978.91	—	30% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri Brain, W/O	$1,787.35	$2,978.91	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 Mri Brain, W & W/O	$2,155.37	$3,592.28	—	11% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Brain, W & W/O	$2,155.37	$3,592.28	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 Mri Lumbar Spine, W/O	$2,124.36	$3,540.60	—	57% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri Lumbar Spine, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Lumbar Spine, W & W/O	$2,124.36	$3,540.60	—	11% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri Lumbar Spine, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Thoracic Spine, W/O	$2,124.36	$3,540.60	—	58% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri Thoracic Spine, W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Cervical Spine, W & W/O	$2,155.37	$3,592.28	—	14% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri Cervical Spine, W & W/O	$2,155.37	$3,592.28	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Cervical Spine, W/O	$2,155.37	$3,592.28	—	48% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri Cervical Spine, W/O	$2,155.37	$3,592.28	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis, Soft Tissue, W&W/O	$2,124.36	$3,540.60	—	9% above	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Prostate, W & W/O	$2,124.36	$3,540.60	—	9% above	40%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis, Bone Str, W & W/O	$2,124.36	$3,540.60	—	9% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis, Bone Str, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Pelvis, Soft Tissue, W&W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri Prostate, W & W/O	$2,124.36	$3,540.60	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis, Bone Str, W/O	$1,913.34	$3,188.90	—	42% above	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis, Soft Tissue, W/O	$1,913.34	$3,188.90	—	42% above	40%
MRI of the pelvis, no contrast dye CPT 72195 Mri Prostate, W/O	$1,913.34	$3,188.90	—	42% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis, Bone Str, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Pelvis, Soft Tissue, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri Prostate, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder, Right, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow, Right, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist, Left, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist, Right, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder, Left, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow, Left, W/O	$1,913.34	$3,188.90	—	43% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow, Left, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder, Left, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow, Right, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder, Right, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist, Right, W/O	$1,913.34	$3,188.90	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist, Left, W/O	$1,913.34	$3,188.90	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr C-Spine, 4-5V	$385.04	$641.74	—	38% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Xr C-Spine, 4-5V	$385.04	$641.74	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck, W	$1,173.13	$1,955.22	—	8% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Ct Soft Tissue Neck, W	$1,173.13	$1,955.22	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck, W/O	$976.57	$1,627.62	—	42% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Ct Soft Tissue Neck, W/O	$976.57	$1,627.62	—	—	40%
Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue	$200.74	$334.57	—	10% above	40%
Neck soft tissue X-ray inpatient CPT 70360 Xr Neck Soft Tissue	$200.74	$334.57	—	—	40%
OCT scan of the retina (optical coherence tomography) CPT 92134 Retinal Img Post Segment	$72.51	$120.85	—	48% below	40%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Retinal Img Post Segment	$72.51	$120.85	—	—	40%
Pelvic CT scan without contrast CPT 72192 Ct Cystogram	$1,621.69	$2,702.81	—	102% above	40%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis, W/O	$1,621.69	$2,702.81	—	102% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Cystogram	$1,621.69	$2,702.81	—	—	40%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis, W/O	$1,621.69	$2,702.81	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg. Soft Tissue Buttock	$402.37	$670.62	—	30% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg Bladder Only	$421.97	$703.29	—	36% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Usg Pelvic Non Ob Ltd Wo Travg	$429.21	$715.35	—	39% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg. Soft Tissue Buttock	$402.37	$670.62	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg Bladder Only	$421.97	$703.29	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Usg Pelvic Non Ob Ltd Wo Travg	$429.21	$715.35	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis (Non Ob) (Complete)	$420.24	$700.40	—	2% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Pelvis (Non Ob) (Complete)	$420.24	$700.40	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us Pelvis Ob	$346.85	$578.08	—	18% below	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us Pelvis Ob	$346.85	$578.08	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Usg Echopelv Sngl Fetus <14Wks	$301.09	$501.81	—	26% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Usg Echopelv Sngl Fetus <14Wks	$301.09	$501.81	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Usg Echopelvic (Lmtd) Ob Eval	$243.28	$405.46	—	20% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Usg Echopelvic (Lmtd) Ob Eval	$243.28	$405.46	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs, Rt, 2V	$169.15	$281.91	—	12% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs, Lt, 2V	$169.15	$281.91	—	12% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xr Ribs, Lt, 2V	$169.15	$281.91	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xr Ribs, Rt, 2V	$169.15	$281.91	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs, Rt, 3+V	$245.04	$408.40	—	6% above	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs, Lt, 3+V	$245.04	$408.40	—	6% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xr Ribs, Rt, 3+V	$245.04	$408.40	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xr Ribs, Lt, 3+V	$245.04	$408.40	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 Mam Screening W Wo Cad Bilat	$244.09	$406.81	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 Mam Screening W Wo Cad Bilat	$244.09	$406.81	—	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder, Rt, 2+ V	$207.10	$345.16	—	16% above	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder, Lt, 2+ V	$207.10	$345.16	—	16% above	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Xr Shoulder, Rt, 2+ V	$207.10	$345.16	—	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Xr Shoulder, Lt, 2+ V	$207.10	$345.16	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses, 3+V	$312.12	$520.20	—	42% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Xr Sinuses, 3+V	$312.12	$520.20	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull, 4<V	$274.45	$457.42	—	36% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Xr Skull, 4<V	$274.45	$457.42	—	—	40%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography 4+	$2,133.58	$3,555.96	—	17% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography 4+	$2,133.58	$3,555.96	—	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur, Left, 2V	$171.98	$286.64	—	9% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur, Right, 2V	$171.98	$286.64	—	9% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Xr Femur, Left, 2V	$171.98	$286.64	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Xr Femur, Right, 2V	$171.98	$286.64	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Thoracic Spine, W/O	$1,621.69	$2,702.81	—	96% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Ct Thoracic Spine, W/O	$1,621.69	$2,702.81	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 Us Transvaginal (Non Ob)	$420.24	$700.40	—	4% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 Us Transvaginal (Non Ob)	$420.24	$700.40	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 Us Pelvis Transvaginal Ob	$240.85	$401.42	—	17% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Pelvis Transvaginal Ob	$240.85	$401.42	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 Us Abd Complete	$420.24	$700.40	—	5% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us Abd Complete	$420.24	$700.40	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum	$366.23	$610.38	—	3% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us Scrotum	$366.23	$610.38	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Neck	$366.23	$610.38	—	1% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Usg Thyroid Gland	$496.18	$826.96	—	34% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Soft Tissue Neck	$366.23	$610.38	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Usg Thyroid Gland	$496.18	$826.96	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Upper Gi, Single Contrast	$352.11	$586.85	—	6% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Xr Upper Gi, Single Contrast	$352.11	$586.85	—	—	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Left, 1V	$128.72	$214.54	—	29% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Right, 2V	$256.37	$427.29	—	42% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus, Left, 2V	$256.37	$427.29	—	42% above	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Left, 1V	$128.72	$214.54	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Left, 2V	$256.37	$427.29	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Xr Humerus, Right, 2V	$256.37	$427.29	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Upper Extr Lt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Lower Ext Rt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Upper Extr Rt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Image Uni Lower Ext Lt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usv Saphenous Vein Map Uni Rt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dplx Ext Veins; Unil/Limit Rt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dplx Ext Veins; Unil/Limit Lt	$366.43	$610.72	—	5% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Ue Lt	$398.63	$664.39	—	4% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Ue Rt	$398.63	$664.39	—	4% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Usg Venous Doppler Le Lt	$398.63	$664.39	—	4% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Dvt Rt Ven Im Lower Ext	$398.63	$664.39	—	4% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dplx Ext Veins; Unil/Limit Lt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Upper Extr Rt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Lower Ext Lt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Upper Extr Lt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Image Uni Lower Ext Rt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usv Saphenous Vein Map Uni Rt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dplx Ext Veins; Unil/Limit Rt	$366.43	$610.72	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Le Lt	$398.63	$664.39	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Ue Lt	$398.63	$664.39	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Usg Venous Doppler Ue Rt	$398.63	$664.39	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Us Dvt Rt Ven Im Lower Ext	$398.63	