Hospital Portland-South Portland, ME

Northern Light Mercy Hospital

Listed in its price file as “Mercy Hospital”.

Northern Light Mercy Hospital in Portland, ME publishes cash prices for 420 common procedures listed here, from its own machine-readable price file updated Apr 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Maine median for 367 of 418 procedures and above it for 44. By typical cash price it ranks #5 of 28 Maine hospitals and #1 of 6 hospitals in the Portland, ME area, cheapest first. Select a procedure to compare it with other hospitals nearby.

175 Fore River Parkway, Portland, ME 04102 Collected Sep 23, 2026 Source price file Check a bill from this hospital (207) 879-3000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 200008 · CMS hospital register NPI 1629078712

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Northern Light Mercy Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO&W CONT	$542.88	$2,088.00	$1,114.99–$1,591.06	61% below	74%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO&W CONT	$542.88	$2,088.00	$1,357.20–$1,557.65	—	74%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS	$121.68	$468.00	$249.91–$356.62	50% below	74%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+ VIEWS LT	$100.62	$387.00	$206.66–$294.89	53% below	74%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3+ VIEWS RT	$100.62	$387.00	$206.66–$294.89	53% below	74%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+ VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3+ VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXT U/L STDY 1-2 LVL BIL LIMTD	$141.44	$544.00	$290.50–$414.53	3% below	74%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 EXT U/L STDY 1-2 LVL BIL LIMTD	$141.44	$544.00	$353.60–$405.82	—	74%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONT LT	$260.78	$1,003.00	$535.60–$764.29	77% below	74%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONT RT	$260.78	$1,003.00	$535.60–$764.29	77% below	74%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONT LT	$260.78	$1,003.00	$651.95–$748.24	—	74%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONT RT	$260.78	$1,003.00	$651.95–$748.24	—	74%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHOGRAM S&I	$203.32	$782.00	$417.59–$595.88	42% below	74%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHOGRAM S&I	$203.32	$782.00	$508.30–$583.37	—	74%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JOINT IMAGE WHOLE BODY	$486.46	$1,871.00	$999.11–$1,425.70	59% below	74%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE/JOINT IMAGE WHOLE BODY	$486.46	$1,871.00	$1,216.15–$1,395.77	—	74%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLETE LT	$202.80	$780.00	$416.52–$594.36	at median	74%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLETE RT	$202.80	$780.00	$416.52–$594.36	at median	74%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLETE RT	$202.80	$780.00	$507.00–$581.88	—	74%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLETE LT	$202.80	$780.00	$507.00–$581.88	—	74%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED LT	$109.20	$420.00	$224.28–$320.04	54% below	74%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED RT	$109.20	$420.00	$224.28–$320.04	54% below	74%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED LT	$109.20	$420.00	$273.00–$313.32	—	74%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED RT	$109.20	$420.00	$273.00–$313.32	—	74%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELVIS WO&W DYE	$1,218.62	$4,687.00	$2,502.86–$3,571.49	20% below	74%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PELVIS WO&W DYE	$1,218.62	$4,687.00	$3,046.55–$3,496.50	—	74%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WO&W CONT	$514.80	$1,980.00	$1,057.32–$1,508.76	67% below	74%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WO&W CONT	$514.80	$1,980.00	$1,287.00–$1,477.08	—	74%
CT angiography (CTA) of the neck CPT 70498 CTA NECK WO&W CONT	$514.54	$1,979.00	$1,056.79–$1,508.00	67% below	74%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WO&W CONT	$514.54	$1,979.00	$1,286.35–$1,476.33	—	74%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WO&W CONT	$671.58	$2,583.00	$1,379.32–$1,968.25	63% below	74%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WO&W CONT	$671.58	$2,583.00	$1,678.95–$1,926.92	—	74%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W 3D IMAGE	$366.60	$1,410.00	$752.94–$1,074.42	30% below	74%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W 3D IMAGE	$366.60	$1,410.00	$916.50–$1,051.86	—	74%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT WO CONT W EVAL CALCIUM	$78.00	$300.00	$160.20–$228.60	41% below	74%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT WO CONT W EVAL CALCIUM	$78.00	$300.00	$195.00–$223.80	—	74%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS WO CONT	$729.04	$2,804.00	$1,497.34–$2,136.65	48% below	74%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS WO CONT	$729.04	$2,804.00	$1,822.60–$2,091.78	—	74%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONT	$980.72	$3,772.00	$2,014.25–$2,874.26	51% below	74%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CONT	$980.72	$3,772.00	$2,451.80–$2,813.91	—	74%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS WO/ W CONT	$1,107.86	$4,261.00	$2,275.37–$3,246.88	50% below	74%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS WO/ W CONT	$1,107.86	$4,261.00	$2,769.65–$3,178.71	—	74%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONT	$432.90	$1,665.00	$889.11–$1,268.73	61% below	74%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONT	$432.90	$1,665.00	$1,082.25–$1,242.09	—	74%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONT	$294.06	$1,131.00	$603.95–$861.82	65% below	74%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONT	$294.06	$1,131.00	$735.15–$843.73	—	74%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT	$267.80	$1,030.00	$550.02–$784.86	69% below	74%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT	$267.80	$1,030.00	$669.50–$768.38	—	74%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONT	$399.62	$1,537.00	$820.76–$1,171.19	59% below	74%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONT	$399.62	$1,537.00	$999.05–$1,146.60	—	74%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONT	$487.76	$1,876.00	$1,001.78–$1,429.51	54% below	74%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONT	$487.76	$1,876.00	$1,219.40–$1,399.50	—	74%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN WO&W CONT	$468.00	$1,800.00	$961.20–$1,371.60	68% below	74%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN WO&W CONT	$468.00	$1,800.00	$1,170.00–$1,342.80	—	74%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT	$291.98	$1,123.00	$599.68–$855.73	70% below	74%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONT	$291.98	$1,123.00	$729.95–$837.76	—	74%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE WO CONT	$329.94	$1,269.00	$677.65–$966.98	66% below	74%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE WO CONT	$329.94	$1,269.00	$824.85–$946.67	—	74%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT	$379.86	$1,461.00	$780.17–$1,113.28	62% below	74%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT	$379.86	$1,461.00	$949.65–$1,089.91	—	74%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUPLEX EXTRACRANIAL ART BIL	$291.46	$1,121.00	$598.61–$854.20	56% below	74%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUPLEX EXTRACRANIAL ART BIL	$291.46	$1,121.00	$728.65–$836.27	—	74%
Chest CT scan without and with contrast CPT 71270 CT THORAX WO&W CONT	$613.08	$2,358.00	$1,259.17–$1,796.80	64% below	74%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX WO&W CONT	$613.08	$2,358.00	$1,532.70–$1,759.07	—	74%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS PA/LAT	$112.32	$432.00	$230.69–$329.18	47% below	74%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS PA/LAT	$112.32	$432.00	$280.80–$322.27	—	74%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW FRONTAL	$101.66	$391.00	$208.79–$297.94	49% below	74%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW FRONTAL	$101.66	$391.00	$254.15–$291.69	—	74%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE LT	$100.62	$387.00	$206.66–$294.89	54% below	74%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE RT	$100.62	$387.00	$206.66–$294.89	54% below	74%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE RT	$100.62	$387.00	$251.55–$288.70	—	74%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE LT	$100.62	$387.00	$251.55–$288.70	—	74%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETRPER RENAL/AORT COMP	$166.14	$639.00	$341.23–$486.92	63% below	74%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETRPER RENAL/AORT COMP	$166.14	$639.00	$415.35–$476.69	—	74%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DNSTY AXIAL 1+ SITES	$121.68	$468.00	$249.91–$356.62	51% below	74%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DNSTY AXIAL 1+ SITES	$121.68	$468.00	$304.20–$349.13	—	74%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$289.12	$1,112.00	$593.81–$847.34	30% below	74%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS	$289.12	$1,112.00	$722.80–$829.55	—	74%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WO CONT	$306.28	$1,178.00	$629.05–$897.64	67% below	74%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WO CONT	$306.28	$1,178.00	$765.70–$878.79	—	74%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W CONT	$553.80	$2,130.00	$1,137.42–$1,623.06	57% below	74%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W CONT	$553.80	$2,130.00	$1,384.50–$1,588.98	—	74%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGITAL DIAGNOSTIC BILAT	$164.32	$632.00	$337.49–$481.58	—	74%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGITAL DIAGNOSTIC BILAT	$164.32	$632.00	$410.80–$471.47	—	74%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL DIAGN UNILAT LT	$128.44	$494.00	$263.80–$376.43	18% below	74%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL DIAGN UNILAT RT	$128.44	$494.00	$263.80–$376.43	18% below	74%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL DIAGN UNILAT RT	$128.44	$494.00	$321.10–$368.52	—	74%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL DIAGN UNILAT LT	$128.44	$494.00	$321.10–$368.52	—	74%
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX SCAN ART LE COMP BIL	$270.92	$1,042.00	$556.43–$794.00	27% below	74%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN ART LE COMP BIL	$270.92	$1,042.00	$677.30–$777.33	—	74%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX SCAN EXT VEINS BIL	$311.74	$1,199.00	$640.27–$913.64	39% below	74%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX SCAN EXT VEINS BIL	$311.74	$1,199.00	$779.35–$894.45	—	74%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$651.56	$2,506.00	$1,338.20–$1,909.57	40% below	74%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$651.56	$2,506.00	$1,628.90–$1,869.48	—	74%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	54% below	74%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	54% below	74%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3+ VIEWS RT	$104.78	$403.00	$215.20–$307.09	52% below	74%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3+ VIEWS LT	$104.78	$403.00	$215.20–$307.09	52% below	74%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3+ VIEWS LT	$104.78	$403.00	$261.95–$300.64	—	74%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3+ VIEWS RT	$104.78	$403.00	$261.95–$300.64	—	74%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA WO CONT	$297.44	$1,144.00	$610.90–$871.73	70% below	74%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA WO CONT	$297.44	$1,144.00	$743.60–$853.42	—	74%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3+ VIEWS	$121.68	$468.00	$249.91–$356.62	47% below	74%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 3+ VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	52% below	74%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	52% below	74%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$455.78	$1,753.00	$936.10–$1,335.79	54% below	74%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$455.78	$1,753.00	$1,139.45–$1,307.74	—	74%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$79.30	$305.00	$162.87–$232.41	63% below	74%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$79.30	$305.00	$162.87–$232.41	63% below	74%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT	$79.30	$305.00	$198.25–$227.53	—	74%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT	$79.30	$305.00	$198.25–$227.53	—	74%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL/CALCANEUS 2+ VIEWS RT	$100.62	$387.00	$206.66–$294.89	52% below	74%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL/CALCANEUS 2+ VIEWS LT	$100.62	$387.00	$206.66–$294.89	52% below	74%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL/CALCANEUS 2+ VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL/CALCANEUS 2+ VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RT	$113.10	$435.00	$232.29–$331.47	50% below	74%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LT	$113.10	$435.00	$232.29–$331.47	50% below	74%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RT	$113.10	$435.00	$282.75–$324.51	—	74%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LT	$113.10	$435.00	$282.75–$324.51	—	74%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4+ VIEWS RT	$121.68	$468.00	$249.91–$356.62	52% below	74%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4+ VIEWS LT	$121.68	$468.00	$249.91–$356.62	52% below	74%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4+ VIEWS RT	$121.68	$468.00	$304.20–$349.13	—	74%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4+ VIEWS LT	$121.68	$468.00	$304.20–$349.13	—	74%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT WO CONT LT	$260.78	$1,003.00	$535.60–$764.29	75% below	74%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT WO CONT RT	$260.78	$1,003.00	$535.60–$764.29	75% below	74%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT WO CONT RT	$260.78	$1,003.00	$651.95–$748.24	—	74%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT WO CONT LT	$260.78	$1,003.00	$651.95–$748.24	—	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC POCUS ABDOMEN	$199.68	$768.00	$410.11–$585.22	18% below	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US EXAM OF ABDOMEN	$199.68	$768.00	$410.11–$585.22	18% below	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$199.68	$768.00	$410.11–$585.22	18% below	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US EXAM OF ABDOMEN	$199.68	$768.00	$499.20–$572.93	—	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC POCUS ABDOMEN	$199.68	$768.00	$499.20–$572.93	—	74%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LTD	$199.68	$768.00	$499.20–$572.93	—	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC POCUS MSK/SOFT TISSUE LT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC POCUS MSK/SOFT TISSUE RT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASC LTD LT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON-VASC LIMITED LT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON-VASC LIMITED RT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY NONVASC LTD RT	$121.68	$468.00	$249.91–$356.62	27% below	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASC LTD LT	$121.68	$468.00	$304.20–$349.13	—	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC POCUS MSK/SOFT TISSUE RT	$121.68	$468.00	$304.20–$349.13	—	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY NONVASC LTD RT	$121.68	$468.00	$304.20–$349.13	—	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC POCUS MSK/SOFT TISSUE LT	$121.68	$468.00	$304.20–$349.13	—	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON-VASC LIMITED LT	$121.68	$468.00	$304.20–$349.13	—	74%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON-VASC LIMITED RT	$121.68	$468.00	$304.20–$349.13	—	74%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING	$157.04	$604.00	$322.54–$460.25	31% below	74%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING	$157.04	$604.00	$392.60–$450.58	—	74%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	53% below	74%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	53% below	74%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST	$484.64	$1,864.00	$995.38–$1,420.37	72% below	74%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST	$484.64	$1,864.00	$1,211.60–$1,390.54	—	74%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST WO&W CONT BIL	$1,153.62	$4,437.00	$2,369.36–$3,380.99	54% below	74%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST WO&W CONT BIL	$1,153.62	$4,437.00	$2,884.05–$3,310.00	—	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST RT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST RT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTRAST LT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTR LIMITED RT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE W/O CONTR LIMITED LT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST LT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST RT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP W/O CONTRAST LT	$319.28	$1,228.00	$655.75–$935.74	79% below	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST RT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTRAST LT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTR LIMITED RT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE W/O CONTR LIMITED LT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST RT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST LT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST LT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP W/O CONTRAST RT	$319.28	$1,228.00	$798.20–$916.09	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W & W/O CONTRAST RT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE W & W/O CONTRAST LT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W & W/O CONTRAST RT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W & W/O CONTRAST LT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W&W/O CONTRAST RT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W&W/O CONTRAST LT	$972.92	$3,742.00	$1,998.23–$2,851.40	63% below	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W & W/O CONTRAST RT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W&W/O CONTRAST LT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W & W/O CONTRAST RT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE W & W/O CONTRAST LT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE W&W/O CONTRAST RT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP W & W/O CONTRAST LT	$972.92	$3,742.00	$2,432.30–$2,791.53	—	74%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$474.50	$1,825.00	$974.55–$1,390.65	73% below	74%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$474.50	$1,825.00	$1,186.25–$1,361.45	—	74%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI MRCP W&WO CONTRAST	$882.96	$3,396.00	$1,813.46–$2,587.75	59% below	74%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO&W CONTRAST	$882.96	$3,396.00	$1,813.46–$2,587.75	59% below	74%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP W&WO CONTRAST	$882.96	$3,396.00	$2,207.40–$2,533.42	—	74%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO&W CONTRAST	$882.96	$3,396.00	$2,207.40–$2,533.42	—	74%
MRI of the brain, no contrast dye CPT 70551 MRI HEAD W/O CONTRAST	$655.20	$2,520.00	$1,345.68–$1,920.24	55% below	74%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI HEAD W/O CONTRAST	$655.20	$2,520.00	$1,638.00–$1,879.92	—	74%