$664.39	—	—	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Rt, 1 V Portable	$123.41	$205.68	—	23% below	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Lt, 1 V Portable	$123.41	$205.68	—	23% below	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Lt, 2V	$159.57	$265.95	—	at median	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Rt, 2V	$159.57	$265.95	—	at median	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Rt, 3 V	$207.10	$345.16	—	29% above	40%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist, Lt, 3V	$207.10	$345.16	—	29% above	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Lt, 1 V Portable	$123.41	$205.68	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Rt, 1 V Portable	$123.41	$205.68	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Lt, 2V	$159.57	$265.95	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Rt, 2V	$159.57	$265.95	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Rt, 3 V	$207.10	$345.16	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 Xr Wrist, Lt, 3V	$207.10	$345.16	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Xr Hip, Uni, W/Pelvis, 2-3V	$171.98	$286.64	—	9% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Xr Hip, Uni, W/Pelvis, 2-3V	$171.98	$286.64	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View	$152.44	$254.07	—	17% below	40%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Portable	$223.29	$372.15	—	21% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xr Abdomen 1 View	$152.44	$254.07	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xr Abdomen Portable	$223.29	$372.15	—	—	40%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle, Left, 2V	$126.59	$210.99	—	29% below	40%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle, Right, 2V	$126.59	$210.99	—	29% below	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 Xr Ankle, Right, 2V	$126.59	$210.99	—	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 Xr Ankle, Left, 2V	$126.59	$210.99	—	—	40%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot, Right, 2V	$153.17	$255.29	—	5% below	40%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot, Left, 2V	$153.17	$255.29	—	5% below	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 Xr Foot, Right, 2V	$153.17	$255.29	—	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 Xr Foot, Left, 2V	$153.17	$255.29	—	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot, Lt, 1V	$73.39	$122.32	—	59% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot, Right, 3V	$207.10	$345.16	—	17% above	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot, Left, 3V	$207.10	$345.16	—	17% above	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Xr Foot, Lt, 1V	$73.39	$122.32	—	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Xr Foot, Right, 3V	$207.10	$345.16	—	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Xr Foot, Left, 3V	$207.10	$345.16	—	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand, Rt, 3/+ Views	$207.10	$345.16	—	14% above	40%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand, Lt, 3/+ Views	$207.10	$345.16	—	14% above	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Xr Hand, Rt, 3/+ Views	$207.10	$345.16	—	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Xr Hand, Lt, 3/+ Views	$207.10	$345.16	—	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee, Rt, 2V	$207.10	$345.16	—	15% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee, Lt, 2V	$207.10	$345.16	—	15% above	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Xr Knee, Lt, 2V	$207.10	$345.16	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Xr Knee, Rt, 2V	$207.10	$345.16	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L-Spine Flex+Ext, 2V	$314.88	$524.80	—	45% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L-Spine, 2V	$314.88	$524.80	—	45% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xr L-Spine, 2V	$314.88	$524.80	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xr L-Spine Flex+Ext, 2V	$314.88	$524.80	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 Xr L-Spine W/Obliq, 4V	$360.25	$600.41	—	27% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Xr L-Spine W/Obliq, 4V	$360.25	$600.41	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr T-Spine, 2V	$258.15	$430.25	—	12% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Xr T-Spine, 2V	$258.15	$430.25	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones, 3+V	$207.10	$345.16	—	12% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Xr Nasal Bones, 3+V	$207.10	$345.16	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C-Spine Flex+Ext Views Only	$221.27	$368.78	—	14% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C-Spine, 3V	$221.27	$368.78	—	14% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xr C-Spine Flex+Ext Views Only	$221.27	$368.78	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xr C-Spine, 3V	$221.27	$368.78	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis, 1-2V	$223.15	$371.92	—	14% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xr Pelvis, 1-2V	$223.15	$371.92	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum & Coccyx, 2+V	$255.23	$425.39	—	43% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Xr Sacrum & Coccyx, 2+V	$255.23	$425.39	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
ACTH blood test CPT 82024 Acth(Adrenocorticotropic Hor)	$157.57	$262.61	—	16% below	40%
ACTH blood test inpatient CPT 82024 Acth(Adrenocorticotropic Hor)	$157.57	$262.61	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel	$168.06	$280.10	—	24% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel	$168.06	$280.10	—	—	40%
Aldosterone blood test CPT 82088 Aldosterone, Serum	$166.27	$277.12	—	352% above	40%
Aldosterone blood test inpatient CPT 82088 Aldosterone, Serum	$166.27	$277.12	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grapefruit Ige	$16.88	$28.13	—	2% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Apple Ige	$17.72	$29.54	—	3% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Malt Ige	$19.15	$31.91	—	12% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Barley Ige	$19.15	$31.91	—	12% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oat Ige	$19.15	$31.91	—	12% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lettuce Ige	$19.15	$31.91	—	12% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Carrot Ige	$19.69	$32.81	—	15% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pea Ige	$19.69	$32.81	—	15% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Potato Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mugwort Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sheep Sorrel Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cocklebur Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pigweed Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Giant Ragweed Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, English Plantain Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sweet Gum Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sycamore Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Red Maple Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Birch Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, White Ash Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Meadow Fescue Grass Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Prerennial Rye Grass Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Orchard Gr/Cocksfoot Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bent/Red Top Gr Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Sw Vernal Grass Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Timothy Grass Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, June/Kent Gr Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Clam Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Shrimp Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cod/Perch Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Dog Dander Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cat Dander/Epi Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Alternaria Alter Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Mites-D.Pterony Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Penicillium Notatum Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lamb Qrt Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Com/St Ragweed Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Elm Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oak Tree Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Bermuda Grass Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Wheat Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Walnut/Black Wn Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tomato Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Soybean	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Rice Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pistachio Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pecan Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Milk (Cow's) Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Hazelnut Filbert Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg Yolk Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Egg White Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Corn Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Cashew Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Brazil Nut Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Almond Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Penicillin G Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg, Mucor Racemosus Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cockroach	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Derm Farinae Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg White Mulberry Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Russian Thistle Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Mount Cedar Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Cottonwood Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Maple (Box Elder) Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Coconut Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Sesame Seed Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Tuna Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Crab Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Scallop Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Asperg. Fumig Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites-D.Farinae Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Hormodendrum Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Banana Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Beef Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Chicken	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Chocolate Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Crab Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Halibut Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Lobster Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Oyster Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Salmon Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tuna Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Strawberry Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Pork Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Baker's Yeast Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hickory/Pecan Tree	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Epicocum P- Ige	$20.67	$34.45	—	21% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Panel 15326	$23.46	$39.10	—	37% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grapefruit Ige	$16.88	$28.13	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Apple Ige	$17.72	$29.54	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Malt Ige	$19.15	$31.91	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oat Ige	$19.15	$31.91	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Barley Ige	$19.15	$31.91	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lettuce Ige	$19.15	$31.91	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pea Ige	$19.69	$32.81	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Carrot Ige	$19.69	$32.81	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lamb Qrt Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tomato Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Soybean	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Mites-D.Pterony Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Rice Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Alternaria Alter Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pistachio Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cat Dander/Epi Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pecan Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Dog Dander Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Milk (Cow's) Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Hazelnut Filbert Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cod/Perch Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Baker's Yeast Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg Yolk Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Egg White Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Shrimp Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Corn Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hickory/Pecan Tree	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cashew Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Giant Ragweed Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Brazil Nut Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, English Plantain Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Almond Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sweet Gum Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Penicillin G Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sycamore Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Clam Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Penicillium Notatum Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, June/Kent Gr Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Mucor Racemosus Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Timothy Grass Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cockroach	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pork Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Derm Farinae Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sw Vernal Grass Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg White Mulberry Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bent/Red Top Gr Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Orchard Gr/Cocksfoot Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Prerennial Rye Grass Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg, Meadow Fescue Grass Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, White Ash Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Strawberry Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Russian Thistle Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Epicocum P- Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Mount Cedar Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Birch Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Cottonwood Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Red Maple Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Maple (Box Elder) Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Potato Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Coconut Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tuna Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Sesame Seed Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Salmon Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Tuna Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oyster Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Crab Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Lobster Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Scallop Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Sheep Sorrel Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Asperg. Fumig Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mugwort Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites-D.Farinae Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Halibut Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Hormodendrum Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Crab Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Chocolate Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Banana Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Beef Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Chicken	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Pigweed Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Bermuda Grass Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Cocklebur Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Oak Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Wheat Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Elm Tree Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Com/St Ragweed Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Walnut/Black Wn Ige	$20.67	$34.45	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Panel 15326	$23.46	$39.10	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein	$68.44	$114.07	—	10% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein	$68.44	$114.07	—	—	40%
Ammonia blood test CPT 82140 Ammonia, Blood	$123.73	$206.22	—	169% above	40%
Ammonia blood test inpatient CPT 82140 Ammonia, Blood	$123.73	$206.22	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrull Peptide Ab,Igg	$51.24	$85.40	—	21% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrull Peptide Ab,Igg	$51.24	$85.40	—	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies	$23.22	$38.70	—	62% below	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen	$48.92	$81.54	—	19% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies	$23.22	$38.70	—	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen	$48.92	$81.54	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture,Bacterial	$10.91	$18.18	—	79% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture	$73.11	$121.85	—	42% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture (Screen - )	$127.18	$211.96	—	148% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Joint Fluid Culture Bacterial	$127.18	$211.96	—	148% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nose Culture	$127.18	$211.96	—	148% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ivtip	$127.18	$211.96	—	148% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Misc Culture	$127.18	$211.96	—	148% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture,Bacterial	$10.91	$18.18	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture	$73.11	$121.85	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nose Culture	$127.18	$211.96	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Ivtip	$127.18	$211.96	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Misc Culture	$127.18	$211.96	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Joint Fluid Culture Bacterial	$127.18	$211.96	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture (Screen - )	$127.18	$211.96	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level Iv Path	$181.33	$302.21	—	67% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level Iv-M Path	$181.33	$302.21	—	67% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level Iv-M Path	$181.33	$302.21	—	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level Iv Path	$181.33	$302.21	—	—	40%
Blood culture for bacteria CPT 87040 Culture, Blood Aero & Anaero	$65.55	$109.25	—	12% below	40%
Blood culture for bacteria inpatient CPT 87040 Culture, Blood Aero & Anaero	$65.55	$109.25	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$12.34	$20.57	—	18% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$12.34	$20.57	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Arc Abo Type	$121.17	$201.95	—	197% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Pre & Post	$121.17	$201.95	—	197% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Charge	$121.17	$201.95	—	197% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Arc Abo Type	$121.17	$201.95	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Charge	$121.17	$201.95	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Pre & Post	$121.17	$201.95	—	—	40%
C-peptide blood test CPT 84681 C-Peptide,Serum	$84.92	$141.54	—	15% above	40%
C-peptide blood test inpatient CPT 84681 C-Peptide,Serum	$84.92	$141.54	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$60.53	$100.88	—	98% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$60.53	$100.88	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficle By Pcr	$293.60	$489.34	—	158% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Difficle By Pcr	$293.60	$489.34	—	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 Ca19-9	$64.24	$107.07	—	23% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca19-9	$64.24	$107.07	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca-125 Serum	$96.28	$160.46	—	10% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca-125 Serum	$96.28	$160.46	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19/Sars-Cov-2 Rna	$183.44	$305.74	—	70% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid-19/Sars-Cov-2 Rna	$183.44	$305.74	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Cea (Carcindembryonic Antigen	$93.57	$155.95	—	10% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea (Carcindembryonic Antigen	$93.57	$155.95	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab,Igm	$38.25	$63.75	—	at median	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Immune Status Igg	$40.17	$66.95	—	5% above	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab,Igm	$38.25	$63.75	—	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Immune Status Igg	$40.17	$66.95	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Quest Chlam Trachomat Amp Prob	$164.45	$274.08	—	190% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia	$184.19	$306.98	—	225% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Amp Prob	$184.19	$306.98	—	225% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Quest Chlam Trachomat Amp Prob	$164.45	$274.08	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia	$184.19	$306.98	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis Amp Prob	$184.19	$306.98	—	—	40%
Complete blood count (CBC) with differential CPT 85025 Cbc W/ Automated Differential	$54.68	$91.13	—	32% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W/ Automated Differential	$54.68	$91.13	—	—	40%
Complete blood count (CBC), no differential CPT 85027 Cbc: Automated Hemogram	$54.68	$91.13	—	56% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc: Automated Hemogram	$54.68	$91.13	—	—	40%