MRI of the brain, with and without contrast dye CPT 70553 MRI HEAD W & W/O CONTRAST	$904.54	$3,479.00	$1,857.79–$2,651.00	59% below	74%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI HEAD W & W/O CONTRAST	$904.54	$3,479.00	$2,261.35–$2,595.33	—	74%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST	$484.64	$1,864.00	$995.38–$1,420.37	66% below	74%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST	$484.64	$1,864.00	$1,211.60–$1,390.54	—	74%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR WO&W CONTRAST	$739.96	$2,846.00	$1,519.76–$2,168.65	68% below	74%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR WO&W CONTRAST	$739.96	$2,846.00	$1,849.90–$2,123.12	—	74%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST	$483.34	$1,859.00	$992.71–$1,416.56	66% below	74%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONTRAST	$483.34	$1,859.00	$1,208.35–$1,386.81	—	74%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL WO&W CONT	$905.58	$3,483.00	$1,859.92–$2,654.05	56% below	74%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL WO&W CONT	$905.58	$3,483.00	$2,263.95–$2,598.32	—	74%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST	$655.20	$2,520.00	$1,345.68–$1,920.24	54% below	74%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONTRAST	$655.20	$2,520.00	$1,638.00–$1,879.92	—	74%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO&W CONTRAST	$1,001.52	$3,852.00	$2,056.97–$2,935.22	57% below	74%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO&W CONTRAST	$1,001.52	$3,852.00	$2,503.80–$2,873.59	—	74%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$467.48	$1,798.00	$960.13–$1,370.08	70% below	74%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$467.48	$1,798.00	$1,168.70–$1,341.31	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER W/O CONTRAST RT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST W/O CONTRAST RT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST W/O CONTRAST LT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER W/O CONTRAST LT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW W/O CONTRAST RT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW W/O CONTRAST LT	$521.30	$2,005.00	$1,070.67–$1,527.81	65% below	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST W/O CONTRAST RT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW W/O CONTRAST LT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW W/O CONTRAST RT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER W/O CONTRAST LT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER W/O CONTRAST RT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST W/O CONTRAST LT	$521.30	$2,005.00	$1,303.25–$1,495.73	—	74%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERV SPINE 4 OR 5 VIEWS	$121.68	$468.00	$249.91–$356.62	59% below	74%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERV SPINE 4 OR 5 VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSSUE W CONT	$424.32	$1,632.00	$871.49–$1,243.58	67% below	74%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TISSSUE W CONT	$424.32	$1,632.00	$1,060.80–$1,217.47	—	74%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE WO CONT	$269.88	$1,038.00	$554.29–$790.96	73% below	74%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE WO CONT	$269.88	$1,038.00	$674.70–$774.35	—	74%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$100.62	$387.00	$206.66–$294.89	52% below	74%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$100.62	$387.00	$251.55–$288.70	—	74%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD PERFUSN SPECT MULTI	$1,550.64	$5,964.00	$3,184.78–$4,544.57	25% below	74%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD PERFUSN SPECT MULTI	$1,550.64	$5,964.00	$3,876.60–$4,449.14	—	74%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL TO THIGH SUBSQ	$2,076.62	$7,987.00	$4,265.06–$6,086.09	37% below	74%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL TO THIGH INITIAL	$2,076.62	$7,987.00	$4,265.06–$6,086.09	37% below	74%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL TO THIGH SUBSQ	$2,076.62	$7,987.00	$5,191.55–$5,958.30	—	74%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL TO THIGH INITIAL	$2,076.62	$7,987.00	$5,191.55–$5,958.30	—	74%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT	$256.88	$988.00	$527.59–$752.86	73% below	74%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONT	$256.88	$988.00	$642.20–$737.05	—	74%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC POCUS PST VOID RESIDL BLADR	$121.68	$468.00	$249.91–$356.62	30% below	74%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELV LTD FOLLOW UP	$121.68	$468.00	$249.91–$356.62	30% below	74%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC POCUS PST VOID RESIDL BLADR	$121.68	$468.00	$304.20–$349.13	—	74%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELV LTD FOLLOW UP	$121.68	$468.00	$304.20–$349.13	—	74%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELV COMP NON OB	$174.46	$671.00	$358.31–$511.30	56% below	74%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELV COMP NON OB	$174.46	$671.00	$436.15–$500.57	—	74%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS>=14WK SNGL	$193.96	$746.00	$398.36–$568.45	56% below	74%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREG UTERUS>=14WK SNGL	$193.96	$746.00	$398.36–$568.45	56% below	74%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS>=14WK SNGL	$193.96	$746.00	$484.90–$556.52	—	74%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREG UTERUS>=14WK SNGL	$193.96	$746.00	$484.90–$556.52	—	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS	$161.98	$623.00	$332.68–$474.73	48% below	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS<14WK SNGL	$192.92	$742.00	$396.23–$565.40	38% below	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS, SINGLE FETUS	$192.92	$742.00	$396.23–$565.40	38% below	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS	$161.98	$623.00	$404.95–$464.76	—	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS, SINGLE FETUS	$192.92	$742.00	$482.30–$553.53	—	74%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS<14WK SNGL	$192.92	$742.00	$482.30–$553.53	—	74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US, LTD STUDY; => 1 FETUSES	$121.68	$468.00	$249.91–$356.62	37% below	74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US FOLLOW-UP PER FETUS	$121.68	$468.00	$249.91–$356.62	37% below	74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US FOLLOW-UP PER FETUS	$121.68	$468.00	$304.20–$349.13	—	74%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US, LTD STUDY; => 1 FETUSES	$121.68	$468.00	$304.20–$349.13	—	74%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	56% below	74%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	56% below	74%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST 3 VIEWS RT	$121.68	$468.00	$249.91–$356.62	63% below	74%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W PA CHEST 3 VIEWS LT	$121.68	$468.00	$249.91–$356.62	63% below	74%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST 3 VIEWS LT	$121.68	$468.00	$304.20–$349.13	—	74%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W PA CHEST 3 VIEWS RT	$121.68	$468.00	$304.20–$349.13	—	74%
Screening mammogram, both breasts both sides CPT 77067 MAMMO DIGITAL SCREENING BILAT	$135.72	$522.00	$278.75–$397.76	—	74%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DIGITAL SCREENING BILAT	$135.72	$522.00	$339.30–$389.41	—	74%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$106.86	$411.00	$219.47–$313.18	53% below	74%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$106.86	$411.00	$219.47–$313.18	53% below	74%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$106.86	$411.00	$267.15–$306.61	—	74%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$106.86	$411.00	$267.15–$306.61	—	74%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMPLETE 3+ VIEWS	$100.62	$387.00	$206.66–$294.89	56% below	74%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES COMPLETE 3+ VIEWS	$100.62	$387.00	$251.55–$288.70	—	74%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1-3 VIEWS	$82.16	$316.00	$168.74–$240.79	62% below	74%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 1-3 VIEWS	$82.16	$316.00	$205.40–$235.74	—	74%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$609.70	$2,345.00	$1,252.23–$1,786.89	46% below	74%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE	$609.70	$2,345.00	$1,524.25–$1,749.37	—	74%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOWNG FUNC W CINE/VIDEO	$203.32	$782.00	$417.59–$595.88	54% below	74%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOWNG FUNC W CINE/VIDEO	$203.32	$782.00	$508.30–$583.37	—	74%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR EXAM OF FEMUR 2 VIEWS RIGHT	$81.38	$313.00	$167.14–$238.51	62% below	74%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR EXAM OF FEMUR 2 VIEWS LEFT	$81.38	$313.00	$167.14–$238.51	62% below	74%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR EXAM OF FEMUR 2 VIEWS RIGHT	$81.38	$313.00	$203.45–$233.50	—	74%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR EXAM OF FEMUR 2 VIEWS LEFT	$81.38	$313.00	$203.45–$233.50	—	74%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONT	$251.68	$968.00	$516.91–$737.62	76% below	74%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONT	$251.68	$968.00	$629.20–$722.13	—	74%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$100.62	$387.00	$206.66–$294.89	44% below	74%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$100.62	$387.00	$206.66–$294.89	44% below	74%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) 2+ VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$154.70	$595.00	$317.73–$453.39	59% below	74%
Transvaginal pelvic ultrasound CPT 76830 HC POCUS NON-PREGNT TRNSVAGNL	$154.70	$595.00	$317.73–$453.39	59% below	74%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB	$154.70	$595.00	$317.73–$453.39	59% below	74%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$154.70	$595.00	$386.75–$443.87	—	74%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC POCUS NON-PREGNT TRNSVAGNL	$154.70	$595.00	$386.75–$443.87	—	74%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB	$154.70	$595.00	$386.75–$443.87	—	74%
Transvaginal ultrasound during pregnancy CPT 76817 HC POCUS PREGNANT TRANSVAGINAL	$167.96	$646.00	$344.96–$492.25	46% below	74%
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC	$167.96	$646.00	$344.96–$492.25	46% below	74%
Transvaginal ultrasound during pregnancy CPT 76817 OB US, TRANSVAGINAL	$167.96	$646.00	$344.96–$492.25	46% below	74%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG TRANSVAGINAL	$167.96	$646.00	$344.96–$492.25	46% below	74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC	$167.96	$646.00	$419.90–$481.92	—	74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB US, TRANSVAGINAL	$167.96	$646.00	$419.90–$481.92	—	74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG TRANSVAGINAL	$167.96	$646.00	$419.90–$481.92	—	74%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC POCUS PREGNANT TRANSVAGINAL	$167.96	$646.00	$419.90–$481.92	—	74%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$229.06	$881.00	$470.45–$671.32	51% below	74%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOMEN COMPLETE	$229.06	$881.00	$470.45–$671.32	51% below	74%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOMEN COMPLETE	$229.06	$881.00	$572.65–$657.23	—	74%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$229.06	$881.00	$572.65–$657.23	—	74%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$139.36	$536.00	$286.22–$408.43	70% below	74%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$139.36	$536.00	$348.40–$399.86	—	74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$162.24	$624.00	$333.22–$475.49	60% below	74%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$162.24	$624.00	$405.60–$465.50	—	74%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI 1 CONTRAST	$225.68	$868.00	$463.51–$661.42	49% below	74%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI 1 CONTRAST	$225.68	$868.00	$564.20–$647.53	—	74%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+ VIEWS LT	$102.96	$396.00	$211.46–$301.75	50% below	74%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2+ VIEWS RT	$102.96	$396.00	$211.46–$301.75	50% below	74%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+ VIEWS RT	$102.96	$396.00	$257.40–$295.42	—	74%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2+ VIEWS LT	$102.96	$396.00	$257.40–$295.42	—	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX SCAN EXT VEINS UNI/LTD	$191.62	$737.00	$393.56–$561.59	61% below	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX EXT VEINS UNI/LTD LT	$191.62	$737.00	$393.56–$561.59	61% below	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC POCUS FOCUSED DVT STUDY LT	$191.62	$737.00	$393.56–$561.59	61% below	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC POCUS FOCUSED DVT STUDY RT	$191.62	$737.00	$393.56–$561.59	61% below	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX SCAN EXT VEINS UNI/LTD	$191.62	$737.00	$393.56–$561.59	61% below	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX SCAN EXT VEINS UNI/LTD	$191.62	$737.00	$479.05–$549.80	—	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC POCUS FOCUSED DVT STUDY LT	$191.62	$737.00	$479.05–$549.80	—	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC POCUS FOCUSED DVT STUDY RT	$191.62	$737.00	$479.05–$549.80	—	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX EXT VEINS UNI/LTD LT	$191.62	$737.00	$479.05–$549.80	—	74%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX SCAN EXT VEINS UNI/LTD	$191.62	$737.00	$479.05–$549.80	—	74%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT	$89.44	$344.00	$183.70–$262.13	61% below	74%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	56% below	74%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT	$89.44	$344.00	$223.60–$256.62	—	74%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3+ VIEWS RT	$103.48	$398.00	$212.53–$303.28	53% below	74%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3+ VIEWS LT	$103.48	$398.00	$212.53–$303.28	53% below	74%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3+ VIEWS LT	$103.48	$398.00	$258.70–$296.91	—	74%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3+ VIEWS RT	$103.48	$398.00	$258.70–$296.91	—	74%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI 2-3 VIEWS LEFT	$101.92	$392.00	$209.33–$298.70	50% below	74%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNI 2-3 VIEWS RIGHT	$101.92	$392.00	$209.33–$298.70	50% below	74%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNI 2-3 VIEWS RIGHT	$101.92	$392.00	$254.80–$292.43	—	74%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNI 2-3 VIEWS LEFT	$101.92	$392.00	$254.80–$292.43	—	74%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN SINGLE AP VIEWS	$101.14	$389.00	$207.73–$296.42	52% below	74%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN SINGLE AP VIEWS	$101.14	$389.00	$252.85–$290.19	—	74%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$69.16	$266.00	$142.04–$202.69	67% below	74%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$86.58	$333.00	$177.82–$253.75	58% below	74%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT	$69.16	$266.00	$172.90–$198.44	—	74%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT	$86.58	$333.00	$216.45–$248.42	—	74%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS 2+ VIEWS RT	$100.62	$387.00	$206.66–$294.89	49% below	74%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGERS 2+ VIEWS LT	$100.62	$387.00	$206.66–$294.89	49% below	74%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS 2+ VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS 2+ VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	50% below	74%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	50% below	74%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3+ VIEWS LT	$103.48	$398.00	$212.53–$303.28	51% below	74%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3+ VIEWS RT	$103.48	$398.00	$212.53–$303.28	51% below	74%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3+ VIEWS LT	$103.48	$398.00	$258.70–$296.91	—	74%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3+ VIEWS RT	$103.48	$398.00	$258.70–$296.91	—	74%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3+ VIEWS LT	$113.88	$438.00	$233.89–$333.76	48% below	74%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3+ VIEWS RT	$113.88	$438.00	$233.89–$333.76	48% below	74%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3+ VIEWS LT	$113.88	$438.00	$284.70–$326.75	—	74%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3+ VIEWS RT	$113.88	$438.00	$284.70–$326.75	—	74%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS LT	$100.62	$387.00	$206.66–$294.89	54% below	74%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2 VIEWS RT	$100.62	$387.00	$206.66–$294.89	54% below	74%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS RT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS LT	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L/S SPINE 2-3 VIEWS	$121.68	$468.00	$249.91–$356.62	50% below	74%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L/S SPINE 2-3 VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
X-ray of the lower back, 4 or more views CPT 72110 XR L/S SPINE 4+ VIEWS	$136.50	$525.00	$280.35–$400.05	58% below	74%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L/S SPINE 4+ VIEWS	$136.50	$525.00	$341.25–$391.65	—	74%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$121.68	$468.00	$249.91–$356.62	46% below	74%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3+ VIEWS	$100.62	$387.00	$206.66–$294.89	56% below	74%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3+ VIEWS	$100.62	$387.00	$251.55–$288.70	—	74%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERV SPINE 2 OR 3 VIEWS	$104.52	$402.00	$214.67–$306.32	51% below	74%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERV SPINE 2 OR 3 VIEWS	$104.52	$402.00	$261.30–$299.89	—	74%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VIEWS	$121.68	$468.00	$249.91–$356.62	42% below	74%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2 VIEWS	$121.68	$468.00	$304.20–$349.13	—	74%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2+ VIEWS	$100.62	$387.00	$206.66–$294.89	56% below	74%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2+ VIEWS	$100.62	$387.00	$251.55–$288.70	—	74%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
ACTH blood test CPT 82024 ACTH/LAB	$92.30	$355.00	$189.57–$270.51	42% below	74%
ACTH blood test inpatient CPT 82024 ACTH/LAB	$92.30	$355.00	$230.75–$264.83	—	74%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SPGT	$16.90	$65.00	$34.71–$49.53	50% below	74%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO	$16.90	$65.00	$34.71–$49.53	50% below	74%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE-Q	$16.90	$65.00	$34.71–$49.53	50% below	74%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE-Q	$16.90	$65.00	$42.25–$48.49	—	74%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO	$16.90	$65.00	$42.25–$48.49	—	74%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SPGT	$16.90	$65.00	$42.25–$48.49	—	74%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST OR SGOT	$12.22	$47.00	$25.10–$35.81	60% below	74%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE-Q	$12.22	$47.00	$25.10–$35.81	60% below	74%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$12.22	$47.00	$25.10–$35.81	60% below	74%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE-Q	$12.22	$47.00	$30.55–$35.06	—	74%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST OR SGOT	$12.22	$47.00	$30.55–$35.06	—	74%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$12.22	$47.00	$30.55–$35.06	—	74%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$70.20	$270.00	$144.18–$205.74	56% below	74%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$70.20	$270.00	$175.50–$201.42	—	74%
Albumin blood test CPT 82040 ALBUMIN SERUM	$9.88	$38.00	$20.29–$28.96	57% below	74%
Albumin blood test CPT 82040 ALBUMIN	$9.88	$38.00	$20.29–$28.96	57% below	74%
Albumin blood test CPT 82040 ALBUMIN LEVEL-Q	$9.88	$38.00	$20.29–$28.96	57% below	74%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$9.88	$38.00	$24.70–$28.35	—	74%
Albumin blood test inpatient CPT 82040 ALBUMIN LEVEL-Q	$9.88	$38.00	$24.70–$28.35	—	74%
Albumin blood test inpatient CPT 82040 ALBUMIN	$9.88	$38.00	$24.70–$28.35	—	74%
Aldosterone blood test CPT 82088 ALDOSTERONE	$42.12	$162.00	$86.51–$123.44	73% below	74%
Aldosterone blood test CPT 82088 ALDOSTERONE/LAB	$42.12	$162.00	$86.51–$123.44	73% below	74%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$42.12	$162.00	$105.30–$120.85	—	74%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE/LAB	$42.12	$162.00	$105.30–$120.85	—	74%