Cortisol blood test, total CPT 82533 Cortisol, Total	$115.69	$192.82	—	95% above	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol, Total	$115.69	$192.82	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 Cpk	$45.27	$75.45	—	4% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Cpk	$45.27	$75.45	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab, Igg	$52.84	$88.07	—	5% above	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus Ab Igg	$61.48	$102.46	—	22% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab, Igg	$52.84	$88.07	—	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus Ab Igg	$61.48	$102.46	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, Quant	$141.55	$235.91	—	121% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, Quant	$141.55	$235.91	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate	$90.73	$151.22	—	2% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea Sulfate	$90.73	$151.22	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scr 9 Meconium Q30427X	$150.79	$251.32	—	396% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Tramadol	$150.79	$251.32	—	396% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Monitor Alcohol	$150.79	$251.32	—	396% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Panel 9 Serum Q19733X	$150.79	$251.32	—	396% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine 11 Panel	$150.79	$251.32	—	396% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine 11 Panel	$150.79	$251.32	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Monitor Alcohol	$150.79	$251.32	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Tramadol	$150.79	$251.32	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Scr 9 Meconium Q30427X	$150.79	$251.32	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Panel 9 Serum Q19733X	$150.79	$251.32	—	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Ab Igg	$43.09	$71.81	—	29% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Viral Capsid Igg	$50.45	$84.08	—	17% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Capsid Anti Igm	$50.45	$84.08	—	17% below	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Vca Igm	$58.68	$97.80	—	3% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Ebv Vca Ab Igg	$43.09	$71.81	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Capsid Anti Igm	$50.45	$84.08	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Viral Capsid Igg	$50.45	$84.08	—	—	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein Barr Vca Igm	$58.68	$97.80	—	—	40%
Estradiol blood test CPT 82670 Estradiol Serum, Total	$113.77	$189.62	—	32% above	40%
Estradiol blood test inpatient CPT 82670 Estradiol Serum, Total	$113.77	$189.62	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool	$79.99	$133.32	—	11% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool	$79.99	$133.32	—	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$82.51	$137.51	—	17% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$82.51	$137.51	—	—	40%
Fibrinogen blood test CPT 85384 Fibrinogen	$104.45	$174.09	—	104% above	40%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$104.45	$174.09	—	—	40%
Folate (folic acid) blood test CPT 82746 Folate	$71.43	$119.05	—	1% above	40%
Folate (folic acid) blood test inpatient CPT 82746 Folate	$71.43	$119.05	—	—	40%
Free T3 thyroid hormone test CPT 84481 Free T3	$78.47	$130.78	—	14% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 Free T3	$78.47	$130.78	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free	$107.65	$179.41	—	86% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 Free (Profile)	$107.65	$179.41	—	86% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 Free	$107.65	$179.41	—	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 Free (Profile)	$107.65	$179.41	—	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$95.79	$159.65	—	58% below	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$95.79	$159.65	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Quest Neisser Gonorr Amp Probe	$164.45	$274.08	—	170% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhea Amp Probe	$184.19	$306.98	—	203% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Probe	$184.19	$306.98	—	203% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Quest Neisser Gonorr Amp Probe	$164.45	$274.08	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Probe	$184.19	$306.98	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhea Amp Probe	$184.19	$306.98	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Qnt By Real-Time Pcr	$504.55	$840.92	—	100% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Qnt By Real-Time Pcr	$504.55	$840.92	—	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Pap Virus(Hpv) E6/E7	$89.14	$148.57	—	39% above	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High Risk Q90942	$157.73	$262.89	—	146% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Human Pap Virus(Hpv) E6/E7	$89.14	$148.57	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High Risk Q90942	$157.73	$262.89	—	—	40%
Hemoglobin blood test CPT 85018 Hemoglobin	$15.61	$26.02	—	12% above	40%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$15.61	$26.02	—	—	40%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody:Prof	$47.71	$79.52	—	5% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody:Prof	$47.71	$79.52	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$51.67	$86.12	—	49% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$51.67	$86.12	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Rna Quantitative Pcr	$253.98	$423.30	—	27% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hcv Rna Quantitative Pcr	$253.98	$423.30	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Antibody:Herpes Simplex 1	$52.24	$87.07	—	19% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Antibody:Herpes Simplex 1	$52.24	$87.07	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Antibody;Herpes Simplex Ii	$62.08	$103.46	—	29% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Antibody;Herpes Simplex Ii	$62.08	$103.46	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp - (High Sensitive)	$71.26	$118.76	—	15% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crp - (High Sensitive)	$71.26	$118.76	—	—	40%
Homocysteine blood test CPT 83090 Homocysteine	$78.47	$130.78	—	11% below	40%
Homocysteine blood test inpatient CPT 83090 Homocysteine	$78.47	$130.78	—	—	40%
Insulin blood test CPT 83525 Insulin Total	$46.22	$77.04	—	17% below	40%
Insulin blood test inpatient CPT 83525 Insulin Total	$46.22	$77.04	—	—	40%
Iron blood test (serum iron) CPT 83540 Iron	$42.26	$70.44	—	at median	40%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$42.26	$70.44	—	—	40%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$41.25	$68.75	—	7% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$41.25	$68.75	—	—	40%
Lactate (lactic acid) blood test CPT 83605 Lactate	$43.57	$72.62	—	23% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate	$43.57	$72.62	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh, Serum	$42.26	$70.44	—	122% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh, Body Fluid	$42.26	$70.44	—	122% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh, Body Fluid	$42.26	$70.44	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh, Serum	$42.26	$70.44	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$73.43	$122.38	—	83% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$73.43	$122.38	—	—	40%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$74.08	$123.46	—	57% above	40%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$74.08	$123.46	—	—	40%
Lyme disease antibody test CPT 86618 Borrelia Burgdorferi Igg Serum	$40.27	$67.11	—	28% above	40%
Lyme disease antibody test inpatient CPT 86618 Borrelia Burgdorferi Igg Serum	$40.27	$67.11	—	—	40%
Magnesium blood test CPT 83735 Ionized Magnesium	$46.27	$77.12	—	137% above	40%
Magnesium blood test CPT 83735 Magnesium	$46.27	$77.12	—	137% above	40%
Magnesium blood test CPT 83735 Magnesium Random Urine	$46.27	$77.12	—	137% above	40%
Magnesium blood test inpatient CPT 83735 Magnesium Random Urine	$46.27	$77.12	—	—	40%
Magnesium blood test inpatient CPT 83735 Magnesium	$46.27	$77.12	—	—	40%
Magnesium blood test inpatient CPT 83735 Ionized Magnesium	$46.27	$77.12	—	—	40%
Measles (rubeola) antibody test CPT 86765 Measles Rubeola Igg	$12.82	$21.37	—	67% below	40%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Ab,Igm	$62.39	$103.98	—	59% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Rubeola Igg	$12.82	$21.37	—	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Ab,Igm	$62.39	$103.98	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono-Profile	$36.52	$60.86	—	4% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Test	$36.52	$60.86	—	4% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono-Profile	$36.52	$60.86	—	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test	$36.52	$60.86	—	—	40%
Mumps immunity blood test CPT 86735 Mumps Ab Igg	$55.91	$93.18	—	26% above	40%
Mumps immunity blood test CPT 86735 Mumps Virus Antibody,Igm	$55.91	$93.18	—	26% above	40%
Mumps immunity blood test inpatient CPT 86735 Mumps Ab Igg	$55.91	$93.18	—	—	40%
Mumps immunity blood test inpatient CPT 86735 Mumps Virus Antibody,Igm	$55.91	$93.18	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free	$75.46	$125.76	—	26% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free	$75.46	$125.76	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostatic Specific Antigen Tot	$69.42	$115.70	—	10% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostatic Specific Antigen Tot	$69.42	$115.70	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q-58315 Pap Image Guide	$64.96	$108.27	—	21% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo	$100.03	$166.72	—	22% above	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q-58315 Pap Image Guide	$64.96	$108.27	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto Fluid Redo	$100.03	$166.72	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone-Intactstat	$227.37	$378.95	—	50% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone-Intactstat	$227.37	$378.95	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt	$14.32	$23.87	—	65% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Aptt-Lupus Anticoagulant Prof	$43.93	$73.21	—	6% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Aptt	$43.93	$73.21	—	6% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt	$14.32	$23.87	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Aptt-Lupus Anticoagulant Prof	$43.93	$73.21	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Aptt	$43.93	$73.21	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus	$31.19	$51.99	—	1% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus	$31.19	$51.99	—	—	40%
Potassium blood test CPT 84132 Potassium, Serum	$14.08	$23.47	—	48% below	40%
Potassium blood test inpatient CPT 84132 Potassium, Serum	$14.08	$23.47	—	—	40%
Progesterone blood test CPT 84144 Progesterone	$48.50	$80.84	—	51% below	40%
Progesterone blood test CPT 84144 Progesterone, Serum	$78.20	$130.33	—	21% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone	$48.50	$80.84	—	—	40%
Progesterone blood test inpatient CPT 84144 Progesterone, Serum	$78.20	$130.33	—	—	40%
Prolactin blood test CPT 84146 Prolactin, Serum	$79.11	$131.85	—	23% above	40%
Prolactin blood test CPT 84146 Prolactin, Send Out	$82.12	$136.86	—	27% above	40%
Prolactin blood test CPT 84146 Prolactin, Monomeric	$82.12	$136.86	—	27% above	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Serum	$79.11	$131.85	—	—	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Monomeric	$82.12	$136.86	—	—	40%