Alkaline phosphatase (ALP) blood test CPT 84075 BONE SPECIFIC ALKALINE PHOS	$13.00	$50.00	$26.70–$38.10	53% below	74%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$13.00	$50.00	$26.70–$38.10	53% below	74%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE-Q	$13.00	$50.00	$26.70–$38.10	53% below	74%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS ISO TOTAL	$13.00	$50.00	$26.70–$38.10	53% below	74%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS ISO TOTAL	$13.00	$50.00	$32.50–$37.30	—	74%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 BONE SPECIFIC ALKALINE PHOS	$13.00	$50.00	$32.50–$37.30	—	74%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$13.00	$50.00	$32.50–$37.30	—	74%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE-Q	$13.00	$50.00	$32.50–$37.30	—	74%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN EACH TEST	$10.40	$40.00	$21.36–$30.48	55% below	74%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS EACH/LAB	$10.40	$40.00	$21.36–$30.48	55% below	74%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS EACH/LAB	$10.40	$40.00	$26.00–$29.84	—	74%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN EACH TEST	$10.40	$40.00	$26.00–$29.84	—	74%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN	$36.14	$139.00	$74.23–$105.92	45% below	74%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP PROFILE 4	$36.14	$139.00	$74.23–$105.92	45% below	74%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER/LAB	$36.14	$139.00	$74.23–$105.92	45% below	74%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP PROFILE 4	$36.14	$139.00	$90.35–$103.69	—	74%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN	$36.14	$139.00	$90.35–$103.69	—	74%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP TUMOR MARKER/LAB	$36.14	$139.00	$90.35–$103.69	—	74%
Ammonia blood test CPT 82140 AMMONIA	$26.52	$102.00	$54.47–$77.72	71% below	74%
Ammonia blood test CPT 82140 STONE ANALYSIS AMMONIA	$26.52	$102.00	$54.47–$77.72	71% below	74%
Ammonia blood test inpatient CPT 82140 STONE ANALYSIS AMMONIA	$26.52	$102.00	$66.30–$76.09	—	74%
Ammonia blood test inpatient CPT 82140 AMMONIA	$26.52	$102.00	$66.30–$76.09	—	74%
Amylase blood test CPT 82150 AMYLASE BODY FLUID-Q	$23.14	$89.00	$47.53–$67.82	44% below	74%
Amylase blood test CPT 82150 AMYLASE LEVEL-Q	$23.14	$89.00	$47.53–$67.82	44% below	74%
Amylase blood test CPT 82150 AMYLASE	$23.14	$89.00	$47.53–$67.82	44% below	74%
Amylase blood test CPT 82150 AMYLASE LEVEL RANDOM URINE-Q	$23.14	$89.00	$47.53–$67.82	44% below	74%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID-Q	$23.14	$89.00	$57.85–$66.39	—	74%
Amylase blood test inpatient CPT 82150 AMYLASE LEVEL-Q	$23.14	$89.00	$57.85–$66.39	—	74%
Amylase blood test inpatient CPT 82150 AMYLASE	$23.14	$89.00	$57.85–$66.39	—	74%
Amylase blood test inpatient CPT 82150 AMYLASE LEVEL RANDOM URINE-Q	$23.14	$89.00	$57.85–$66.39	—	74%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULINATED PEPTIDE	$28.86	$111.00	$59.27–$84.58	60% below	74%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$28.86	$111.00	$59.27–$84.58	60% below	74%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULINATED PEPTIDE	$28.86	$111.00	$72.15–$82.81	—	74%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$28.86	$111.00	$72.15–$82.81	—	74%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUALITATIVE SCREEN	$33.80	$130.00	$69.42–$99.06	39% below	74%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA QUALITATIVE SCREEN	$33.80	$130.00	$84.50–$96.98	—	74%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$94.64	$364.00	$194.38–$277.37	40% below	74%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$94.64	$364.00	$236.60–$271.54	—	74%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIA CULTURE OTHER SOURCE	$25.48	$98.00	$52.33–$74.68	53% below	74%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIA CULTURE OTHER SOURCE	$25.48	$98.00	$63.70–$73.11	—	74%
Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA	$50.18	$193.00	$103.06–$147.07	36% below	74%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL-Q	$50.18	$193.00	$103.06–$147.07	36% below	74%
Basic metabolic panel (blood test) inpatient CPT 80048 METABOLIC PANEL TOTAL CA	$50.18	$193.00	$125.45–$143.98	—	74%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL-Q	$50.18	$193.00	$125.45–$143.98	—	74%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL-Q	$20.80	$80.00	$42.72–$60.96	33% below	74%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$20.80	$80.00	$42.72–$60.96	33% below	74%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL-Q	$20.80	$80.00	$52.00–$59.68	—	74%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$20.80	$80.00	$52.00–$59.68	—	74%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 RENAL BIOPSY LEVEL IV	$101.92	$392.00	$209.33–$298.70	26% below	74%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 RENAL BIOPSY LEVEL IV	$101.92	$392.00	$254.80–$292.43	—	74%
Blood culture for bacteria CPT 87040 AEROBIC BACTERIA CULTURE BLD	$48.88	$188.00	$100.39–$143.26	42% below	74%
Blood culture for bacteria inpatient CPT 87040 AEROBIC BACTERIA CULTURE BLD	$48.88	$188.00	$122.20–$140.25	—	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE	$5.98	$23.00	$12.28–$17.53	58% below	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE VENOUS	$9.62	$37.00	$19.76–$28.19	32% below	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$9.62	$37.00	$19.76–$28.19	32% below	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RH VENIPUNCTURE ROUTINE	$9.62	$37.00	$19.76–$28.19	32% below	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE	$9.62	$37.00	$19.76–$28.19	32% below	74%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$9.62	$37.00	$19.76–$28.19	32% below	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE	$5.98	$23.00	$14.95–$17.16	—	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$9.62	$37.00	$24.05–$27.60	—	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE VENOUS	$9.62	$37.00	$24.05–$27.60	—	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$9.62	$37.00	$24.05–$27.60	—	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE	$9.62	$37.00	$24.05–$27.60	—	74%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RH VENIPUNCTURE ROUTINE	$9.62	$37.00	$24.05–$27.60	—	74%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUAN BLOOD	$11.18	$43.00	$22.96–$32.77	52% below	74%
Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL-Q	$11.18	$43.00	$22.96–$32.77	52% below	74%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUAN BLOOD	$11.18	$43.00	$27.95–$32.08	—	74%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LEVEL-Q	$11.18	$43.00	$27.95–$32.08	—	74%
Blood lead test CPT 83655 LEAD URINE	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test CPT 83655 LEAD BLOOD/LAB	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test CPT 83655 LEAD WHOLE BLOOD	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test CPT 83655 RH LEAD WHOLE BLOOD	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test CPT 83655 LEAD WHOLE BLOOD	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test CPT 83655 LEAD INDUSTRIAL EXP	$20.80	$80.00	$42.72–$60.96	54% below	74%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD	$20.80	$80.00	$52.00–$59.68	—	74%
Blood lead test inpatient CPT 83655 RH LEAD WHOLE BLOOD	$20.80	$80.00	$52.00–$59.68	—	74%
Blood lead test inpatient CPT 83655 LEAD WHOLE BLOOD	$20.80	$80.00	$52.00–$59.68	—	74%
Blood lead test inpatient CPT 83655 LEAD URINE	$20.80	$80.00	$52.00–$59.68	—	74%
Blood lead test inpatient CPT 83655 LEAD BLOOD/LAB	$20.80	$80.00	$52.00–$59.68	—	74%
Blood lead test inpatient CPT 83655 LEAD INDUSTRIAL EXP	$20.80	$80.00	$52.00–$59.68	—	74%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG QUALITATIVE-Q	$17.68	$68.00	$36.31–$51.82	59% below	74%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL	$17.68	$68.00	$36.31–$51.82	59% below	74%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM/LAB	$17.68	$68.00	$36.31–$51.82	59% below	74%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL	$17.68	$68.00	$44.20–$50.73	—	74%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM/LAB	$17.68	$68.00	$44.20–$50.73	—	74%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG QUALITATIVE-Q	$17.68	$68.00	$44.20–$50.73	—	74%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$141.44	$544.00	$290.50–$414.53	187% above	74%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$141.44	$544.00	$353.60–$405.82	—	74%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUAN	$8.32	$32.00	$17.09–$24.38	67% below	74%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN (BUN)-Q	$8.32	$32.00	$17.09–$24.38	67% below	74%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUAN	$8.32	$32.00	$20.80–$23.87	—	74%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN (BUN)-Q	$8.32	$32.00	$20.80–$23.87	—	74%
C-peptide blood test CPT 84681 C-PEPTIDE REACTIVITY	$42.64	$164.00	$87.58–$124.97	39% below	74%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE REACTIVITY	$42.64	$164.00	$106.60–$122.34	—	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN MG/L-Q	$16.12	$62.00	$33.11–$47.24	57% below	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$16.12	$62.00	$33.11–$47.24	57% below	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN/LAB	$16.12	$62.00	$33.11–$47.24	57% below	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$16.12	$62.00	$33.11–$47.24	57% below	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$16.12	$62.00	$40.30–$46.25	—	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$16.12	$62.00	$40.30–$46.25	—	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN/LAB	$16.12	$62.00	$40.30–$46.25	—	74%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN MG/L-Q	$16.12	$62.00	$40.30–$46.25	—	74%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$34.84	$134.00	$71.56–$102.11	66% below	74%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$34.84	$134.00	$87.10–$99.96	—	74%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$22.88	$88.00	$46.99–$67.06	65% below	74%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$22.88	$88.00	$57.20–$65.65	—	74%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN CA-125	$35.36	$136.00	$72.62–$103.63	59% below	74%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN CA-125	$35.36	$136.00	$88.40–$101.46	—	74%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID CEPHEID	$33.54	$129.00	$68.89–$98.30	62% below	74%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$33.54	$129.00	$68.89–$98.30	62% below	74%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID CEPHEID	$33.54	$129.00	$83.85–$96.23	—	74%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$33.54	$129.00	$83.85–$96.23	—	74%
Calcium blood test, total CPT 82310 CALCIUM LEVEL TOTAL-Q	$10.92	$42.00	$22.43–$32.00	61% below	74%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$10.92	$42.00	$22.43–$32.00	61% below	74%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$10.92	$42.00	$27.30–$31.33	—	74%
Calcium blood test, total inpatient CPT 82310 CALCIUM LEVEL TOTAL-Q	$10.92	$42.00	$27.30–$31.33	—	74%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$47.32	$182.00	$97.19–$138.68	46% below	74%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$47.32	$182.00	$118.30–$135.77	—	74%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB	$25.74	$99.00	$52.87–$75.44	47% below	74%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB	$25.74	$99.00	$64.35–$73.85	—	74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TMA THROAT/RECTAL	$36.66	$141.00	$75.29–$107.44	49% below	74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIFIED NA PROBE	$36.66	$141.00	$75.29–$107.44	49% below	74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TMA THROAT/RECTAL	$36.66	$141.00	$91.65–$105.19	—	74%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMPLIFIED NA PROBE	$36.66	$141.00	$91.65–$105.19	—	74%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$36.92	$142.00	$75.83–$108.20	50% below	74%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$36.92	$142.00	$92.30–$105.93	—	74%
Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF-Q	$28.34	$109.00	$58.21–$83.06	40% below	74%
Complete blood count (CBC) with differential CPT 85025 COMPLT CBC W PLT W AUTO DIFF	$28.34	$109.00	$58.21–$83.06	40% below	74%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLT CBC W PLT W AUTO DIFF	$28.34	$109.00	$70.85–$81.31	—	74%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF-Q	$28.34	$109.00	$70.85–$81.31	—	74%
Complete blood count (CBC), no differential CPT 85027 COMPLT AUTO CBC W PLT	$27.04	$104.00	$55.54–$79.25	13% below	74%
Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFFERENTIAL-Q	$27.04	$104.00	$55.54–$79.25	13% below	74%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFFERENTIAL-Q	$27.04	$104.00	$67.60–$77.58	—	74%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLT AUTO CBC W PLT	$27.04	$104.00	$67.60–$77.58	—	74%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$80.60	$310.00	$165.54–$236.22	23% below	74%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANL-Q	$80.60	$310.00	$165.54–$236.22	23% below	74%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANL-Q	$80.60	$310.00	$201.50–$231.26	—	74%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$80.60	$310.00	$201.50–$231.26	—	74%
Cortisol blood test, total CPT 82533 ACTH STIMULATION	$36.66	$141.00	$75.29–$107.44	48% below	74%
Cortisol blood test, total CPT 82533 CORTISOL PEDS COSYNTROPIN TEST	$36.66	$141.00	$75.29–$107.44	48% below	74%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$36.66	$141.00	$75.29–$107.44	48% below	74%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PEDS COSYNTROPIN TEST	$36.66	$141.00	$91.65–$105.19	—	74%
Cortisol blood test, total inpatient CPT 82533 ACTH STIMULATION	$36.66	$141.00	$91.65–$105.19	—	74%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$36.66	$141.00	$91.65–$105.19	—	74%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$16.12	$62.00	$33.11–$47.24	64% below	74%
Creatine kinase (CK) blood test, total CPT 82550 TOTAL CK (ARUP)	$16.12	$62.00	$33.11–$47.24	64% below	74%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL-Q	$16.12	$62.00	$33.11–$47.24	64% below	74%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL-Q	$16.12	$62.00	$40.30–$46.25	—	74%
Creatine kinase (CK) blood test, total inpatient CPT 82550 TOTAL CK (ARUP)	$16.12	$62.00	$40.30–$46.25	—	74%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$16.12	$62.00	$40.30–$46.25	—	74%
Creatinine blood test CPT 82565 CREATININE BLOOD	$9.88	$38.00	$20.29–$28.96	66% below	74%
Creatinine blood test CPT 82565 CREATININE SERUM-Q	$9.88	$38.00	$20.29–$28.96	66% below	74%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM-Q	$9.88	$38.00	$24.70–$28.35	—	74%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$9.88	$38.00	$24.70–$28.35	—	74%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY IGG	$32.50	$125.00	$66.75–$95.25	48% below	74%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY IGG	$32.50	$125.00	$81.25–$93.25	—	74%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUAN	$27.82	$107.00	$57.14–$81.53	61% below	74%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUAN	$27.82	$107.00	$69.55–$79.82	—	74%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE/LAB	$53.04	$204.00	$108.94–$155.45	41% below	74%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE/LAB	$53.04	$204.00	$132.60–$152.18	—	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG URINE SCREEN RAPID	$63.70	$245.00	$130.83–$186.69	34% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN RAPID	$70.72	$272.00	$145.25–$207.26	27% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG DETECT PANEL MECONIUM QUA	$70.72	$272.00	$145.25–$207.26	27% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MECONIUM PANEL/LAB	$70.72	$272.00	$145.25–$207.26	27% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG PANEL 9 SERUM	$70.72	$272.00	$145.25–$207.26	27% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHANOL LEVEL URINE-Q	$75.92	$292.00	$155.93–$222.50	22% below	74%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC ANTIDEPRESSANTS	$80.34	$309.00	$165.01–$235.46	17% below	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG URINE SCREEN RAPID	$63.70	$245.00	$159.25–$182.77	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG MECONIUM PANEL/LAB	$70.72	$272.00	$176.80–$202.91	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG DETECT PANEL MECONIUM QUA	$70.72	$272.00	$176.80–$202.91	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG PANEL 9 SERUM	$70.72	$272.00	$176.80–$202.91	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN RAPID	$70.72	$272.00	$176.80–$202.91	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL LEVEL URINE-Q	$75.92	$292.00	$189.80–$217.83	—	74%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLIC ANTIDEPRESSANTS	$80.34	$309.00	$200.85–$230.51	—	74%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYES-Q	$20.80	$80.00	$42.72–$60.96	59% below	74%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$20.80	$80.00	$42.72–$60.96	59% below	74%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$20.80	$80.00	$52.00–$59.68	—	74%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYES-Q	$20.80	$80.00	$52.00–$59.68	—	74%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB V.CAPSID AG	$33.28	$128.00	$68.35–$97.54	45% below	74%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB V.CAPSID AG	$33.28	$128.00	$83.20–$95.49	—	74%
Estradiol blood test CPT 82670 ESTRADIOL/LAB	$79.56	$306.00	$163.40–$233.17	22% below	74%
Estradiol blood test CPT 82670 ESTRADIOL	$79.56	$306.00	$163.40–$233.17	22% below	74%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$79.56	$306.00	$198.90–$228.28	—	74%
Estradiol blood test inpatient CPT 82670 ESTRADIOL/LAB	$79.56	$306.00	$198.90–$228.28	—	74%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN (FSH)	$65.26	$251.00	$134.03–$191.26	18% below	74%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN (FSH)	$65.26	$251.00	$163.15–$187.25	—	74%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN/LAB	$69.42	$267.00	$142.58–$203.45	55% below	74%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN/LAB	$69.42	$267.00	$173.55–$199.18	—	74%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$35.36	$136.00	$72.62–$103.63	53% below	74%
Ferritin blood test (iron stores) CPT 82728 FERRITIN/LAB	$35.36	$136.00	$72.62–$103.63	53% below	74%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$35.36	$136.00	$88.40–$101.46	—	74%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN/LAB	$35.36	$136.00	$88.40–$101.46	—	74%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$29.12	$112.00	$59.81–$85.34	52% below	74%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$29.12	$112.00	$72.80–$83.55	—	74%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$19.50	$75.00	$40.05–$57.15	74% below	74%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$19.50	$75.00	$48.75–$55.95	—	74%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$51.74	$199.00	$106.27–$151.64	40% below	74%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$51.74	$199.00	$129.35–$148.45	—	74%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4/LAB	$37.96	$146.00	$77.96–$111.25	37% below	74%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIRECT DIALYSIS	$37.96	$146.00	$77.96–$111.25	37% below	74%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$37.96	$146.00	$77.96–$111.25	37% below	74%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE DIRECT DIALYSIS	$37.96	$146.00	$94.90–$108.92	—	74%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$37.96	$146.00	$94.90–$108.92	—	74%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4/LAB	$37.96	$146.00	$94.90–$108.92	—	74%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$44.98	$173.00	$92.38–$131.83	56% below	74%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$44.98	$173.00	$112.45–$129.06	—	74%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE GAMMA	$13.52	$52.00	$27.77–$39.62	70% below	74%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE-Q	$13.52	$52.00	$27.77–$39.62	70% below	74%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE GAMMA	$13.52	$52.00	$33.80–$38.79	—	74%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE-Q	$13.52	$52.00	$33.80–$38.79	—	74%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$17.94	$69.00	$36.85–$52.58	52% below	74%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$17.94	$69.00	$44.85–$51.47	—	74%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE TEST-Q	$59.28	$228.00	$121.75–$173.74	7% below	74%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPECIMENS	$59.28	$228.00	$121.75–$173.74	7% below	74%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPECIMENS	$59.28	$228.00	$148.20–$170.09	—	74%
Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE TEST-Q	$59.28	$228.00	$148.20–$170.09	—	74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIFIED NA PROBE	$36.66	$141.00	$75.29–$107.44	44% below	74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NG BY TMA THROAT/RECTAL ONLY	$36.66	$141.00	$75.29–$107.44	44% below	74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA AMPLIFIED NA PROBE	$36.66	$141.00	$91.65–$105.19	—	74%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NG BY TMA THROAT/RECTAL ONLY	$36.66	$141.00	$91.65–$105.19	—	74%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB	$31.46	$121.00	$64.61–$92.20	59% below	74%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB	$31.46	$121.00	$78.65–$90.27	—	74%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL EIA DETECT	$68.64	$264.00	$140.98–$201.17	40% below	74%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI FECAL/LAB	$68.64	$264.00	$140.98–$201.17	40% below	74%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI FECAL/LAB	$68.64	$264.00	$171.60–$196.94	—	74%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL EIA DETECT	$68.64	$264.00	$171.60–$196.94	—	74%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANT/PCR	$156.78	$603.00	$322.00–$459.49	32% below	74%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANT/PCR	$156.78	$603.00	$391.95–$449.84	—	74%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 AND 2 AB SINGL RESULT	$15.34	$59.00	$31.51–$44.96	66% below	74%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 AND 2 AB SINGL RESULT	$15.34	$59.00	$38.35–$44.01	—	74%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV COMBO ANTIGEN/ANTIBODY REF	$36.66	$141.00	$75.29–$107.44	22% below	74%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG, HIV1 & HIV2 AB, SNGL	$36.66	$141.00	$75.29–$107.44	22% below	74%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV COMBO ANTIGEN/ANTIBODY REF	$36.66	$141.00	$91.65–$105.19	—	74%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG, HIV1 & HIV2 AB, SNGL	$36.66	$141.00	$91.65–$105.19	—	74%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPES	$34.58	$133.00	$71.02–$101.35	52% below	74%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPES	$34.58	$133.00	$86.45–$99.22	—	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HGB (A1C)	$36.14	$139.00	$74.23–$105.92	31% below	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$36.14	$139.00	$74.23–$105.92	31% below	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 RH GLYCOSYLATED HEMOGLOB TEST	$36.14	$139.00	$74.23–$105.92	31% below	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOB TEST	$36.14	$139.00	$74.23–$105.92	31% below	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 RH GLYCOSYLATED HEMOGLOB TEST	$36.14	$139.00	$90.35–$103.69	—	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$36.14	$139.00	$90.35–$103.69	—	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HGB (A1C)	$36.14	$139.00	$90.35–$103.69	—	74%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOB TEST	$36.14	$139.00	$90.35–$103.69	—	74%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$5.98	$23.00	$12.28–$17.53	61% below	74%
Hemoglobin blood test CPT 85018 HEMOGLOBIN-Q	$5.98	$23.00	$12.28–$17.53	61% below	74%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN	$5.98	$23.00	$12.28–$17.53	61% below	74%
Hemoglobin blood test CPT 85018 RH HEMOGLOBIN	$5.98	$23.00	$12.28–$17.53	61% below	74%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$5.98	$23.00	$14.95–$17.16	—	74%
Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN	$5.98	$23.00	$14.95–$17.16	—	74%
Hemoglobin blood test inpatient CPT 85018 RH HEMOGLOBIN	$5.98	$23.00	$14.95–$17.16	—	74%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN-Q	$5.98	$23.00	$14.95–$17.16	—	74%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE TOTAL AB	$24.70	$95.00	$50.73–$72.39	59% below	74%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE TOTAL AB	$24.70	$95.00	$61.75–$70.87	—	74%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB	$25.74	$99.00	$52.87–$75.44	49% below	74%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB	$25.74	$99.00	$64.35–$73.85	—	74%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AG DETECT	$20.54	$79.00	$42.19–$60.20	58% below	74%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF AG DETECT	$20.54	$79.00	$51.35–$58.93	—	74%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$29.12	$112.00	$59.81–$85.34	60% below	74%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$29.12	$112.00	$72.80–$83.55	—	74%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QUANT	$80.08	$308.00	$164.47–$234.70	54% below	74%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA QUANT	$80.08	$308.00	$200.20–$229.77	—	74%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$27.04	$104.00	$55.54–$79.25	49% below	74%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$27.04	$104.00	$67.60–$77.58	—	74%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$33.28	$128.00	$68.35–$97.54	53% below	74%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$33.28	$128.00	$83.20–$95.49	—	74%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENSITIVITY-Q	$31.98	$123.00	$65.68–$93.73	38% below	74%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY Q	$31.98	$123.00	$65.68–$93.73	38% below	74%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN HS	$31.98	$123.00	$65.68–$93.73	38% below	74%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY Q	$31.98	$123.00	$79.95–$91.76	—	74%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENSITIVITY-Q	$31.98	$123.00	$79.95–$91.76	—	74%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN HS	$31.98	$123.00	$79.95–$91.76	—	74%
Homocysteine blood test CPT 83090 HOMOCYSTINE ASSAY	$39.52	$152.00	$81.17–$115.82	46% below	74%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE ASSAY	$39.52	$152.00	$98.80–$113.39	—	74%
Insulin blood test CPT 83525 INSULIN/LAB	$36.92	$142.00	$75.83–$108.20	43% below	74%
Insulin blood test inpatient CPT 83525 INSULIN/LAB	$36.92	$142.00	$92.30–$105.93	—	74%
Iron blood test (serum iron) CPT 83540 IRON	$18.20	$70.00	$37.38–$53.34	52% below	74%
Iron blood test (serum iron) CPT 83540 IRON, LIVER TISSUE	$18.20	$70.00	$37.38–$53.34	52% below	74%
Iron blood test (serum iron) inpatient CPT 83540 IRON, LIVER TISSUE	$18.20	$70.00	$45.50–$52.22	—	74%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$18.20	$70.00	$45.50–$52.22	—	74%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$21.32	$82.00	$43.79–$62.48	47% below	74%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$21.32	$82.00	$53.30–$61.17	—	74%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL-Q	$20.54	$79.00	$42.19–$60.20	69% below	74%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$20.54	$79.00	$42.19–$60.20	69% below	74%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL-Q	$20.54	$79.00	$51.35–$58.93	—	74%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$20.54	$79.00	$51.35–$58.93	—	74%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUT HORMONE	$47.58	$183.00	$97.72–$139.45	44% below	74%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUT HORMONE	$47.58	$183.00	$118.95–$136.52	—	74%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$34.32	$132.00	$70.49–$100.58	41% below	74%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$34.32	$132.00	$85.80–$98.47	—	74%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LDH)-Q	$14.04	$54.00	$28.84–$41.15	61% below	74%
Lactate dehydrogenase (LDH) blood test CPT 83615 TOTAL LD (ARUP)	$14.04	$54.00	$28.84–$41.15	61% below	74%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID-Q	$14.04	$54.00	$28.84–$41.15	61% below	74%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$14.04	$54.00	$28.84–$41.15	61% below	74%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LDH)-Q	$14.04	$54.00	$35.10–$40.28	—	74%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID-Q	$14.04	$54.00	$35.10–$40.28	—	74%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$14.04	$54.00	$35.10–$40.28	—	74%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 TOTAL LD (ARUP)	$14.04	$54.00	$35.10–$40.28	—	74%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL-Q	$26.52	$102.00	$54.47–$77.72	43% below	74%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$26.52	$102.00	$54.47–$77.72	43% below	74%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$26.52	$102.00	$66.30–$76.09	—	74%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL-Q	$26.52	$102.00	$66.30–$76.09	—	74%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$30.94	$119.00	$63.55–$90.68	63% below	74%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL-Q	$30.94	$119.00	$63.55–$90.68	63% below	74%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL-Q	$30.94	$119.00	$77.35–$88.77	—	74%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$30.94	$119.00	$77.35–$88.77	—	74%
Lyme disease antibody test CPT 86618 BORRELIA AB (LYME)	$41.08	$158.00	$84.37–$120.40	47% below	74%
Lyme disease antibody test CPT 86618 LYME DISEASE CSF/LAB	$41.08	$158.00	$84.37–$120.40	47% below	74%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE CSF/LAB	$41.08	$158.00	$102.70–$117.87	—	74%
Lyme disease antibody test inpatient CPT 86618 BORRELIA AB (LYME)	$41.08	$158.00	$102.70–$117.87	—	74%
Magnesium blood test CPT 83735 MAGNESIUM URINE RANDOM COLCT-Q	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test CPT 83735 STONE ANALYSIS MAGNESIUM	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test CPT 83735 MAGNESIUM RBC/LAB	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test CPT 83735 MAGNESIUM	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL-Q	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test CPT 83735 MAGNESIUM URINE TIMED-Q	$27.82	$107.00	$57.14–$81.53	31% below	74%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE TIMED-Q	$27.82	$107.00	$69.55–$79.82	—	74%
Magnesium blood test inpatient CPT 83735 STONE ANALYSIS MAGNESIUM	$27.82	$107.00	$69.55–$79.82	—	74%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC/LAB	$27.82	$107.00	$69.55–$79.82	—	74%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$27.82	$107.00	$69.55–$79.82	—	74%
Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL-Q	$27.82	$107.00	$69.55–$79.82	—	74%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE RANDOM COLCT-Q	$27.82	$107.00	$69.55–$79.82	—	74%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM ANTIBOD	$19.50	$75.00	$40.05–$57.15	45% below	74%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$19.50	$75.00	$40.05–$57.15	45% below	74%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM ANTIBOD	$19.50	$75.00	$48.75–$55.95	—	74%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$19.50	$75.00	$48.75–$55.95	—	74%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE AB MONOSPOT	$23.40	$90.00	$48.06–$68.58	35% below	74%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREENING/LAB	$23.40	$90.00	$48.06–$68.58	35% below	74%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCRN	$23.40	$90.00	$48.06–$68.58	35% below	74%
Mono test (heterophile antibody, Monospot) CPT 86308 RH HETEROPHILE AB SCREENING	$23.40	$90.00	$48.06–$68.58	35% below	74%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREENING	$23.40	$90.00	$48.06–$68.58	35% below	74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREENING	$23.40	$90.00	$58.50–$67.14	—	74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE AB MONOSPOT	$23.40	$90.00	$58.50–$67.14	—	74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCRN	$23.40	$90.00	$58.50–$67.14	—	74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREENING/LAB	$23.40	$90.00	$58.50–$67.14	—	74%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 RH HETEROPHILE AB SCREENING	$23.40	$90.00	$58.50–$67.14	—	74%
Mumps immunity blood test CPT 86735 MUMPS AB	$22.36	$86.00	$45.92–$65.53	40% below	74%
Mumps immunity blood test CPT 86735 MUMPS IGM/LAB	$22.36	$86.00	$45.92–$65.53	40% below	74%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGM/LAB	$22.36	$86.00	$55.90–$64.16	—	74%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$22.36	$86.00	$55.90–$64.16	—	74%
Obstetric blood test panel CPT 80055 PRENATAL PROFILE	$123.76	$476.00	$254.18–$362.71	13% below	74%
Obstetric blood test panel inpatient CPT 80055 PRENATAL PROFILE	$123.76	$476.00	$309.40–$355.10	—	74%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$40.30	$155.00	$82.77–$118.11	57% below	74%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$40.30	$155.00	$100.75–$115.63	—	74%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (PART OF PSA FREE)	$36.40	$140.00	$74.76–$106.68	49% below	74%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$36.40	$140.00	$74.76–$106.68	49% below	74%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$36.40	$140.00	$91.00–$104.44	—	74%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (PART OF PSA FREE)	$36.40	$140.00	$91.00–$104.44	—	74%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$26.00	$100.00	$53.40–$76.20	60% below	74%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$26.00	$100.00	$65.00–$74.60	—	74%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CP CERV/VAG ATL MANUAL SCRN	$35.88	$138.00	$73.69–$105.16	49% below	74%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CP CERV/VAG ATL MANUAL SCRN	$35.88	$138.00	$89.70–$102.95	—	74%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$56.94	$219.00	$116.95–$166.88	42% below	74%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$56.94	$219.00	$142.35–$163.37	—	74%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$16.12	$62.00	$33.11–$47.24	63% below	74%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$16.12	$62.00	$33.11–$47.24	63% below	74%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$16.12	$62.00	$40.30–$46.25	—	74%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$16.12	$62.00	$40.30–$46.25	—	74%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE	$10.40	$40.00	$21.36–$30.48	63% below	74%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL-Q	$10.40	$40.00	$21.36–$30.48	63% below	74%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS LEVEL-Q	$10.40	$40.00	$26.00–$29.84	—	74%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE	$10.40	$40.00	$26.00–$29.84	—	74%
Potassium blood test CPT 84132 POTASSIUM LEVEL-Q	$7.80	$30.00	$16.02–$22.86	68% below	74%
Potassium blood test CPT 84132 POTASSIUM SERUM	$7.80	$30.00	$16.02–$22.86	68% below	74%
Potassium blood test inpatient CPT 84132 POTASSIUM LEVEL-Q	$7.80	$30.00	$19.50–$22.38	—	74%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$7.80	$30.00	$19.50–$22.38	—	74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NON-INVAS FETAL TST ANEUPLOIDY	$1,055.08	$4,058.00	$2,166.97–$3,092.20	1% above	74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$1,055.08	$4,058.00	$2,166.97–$3,092.20	1% above	74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NON-INVAS FETAL TST ANEUPLOIDY	$1,055.08	$4,058.00	$2,637.70–$3,027.27	—	74%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY	$1,055.08	$4,058.00	$2,637.70–$3,027.27	—	74%
Progesterone blood test CPT 84144 PROGESTERONE ASSAY	$57.98	$223.00	$119.08–$169.93	35% below	74%
Progesterone blood test inpatient CPT 84144 PROGESTERONE ASSAY	$57.98	$223.00	$144.95–$166.36	—	74%
Prolactin blood test CPT 84146 PROLACTIN DILUTION STUDY	$39.52	$152.00	$81.17–$115.82	47% below	74%
Prolactin blood test CPT 84146 PROLACTIN ASSAY	$39.52	$152.00	$81.17–$115.82	47% below	74%
Prolactin blood test inpatient CPT 84146 PROLACTIN DILUTION STUDY	$39.52	$152.00	$98.80–$113.39	—	74%
Prolactin blood test inpatient CPT 84146 PROLACTIN ASSAY	$39.52	$152.00	$98.80–$113.39	—	74%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$9.36	$36.00	$19.22–$27.43	68% below	74%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$9.36	$36.00	$23.40–$26.86	—	74%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN MULTI DRUG CLASS	$16.12	$62.00	$33.11–$47.24	38% below	74%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRESUMP OPTICAL	$16.12	$62.00	$33.11–$47.24	38% below	74%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN MULTI DRUG CLASS	$16.12	$62.00	$40.30–$46.25	—	74%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRESUMP OPTICAL	$16.12	$62.00	$40.30–$46.25	—	74%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY RAPID STREP	$15.60	$60.00	$32.04–$45.72	60% below	74%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$16.38	$63.00	$33.64–$48.01	58% below	74%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY RAPID STREP	$15.60	$60.00	$39.00–$44.76	—	74%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$16.38	$63.00	$40.95–$47.00	—	74%
Renin blood test CPT 84244 RENIN	$27.04	$104.00	$55.54–$79.25	63% below	74%
Renin blood test CPT 84244 RENIN 1/LAB	$27.04	$104.00	$55.54–$79.25	63% below	74%
Renin blood test inpatient CPT 84244 RENIN	$27.04	$104.00	$67.60–$77.58	—	74%
Renin blood test inpatient CPT 84244 RENIN 1/LAB	$27.04	$104.00	$67.60–$77.58	—	74%
Rh blood typing CPT 86901 BLOOD TYPING RH	$44.46	$171.00	$91.31–$130.30	22% above	74%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH	$44.46	$171.00	$111.15–$127.57	—	74%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN	$11.44	$44.00	$23.50–$33.53	66% below	74%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$11.44	$44.00	$23.50–$33.53	66% below	74%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$11.44	$44.00	$23.50–$33.53	66% below	74%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$11.44	$44.00	$28.60–$32.82	—	74%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN	$11.44	$44.00	$28.60–$32.82	—	74%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$11.44	$44.00	$28.60–$32.82	—	74%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$27.82	$107.00	$57.14–$81.53	45% below	74%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$27.82	$107.00	$57.14–$81.53	45% below	74%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$27.82	$107.00	$69.55–$79.82	—	74%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$27.82	$107.00	$69.55–$79.82	—	74%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE (ESR)-Q	$14.82	$57.00	$30.44–$43.43	50% below	74%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE (ESR)-Q	$14.82	$57.00	$37.05–$42.52	—	74%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VOL/COUNT/MOT	$14.82	$57.00	$30.44–$43.43	82% below	74%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANAL VOL/COUNT/MOT	$14.82	$57.00	$37.05–$42.52	—	74%
Sodium blood test CPT 84295 SODIUM LEVEL-Q	$7.54	$29.00	$15.49–$22.10	68% below	74%
Sodium blood test CPT 84295 SODIUM SERUM	$7.54	$29.00	$15.49–$22.10	68% below	74%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$7.54	$29.00	$18.85–$21.63	—	74%
Sodium blood test inpatient CPT 84295 SODIUM LEVEL-Q	$7.54	$29.00	$18.85–$21.63	—	74%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIR SMEAR W ID	$13.78	$53.00	$28.30–$40.39	63% below	74%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIR SMEAR W ID	$13.78	$53.00	$34.45–$39.54	—	74%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES	$3.90	$15.00	$8.01–$11.43	81% below	74%
Stool test for hidden blood (guaiac FOBT) CPT 82270 POCT BLOOD OCCULT FECES SCREEN	$3.90	$15.00	$8.01–$11.43	81% below	74%
Stool test for hidden blood (guaiac FOBT) CPT 82270 RH BLOOD OCCULT FECES SCREEN	$3.90	$15.00	$8.01–$11.43	81% below	74%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT FECES SCREENING	$3.90	$15.00	$8.01–$11.43	81% below	74%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT FECES SCREENING	$3.90	$15.00	$9.75–$11.19	—	74%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 POCT BLOOD OCCULT FECES SCREEN	$3.90	$15.00	$9.75–$11.19	—	74%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 RH BLOOD OCCULT FECES SCREEN	$3.90	$15.00	$9.75–$11.19	—	74%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES	$3.90	$15.00	$9.75–$11.19	—	74%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD OCCULT FHG QUAL 1-3	$21.84	$84.00	$44.86–$64.01	46% below	74%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLOOD OCCULT FHG QUAL 1-3	$21.84	$84.00	$54.60–$62.66	—	74%