Prolactin blood test inpatient CPT 84146 Prolactin, Send Out	$82.12	$136.86	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Pt	$10.22	$17.04	—	64% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Quest Pitt - Pt	$10.22	$17.04	—	64% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Pt/Inr	$45.88	$76.46	—	60% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Pt	$10.22	$17.04	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Quest Pitt - Pt	$10.22	$17.04	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Pt/Inr	$45.88	$76.46	—	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Assay W/Optic(Fac)	$18.41	$30.68	—	55% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Assay W/Optic(Fac)	$18.41	$30.68	—	—	40%
Renin blood test CPT 84244 Renin	$71.75	$119.58	—	24% above	40%
Renin blood test inpatient CPT 84244 Renin	$71.75	$119.58	—	—	40%
Rh blood typing CPT 86901 Blood Rh	$27.76	$46.26	—	3% below	40%
Rh blood typing CPT 86901 Blood Rh Pre & Post	$27.76	$46.26	—	3% below	40%
Rh blood typing inpatient CPT 86901 Blood Rh Pre & Post	$27.76	$46.26	—	—	40%
Rh blood typing inpatient CPT 86901 Blood Rh	$27.76	$46.26	—	—	40%
Rheumatoid factor (RF) test CPT 86431 Q- 90136 Rheumatoid Fctr Quant	$11.75	$19.58	—	67% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Q- 90136 Rheumatoid Fctr Quant	$11.75	$19.58	—	—	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Screen	$87.86	$146.44	—	77% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen	$87.86	$146.44	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedmentation Rate	$41.00	$68.33	—	145% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedmentation Rate	$41.00	$68.33	—	—	40%
Sodium blood test CPT 84295 Sodium, Serum	$14.08	$23.47	—	46% below	40%
Sodium blood test inpatient CPT 84295 Sodium, Serum	$14.08	$23.47	—	—	40%
Stool ova and parasites exam CPT 87177 Ova & Parasites, Conc & Id	$107.13	$178.55	—	123% above	40%
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites, Conc & Id	$107.13	$178.55	—	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screening	$6.04	$10.07	—	62% below	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screening	$6.04	$10.07	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Serology	$17.97	$29.95	—	33% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Q-799 Treponema Pallidum (Rpr)	$23.36	$38.94	—	13% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Serology	$17.97	$29.95	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Q-799 Treponema Pallidum (Rpr)	$23.36	$38.94	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon	$87.14	$145.23	—	54% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon	$87.14	$145.23	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone	$111.67	$186.12	—	27% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone	$111.67	$186.12	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Abs Tpo	$35.06	$58.43	—	52% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (Tpo)Antibx	$46.63	$77.71	—	36% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Lkm1 Quest #15038X	$48.20	$80.33	—	34% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Abs Tpo	$35.06	$58.43	—	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (Tpo)Antibx	$46.63	$77.71	—	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Lkm1 Quest #15038X	$48.20	$80.33	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh	$115.69	$192.82	—	79% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh	$115.69	$192.82	—	—	40%
Total IgE blood test CPT 82785 Immunoglobulin E	$115.69	$192.82	—	112% above	40%
Total IgE blood test CPT 82785 Ig-E	$115.69	$192.82	—	112% above	40%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E	$115.69	$192.82	—	—	40%
Total IgE blood test inpatient CPT 82785 Ig-E	$115.69	$192.82	—	—	40%
Total thyroxine (T4) blood test CPT 84436 Q-7020 Assay Of Tot Thyroxine	$15.97	$26.62	—	65% below	40%
Total thyroxine (T4) blood test CPT 84436 T-4 Thyroxine	$52.30	$87.17	—	15% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 Q-7020 Assay Of Tot Thyroxine	$15.97	$26.62	—	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 T-4 Thyroxine	$52.30	$87.17	—	—	40%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3),Total	$71.43	$119.05	—	9% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3),Total	$71.43	$119.05	—	—	40%
Transferrin blood test CPT 84466 Transferrin,Serum	$71.43	$119.05	—	28% above	40%
Transferrin blood test inpatient CPT 84466 Transferrin,Serum	$71.43	$119.05	—	—	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vag Rna Pap	$89.14	$148.57	—	15% above	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas Probe	$185.67	$309.45	—	140% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vag Rna Pap	$89.14	$148.57	—	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Probe	$185.67	$309.45	—	—	40%
Troponin test, quantitative CPT 84484 Cardiac Troponin	$103.61	$172.68	—	39% above	40%
Troponin test, quantitative inpatient CPT 84484 Cardiac Troponin	$103.61	$172.68	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis,Auto W/Scope	$4.86	$8.10	—	84% below	40%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis	$9.62	$16.03	—	68% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis,Auto W/Scope	$4.86	$8.10	—	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis	$9.62	$16.03	—	—	40%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis, Nonauto W/Scope	$5.55	$9.25	—	65% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis, Nonauto W/Scope	$5.55	$9.25	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Nonauto W/O Scope	$4.80	$8.00	—	62% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Nonauto W/O Scope	$4.80	$8.00	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$51.62	$86.03	—	12% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$51.62	$86.03	—	—	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy(Fac)	$11.29	$18.81	—	49% below	40%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy	$11.88	$19.80	—	47% below	40%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test, Urine	$35.54	$59.24	—	60% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy(Fac)	$11.29	$18.81	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy	$11.88	$19.80	—	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test, Urine	$35.54	$59.24	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12	$101.61	$169.35	—	26% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12	$101.61	$169.35	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D,25-Hydroxy	$90.54	$150.90	—	6% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D,25-Hydroxy	$90.54	$150.90	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D,1,25-Dihydroxy	$157.08	$261.80	—	104% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D,1,25-Dihydroxy	$157.08	$261.80	—	—	40%
Zinc blood test CPT 84630 Zinc	$46.47	$77.45	—	19% above	40%
Zinc blood test inpatient CPT 84630 Zinc	$46.47	$77.45	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Quantatative Hcg	$159.95	$266.58	—	118% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Tumor Marker	$164.99	$274.99	—	124% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Quantatative Hcg	$159.95	$266.58	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Hcg Tumor Marker	$164.99	$274.99	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Botox injections for chronic migraine CPT 64615 Chemodenerv Musc Migraine	$298.60	$497.66	—	15% below	40%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv Musc Migraine	$298.60	$497.66	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$406.86	$678.10	—	34% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$569.33	$948.89	—	87% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 Clsd Treat Frac Fib Rt W/O Man	$569.33	$948.89	—	87% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$406.86	$678.10	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Clsd Treat Frac Fib Lt W/O Man	$569.33	$948.89	—	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 Clsd Treat Frac Fib Rt W/O Man	$569.33	$948.89	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Cls Tx, Talotars Jt Disloc,Inc	$372.30	$620.50	—	57% above	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$736.27	$1,227.12	—	211% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Cls Tx, Talotars Jt Disloc,Inc	$372.30	$620.50	—	—	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$736.27	$1,227.12	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$1,947.32	$3,245.53	—	83% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$1,947.32	$3,245.53	—	—	40%
Cervical biopsy CPT 57500 Cervical Bx	$419.27	$698.78	—	62% below	40%
Cervical biopsy inpatient CPT 57500 Cervical Bx	$419.27	$698.78	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Newborn Circumcision	$1,145.21	$1,908.68	—	52% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Newborn Circumcision	$1,145.21	$1,908.68	—	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cltx Dstl Rad Fx/Epi Sep Wo M	$736.27	$1,227.12	—	132% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cltx Dstl Rad Fx/Epi Sep Wo M	$736.27	$1,227.12	—	—	40%
Colonoscopy with endoscopic ultrasound CPT 45391 Colonoscopy W/Us Exam	$303.19	$505.32	—	42% below	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colonoscopy W/Us Exam	$303.19	$505.32	—	—	40%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy	$234.99	$391.65	—	85% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy W/Biopsy	$234.99	$391.65	—	—	40%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colpscopy Cx W/Bx Cx/Endocx	$303.02	$505.04	—	8% below	40%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colpscopy Cx W/Bx Cx/Endocx	$303.02	$505.04	—	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy/Endoscopy	$404.07	$673.45	—	51% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy/Endoscopy	$404.07	$673.45	—	—	40%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D&C Dx Or Therapuetic	$1,659.54	$2,765.90	—	56% below	40%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C Dx Or Therapuetic	$1,659.54	$2,765.90	—	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct Premlg Lesion 1St	$167.84	$279.74	—	19% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct Premlg Lesion 1St	$167.84	$279.74	—	—	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy W/Vent Tube Local	$443.96	$739.93	—	28% below	40%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy W/Vent Tube Local	$443.96	$739.93	—	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax Uni	$32.89	$54.82	—	61% below	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal Impacted Ear Wax Uni	$260.80	$434.67	—	210% above	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Rem Impacted Ear Wax Uni (50)	$391.21	$652.01	—	364% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax Uni	$32.89	$54.82	—	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal Impacted Ear Wax Uni	$260.80	$434.67	—	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Rem Impacted Ear Wax Uni (50)	$391.21	$652.01	—	—	40%
Earwax removal with instruments, one ear CPT 69210 Cerumen Removal,1 Or Both Ears	$73.16	$121.94	—	3% above	40%