Syphilis antibody test (Treponema pallidum) CPT 86780 RPR-FTA-ABS/LAB	$16.90	$65.00	$34.71–$49.53	68% below	74%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$16.90	$65.00	$34.71–$49.53	68% below	74%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 RPR-FTA-ABS/LAB	$16.90	$65.00	$42.25–$48.49	—	74%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$16.90	$65.00	$42.25–$48.49	—	74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL/LAB	$21.84	$84.00	$44.86–$64.01	30% below	74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR/LAB	$21.84	$84.00	$44.86–$64.01	30% below	74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL/LAB	$21.84	$84.00	$54.60–$62.66	—	74%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR/LAB	$21.84	$84.00	$54.60–$62.66	—	74%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB QUANTIFERON GOLD/LAB	$91.78	$353.00	$188.50–$268.99	22% below	74%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB QUANTIFERON GOLD/LAB	$91.78	$353.00	$229.45–$263.34	—	74%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$55.90	$215.00	$114.81–$163.83	39% below	74%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTERONE TOTAL	$55.90	$215.00	$114.81–$163.83	39% below	74%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTERONE TOTAL	$55.90	$215.00	$139.75–$160.39	—	74%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$55.90	$215.00	$139.75–$160.39	—	74%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AUTOANTIBODY	$43.94	$169.00	$90.25–$128.78	49% below	74%
Thyroid peroxidase (TPO) antibody test CPT 86376 NK CELLS TOTAL COUNT	$43.94	$169.00	$90.25–$128.78	49% below	74%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 NK CELLS TOTAL COUNT	$43.94	$169.00	$109.85–$126.07	—	74%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AUTOANTIBODY	$43.94	$169.00	$109.85–$126.07	—	74%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$60.32	$232.00	$123.89–$176.78	23% below	74%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/LAB	$60.32	$232.00	$123.89–$176.78	23% below	74%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$60.32	$232.00	$150.80–$173.07	—	74%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH/LAB	$60.32	$232.00	$150.80–$173.07	—	74%
Total IgE blood test CPT 82785 IGE	$32.50	$125.00	$66.75–$95.25	49% below	74%
Total IgE blood test inpatient CPT 82785 IGE	$32.50	$125.00	$81.25–$93.25	—	74%
Total cholesterol blood test CPT 82465 CHOLESTEROL (LDL SUBCLASS)/LAB	$11.96	$46.00	$24.56–$35.05	51% below	74%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL-Q	$11.96	$46.00	$24.56–$35.05	51% below	74%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM/WB TOTAL	$11.96	$46.00	$24.56–$35.05	51% below	74%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM/WB TOTAL	$11.96	$46.00	$29.90–$34.32	—	74%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL (LDL SUBCLASS)/LAB	$11.96	$46.00	$29.90–$34.32	—	74%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL-Q	$11.96	$46.00	$29.90–$34.32	—	74%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$36.66	$141.00	$75.29–$107.44	25% below	74%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$36.66	$141.00	$91.65–$105.19	—	74%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$33.28	$128.00	$68.35–$97.54	60% below	74%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$33.28	$128.00	$83.20–$95.49	—	74%
Transferrin blood test CPT 84466 TRANSFERRIN/LAB	$28.08	$108.00	$57.67–$82.30	52% below	74%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN/LAB	$28.08	$108.00	$70.20–$80.57	—	74%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS BY PCR/LAB	$38.48	$148.00	$79.03–$112.78	57% below	74%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$38.48	$148.00	$79.03–$112.78	57% below	74%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS BY PCR/LAB	$38.48	$148.00	$96.20–$110.41	—	74%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$38.48	$148.00	$96.20–$110.41	—	74%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$12.48	$48.00	$25.63–$36.58	72% below	74%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$12.48	$48.00	$31.20–$35.81	—	74%
Troponin test, quantitative CPT 84484 TROPONIN QUAN	$52.26	$201.00	$107.33–$153.16	35% below	74%
Troponin test, quantitative CPT 84484 TROPONIN T HS (RANDOM)-Q	$52.26	$201.00	$107.33–$153.16	35% below	74%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN	$52.26	$201.00	$130.65–$149.95	—	74%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T HS (RANDOM)-Q	$52.26	$201.00	$130.65–$149.95	—	74%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$15.34	$59.00	$31.51–$44.96	51% below	74%
Uric acid blood test CPT 84550 URIC ACID-Q	$15.34	$59.00	$31.51–$44.96	51% below	74%
Uric acid blood test inpatient CPT 84550 URIC ACID-Q	$15.34	$59.00	$38.35–$44.01	—	74%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$15.34	$59.00	$38.35–$44.01	—	74%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS REFLEX TO CULTURE-Q	$11.70	$45.00	$24.03–$34.29	66% below	74%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS REFLEX TO CULTURE-Q	$11.70	$45.00	$29.25–$33.57	—	74%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE-Q	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 PH URINE-Q	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC-Q	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/MICROSCOPIC-Q	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated CPT 81003 RH URINE ALYSIS AUTO W/O SCOPE	$9.10	$35.00	$18.69–$26.67	58% below	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/MICROSCOPIC-Q	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 RH URINE ALYSIS AUTO W/O SCOPE	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO MICRO	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 PH URINE-Q	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE-Q	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC-Q	$9.10	$35.00	$22.75–$26.11	—	74%
Urinalysis without microscope exam, manual CPT 81002 POCT URINALYS NONAUTO WO MICRO	$3.38	$13.00	$6.94–$9.91	79% below	74%
Urinalysis without microscope exam, manual CPT 81002 N-AUTOM URINALYS WO MICRO	$3.38	$13.00	$6.94–$9.91	79% below	74%
Urinalysis without microscope exam, manual CPT 81002 RH POCT URINE NONAUTO WO MICRO	$3.38	$13.00	$6.94–$9.91	79% below	74%
Urinalysis without microscope exam, manual CPT 81002 HC UA NONAUTO W/O SCOPE	$3.38	$13.00	$6.94–$9.91	79% below	74%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO WO MICRO	$3.38	$13.00	$6.94–$9.91	79% below	74%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO WO MICRO	$3.38	$13.00	$8.45–$9.70	—	74%
Urinalysis without microscope exam, manual inpatient CPT 81002 POCT URINALYS NONAUTO WO MICRO	$3.38	$13.00	$8.45–$9.70	—	74%
Urinalysis without microscope exam, manual inpatient CPT 81002 N-AUTOM URINALYS WO MICRO	$3.38	$13.00	$8.45–$9.70	—	74%
Urinalysis without microscope exam, manual inpatient CPT 81002 RH POCT URINE NONAUTO WO MICRO	$3.38	$13.00	$8.45–$9.70	—	74%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC UA NONAUTO W/O SCOPE	$3.38	$13.00	$8.45–$9.70	—	74%
Urine culture for bacteria, with colony count CPT 87086 BC URINE QUAN COLONY COUNT	$36.14	$139.00	$74.23–$105.92	44% below	74%
Urine culture for bacteria, with colony count inpatient CPT 87086 BC URINE QUAN COLONY COUNT	$36.14	$139.00	$90.35–$103.69	—	74%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE RNDM CLCT-Q	$23.40	$90.00	$48.06–$68.58	54% below	74%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE QUAN	$23.40	$90.00	$48.06–$68.58	54% below	74%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE TIMED-Q	$23.40	$90.00	$48.06–$68.58	54% below	74%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE RNDM CLCT-Q	$23.40	$90.00	$58.50–$67.14	—	74%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE QUAN	$23.40	$90.00	$58.50–$67.14	—	74%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE TIMED-Q	$23.40	$90.00	$58.50–$67.14	—	74%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE/LAB	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 URINE PREGN VISUAL COLOR	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 POCT URINE PREGN VISUAL COLOR	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 RH POCT URINE PREGN VIS COLOR	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL COLOR	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change CPT 81025 BETA HCG QUALITATIVE URINE-Q	$15.08	$58.00	$30.97–$44.20	46% below	74%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 BETA HCG QUALITATIVE URINE-Q	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL COLOR	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE/LAB	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 RH POCT URINE PREGN VIS COLOR	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 POCT URINE PREGN VISUAL COLOR	$15.08	$58.00	$37.70–$43.27	—	74%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGN VISUAL COLOR	$15.08	$58.00	$37.70–$43.27	—	74%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$20.80	$80.00	$42.72–$60.96	76% below	74%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 REFLEX	$20.80	$80.00	$42.72–$60.96	76% below	74%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$20.80	$80.00	$52.00–$59.68	—	74%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 REFLEX	$20.80	$80.00	$52.00–$59.68	—	74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 AND D3 LCMS/LAB	$52.00	$200.00	$106.80–$152.40	54% below	74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY/LAB	$52.00	$200.00	$106.80–$152.40	54% below	74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 AND D3 LCMS/LAB	$52.00	$200.00	$130.00–$149.20	—	74%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY/LAB	$52.00	$200.00	$130.00–$149.20	—	74%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25-DIHYDROXY/LAB	$72.54	$279.00	$148.99–$212.60	45% below	74%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25-DIHYDROXY/LAB	$72.54	$279.00	$181.35–$208.13	—	74%
Zinc blood test CPT 84630 ZINC	$27.82	$107.00	$57.14–$81.53	34% below	74%
Zinc blood test CPT 84630 ZINC/LAB	$27.82	$107.00	$57.14–$81.53	34% below	74%
Zinc blood test inpatient CPT 84630 ZINC	$27.82	$107.00	$69.55–$79.82	—	74%
Zinc blood test inpatient CPT 84630 ZINC/LAB	$27.82	$107.00	$69.55–$79.82	—	74%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE SERUM-Q	$35.36	$136.00	$72.62–$103.63	57% below	74%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG	$35.36	$136.00	$72.62–$103.63	57% below	74%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTRPIN CHORIONIC HCG QUAN	$35.36	$136.00	$72.62–$103.63	57% below	74%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG	$35.36	$136.00	$88.40–$101.46	—	74%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE SERUM-Q	$35.36	$136.00	$88.40–$101.46	—	74%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTRPIN CHORIONIC HCG QUAN	$35.36	$136.00	$88.40–$101.46	—	74%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Botox injections for chronic migraine CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$249.60	$960.00	$512.64–$731.52	18% above	74%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE/MIP	$249.60	$960.00	$512.64–$731.52	18% above	74%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE/MIP	$249.60	$960.00	$624.00–$716.16	—	74%
Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODENERV MUSC MIGRAINE	$249.60	$960.00	$624.00–$716.16	—	74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LSN STRTCTC-RT	$1,324.18	$5,093.00	$2,719.66–$3,880.87	29% below	74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LSN STRTCTC-LT	$1,324.18	$5,093.00	$2,719.66–$3,880.87	29% below	74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LSN STRTCTC-LT	$1,324.18	$5,093.00	$3,310.45–$3,799.38	—	74%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LSN STRTCTC-RT	$1,324.18	$5,093.00	$3,310.45–$3,799.38	—	74%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$260.78	$1,003.00	$535.60–$764.29	6% below	74%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX FX ANKLE DIST CLOSED	$313.04	$1,204.00	$642.94–$917.45	13% above	74%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CL TX DSTL FIB FX WO MANIP	$260.78	$1,003.00	$651.95–$748.24	—	74%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TX FX ANKLE DIST CLOSED	$313.04	$1,204.00	$782.60–$898.18	—	74%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX FX METATARSAL CLOSED	$199.16	$766.00	$409.04–$583.69	18% below	74%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TX FX METATARSAL CLOSED	$199.16	$766.00	$497.90–$571.44	—	74%
Cardiac catheterization with coronary angiogram CPT 93458 LT HT/COR CTH W L VEN/COR ANG	$1,857.18	$7,143.00	$3,814.36–$5,442.97	52% below	74%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LT HT/COR CTH W L VEN/COR ANG	$1,857.18	$7,143.00	$4,642.95–$5,328.68	—	74%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXT ELECTIVE	$718.64	$2,764.00	$1,475.98–$2,106.17	47% above	74%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$862.42	$3,317.00	$1,771.28–$2,527.55	77% above	74%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXT ELECTIVE	$718.64	$2,764.00	$1,796.60–$2,061.94	—	74%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$862.42	$3,317.00	$2,156.05–$2,474.48	—	74%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$575.38	$2,213.00	$1,181.74–$1,686.31	59% above	74%
Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX	$575.38	$2,213.00	$1,181.74–$1,686.31	59% above	74%
Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX	$575.38	$2,213.00	$1,438.45–$1,650.90	—	74%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$575.38	$2,213.00	$1,438.45–$1,650.90	—	74%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLK	$383.76	$1,476.00	$788.18–$1,124.71	23% above	74%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONAL BLOCK	$383.76	$1,476.00	$788.18–$1,124.71	23% above	74%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONAL BLOCK	$383.76	$1,476.00	$959.40–$1,101.10	—	74%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC TREAT FRACTURE RADIUS/ULNA	$260.78	$1,003.00	$535.60–$764.29	12% below	74%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TX FX DISTAL RADIAL CLSD	$313.04	$1,204.00	$642.94–$917.45	6% above	74%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC TREAT FRACTURE RADIUS/ULNA	$260.78	$1,003.00	$651.95–$748.24	—	74%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TX FX DISTAL RADIAL CLSD	$313.04	$1,204.00	$782.60–$898.18	—	74%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W REMV LESN SNARE	$1,375.66	$5,291.00	$2,825.39–$4,031.74	20% below	74%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W REMV LESN SNARE	$1,375.66	$5,291.00	$3,439.15–$3,947.09	—	74%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEX W BX(S)	$1,564.42	$6,017.00	$3,213.08–$4,584.95	1% above	74%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEX W BX(S)	$1,564.42	$6,017.00	$3,911.05–$4,488.68	—	74%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEXIBLE DX	$1,211.86	$4,661.00	$2,488.97–$3,551.68	4% below	74%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEXIBLE DX	$1,211.86	$4,661.00	$3,029.65–$3,477.11	—	74%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC BX OF CERVIX W/SCOPE LEEP	$1,522.82	$5,857.00	$3,127.64–$4,463.03	81% above	74%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC BX OF CERVIX W/SCOPE LEEP	$1,522.82	$5,857.00	$3,807.05–$4,369.32	—	74%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOS CERVIX W BX & CURRET	$256.10	$985.00	$525.99–$750.57	22% above	74%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOS CERVIX W BX & CURRET	$256.10	$985.00	$640.25–$734.81	—	74%
Coronary stent placement, one artery CPT 92928 HC PRQ CARD STENT W/ANGO 1 VSL	$11,794.12	$45,362.00	$24,223.31–$34,565.84	4% above	74%
Coronary stent placement, one artery inpatient CPT 92928 HC PRQ CARD STENT W/ANGO 1 VSL	$11,794.12	$45,362.00	$29,485.30–$33,840.05	—	74%
Cystoscopy with ureteral stent placement CPT 52332 HC CYSTO W/INSRT URETERL STENT	$4,304.30	$16,555.00	$8,840.37–$12,614.91	6% above	74%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTO W/INSRT URETERL STENT	$4,304.30	$16,555.00	$10,760.75–$12,350.03	—	74%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$462.80	$1,780.00	$950.52–$1,356.36	16% below	74%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$462.80	$1,780.00	$1,157.00–$1,327.88	—	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTN PREMAL LESION 1ST	$101.40	$390.00	$208.26–$297.18	10% above	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALG LESION	$101.40	$390.00	$208.26–$297.18	10% above	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALG LESION 1ST	$101.40	$390.00	$208.26–$297.18	10% above	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION 1ST	$121.68	$468.00	$249.91–$356.62	32% above	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTN PREMAL LESION 1ST	$101.40	$390.00	$253.50–$290.94	—	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALG LESION 1ST	$101.40	$390.00	$253.50–$290.94	—	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALG LESION	$101.40	$390.00	$253.50–$290.94	—	74%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALG LESION 1ST	$121.68	$468.00	$304.20–$349.13	—	74%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC TYMPANOSTOMY LOC/TOP ANES	$409.76	$1,576.00	$841.58–$1,200.91	19% above	74%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC TYMPANOSTOMY LOC/TOP ANES	$409.76	$1,576.00	$1,024.40–$1,175.70	—	74%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC RMV IMPACTED EAR WAX UNI	$21.06	$81.00	$43.25–$61.72	58% below	74%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RMV IMPACT EAR WAX IRR/LVG UNI	$21.06	$81.00	$43.25–$61.72	58% below	74%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC BH RMV IMPACTED EAR WAX UNI	$21.06	$81.00	$43.25–$61.72	58% below	74%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMV IMPACT EAR WAX IRR/LVG UNI	$21.06	$81.00	$52.65–$60.43	—	74%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC RMV IMPACTED EAR WAX UNI	$21.06	$81.00	$52.65–$60.43	—	74%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC BH RMV IMPACTED EAR WAX UNI	$21.06	$81.00	$52.65–$60.43	—	74%
Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED EAR WAX UNI	$21.06	$81.00	$43.25–$61.72	64% below	74%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$21.06	$81.00	$43.25–$61.72	64% below	74%
Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN IMPACTED	$25.22	$97.00	$51.80–$73.91	57% below	74%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$21.06	$81.00	$52.65–$60.43	—	74%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE IMPACTED EAR WAX UNI	$21.06	$81.00	$52.65–$60.43	—	74%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN IMPACTED	$25.22	$97.00	$63.05–$72.36	—	74%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BX ENDOMETRIAL WO CERV DIL	$154.96	$596.00	$318.26–$454.15	22% below	74%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BX ENDOMETRIAL WO CERV DIL	$154.96	$596.00	$387.40–$444.62	—	74%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTRLMINR CRV/THRC W IMAG	$917.02	$3,527.00	$1,883.42–$2,687.57	2% below	74%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTRLMINR CRV/THRC W IMAG	$917.02	$3,527.00	$2,292.55–$2,631.14	—	74%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$893.36	$3,436.00	$1,834.82–$2,618.23	9% below	74%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT INJ PARAVERT F JNT L/S 1 LV	$893.36	$3,436.00	$1,834.82–$2,618.23	9% below	74%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$893.36	$3,436.00	$2,233.40–$2,563.26	—	74%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT INJ PARAVERT F JNT L/S 1 LV	$893.36	$3,436.00	$2,233.40–$2,563.26	—	74%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX	$739.70	$2,845.00	$1,519.23–$2,167.89	33% above	74%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX	$739.70	$2,845.00	$1,849.25–$2,122.37	—	74%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC LIGATION OF HEMORRHOID(S)	$532.74	$2,049.00	$1,094.17–$1,561.34	30% below	74%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC LIGATION OF HEMORRHOID(S)	$532.74	$2,049.00	$1,331.85–$1,528.55	—	74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH FOR HYSTEROSONOGRAPY	$84.76	$326.00	$174.08–$248.41	75% below	74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ HYSTEROGR/SIS CONT/SALINE	$84.76	$326.00	$174.08–$248.41	75% below	74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ HYSTEROGR/SIS CONT/SALINE	$84.76	$326.00	$211.90–$243.20	—	74%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH FOR HYSTEROSONOGRAPY	$84.76	$326.00	$211.90–$243.20	—	74%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC HYSTEROSCOPY BIOPSY	$1,589.38	$6,113.00	$3,264.34–$4,658.11	24% above	74%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC HYSTEROSCOPY BIOPSY	$1,589.38	$6,113.00	$3,973.45–$4,560.30	—	74%
IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE	$32.76	$126.00	$67.28–$96.01	80% below	74%
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD	$33.02	$127.00	$67.82–$96.77	80% below	74%
IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT INTRAUTERINE DEVICE	$32.76	$126.00	$81.90–$94.00	—	74%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD	$33.02	$127.00	$82.55–$94.74	—	74%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCSS SIMPLE OR SINGLE	$178.36	$686.00	$366.32–$522.73	12% above	74%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$178.36	$686.00	$366.32–$522.73	12% above	74%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAIN SKIN ABSCESS SGL	$178.36	$686.00	$366.32–$522.73	12% above	74%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$213.98	$823.00	$439.48–$627.13	34% above	74%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCSS SIMPLE OR SINGLE	$178.36	$686.00	$445.90–$511.76	—	74%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC DRAIN SKIN ABSCESS SGL	$178.36	$686.00	$445.90–$511.76	—	74%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$178.36	$686.00	$445.90–$511.76	—	74%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$213.98	$823.00	$534.95–$613.96	—	74%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$237.38	$913.00	$487.54–$695.71	26% above	74%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SGL TENDON SHEATH/LIGAMENT	$284.96	$1,096.00	$585.26–$835.15	51% above	74%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ TENDON SHEATH/LIGAMENT	$237.38	$913.00	$593.45–$681.10	—	74%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SGL TENDON SHEATH/LIGAMENT	$284.96	$1,096.00	$712.40–$817.62	—	74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC DRN/INJ JNT/BRSA WO US LT	$316.16	$1,216.00	$649.34–$926.59	20% above	74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 HC DRN/INJ JNT/BRSA WO US RT	$316.16	$1,216.00	$649.34–$926.59	20% above	74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC DRN/INJ JNT/BRSA WO US RT	$316.16	$1,216.00	$790.40–$907.14	—	74%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 HC DRN/INJ JNT/BRSA WO US LT	$316.16	$1,216.00	$790.40–$907.14	—	74%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DLVR IMPLANT	$58.76	$226.00	$120.68–$172.21	49% below	74%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$58.76	$226.00	$120.68–$172.21	49% below	74%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT	$58.76	$226.00	$120.68–$172.21	49% below	74%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERT DRUG IMPLANT DEVICE	$58.76	$226.00	$146.90–$168.60	—	74%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT	$58.76	$226.00	$146.90–$168.60	—	74%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DLVR IMPLANT	$58.76	$226.00	$146.90–$168.60	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JT/BURSA INTER	$73.84	$284.00	$151.66–$216.41	59% below	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ/ASPIRATE MED JNT	$237.38	$913.00	$487.54–$695.71	31% above	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC INTERMEDIATE JOINT INJ	$237.38	$913.00	$487.54–$695.71	31% above	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCEN ASP INTERM JNT/BURSA	$284.96	$1,096.00	$585.26–$835.15	57% above	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT INT JT/BURSA	$284.96	$1,096.00	$585.26–$835.15	57% above	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$284.96	$1,096.00	$585.26–$835.15	57% above	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JT/BURSA INTER	$73.84	$284.00	$184.60–$211.86	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC INTERMEDIATE JOINT INJ	$237.38	$913.00	$593.45–$681.10	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ/ASPIRATE MED JNT	$237.38	$913.00	$593.45–$681.10	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$284.96	$1,096.00	$712.40–$817.62	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT INT JT/BURSA	$284.96	$1,096.00	$712.40–$817.62	—	74%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCEN ASP INTERM JNT/BURSA	$284.96	$1,096.00	$712.40–$817.62	—	74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ/ASPIRATE SMALL JNT	$200.98	$773.00	$412.78–$589.03	at median	74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ JNT/BURSA W/O US	$200.98	$773.00	$412.78–$589.03	at median	74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ JOINT/BURSA WO US	$200.98	$773.00	$412.78–$589.03	at median	74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC SMALL JOINT/GANGLION INJ	$200.98	$773.00	$412.78–$589.03	at median	74%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS/INJ-SM JT	$241.28	$928.00	$495.55–$707.14	20% above	74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC SMALL JOINT/GANGLION INJ	$200.98	$773.00	$502.45–$576.66	—	74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ JNT/BURSA W/O US	$200.98	$773.00	$502.45–$576.66	—	74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ/ASPIRATE SMALL JNT	$200.98	$773.00	$502.45–$576.66	—	74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJ JOINT/BURSA WO US	$200.98	$773.00	$502.45–$576.66	—	74%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS/INJ-SM JT	$241.28	$928.00	$603.20–$692.29	—	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS SCLP/EXTR<2.5 CM	$253.76	$976.00	$521.18–$743.71	12% below	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYER CLOS SCLP/EXTR<2.5 CM	$253.76	$976.00	$521.18–$743.71	12% below	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LR INT SCLP/TRNK <=2.5	$304.46	$1,171.00	$625.31–$892.30	6% above	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOS SCLP/EXTR<2.5 CM	$253.76	$976.00	$634.40–$728.10	—	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYER CLOS SCLP/EXTR<2.5 CM	$253.76	$976.00	$634.40–$728.10	—	74%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LR INT SCLP/TRNK <=2.5	$304.46	$1,171.00	$761.15–$873.57	—	74%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTRLMINR LMBR/SAC W IMAG	$588.38	$2,263.00	$1,208.44–$1,724.41	37% below	74%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTRLMINR LMBR/SAC W IMAG	$588.38	$2,263.00	$1,470.95–$1,688.20	—	74%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ A/S TRN EPI W IMG L/S SGL	$1,163.24	$4,474.00	$2,389.12–$3,409.19	20% above	74%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ A/S TRN EPI W IMG L/S SGL	$1,163.24	$4,474.00	$2,908.10–$3,337.60	—	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LES < 0.5 CM	$268.58	$1,033.00	$551.62–$787.15	57% above	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$268.58	$1,033.00	$551.62–$787.15	57% above	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5CM/< FAC	$268.58	$1,033.00	$551.62–$787.15	57% above	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5CM/<	$268.58	$1,033.00	$551.62–$787.15	57% above	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5 < CM	$268.58	$1,033.00	$551.62–$787.15	57% above	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LES < 0.5 CM	$268.58	$1,033.00	$671.45–$770.62	—	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5CM/<	$268.58	$1,033.00	$671.45–$770.62	—	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5CM/< FAC	$268.58	$1,033.00	$671.45–$770.62	—	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/<	$268.58	$1,033.00	$671.45–$770.62	—	74%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5 < CM	$268.58	$1,033.00	$671.45–$770.62	—	74%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC FACE-MM B9+MARG 0.5CM/<	$402.74	$1,549.00	$827.17–$1,180.34	50% above	74%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC FACE-MM B9+MARG 0.5< CM	$402.74	$1,549.00	$827.17–$1,180.34	50% above	74%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC FACE-MM B9+MARG 0.5CM/<	$402.74	$1,549.00	$1,006.85–$1,155.55	—	74%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC FACE-MM B9+MARG 0.5< CM	$402.74	$1,549.00	$1,006.85–$1,155.55	—	74%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE	$101.40	$390.00	$208.26–$297.18	22% below	74%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL SIMPLE SINGLE	$101.40	$390.00	$208.26–$297.18	22% below	74%
Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE	$101.40	$390.00	$208.26–$297.18	22% below	74%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SNGLE	$121.68	$468.00	$249.91–$356.62	7% below	74%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE	$101.40	$390.00	$253.50–$290.94	—	74%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL SIMPLE SINGLE	$101.40	$390.00	$253.50–$290.94	—	74%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE	$101.40	$390.00	$253.50–$290.94	—	74%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SNGLE	$121.68	$468.00	$304.20–$349.13	—	74%
Occipital nerve block (injection for headaches) CPT 64405 HC INJ ANES GRTR OCCPL NERVE	$237.38	$913.00	$487.54–$695.71	20% below	74%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES GRTR OCCIPITAL NRV	$284.96	$1,096.00	$585.26–$835.15	4% below	74%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES GRTR OCCIPITAL NRV	$284.96	$1,096.00	$585.26–$835.15	4% below	74%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES PERIPH NERVE OCCIPUT	$284.96	$1,096.00	$585.26–$835.15	4% below	74%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJ ANES GRTR OCCPL NERVE	$237.38	$913.00	$593.45–$681.10	—	74%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES PERIPH NERVE OCCIPUT	$284.96	$1,096.00	$712.40–$817.62	—	74%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES GRTR OCCIPITAL NRV	$284.96	$1,096.00	$712.40–$817.62	—	74%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES GRTR OCCIPITAL NRV	$284.96	$1,096.00	$712.40–$817.62	—	74%
Pacemaker implant (dual chamber) CPT 33208 INS NEW/REPLC PACER&LEADS DUAL	$6,850.48	$26,348.00	$14,069.83–$20,077.18	30% below	74%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS NEW/REPLC PACER&LEADS DUAL	$6,850.48	$26,348.00	$17,126.20–$19,655.61	—	74%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAG GUIDE	$1,201.72	$4,622.00	$2,468.15–$3,521.96	48% above	74%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS W IMAG GUIDE	$1,201.72	$4,622.00	$2,468.15–$3,521.96	48% above	74%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS W IMAG GUIDE	$1,201.72	$4,622.00	$3,004.30–$3,448.01	—	74%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W IMAG GUIDE	$1,201.72	$4,622.00	$3,004.30–$3,448.01	—	74%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$313.56	$1,206.00	$644.00–$918.97	4% below	74%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL & MATRIX	$376.22	$1,447.00	$772.70–$1,102.61	15% above	74%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$313.56	$1,206.00	$783.90–$899.68	—	74%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL & MATRIX	$376.22	$1,447.00	$940.55–$1,079.46	—	74%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST NEUROLYT LMB FC JT NV SGL	$1,140.10	$4,385.00	$2,341.59–$3,341.37	21% below	74%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST NEUROLYT LMB FC JT NV SGL	$1,140.10	$4,385.00	$2,850.25–$3,271.21	—	74%
Removal of a breast lump, open surgery CPT 19120 HC REMOVAL OF BREAST LESION	$1,686.88	$6,488.00	$3,464.59–$4,943.86	19% above	74%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION 1+	$1,861.34	$7,159.00	$3,822.91–$5,455.16	31% above	74%
Removal of a breast lump, open surgery CPT 19120 HC REMOVAL OF BREAST LESION 1+	$1,861.34	$7,159.00	$3,822.91–$5,455.16	31% above	74%
Removal of a breast lump, open surgery inpatient CPT 19120 HC REMOVAL OF BREAST LESION	$1,686.88	$6,488.00	$4,217.20–$4,840.05	—	74%
Removal of a breast lump, open surgery inpatient CPT 19120 HC REMOVAL OF BREAST LESION 1+	$1,861.34	$7,159.00	$4,653.35–$5,340.61	—	74%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION 1+	$1,861.34	$7,159.00	$4,653.35–$5,340.61	—	74%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SUBQ	$297.44	$1,144.00	$610.90–$871.73	30% above	74%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVL FB SQ SIMPLE	$297.44	$1,144.00	$610.90–$871.73	30% above	74%
Removal of a foreign object under the skin, simple CPT 10120 I&R FOREIGN BODY SQ SIMPLE	$297.44	$1,144.00	$610.90–$871.73	30% above	74%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY	$297.44	$1,144.00	$610.90–$871.73	30% above	74%
Removal of a foreign object under the skin, simple CPT 10120 I&R FB SUBQ SIMPLE	$356.98	$1,373.00	$733.18–$1,046.23	56% above	74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVL FB SQ SIMPLE	$297.44	$1,144.00	$743.60–$853.42	—	74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FOREIGN BODY SQ SIMPLE	$297.44	$1,144.00	$743.60–$853.42	—	74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY	$297.44	$1,144.00	$743.60–$853.42	—	74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SUBQ	$297.44	$1,144.00	$743.60–$853.42	—	74%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&R FB SUBQ SIMPLE	$356.98	$1,373.00	$892.45–$1,024.26	—	74%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONSCOPY SCREEN NON HI RISK	$1,002.82	$3,857.00	$2,059.64–$2,939.03	at median	74%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONSCOPY SCREEN NON HI RISK	$1,002.82	$3,857.00	$2,507.05–$2,877.32	—	74%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREEN HI RISK PT	$1,001.00	$3,850.00	$2,055.90–$2,933.70	3% below	74%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREEN HI RISK PT	$1,001.00	$3,850.00	$2,502.50–$2,872.10	—	74%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$1,881.10	$7,235.00	$3,863.49–$5,513.07	27% below	74%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$1,881.10	$7,235.00	$4,702.75–$5,397.31	—	74%
Short arm cast (elbow to hand) CPT 29075 HC APPLY SHORT ARM CAST	$219.44	$844.00	$450.70–$643.13	25% above	74%
Short arm cast (elbow to hand) CPT 29075 OT SHORT ARM CAST	$219.44	$844.00	$450.70–$643.13	25% above	74%
Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY SHORT ARM CAST	$219.44	$844.00	$548.60–$629.62	—	74%
Short arm cast (elbow to hand) inpatient CPT 29075 OT SHORT ARM CAST	$219.44	$844.00	$548.60–$629.62	—	74%
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT STATIC	$72.80	$280.00	$149.52–$213.36	37% below	74%
Short arm splint (forearm and hand) CPT 29125 PTA APPL SPL SHORT STATIC FH	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) CPT 29125 PT APPL SPLINT SHORT STATIC FH	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC	$123.50	$475.00	$253.65–$361.95	7% above	74%
Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT	$123.50	$475.00	$253.65–$361.95	7% above	74%
Short arm splint (forearm and hand) CPT 29125 OT SHORT ARM SPLINT	$123.50	$475.00	$253.65–$361.95	7% above	74%
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHRT ARM STC	$148.20	$570.00	$304.38–$434.34	29% above	74%
Short arm splint (forearm and hand) one side CPT 29125 PT SPLINT APPL SHRT ARM STC LT	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) one side CPT 29125 PTA SPLINT APL SHRT ARM STC RT	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) one side CPT 29125 PT SPLINT APPL SHRT ARM STC RT	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) one side CPT 29125 PTA SPLINT APL SHRT ARM STC LT	$98.80	$380.00	$202.92–$289.56	14% below	74%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT STATIC	$72.80	$280.00	$182.00–$208.88	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 PT APPL SPLINT SHORT STATIC FH	$98.80	$380.00	$247.00–$283.48	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 PTA APPL SPL SHORT STATIC FH	$98.80	$380.00	$247.00–$283.48	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 OT SHORT ARM SPLINT	$123.50	$475.00	$308.75–$354.35	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT	$123.50	$475.00	$308.75–$354.35	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC	$123.50	$475.00	$308.75–$354.35	—	74%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHRT ARM STC	$148.20	$570.00	$370.50–$425.22	—	74%
Short arm splint (forearm and hand) inpatient one side CPT 29125 PT SPLINT APPL SHRT ARM STC RT	$98.80	$380.00	$247.00–$283.48	—	74%
Short arm splint (forearm and hand) inpatient one side CPT 29125 PTA SPLINT APL SHRT ARM STC RT	$98.80	$380.00	$247.00–$283.48	—	74%
Short arm splint (forearm and hand) inpatient one side CPT 29125 PTA SPLINT APL SHRT ARM STC LT	$98.80	$380.00	$247.00–$283.48	—	74%
Short arm splint (forearm and hand) inpatient one side CPT 29125 PT SPLINT APPL SHRT ARM STC LT	$98.80	$380.00	$247.00–$283.48	—	74%
Short leg cast (below the knee) CPT 29405 PTA SHRT LEG CAST APP UNITS	$175.50	$675.00	$360.45–$514.35	9% above	74%
Short leg cast (below the knee) CPT 29405 HC APPLY SHORT LEG CAST	$219.44	$844.00	$450.70–$643.13	37% above	74%
Short leg cast (below the knee) CPT 29405 APPLY CAST SHORT LEG	$263.38	$1,013.00	$540.94–$771.91	64% above	74%
Short leg cast (below the knee) one side CPT 29405 PTA APL SHRT LG CAST KN-TOE RT	$175.50	$675.00	$360.45–$514.35	9% above	74%
Short leg cast (below the knee) one side CPT 29405 PTA APL SHRT LG CAST KN-TOE LT	$175.50	$675.00	$360.45–$514.35	9% above	74%
Short leg cast (below the knee) inpatient CPT 29405 PTA SHRT LEG CAST APP UNITS	$175.50	$675.00	$438.75–$503.55	—	74%
Short leg cast (below the knee) inpatient CPT 29405 HC APPLY SHORT LEG CAST	$219.44	$844.00	$548.60–$629.62	—	74%
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST SHORT LEG	$263.38	$1,013.00	$658.45–$755.70	—	74%
Short leg cast (below the knee) inpatient one side CPT 29405 PTA APL SHRT LG CAST KN-TOE RT	$175.50	$675.00	$438.75–$503.55	—	74%
Short leg cast (below the knee) inpatient one side CPT 29405 PTA APL SHRT LG CAST KN-TOE LT	$175.50	$675.00	$438.75–$503.55	—	74%
Short leg splint (calf to foot) CPT 29515 PTA APPL SPLINT SHORT LEG	$102.96	$396.00	$211.46–$301.75	19% below	74%
Short leg splint (calf to foot) CPT 29515 PT APPL SPLINT SHORT LEG	$102.96	$396.00	$211.46–$301.75	19% below	74%
Short leg splint (calf to foot) CPT 29515 HC APP LOWER LEG SPLINT	$121.68	$468.00	$249.91–$356.62	4% below	74%
Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT	$128.70	$495.00	$264.33–$377.19	2% above	74%
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT SHORT LEG	$154.44	$594.00	$317.20–$452.63	22% above	74%
Short leg splint (calf to foot) one side CPT 29515 PT SPLINT APPL SHORT LEG LT	$102.96	$396.00	$211.46–$301.75	19% below	74%
Short leg splint (calf to foot) one side CPT 29515 PT SPLINT APPL SHORT LEG RT	$102.96	$396.00	$211.46–$301.75	19% below	74%
Short leg splint (calf to foot) inpatient CPT 29515 PT APPL SPLINT SHORT LEG	$102.96	$396.00	$257.40–$295.42	—	74%
Short leg splint (calf to foot) inpatient CPT 29515 PTA APPL SPLINT SHORT LEG	$102.96	$396.00	$257.40–$295.42	—	74%
Short leg splint (calf to foot) inpatient CPT 29515 HC APP LOWER LEG SPLINT	$121.68	$468.00	$304.20–$349.13	—	74%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SHORT LEG SPLINT	$128.70	$495.00	$321.75–$369.27	—	74%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SPLINT SHORT LEG	$154.44	$594.00	$386.10–$443.12	—	74%
Short leg splint (calf to foot) inpatient one side CPT 29515 PT SPLINT APPL SHORT LEG LT	$102.96	$396.00	$257.40–$295.42	—	74%
Short leg splint (calf to foot) inpatient one side CPT 29515 PT SPLINT APPL SHORT LEG RT	$102.96	$396.00	$257.40–$295.42	—	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SCALP-TRNK EXTR <2.6CM	$108.16	$416.00	$222.14–$316.99	27% below	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RPR SCALP-TRNK EXTR <2.6CM	$108.16	$416.00	$222.14–$316.99	27% below	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LR SMPL TRNK/NECK <=2.5	$129.74	$499.00	$266.47–$380.24	13% below	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SCALP-TRNK EXTR <2.6CM	$108.16	$416.00	$270.40–$310.34	—	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RPR SCALP-TRNK EXTR <2.6CM	$108.16	$416.00	$270.40–$310.34	—	74%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LR SMPL TRNK/NECK <=2.5	$129.74	$499.00	$324.35–$372.25	—	74%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$145.60	$560.00	$299.04–$426.72	43% below	74%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BX SKIN SINGLE LSN	$296.66	$1,141.00	$609.29–$869.44	16% above	74%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN SINGLE LESION	$145.60	$560.00	$364.00–$417.76	—	74%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BX SKIN SINGLE LSN	$296.66	$1,141.00	$741.65–$851.19	—	74%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC TR-EXT MLG+MARG 0.5 <CM	$204.10	$785.00	$419.19–$598.17	37% below	74%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC TR-EXT MLG+MARG 0.5 <CM	$204.10	$785.00	$510.25–$585.61	—	74%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS <=15	$101.40	$390.00	$208.26–$297.18	23% below	74%
Skin tag removal, up to 15 tags CPT 11200 REM SKIN TAGS <= 15 LESIONS	$101.40	$390.00	$208.26–$297.18	23% below	74%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS	$101.40	$390.00	$208.26–$297.18	23% below	74%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS <W/15	$101.40	$390.00	$208.26–$297.18	23% below	74%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS <=15 LESIONS	$101.40	$390.00	$208.26–$297.18	23% below	74%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS <=15	$121.68	$468.00	$249.91–$356.62	7% below	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS <=15 LESIONS	$101.40	$390.00	$253.50–$290.94	—	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS	$101.40	$390.00	$253.50–$290.94	—	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS <W/15	$101.40	$390.00	$253.50–$290.94	—	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN TAGS <= 15 LESIONS	$101.40	$390.00	$253.50–$290.94	—	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS <=15	$101.40	$390.00	$253.50–$290.94	—	74%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS <=15	$121.68	$468.00	$304.20–$349.13	—	74%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR	$451.10	$1,735.00	$926.49–$1,322.07	7% below	74%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE SPINAL LUMBAR DIAG	$451.10	$1,735.00	$926.49–$1,322.07	7% below	74%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTC	$451.10	$1,735.00	$926.49–$1,322.07	7% below	74%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR	$451.10	$1,735.00	$1,127.75–$1,294.31	—	74%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTC	$451.10	$1,735.00	$1,127.75–$1,294.31	—	74%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE SPINAL LUMBAR DIAG	$451.10	$1,735.00	$1,127.75–$1,294.31	—	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RPR SCLP-TRNK EXTR 2.6-7.5	$112.84	$434.00	$231.76–$330.71	39% below	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RPR S/N/AX/GEN/TRK2.6-7.5CM	$113.62	$437.00	$233.36–$332.99	39% below	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SCLP-TRNK EXTR 2.6-7.5	$113.62	$437.00	$233.36–$332.99	39% below	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LR SMPL TRNK/NECK 2.6-7.5	$136.24	$524.00	$279.82–$399.29	27% below	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RPR SCLP-TRNK EXTR 2.6-7.5	$112.84	$434.00	$282.10–$323.76	—	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RPR S/N/AX/GEN/TRK2.6-7.5CM	$113.62	$437.00	$284.05–$326.00	—	74%
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 SCLP-TRNK EXTR 2.6-7.5	$113.62	$437.00	$284.05–$326.00	—	74%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LR SMPL TRNK/NECK 2.6-7.5	$136.24	$524.00	$340.60–$390.90	—	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SIM FACE <2.6CM	$123.76	$476.00	$254.18–$362.71	25% below	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RPR F/E/E/N/L/M 2.5 CM/<	$123.76	$476.00	$254.18–$362.71	25% below	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LR SMPL FACE/EAR <=2.5	$148.46	$571.00	$304.91–$435.10	10% below	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RPR F/E/E/N/L/M 2.5 CM/<	$123.76	$476.00	$309.40–$355.10	—	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR SIM FACE <2.6CM	$123.76	$476.00	$309.40–$355.10	—	74%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LR SMPL FACE/EAR <=2.5	$148.46	$571.00	$371.15–$425.97	—	74%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKIN SING LESION	$154.44	$594.00	$317.20–$452.63	21% below	74%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKIN SINGLE LES	$163.28	$628.00	$335.35–$478.54	17% below	74%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKIN SING LESION	$154.44	$594.00	$386.10–$443.12	—	74%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKIN SINGLE LES	$163.28	$628.00	$408.20–$468.49	—	74%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGING	$625.56	$2,406.00	$1,284.80–$1,833.37	7% below	74%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS PLEURA W IMG	$750.62	$2,887.00	$1,541.66–$2,199.89	12% above	74%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS PLEURA W IMAGING	$750.62	$2,887.00	$1,541.66–$2,199.89	12% above	74%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W IMAGING	$625.56	$2,406.00	$1,563.90–$1,794.88	—	74%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS PLEURA W IMAGING	$750.62	$2,887.00	$1,876.55–$2,153.70	—	74%
Thoracentesis with imaging guidance inpatient CPT 32555 CT THORACENTESIS PLEURA W IMG	$750.62	$2,887.00	$1,876.55–$2,153.70	—	74%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$202.80	$780.00	$416.52–$594.36	6% above	74%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT 1-2 MUSCL	$202.80	$780.00	$416.52–$594.36	6% above	74%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES	$202.80	$780.00	$416.52–$594.36	6% above	74%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1-2 MUSCL	$243.36	$936.00	$499.82–$713.23	27% above	74%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT 1-2 MUSCL	$202.80	$780.00	$507.00–$581.88	—	74%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES	$202.80	$780.00	$507.00–$581.88	—	74%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT 1/2 MUSCL	$202.80	$780.00	$507.00–$581.88	—	74%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1-2 MUSCL	$243.36	$936.00	$608.40–$698.26	—	74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LESION US IMG-LT	$1,334.06	$5,131.00	$2,739.95–$3,909.82	4% below	74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LESION US IMG-RT	$1,334.06	$5,131.00	$2,739.95–$3,909.82	4% below	74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LESION US IMG-RT	$1,334.06	$5,131.00	$3,335.15–$3,827.73	—	74%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LESION US IMG-LT	$1,334.06	$5,131.00	$3,335.15–$3,827.73	—	74%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD FLX TRNSORL BAL DIL >30	$1,331.98	$5,123.00	$2,735.68–$3,903.73	10% above	74%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD FLX TRNSORL BAL DIL >30	$1,331.98	$5,123.00	$3,329.95–$3,821.76	—	74%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD FLX TRNSORL BIOPSY(S)	$1,202.76	$4,626.00	$2,470.28–$3,525.01	2% above	74%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD FLX TRNSORL BIOPSY(S)	$1,202.76	$4,626.00	$3,006.90–$3,451.00	—	74%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD FLX TRNSORL SUBMUC INJ	$1,202.76	$4,626.00	$2,470.28–$3,525.01	83% above	74%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD FLX TRNSORL SUBMUC INJ	$1,202.76	$4,626.00	$3,006.90–$3,451.00	—	74%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD FLX TRNSORL REM LES SNARE	$1,695.46	$6,521.00	$3,482.21–$4,969.00	63% above	74%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD FLX TRNSORL REM LES SNARE	$1,695.46	$6,521.00	$4,238.65–$4,864.67	—	74%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD FLX TRNSORL GUIDE WIRE DIL	$1,440.14	$5,539.00	$2,957.83–$4,220.72	84% above	74%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD FLX TRNSORL GUIDE WIRE DIL	$1,440.14	$5,539.00	$3,600.35–$4,132.09	—	74%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD FLX TRNSORL DX BRUSH/WASH	$1,064.96	$4,096.00	$2,187.26–$3,121.15	5% above	74%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD FLX TRNSORL DX BRUSH/WASH	$1,064.96	$4,096.00	$2,662.40–$3,055.62	—	74%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT B9 LESION 1-14	$101.40	$390.00	$208.26–$297.18	40% below	74%
Wart removal, up to 14 warts CPT 17110 DESTRUCTN 1-14 BENIGN LESIONS	$121.68	$468.00	$249.91–$356.62	28% below	74%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT B9 LESION 1-14	$101.40	$390.00	$253.50–$290.94	—	74%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTN 1-14 BENIGN LESIONS	$121.68	$468.00	$304.20–$349.13	—	74%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$250.90	$965.00	$515.31–$735.33	35% above	74%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SQ TISSUE <=20CM	$313.56	$1,206.00	$644.00–$918.97	69% above	74%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ TISSUE <=20CM	$376.22	$1,447.00	$772.70–$1,102.61	102% above	74%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE 20 SQ CM/<	$250.90	$965.00	$627.25–$719.89	—	74%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SQ TISSUE <=20CM	$313.56	$1,206.00	$783.90–$899.68	—	74%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SQ TISSUE <=20CM	$376.22	$1,447.00	$940.55–$1,079.46	—	74%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUS BLOOD/BLOOD COMP	$479.70	$1,845.00	$985.23–$1,405.89	2% below	74%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD PRODUCTS	$479.70	$1,845.00	$985.23–$1,405.89	2% below	74%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$479.70	$1,845.00	$985.23–$1,405.89	2% below	74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUS BLOOD/BLOOD COMP	$479.70	$1,845.00	$1,199.25–$1,376.37	—	74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION OF BLOOD PRODUCTS	$479.70	$1,845.00	$1,199.25–$1,376.37	—	74%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$479.70	$1,845.00	$1,199.25–$1,376.37	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT/ MD	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RH AIRWAY INHALATION TRMNT	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TRMNT	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC SPUTUM INDUCTION	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$235.82	$907.00	$484.34–$691.13	29% above	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RH AIRWAY INHALATION TRMNT	$235.82	$907.00	$589.55–$676.62	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT/ MD	$235.82	$907.00	$589.55–$676.62	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$235.82	$907.00	$589.55–$676.62	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC SPUTUM INDUCTION	$235.82	$907.00	$589.55–$676.62	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT	$235.82	$907.00	$589.55–$676.62	—	74%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TRMNT	$235.82	$907.00	$589.55–$676.62	—	74%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$363.74	$1,399.00	$747.07–$1,066.04	7% below	74%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$363.74	$1,399.00	$909.35–$1,043.65	—	74%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPLETE AUDIO THRESH W SPEECH	$96.46	$371.00	$198.11–$282.70	23% below	74%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPLETE AUDIO THRESH W SPEECH	$96.46	$371.00	$241.15–$276.77	—	74%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, 1ST HOUR	$1,206.40	$4,640.00	$2,477.76–$3,535.68	18% above	74%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, 1ST HOUR	$1,206.40	$4,640.00	$3,016.00–$3,461.44	—	74%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE AND DROWSY	$140.14	$539.00	$287.83–$410.72	61% below	74%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE AND DROWSY	$140.14	$539.00	$350.35–$402.09	—	74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING 12-LEAD	$67.86	$261.00	$139.37–$198.88	40% below	74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM TRACING	$79.04	$304.00	$162.34–$231.65	30% below	74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG TRACING 12-LEAD	$67.86	$261.00	$169.65–$194.71	—	74%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM TRACING	$79.04	$304.00	$197.60–$226.78	—	74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$103.22	$397.00	$212.00–$302.51	at median	74%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1	$103.22	$397.00	$258.05–$296.16	—	74%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2	$219.44	$844.00	$450.70–$643.13	5% above	74%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2	$219.44	$844.00	$548.60–$629.62	—	74%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3	$415.22	$1,597.00	$852.80–$1,216.91	24% above	74%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3	$415.22	$1,597.00	$1,038.05–$1,191.36	—	74%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4	$822.12	$3,162.00	$1,688.51–$2,409.44	35% above	74%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4	$822.12	$3,162.00	$2,055.30–$2,358.85	—	74%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5	$1,379.04	$5,304.00	$2,832.34–$4,041.65	40% above	74%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5	$1,379.04	$5,304.00	$3,447.60–$3,956.78	—	74%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST CARDIAC TRACING	$346.84	$1,334.00	$712.36–$1,016.51	40% below	74%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$346.84	$1,334.00	$712.36–$1,016.51	40% below	74%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST CARDIAC TRACING	$346.84	$1,334.00	$867.10–$995.16	—	74%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST	$346.84	$1,334.00	$867.10–$995.16	—	74%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PT 50 MIN	$134.16	$516.00	$275.54–$393.19	1% below	74%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PT 50 MIN	$134.16	$516.00	$335.40–$384.94	—	74%
Group psychotherapy session CPT 90853 PSYCHOTHERAPY GROUP	$52.26	$201.00	$107.33–$153.16	14% below	74%
Group psychotherapy session inpatient CPT 90853 PSYCHOTHERAPY GROUP	$52.26	$201.00	$130.65–$149.95	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$210.34	$809.00	$432.01–$616.46	at median	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INITIAL	$210.34	$809.00	$432.01–$616.46	at median	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFU HYDRATION 31-90MINUTES	$210.34	$809.00	$432.01–$616.46	at median	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION INIT	$210.34	$809.00	$432.01–$616.46	at median	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 RH IV INFUSION HYDRATION INIT	$210.34	$809.00	$432.01–$616.46	at median	74%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION 31-60MIN	$237.12	$912.00	$487.01–$694.94	13% above	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFU HYDRATION 31-90MINUTES	$210.34	$809.00	$525.85–$603.51	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION INIT	$210.34	$809.00	$525.85–$603.51	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INITIAL	$210.34	$809.00	$525.85–$603.51	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 RH IV INFUSION HYDRATION INIT	$210.34	$809.00	$525.85–$603.51	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$210.34	$809.00	$525.85–$603.51	—	74%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION 31-60MIN	$237.12	$912.00	$592.80–$680.35	—	74%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION DX INIT 1ST HR	$175.76	$676.00	$360.98–$515.11	46% below	74%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY 16-90 MINUTES	$407.68	$1,568.00	$837.31–$1,194.82	25% above	74%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$407.68	$1,568.00	$837.31–$1,194.82	25% above	74%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INFUSN INIT	$407.68	$1,568.00	$837.31–$1,194.82	25% above	74%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$407.68	$1,568.00	$837.31–$1,194.82	25% above	74%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION DX INIT 1ST HR	$175.76	$676.00	$439.40–$504.30	—	74%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INFUSN INIT	$407.68	$1,568.00	$1,019.20–$1,169.73	—	74%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$407.68	$1,568.00	$1,019.20–$1,169.73	—	74%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$407.68	$1,568.00	$1,019.20–$1,169.73	—	74%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY 16-90 MINUTES	$407.68	$1,568.00	$1,019.20–$1,169.73	—	74%
IV push of a medicine, first drug CPT 96374 HC IV INJECTION	$175.76	$676.00	$360.98–$515.11	11% below	74%
IV push of a medicine, first drug CPT 96374 HC THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 INJECTION IVP SNGL/INIT DRUG	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 HC THER INJ IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 RH INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug CPT 96374 HC INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$487.01–$694.94	20% above	74%
IV push of a medicine, first drug inpatient CPT 96374 HC IV INJECTION	$175.76	$676.00	$439.40–$504.30	—	74%
IV push of a medicine, first drug inpatient CPT 96374 HC THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 HC INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 RH INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 HC THER INJ IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 INJ THER/PROPH/DIAG IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IVP SNGL/INIT DRUG	$237.12	$912.00	$592.80–$680.35	—	74%
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$237.12	$912.00	$592.80–$680.35	—	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ THER PROPHYLACTIC SC/IM	$42.38	$163.00	$87.04–$124.21	39% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION,IM OR SQ	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DIAG SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ, SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 RH INJ THER/PROPH/DIAG SC/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX/PROPH/DX INJ, SUBQ/IM	$52.78	$203.00	$108.40–$154.69	24% below	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ THER PROPHYLACTIC SC/IM	$42.38	$163.00	$105.95–$121.60	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION,IM OR SQ	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RH INJ THER/PROPH/DIAG SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DIAG SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ, SC/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX/PROPH/DX INJ, SUBQ/IM	$52.78	$203.00	$131.95–$151.44	—	74%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION	$176.28	$678.00	$362.05–$516.64	18% below	74%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$176.28	$678.00	$362.05–$516.64	18% below	74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAGNOSTIC EVALUATION	$176.28	$678.00	$440.70–$505.79	—	74%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL	$176.28	$678.00	$440.70–$505.79	—	74%
Neuromuscular re-education, 15 minutes CPT 97112 SP NEUROMUSCULAR RE-ED 15 MINS	$24.96	$96.00	$51.26–$73.15	75% below	74%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSC REEDUCAT EA 15MIN	$24.96	$96.00	$51.26–$73.15	75% below	74%
Neuromuscular re-education, 15 minutes CPT 97112 PTA NEUROMSC REEDUCAT EA 15MIN	$24.96	$96.00	$51.26–$73.15	75% below	74%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSC RE-EDU EA 15 MIN	$24.96	$96.00	$51.26–$73.15	75% below	74%
Neuromuscular re-education, 15 minutes CPT 97112 OTA NEUROMUSC REEDU EA 15 MIN	$24.96	$96.00	$51.26–$73.15	75% below	74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSC REEDUCAT EA 15MIN	$24.96	$96.00	$62.40–$71.62	—	74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 SP NEUROMUSCULAR RE-ED 15 MINS	$24.96	$96.00	$62.40–$71.62	—	74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OTA NEUROMUSC REEDU EA 15 MIN	$24.96	$96.00	$62.40–$71.62	—	74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSC RE-EDU EA 15 MIN	$24.96	$96.00	$62.40–$71.62	—	74%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PTA NEUROMSC REEDUCAT EA 15MIN	$24.96	$96.00	$62.40–$71.62	—	74%
New patient office visit, about 30 minutes CPT 99203 HC AMWELL NEW PT OFF VIS LVL 3	$46.28	$178.00	$95.05–$135.64	68% below	74%
New patient office visit, about 30 minutes CPT 99203 HC OFFIC/OUTPT VISIT LVL 3 NEW	$46.28	$178.00	$95.05–$135.64	68% below	74%
New patient office visit, about 45 minutes CPT 99204 HC AMWELL NEW PT OFF VIS LVL 4	$63.18	$243.00	$129.76–$185.17	70% below	74%
New patient office visit, about 45 minutes CPT 99204 HC OFFIC/OUTPT VISIT LVL 4 NEW	$63.18	$243.00	$129.76–$185.17	70% below	74%