Earwax removal with instruments, one ear one side CPT 69210 Rem Impcted Cerumen, Unilat	$346.12	$576.86	—	389% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Cerumen Removal,1 Or Both Ears	$73.16	$121.94	—	—	40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Rem Impcted Cerumen, Unilat	$346.12	$576.86	—	—	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial (Biopsy) Wo Cerv D	$183.41	$305.68	—	9% below	40%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial (Biopsy) Wo Cerv D	$183.41	$305.68	—	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Cerv/Thor Interlaminar W/ Fluo	$205.25	$342.09	—	79% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Cerv/Thor Interlaminar W/ Fluo	$205.25	$342.09	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hsg	$65.15	$108.58	—	76% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Catheter For Hysterography	$272.19	$453.65	—	2% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hsg	$65.15	$108.58	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Catheter For Hysterography	$272.19	$453.65	—	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy W/Endometrial Bx	$1,672.98	$2,788.30	—	60% below	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy W/Endometrial Bx	$1,672.98	$2,788.30	—	—	40%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Iud Device	$69.66	$116.10	—	58% below	40%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion Iud Device	$69.66	$116.10	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Skin Abscess Simple(Prof)	$117.89	$196.49	—	50% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Skin Abscess Simple	$221.71	$369.52	—	6% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D Abcess Simple	$695.47	$1,159.12	—	196% above	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Abscess; Single	$695.47	$1,159.12	—	196% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Skin Abscess Simple(Prof)	$117.89	$196.49	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Skin Abscess Simple	$221.71	$369.52	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Abscess; Single	$695.47	$1,159.12	—	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D Abcess Simple	$695.47	$1,159.12	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament(Pro	$48.49	$80.82	—	85% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament	$145.61	$242.69	—	56% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Tendon Shth Or Ligamnt	$194.11	$323.51	—	42% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Tendon Sheath/Ligament(Pro	$48.49	$80.82	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Tendon Sheath/Ligament	$145.61	$242.69	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sgl Tendon Shth Or Ligamnt	$194.11	$323.51	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Major Jt Inj/Bursa(Prof)	$56.40	$94.00	—	84% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Major Jt Inj/Bursa	$127.71	$212.85	—	63% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610*Major Jt Inj/Bursa Wo Us	$202.01	$336.69	—	41% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection-Steroid-Joint-Lt	$960.72	$1,601.20	—	180% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 Injection-Steroid-Joint-Rt	$960.72	$1,601.20	—	180% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Major Jt Inj/Bursa(Prof)	$56.40	$94.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Major Jt Inj/Bursa	$127.71	$212.85	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610*Major Jt Inj/Bursa Wo Us	$202.01	$336.69	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection-Steroid-Joint-Rt	$960.72	$1,601.20	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 Injection-Steroid-Joint-Lt	$960.72	$1,601.20	—	—	40%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert Nonbio Drug Del Impl	$165.52	$275.86	—	at median	40%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert Nonbio Drug Del Impl	$165.52	$275.86	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj/Aspir Jt/Bursa,Interm(Prof	$45.79	$76.32	—	87% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj/Aspir Jt/Bursa,Interm	$127.71	$212.85	—	63% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Inter Jnt/Brsa Wo Us	$191.41	$319.01	—	44% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Lt	$960.72	$1,601.20	—	180% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Rt	$960.72	$1,601.20	—	180% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj/Aspir Jt/Bursa,Interm(Prof	$45.79	$76.32	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj/Aspir Jt/Bursa,Interm	$127.71	$212.85	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Inter Jnt/Brsa Wo Us	$191.41	$319.01	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Lt	$960.72	$1,601.20	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 Drain Int Jnt,Bursa,G Cyst Rt	$960.72	$1,601.20	—	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inj/Aspir Small Jt(Prof)	$44.11	$73.52	—	87% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Inj/Aspir Small Jt	$145.61	$242.69	—	58% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inj Sm Jnt/Bursa Wo Us	$189.73	$316.22	—	46% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inject Sm Joint Bursa Ff	$905.74	$1,509.56	—	159% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Inj/Aspir Small Jt(Prof)	$44.11	$73.52	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Inj/Aspir Small Jt	$145.61	$242.69	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inj Sm Jnt/Bursa Wo Us	$189.73	$316.22	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inject Sm Joint Bursa Ff	$905.74	$1,509.56	—	—	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Posterior Caps-Yag	$750.08	$1,250.13	—	2% above	40%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Posterior Caps-Yag	$750.08	$1,250.13	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Rpr Lac Intm Sc/Axil/Trnk<2.5	$370.14	$616.90	—	13% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Suture Layrd2.5-Less S,N,T.Ext	$481.98	$803.30	—	13% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Rpr Lac Intm Sc/Axil/Trnk<2.5	$370.14	$616.90	—	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Suture Layrd2.5-Less S,N,T.Ext	$481.98	$803.30	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Bgn Les T/A/L 0.5 Or <	$438.32	$730.53	—	34% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Bgn Les T/A/L 0.5 Or <	$438.32	$730.53	—	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Bgn Les F/E/Ey/N/L 0.5<	$464.17	$773.62	—	32% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Bgn Les F/E/Ey/N/L 0.5<	$464.17	$773.62	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 Removal Of Nail Plate(Prof)	$67.64	$112.73	—	75% below	40%
Nail removal (partial or complete), one nail CPT 11730 Removal Of Nail Plate	$171.46	$285.76	—	36% below	40%
Nail removal (partial or complete), one nail CPT 11730 Removal Nail Plate/Simple	$574.73	$957.89	—	114% above	40%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Single	$643.70	$1,072.83	—	140% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Of Nail Plate(Prof)	$67.64	$112.73	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Of Nail Plate	$171.46	$285.76	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Nail Plate/Simple	$574.73	$957.89	—	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Single	$643.70	$1,072.83	—	—	40%
Occipital nerve block (injection for headaches) CPT 64405 Inj Anes Greater Occipital Nrv	$211.71	$352.85	—	42% below	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj Anes Greater Occipital Nrv	$211.71	$352.85	—	—	40%
Paracentesis with imaging guidance CPT 49083 Us Guided Paracentesis W S&I	$1,146.97	$1,911.62	—	20% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 Us Guided Paracentesis W S&I	$1,146.97	$1,911.62	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed(Prof)	$123.58	$205.97	—	74% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed	$308.39	$513.98	—	34% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Nail Bed	$1,662.16	$2,770.26	—	256% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed(Prof)	$123.58	$205.97	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed	$308.39	$513.98	—	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Nail Bed	$1,662.16	$2,770.26	—	—	40%
Prostate biopsy CPT 55700 Biopsy,Prostate;Needl/Punch	$1,185.32	$1,975.53	—	61% below	40%
Prostate biopsy inpatient CPT 55700 Biopsy,Prostate;Needl/Punch	$1,185.32	$1,975.53	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body	$308.75	$514.59	—	21% below	40%
Removal of a foreign object under the skin, simple CPT 10120 Incis&Fb Rem Subcut	$1,035.11	$1,725.19	—	166% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body	$308.75	$514.59	—	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis&Fb Rem Subcut	$1,035.11	$1,725.19	—	—	40%
Short arm cast (elbow to hand) CPT 29075 Applicat Forearm Cast(Prof)	$74.45	$124.08	—	74% below	40%
Short arm cast (elbow to hand) CPT 29075 Applicat Forearm Cast(Fac)	$138.61	$231.02	—	52% below	40%
Short arm cast (elbow to hand) CPT 29075 Applicat Forearm Cast	$213.06	$355.10	—	26% below	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Applicat Forearm Cast(Prof)	$74.45	$124.08	—	—	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Applicat Forearm Cast(Fac)	$138.61	$231.02	—	—	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Applicat Forearm Cast	$213.06	$355.10	—	—	40%
Short arm splint (forearm and hand) CPT 29125 Applicat Forearm Splint	$110.16	$183.60	—	40% below	40%
Short arm splint (forearm and hand) one side CPT 29125 Splinting Short Arm - Rt	$404.36	$673.93	—	120% above	40%
Short arm splint (forearm and hand) one side CPT 29125 Splinting Short Arm - Lt	$404.36	$673.93	—	120% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Applicat Forearm Splint	$110.16	$183.60	—	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Splinting Short Arm - Rt	$404.36	$673.93	—	—	40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Splinting Short Arm - Lt	$404.36	$673.93	—	—	40%
Short leg cast (below the knee) CPT 29405 Applicat Short Leg Cast	$210.31	$350.52	—	34% below	40%
Short leg cast (below the knee) CPT 29405 Short Leg Serial Casting	$216.19	$360.31	—	32% below	40%
Short leg cast (below the knee) inpatient CPT 29405 Applicat Short Leg Cast	$210.31	$350.52	—	—	40%
Short leg cast (below the knee) inpatient CPT 29405 Short Leg Serial Casting	$216.19	$360.31	—	—	40%
Short leg splint (calf to foot) CPT 29515 Applic Short Leg Splint	$139.29	$232.15	—	40% below	40%
Short leg splint (calf to foot) one side CPT 29515 Short Leg Splint Procedure Rt	$404.36	$673.93	—	75% above	40%
Short leg splint (calf to foot) one side CPT 29515 Short Leg Splint Procedure Lt	$404.36	$673.93	—	75% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 Applic Short Leg Splint	$139.29	$232.15	—	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 Short Leg Splint Procedure Rt	$404.36	$673.93	—	—	40%
Short leg splint (calf to foot) inpatient one side CPT 29515 Short Leg Splint Procedure Lt	$404.36	$673.93	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Superfic Wnds 2.5Cm Or <	$158.35	$263.91	—	44% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Gen/Trnk 2.5/Less	$481.98	$803.30	—	70% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr Superfic Wnds 2.5Cm Or <	$158.35	$263.91	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Gen/Trnk 2.5/Less	$481.98	$803.30	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx; Single Lesion	$164.74	$274.57	—	57% below	40%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion	$620.52	$1,034.20	—	61% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx; Single Lesion	$164.74	$274.57	—	—	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion	$620.52	$1,034.20	—	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Mal Les T/A/L 0.5<	$486.41	$810.68	—	40% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc Mal Les T/A/L 0.5<	$486.41	$810.68	—	—	40%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags 1-15 Les	$191.60	$319.33	—	2% below	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags 1-15 Les	$191.60	$319.33	—	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270*Spna Fld Tap Lumb Diagn	$447.65	$746.08	—	55% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx L-Spine Punct W/O Fluoro	$1,400.65	$2,334.42	—	39% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270*Spna Fld Tap Lumb Diagn	$447.65	$746.08	—	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Dx L-Spine Punct W/O Fluoro	$1,400.65	$2,334.42	—	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr Superfic Wnds 2.6-7.5Cm	$175.67	$292.79	—	32% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Gen/Trnk 2.6-7.5	$481.98	$803.30	—	86% above	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 Rpr Superfic Wnds 2.6-7.5Cm	$175.67	$292.79	—	—	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 Repair Gen/Trnk 2.6-7.5	$481.98	$803.30	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr Superfic Wnd F/E/Ey/N/L 2.	$171.36	$285.60	—	41% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair F/E/N/L/M 2.5/Less	$481.98	$803.30	—	67% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr Superfic Wnd F/E/Ey/N/L 2.	$171.36	$285.60	—	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair F/E/N/L/M 2.5/Less	$481.98	$803.30	—	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tan Bx Of Skin; Single Lesion	$152.39	$253.98	—	56% below	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tan Bx Of Skin; Single Lesion	$152.39	$253.98	—	—	40%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Us Guided S&I	$2,041.13	$3,401.89	—	63% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Us Guided S&I	$2,041.13	$3,401.89	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1-2 Musc Grp(Pr	$46.49	$77.48	—	84% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1-2 Musc Grp	$145.61	$242.69	—	50% below	40%
Trigger point injections, 1 or 2 muscles CPT 20552 20552*Inj Trigger Pt 1-2 Musc	$192.10	$320.17	—	35% below	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Pt 1-2 Musc Grp(Pr	$46.49	$77.48	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Pt 1-2 Musc Grp	$145.61	$242.69	—	—	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552*Inj Trigger Pt 1-2 Musc	$192.10	$320.17	—	—	40%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy,Unilat Or Bilat	$1,477.12	$2,461.87	—	—	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy,Unilat Or Bilat	$1,477.12	$2,461.87	—	—	40%
Wart removal, up to 14 warts CPT 17110 Destruct Bgn Lesion 1-14(Fac)	$67.50	$112.50	—	67% below	40%
Wart removal, up to 14 warts CPT 17110 Destruct Bgn Lesion 1-14(Prof)	$81.67	$136.12	—	60% below	40%
Wart removal, up to 14 warts CPT 17110 Destruct Bgn Lesion 1-14	$185.49	$309.15	—	10% below	40%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct Bgn Lesion 1-14(Fac)	$67.50	$112.50	—	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct Bgn Lesion 1-14(Prof)	$81.67	$136.12	—	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct Bgn Lesion 1-14	$185.49	$309.15	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin/Tissue(Prof)	$72.92	$121.54	—	81% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin/Tissue	$280.16	$466.94	—	26% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Skin	$1,269.99	$2,116.65	—	237% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Epi/Dem First 20Sqcm	$1,460.48	$2,434.14	—	287% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin/Tissue(Prof)	$72.92	$121.54	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin/Tissue	$280.16	$466.94	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Skin	$1,269.99	$2,116.65	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Epi/Dem First 20Sqcm	$1,460.48	$2,434.14	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood Or Component	$1,623.53	$2,705.88	—	154% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood Or Component	$1,623.53	$2,705.88	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment	$21.03	$35.05	—	90% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hhn/Initial	$216.06	$360.10	—	5% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi/Initial	$216.06	$360.10	—	5% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hhn/Sub	$216.06	$360.10	—	5% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment	$21.03	$35.05	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hhn/Sub	$216.06	$360.10	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hhn/Initial	$216.06	$360.10	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi/Initial	$216.06	$360.10	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 Iv Chemo 16-90 Min,Initial	$1,167.22	$1,945.36	—	90% above	40%
Chemotherapy IV infusion, first hour CPT 96413 Ivt Chemo Iv Infusion 1 Hr	$1,167.22	$1,945.36	—	90% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Ivt Chemo Iv Infusion 1 Hr	$1,167.22	$1,945.36	—	—	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Iv Chemo 16-90 Min,Initial	$1,167.22	$1,945.36	—	—	40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 Np-Complete Eye Exam	$200.23	$333.71	—	18% above	40%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 Np-Complete Eye Exam	$200.23	$333.71	—	—	40%
Comprehensive eye exam, returning patient CPT 92014 Est Pt Complete Eye Exm	$174.67	$291.11	—	52% above	40%
Comprehensive eye exam, returning patient inpatient CPT 92014 Est Pt Complete Eye Exm	$174.67	$291.11	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 Crit Care E/M 30-74 Minutes	$253.36	$422.26	—	80% below	40%
Critical care, first 30 to 74 minutes CPT 99291 Ed Critical Care/30-74 Min	$817.34	$1,362.24	—	35% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Crit Care E/M 30-74 Minutes	$253.36	$422.26	—	—	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Ed Critical Care/30-74 Min	$817.34	$1,362.24	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake	$807.76	$1,346.27	—	30% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake	$807.76	$1,346.27	—	—	40%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram,Complete	$49.01	$81.68	—	67% below	40%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Electrocardiogram,Complete	$49.01	$81.68	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg, 12+ Leads, Tracing Only	$133.37	$222.28	—	11% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg, 12+ Leads, Tracing Only	$133.37	$222.28	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Ob/Ed Fac Level 1	$59.08	$98.46	—	63% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Fac Ed Level 1	$81.29	$135.49	—	49% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Ob/Ed Fac Level 1	$59.08	$98.46	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Fac Ed Level 1	$81.29	$135.49	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Ed Visit Level Ii	$47.36	$78.94	—	81% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Ob/Ed Fac Level 2	$110.86	$184.76	—	56% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Fac Ed Level 2	$152.55	$254.25	—	40% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Ed Visit Level Ii	$47.36	$78.94	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Ob/Ed Fac Level 2	$110.86	$184.76	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Fac Ed Level 2	$152.55	$254.25	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Ob/Ed Fac Level 3	$172.36	$287.26	—	57% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Fac Ed Level 3	$237.19	$395.31	—	41% below	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Ob/Ed Fac Level 3	$172.36	$287.26	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Fac Ed Level 3	$237.19	$395.31	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Ed Visit Level Iv	$134.65	$224.41	—	80% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Ob/Ed Fac Level 4	$245.18	$408.63	—	64% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Fac Ed Level 4	$337.41	$562.35	—	51% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Ed Visit Level Iv	$134.65	$224.41	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Ob/Ed Fac Level 4	$245.18	$408.63	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Fac Ed Level 4	$337.41	$562.35	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Ed Visit Level V	$198.45	$330.75	—	79% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Ob/Ed Fac Level 5	$449.90	$749.84	—	53% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Fac Ed Level 5	$619.13	$1,031.89	—	35% below	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Ed Visit Level V	$198.45	$330.75	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Ob/Ed Fac Level 5	$449.90	$749.84	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Fac Ed Level 5	$619.13	$1,031.89	—	—	40%
Eye exam, returning patient, intermediate CPT 92012 Est Pt Intermediate Eye Exam	$140.11	$233.51	—	73% above	40%
Eye exam, returning patient, intermediate inpatient CPT 92012 Est Pt Intermediate Eye Exam	$140.11	$233.51	—	—	40%
Family therapy with the patient, 50 minutes CPT 90847 Family/Couple Therapy	$221.03	$368.39	—	16% above	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family/Couple Therapy	$221.03	$368.39	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Hydration 31-90 Min	$124.96	$208.26	—	45% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Ivt Iv Hydration 31-90 Min	$184.83	$308.05	—	18% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Inf Hyd Initial Er 1St Hr	$184.83	$308.05	—	18% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Hydration 31-90 Min	$124.96	$208.26	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Ivt Iv Hydration 31-90 Min	$184.83	$308.05	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Inf Hyd Initial Er 1St Hr	$184.83	$308.05	—	—	40%
IV infusion of a medicine, first hour CPT 96365 Iv Therapy 16-90 Min	$124.96	$208.26	—	50% below	40%
IV infusion of a medicine, first hour CPT 96365 Ivt Iv Therapy 16-90 Min	$384.06	$640.10	—	55% above	40%
IV infusion of a medicine, first hour CPT 96365 Iv Infusion First Hour	$384.06	$640.10	—	55% above	40%
IV infusion of a medicine, first hour CPT 96365 Ivt Iv Infusion-Obs 16-90 Min	$384.06	$640.10	—	55% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Iv Therapy 16-90 Min	$124.96	$208.26	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Ivt Iv Infusion-Obs 16-90 Min	$384.06	$640.10	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Iv Infusion First Hour	$384.06	$640.10	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Ivt Iv Therapy 16-90 Min	$384.06	$640.10	—	—	40%
IV push of a medicine, first drug CPT 96374 Ther/Proph/Diag Inj,Iv Push	$124.96	$208.26	—	39% below	40%
IV push of a medicine, first drug CPT 96374 Iv Injection	$180.02	$300.04	—	12% below	40%
IV push of a medicine, first drug CPT 96374 Ther/Diag Inj Iv Push (59)	$180.02	$300.04	—	12% below	40%
IV push of a medicine, first drug CPT 96374 Ivt Ivp Outpt Initial	$180.02	$300.04	—	12% below	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Proph/Diag Inj,Iv Push	$124.96	$208.26	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ther/Diag Inj Iv Push (59)	$180.02	$300.04	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Ivt Ivp Outpt Initial	$180.02	$300.04	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Iv Injection	$180.02	$300.04	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im(Fac)	$28.98	$48.30	—	59% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$51.85	$86.42	—	27% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ivt Sq/Im Outpatient	$67.21	$112.02	—	6% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Im Subcutaneous Injection	$67.21	$112.02	—	6% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 3W Sq/Im Injection	$133.07	$221.79	—	86% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im(Fac)	$28.98	$48.30	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$51.85	$86.42	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ivt Sq/Im Outpatient	$67.21	$112.02	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Im Subcutaneous Injection	$67.21	$112.02	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 3W Sq/Im Injection	$133.07	$221.79	—	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Evaluation	$243.54	$405.90	—	26% above	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Evaluation	$243.54	$405.90	—	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nvr Cndj Tst 7-8 Studies	$321.69	$536.15	—	25% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nvr Cndj Tst 7-8 Studies	$321.69	$536.15	—	—	40%
New patient office visit, about 30 minutes CPT 99203 Ov New Pt Level Iii(Fac)	$69.95	$116.58	—	16% below	40%
New patient office visit, about 30 minutes CPT 99203 Ov New Pt Level Iii(Prof)	$107.47	$179.12	—	29% above	40%
New patient office visit, about 30 minutes CPT 99203 99203*Ov New Pt Level Iii	$170.70	$284.50	—	106% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 Ov New Pt Level Iii(Fac)	$69.95	$116.58	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 Ov New Pt Level Iii(Prof)	$107.47	$179.12	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 99203*Ov New Pt Level Iii	$170.70	$284.50	—	—	40%
New patient office visit, about 45 minutes CPT 99204 Ov New Pt Level Iv(Fac)	$69.95	$116.58	—	24% below	40%
New patient office visit, about 45 minutes CPT 99204 Ov New Pt Level Iv(Prof)	$185.40	$309.00	—	102% above	40%
New patient office visit, about 45 minutes CPT 99204 99204*Ov New Pt Level Iv	$238.69	$397.82	—	160% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 Ov New Pt Level Iv(Fac)	$69.95	$116.58	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 Ov New Pt Level Iv(Prof)	$185.40	$309.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 99204*Ov New Pt Level Iv	$238.69	$397.82	—	—	40%
New patient office visit, about 60 minutes CPT 99205 Ov New Pt Level V(Fac)	$69.95	$116.58	—	43% below	40%
New patient office visit, about 60 minutes CPT 99205 99205*Ov New Pt Level V	$289.33	$482.21	—	136% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 Ov New Pt Level V(Fac)	$69.95	$116.58	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 99205*Ov New Pt Level V	$289.33	$482.21	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Ov New Pt Level Ii(Prof)	$62.89	$104.81	—	8% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Ov New Pt Level Ii(Fac)	$69.95	$116.58	—	2% above	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202*Ov New Pt Level Ii	$137.74	$229.56	—	101% above	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Eval	$178.00	$296.67	—	160% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Ov New Pt Level Ii(Prof)	$62.89	$104.81	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Ov New Pt Level Ii(Fac)	$69.95	$116.58	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202*Ov New Pt Level Ii	$137.74	$229.56	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt Eval	$178.00	$296.67	—	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Ipr Pt Eval Low 20Min	$336.09	$560.15	—	82% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Ipr Pt Eval Low 20Min	$336.09	$560.15	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Myofascial Release 1/4 Hr	$107.28	$178.80	—	61% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Myofascial Release 1/4 Hr	$107.28	$178.80	—	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 99385*Prv Visit Nw Pt 18-39Yrs	$210.43	$350.72	—	155% above	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385*Prv Visit Nw Pt 18-39Yrs	$210.43	$350.72	—	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 99386*Prv Visit,Nw Pt 40-64Yrs	$179.87	$299.79	—	100% above	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386*Prv Visit,Nw Pt 40-64Yrs	$179.87	$299.79	—	—	40%
Preventive checkup, new patient aged 65 or older CPT 99387 99387*Prv Visit,New Pt 65+Yrs	$195.28	$325.46	—	78% above	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387*Prv Visit,New Pt 65+Yrs	$195.28	$325.46	—	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395*Prv Visit Est Pt18-39Yrs	$137.88	$229.80	—	110% above	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395*Prv Visit Est Pt18-39Yrs	$137.88	$229.80	—	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 Prev Visit, Est Pt, 40-64 Yrs	$40.15	$66.92	—	46% below	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396*Prv Vst Est Pt 40-64Yrs	$147.68	$246.13	—	98% above	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Prev Visit, Est Pt, 40-64 Yrs	$40.15	$66.92	—	—	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396*Prv Vst Est Pt 40-64Yrs	$147.68	$246.13	—	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397*Prv Visit Est Pt 65+Yrs	$159.58	$265.96	—	137% above	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397*Prv Visit Est Pt 65+Yrs	$159.58	$265.96	—	—	40%
Psychiatric evaluation with medical services CPT 90792 Psych Diag Eval W/Med Srvcs	$264.83	$441.39	—	33% above	40%
Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diag Eval W/Med Srvcs	$264.83	$441.39	—	—	40%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$243.14	$405.24	—	at median	40%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$243.14	$405.24	—	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psytx Crisis Initial 60 Min	$254.88	$424.80	—	13% above	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psytx Crisis Initial 60 Min	$254.88	$424.80	—	—	40%
Psychotherapy session, 30 minutes CPT 90832 Psytx Pt&/Family 30 Minutes	$161.29	$268.81	—	61% above	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psytx Pt&/Family 30 Minutes	$161.29	$268.81	—	—	40%
Psychotherapy session, 45 minutes CPT 90834 Psytx Pt&/Family 45 Minutes	$188.57	$314.28	—	37% above	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psytx Pt&/Family 45 Minutes	$188.57	$314.28	—	—	40%
Psychotherapy session, 60 minutes CPT 90837 Psytx Pt&/Family 60 Minutes	$243.11	$405.18	—	28% above	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx Pt&/Family 60 Minutes	$243.11	$405.18	—	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Couns 3-10 Mins(Prof)	$16.00	$26.66	—	56% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Couns 3-10 Mins(Fac)	$20.92	$34.87	—	43% below	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406*Smking Couns 3-10 Mins	$36.92	$61.53	—	1% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Couns 3-10 Mins(Prof)	$16.00	$26.66	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Couns 3-10 Mins(Fac)	$20.92	$34.87	—	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406*Smking Couns 3-10 Mins	$36.92	$61.53	—	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Ov Est Pt Level V(Fac)	$69.95	$116.58	—	18% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215*Ov Est Pt Level V	$215.38	$358.96	—	153% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Ov Est Pt Level V(Fac)	$69.95	$116.58	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215*Ov Est Pt Level V	$215.38	$358.96	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Ov Est Pt Level Iii(Fac)	$69.95	$116.58	—	10% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Ov Est Pt Level Iii (Prof)	$85.69	$142.81	—	10% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Ov Est Pt Level Iii(Fac)	$69.95	$116.58	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Ov Est Pt Level Iii (Prof)	$85.69	$142.81	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Ov Est Pt Level Iv(Fac)	$69.95	$116.58	—	28% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Ov Est Pt Level Iv(Prof)	$125.51	$209.19	—	29% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Ov Est Pt Level Iv(Fac)	$69.95	$116.58	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Ov Est Pt Level Iv(Prof)	$125.51	$209.19	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Ov Est Pt Level Ii(Prof)	$46.69	$77.81	—	28% below	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Ov Est Pt Level Ii(Fac)	$69.95	$116.58	—	8% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212*Ov Est Pt Level Ii	$105.44	$175.74	—	63% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est Pt Eval	$178.00	$296.67	—	176% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Ov Est Pt Level Ii(Prof)	$46.69	$77.81	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Ov Est Pt Level Ii(Fac)	$69.95	$116.58	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212*Ov Est Pt Level Ii	$105.44	$175.74	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Est Pt Eval	$178.00	$296.67	—	—	40%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Outpt Consult Level Iv	$241.46	$402.43	—	143% above	40%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Outpt Consult Level Iv	$241.46	$402.43	—	—	40%
Spirometry (breathing test) CPT 94010 Spirometry	$52.94	$88.24	—	74% below	40%
Spirometry (breathing test) CPT 94010 Pulm Function Spirometry	$382.49	$637.48	—	85% above	40%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$52.94	$88.24	—	—	40%
Spirometry (breathing test) inpatient CPT 94010 Pulm Function Spirometry	$382.49	$637.48	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 Evaluation Of Wheezing	$168.44	$280.74	—	57% below	40%
Spirometry before and after a bronchodilator CPT 94060 Pulm Func Test C Bron	$634.22	$1,057.03	—	63% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Evaluation Of Wheezing	$168.44	$280.74	—	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pulm Func Test C Bron	$634.22	$1,057.03	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Theraputic	$213.49	$355.82	—	42% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Theraputic	$213.49	$355.82	—	—	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Stress Test W/Phys Superv/Inte	$139.43	$232.39	—	83% below	40%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Stress Test W/Phys Superv/Inte	$139.43	$232.39	—	—	40%
Visual field test, extended CPT 92083 Cvf Armaly Central Or 30-2	$102.53	$170.88	—	27% below	40%
Visual field test, extended inpatient CPT 92083 Cvf Armaly Central Or 30-2	$102.53	$170.88	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs West Virginia	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization	$39.89	$66.48	—	8% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Tetanus Administration	$124.82	$208.04	—	187% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Ivt Immunization Admin	$127.89	$213.15	—	194% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Rabies Administration	$138.00	$230.00	—	217% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumo Vaccine Admin	$138.00	$230.00	—	217% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Immunization	$39.89	$66.48	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Tetanus Administration	$124.82	$208.04	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Ivt Immunization Admin	$127.89	$213.15	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pneumo Vaccine Admin	$138.00	$230.00	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Rabies Administration	$138.00	$230.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization, Each Addl	$17.08	$28.47	—	30% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vacc Admin Additional	$39.05	$65.09	—	59% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Immunization, Each Addl	$17.08	$28.47	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vacc Admin Additional	$39.05	$65.09	—	—	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://HospitalPriceDisclosure.com/Download.aspx?pi=ezKKe3b8wfY6RicI20GCow*-*