New patient office visit, about 60 minutes CPT 99205 HC AMWELL NEW PT OFF VIS LVL 5	$111.28	$428.00	$228.55–$326.14	66% below	74%
New patient office visit, about 60 minutes CPT 99205 HC OFFIC/OUTPT VISIT LVL 5 NEW	$111.28	$428.00	$228.55–$326.14	66% below	74%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC AMWELL NEW PT OFF VIS LVL 2	$39.26	$151.00	$80.63–$115.06	55% below	74%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFIC/OUTPT VISIT LVL 2 NEW	$39.26	$151.00	$80.63–$115.06	55% below	74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION THR INDV INIT EA 15M	$20.80	$80.00	$42.72–$60.96	55% below	74%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION THR INDV INIT EA 15M	$20.80	$80.00	$52.00–$59.68	—	74%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY	$125.32	$482.00	$257.39–$367.28	44% below	74%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW COMPLEXITY	$125.32	$482.00	$313.30–$359.57	—	74%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH COMPLEXITY	$131.82	$507.00	$270.74–$386.33	53% below	74%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH COMPLEXITY	$131.82	$507.00	$329.55–$378.22	—	74%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW COMPLEXITY	$116.74	$449.00	$239.77–$342.14	48% below	74%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW COMPLEXITY	$116.74	$449.00	$291.85–$334.95	—	74%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD COMPLEXITY	$125.58	$483.00	$257.92–$368.05	54% below	74%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD COMPLEXITY	$125.58	$483.00	$313.95–$360.32	—	74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERPY TECH EA 15MIN	$35.88	$138.00	$73.69–$105.16	64% below	74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OTA MANUAL THERPY TECH EA 15MN	$35.88	$138.00	$73.69–$105.16	64% below	74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANUL THERPY TECH EA 15MIN	$35.88	$138.00	$73.69–$105.16	64% below	74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PTA MANL THERPY TECH EA 15MIN	$35.88	$138.00	$73.69–$105.16	64% below	74%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERPY TECH EA 15MIN	$35.88	$138.00	$73.69–$105.16	64% below	74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OTA MANUAL THERPY TECH EA 15MN	$35.88	$138.00	$89.70–$102.95	—	74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MANUL THERPY TECH EA 15MIN	$35.88	$138.00	$89.70–$102.95	—	74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PTA MANL THERPY TECH EA 15MIN	$35.88	$138.00	$89.70–$102.95	—	74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERPY TECH EA 15MIN	$35.88	$138.00	$89.70–$102.95	—	74%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERPY TECH EA 15MIN	$35.88	$138.00	$89.70–$102.95	—	74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OTA THERAPEUTIC EXERCISE 15MIN	$24.70	$95.00	$50.73–$72.39	64% below	74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 SP THERAPEUTIC EXER 15 MINS	$24.70	$95.00	$50.73–$72.39	64% below	74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUTIC EXER EA 15 MIN	$24.70	$95.00	$50.73–$72.39	64% below	74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PTA THERAPEUTIC EXER EA 15 MIN	$24.70	$95.00	$50.73–$72.39	64% below	74%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 15MIN	$24.70	$95.00	$50.73–$72.39	64% below	74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 SP THERAPEUTIC EXER 15 MINS	$24.70	$95.00	$61.75–$70.87	—	74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PTA THERAPEUTIC EXER EA 15 MIN	$24.70	$95.00	$61.75–$70.87	—	74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE 15MIN	$24.70	$95.00	$61.75–$70.87	—	74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OTA THERAPEUTIC EXERCISE 15MIN	$24.70	$95.00	$61.75–$70.87	—	74%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXER EA 15 MIN	$24.70	$95.00	$61.75–$70.87	—	74%
Preventive checkup, new patient aged 18–39 CPT 99385 HC PREV VISIT NEW AGE 18-39	$37.44	$144.00	$76.90–$109.73	74% below	74%
Preventive checkup, new patient aged 18–39 CPT 99385 HC PREV VISIT NEW AGE 18-39YRS	$41.08	$158.00	$84.37–$120.40	72% below	74%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PREV VISIT NEW AGE 18-39	$37.44	$144.00	$93.60–$107.42	—	74%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PREV VISIT NEW AGE 18-39YRS	$41.08	$158.00	$102.70–$117.87	—	74%
Preventive checkup, new patient aged 40–64 CPT 99386 HC PREV VISIT NEW AGE 40-64	$45.24	$174.00	$92.92–$132.59	74% below	74%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PREV VISIT NEW AGE 40-64	$45.24	$174.00	$113.10–$129.80	—	74%
Preventive checkup, new patient aged 65 or older CPT 99387 HC INIT PM E/M NEW PAT 65+ YRS	$48.62	$187.00	$99.86–$142.49	60% below	74%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC INIT PM E/M NEW PAT 65+ YRS	$48.62	$187.00	$121.55–$139.50	—	74%
Preventive checkup, returning patient aged 18–39 CPT 99395 HC PREV VISIT EST AGE 18-39	$31.20	$120.00	$64.08–$91.44	73% below	74%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PREV VISIT EST AGE 18-39	$31.20	$120.00	$78.00–$89.52	—	74%
Preventive checkup, returning patient aged 40–64 CPT 99396 HC PREV VISIT EST AGE 40-64	$33.80	$130.00	$69.42–$99.06	70% below	74%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PREV VISIT EST AGE 40-64	$33.80	$130.00	$84.50–$96.98	—	74%
Preventive checkup, returning patient aged 65 or older CPT 99397 HC PER PM REEVAL EST PAT 65+YR	$35.36	$136.00	$72.62–$103.63	77% below	74%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PER PM REEVAL EST PAT 65+YR	$35.36	$136.00	$88.40–$101.46	—	74%
Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W MED SRVCS	$125.06	$481.00	$256.85–$366.52	45% below	74%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVAL W MED SRVCS	$125.06	$481.00	$312.65–$358.83	—	74%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PSYCL TEST 1ST HOUR	$147.68	$568.00	$303.31–$432.82	at median	74%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PSYCL TEST 1ST HOUR	$147.68	$568.00	$369.20–$423.73	—	74%
Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN	$64.74	$249.00	$132.97–$189.74	52% below	74%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHRPY PT&/FAMILY 30MIN	$64.74	$249.00	$132.97–$189.74	52% below	74%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN	$64.74	$249.00	$161.85–$185.75	—	74%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHRPY PT&/FAMILY 30MIN	$64.74	$249.00	$161.85–$185.75	—	74%
Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN	$67.86	$261.00	$139.37–$198.88	61% below	74%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHRPY PT&/FAMILY 45MIN	$67.86	$261.00	$139.37–$198.88	61% below	74%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHRPY PT&/FAMILY 45MIN	$67.86	$261.00	$169.65–$194.71	—	74%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN	$67.86	$261.00	$169.65–$194.71	—	74%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX W PT 60 MIN	$71.24	$274.00	$146.32–$208.79	58% below	74%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX PT&/FAMILY 60 MIN	$71.24	$274.00	$146.32–$208.79	58% below	74%
Psychotherapy session, 60 minutes CPT 90837 HC PSYTX PT&/FAMILY 60 MINUTES	$71.24	$274.00	$146.32–$208.79	58% below	74%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX PT&/FAMILY 60 MINUTES	$71.24	$274.00	$178.10–$204.40	—	74%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX PT&/FAMILY 60 MIN	$71.24	$274.00	$178.10–$204.40	—	74%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX W PT 60 MIN	$71.24	$274.00	$178.10–$204.40	—	74%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$13.52	$52.00	$27.77–$39.62	46% below	74%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$13.52	$52.00	$27.77–$39.62	46% below	74%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE TOBACCO COUSEL 3-10 MIN	$13.52	$52.00	$27.77–$39.62	46% below	74%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10MIN	$13.52	$52.00	$27.77–$39.62	46% below	74%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10MIN	$13.52	$52.00	$33.80–$38.79	—	74%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$13.52	$52.00	$33.80–$38.79	—	74%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKE TOBACCO COUSEL 3-10 MIN	$13.52	$52.00	$33.80–$38.79	—	74%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN	$13.52	$52.00	$33.80–$38.79	—	74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTAB PT LEVEL5	$85.02	$327.00	$174.62–$249.17	41% below	74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ED FU RECHECK VISIT LEVEL 5	$85.02	$327.00	$174.62–$249.17	41% below	74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTB PT LEVEL 5	$85.02	$327.00	$174.62–$249.17	41% below	74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFIC/OUTPT VISIT LVL 5 EST	$85.02	$327.00	$174.62–$249.17	41% below	74%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC AMWELL EST PT OFF VIS LVL 5	$85.02	$327.00	$174.62–$249.17	41% below	74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ED FU RECHECK VISIT LEVEL 3	$42.64	$164.00	$87.58–$124.97	42% below	74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFIC/OUTPT VISIT LVL 3 EST	$42.64	$164.00	$87.58–$124.97	42% below	74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IR VISIT EST PATIENT LEVEL 3	$42.64	$164.00	$87.58–$124.97	42% below	74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC AMWELL EST PT OFF VIS LVL 3	$42.64	$164.00	$87.58–$124.97	42% below	74%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTB PT LEVEL 3	$42.64	$164.00	$87.58–$124.97	42% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC AMWELL EST PT OFF VIS LVL 4	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IR VISIT EST PATIENT LEVEL 4	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFIC/OUTPT VISIT LVL 4 EST	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTB PT LEVEL 4	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ED FU RECHECK VISIT LEVEL 4	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTAB PT LEVEL4	$55.90	$215.00	$114.81–$163.83	47% below	74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ED FU RECHECK VISIT LEVEL 2	$33.02	$127.00	$67.82–$96.77	41% below	74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB PT LEVEL2	$33.02	$127.00	$67.82–$96.77	41% below	74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC AMWELL EST PT OFF VIS LVL 2	$33.02	$127.00	$67.82–$96.77	41% below	74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFIC/OUTPT VISIT LVL 2 EST	$33.02	$127.00	$67.82–$96.77	41% below	74%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTB PT LEVEL 2	$33.02	$127.00	$67.82–$96.77	41% below	74%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULTATION	$68.38	$263.00	$140.44–$200.41	51% above	74%
Specialist consultation, low complexity or 30+ minutes CPT 99243 HC OFFICE CONSULTATION LVL 3	$68.38	$263.00	$140.44–$200.41	51% above	74%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULTATION LVL 4	$80.34	$309.00	$165.01–$235.46	25% above	74%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HC OFFICE CONSULTATION	$80.34	$309.00	$165.01–$235.46	25% above	74%
Speech and language evaluation CPT 92523 EVAL SPEECH PROD & COMPREHEN	$148.20	$570.00	$304.38–$434.34	54% below	74%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH PROD & COMPREHEN	$148.20	$570.00	$370.50–$425.22	—	74%
Speech therapy session, individual CPT 92507 ST SPEECH TREATMENT	$73.06	$281.00	$150.05–$214.12	55% below	74%
Speech therapy session, individual inpatient CPT 92507 ST SPEECH TREATMENT	$73.06	$281.00	$182.65–$209.63	—	74%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$96.46	$371.00	$198.11–$282.70	32% below	74%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$96.46	$371.00	$241.15–$276.77	—	74%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM - PRE & POST BD	$160.68	$618.00	$330.01–$470.92	50% below	74%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY W BRONCHODILATION	$160.68	$618.00	$330.01–$470.92	50% below	74%
Spirometry before and after a bronchodilator CPT 94060 RH SPIROMETRY W BRONCHODILATIN	$160.68	$618.00	$330.01–$470.92	50% below	74%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM - PRE & POST BD	$160.68	$618.00	$401.70–$461.03	—	74%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY W BRONCHODILATION	$160.68	$618.00	$401.70–$461.03	—	74%
Spirometry before and after a bronchodilator inpatient CPT 94060 RH SPIROMETRY W BRONCHODILATIN	$160.68	$618.00	$401.70–$461.03	—	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 OTA THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 PTA THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THERAPEUTIC ACT EA 15MIN HC	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes CPT 97530 SP THERAPEUTIC ACT 15 MINS CA	$46.80	$180.00	$96.12–$137.16	59% below	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 SP THERAPEUTIC ACT 15 MINS CA	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PTA THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THERAPEUTIC ACT EA 15MIN HC	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OTA THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT EA 15MIN	$46.80	$180.00	$117.00–$134.28	—	74%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$140.66	$541.00	$288.89–$412.24	9% below	74%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$140.66	$541.00	$288.89–$412.24	9% below	74%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$140.66	$541.00	$351.65–$403.59	—	74%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$140.66	$541.00	$351.65–$403.59	—	74%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SPIKEVAX PF (CVX 312) 0.5 ML	$66.36	$255.24	$136.30–$194.49	59% below	74%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX PF (CVX 312) 0.5 ML	$66.36	$255.24	$165.91–$190.41	—	74%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE	$74.82	$287.76	$153.66–$219.27	52% below	74%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE	$74.82	$287.76	$187.04–$214.67	—	74%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL 0.5ML PEDIATRIC INJ	$15.81	$60.80	$32.47–$46.33	33% below	74%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL 0.5ML PEDIATRIC INJ	$15.81	$60.80	$39.52–$45.36	—	74%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DIP/HAEM/PERT/TET./POLIO	$49.40	$189.99	$101.45–$144.77	27% below	74%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DIP/HAEM/PERT/TET./POLIO	$49.40	$189.99	$123.49–$141.73	—	74%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VAC PF TIV 0.5 ML	$9.23	$35.51	$18.96–$27.06	58% below	74%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VAC PF TIV 0.5 ML	$9.23	$35.51	$23.08–$26.49	—	74%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PAPILLOMAVIRUS 9 VALENT INJ	$125.73	$483.57	$258.23–$368.48	15% below	74%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PAPILLOMAVIRUS 9 VALENT INJ	$125.73	$483.57	$314.32–$360.74	—	74%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS-A (ADULT) INJ 1ML	$36.95	$142.13	$75.90–$108.30	62% below	74%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS-A (ADULT) INJ 1ML	$36.95	$142.13	$92.38–$106.03	—	74%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HAVRIX HEPATITIS-A VAC(PEDS)	$16.93	$65.11	$34.77–$49.61	54% below	74%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HAVRIX HEPATITIS-A VAC(PEDS)	$16.93	$65.11	$42.32–$48.57	—	74%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE 20MCG INJ	$30.93	$118.97	$63.53–$90.66	51% below	74%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE 20MCG INJ	$30.93	$118.97	$77.33–$88.75	—	74%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 ENGERIX-B VACCINE 10/0.5 INJ	$12.45	$47.90	$25.58–$36.50	65% below	74%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 ENGERIX-B VACCINE 10/0.5 INJ	$12.45	$47.90	$31.14–$35.73	—	74%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJ VAC (PRP-T)	$8.48	$32.60	$17.41–$24.84	57% below	74%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B CONJ VAC (PRP-T)	$8.48	$32.60	$21.19–$24.32	—	74%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZAPF HIGH DOSE (65YRS+)	$28.71	$110.43	$58.97–$84.15	60% below	74%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZAPF HIGH DOSE (65YRS+)	$28.71	$110.43	$71.78–$82.38	—	74%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMP/RUBELLA VAC 0.5ML	$41.88	$161.08	$86.02–$122.74	68% below	74%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMP/RUBELLA VAC 0.5ML	$41.88	$161.08	$104.70–$120.17	—	74%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL (CON) VAC INJ	$69.14	$265.93	$142.01–$202.64	33% below	74%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL (A, C, Y, W-135)	$69.14	$265.93	$142.01–$202.64	33% below	74%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL (CON) VAC INJ	$69.14	$265.93	$172.85–$198.38	—	74%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL (A, C, Y, W-135)	$69.14	$265.93	$172.85–$198.38	—	74%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUP B VACCINE	$98.55	$379.03	$202.40–$288.82	49% below	74%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUP B VACCINE	$98.55	$379.03	$246.37–$282.76	—	74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ	$118.51	$455.79	$243.39–$347.31	69% below	74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT 0.5ML	$118.51	$455.79	$243.39–$347.31	69% below	74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT 0.5ML	$118.51	$455.79	$296.26–$340.02	—	74%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ	$118.51	$455.79	$296.26–$340.02	—	74%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21-(CVX 327)	$134.32	$516.60	$275.86–$393.65	33% below	74%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21-(CVX 327)	$134.32	$516.60	$335.79–$385.38	—	74%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE 0.5ML INJ	$54.80	$210.75	$112.54–$160.59	43% below	74%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-POLY VACCINE	$54.80	$210.75	$112.54–$160.59	43% below	74%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-POLY VACCINE	$54.80	$210.75	$136.99–$157.22	—	74%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE 0.5ML INJ	$54.80	$210.75	$136.99–$157.22	—	74%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE INJ	$18.07	$69.51	$37.12–$52.97	58% below	74%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE INJ	$18.07	$69.51	$45.18–$51.85	—	74%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF BIVALENT IM	$119.65	$460.20	$245.75–$350.67	35% below	74%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE PREF BIVALENT IM	$119.65	$460.20	$299.13–$343.31	—	74%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 2.5UNIT/1ML INJ	$177.39	$682.28	$364.34–$519.90	76% below	74%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE 2.5UNIT/1ML INJ	$177.39	$682.28	$443.48–$508.98	—	74%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE (SHINGRIX)	$85.83	$330.13	$176.29–$251.56	at median	74%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE (SHINGRIX)	$85.83	$330.13	$214.58–$246.28	—	74%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPH TOXOID 0.5ML INJ	$13.10	$50.37	$26.90–$38.38	68% below	74%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-PIHTHERIA TOXOID INJ	$13.10	$50.37	$26.90–$38.38	68% below	74%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPH TOXOID 0.5ML INJ	$13.10	$50.37	$32.74–$37.58	—	74%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-PIHTHERIA TOXOID INJ	$13.10	$50.37	$32.74–$37.58	—	74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP) 0.5ML SYRINGE	$20.51	$78.89	$42.13–$60.11	54% below	74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX (TDAP) 0.5ML INJ	$20.51	$78.89	$42.13–$60.11	54% below	74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP) 0.5ML SYRINGE	$20.51	$78.89	$51.28–$58.85	—	74%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX (TDAP) 0.5ML INJ	$20.51	$78.89	$51.28–$58.85	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VAC	$20.28	$78.00	$41.65–$59.44	15% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VAC M ADMIN INFLUENZA VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM; 1 VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMONIA VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEPATITIS B VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE SINGLE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCCAL VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM 1 VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMO VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCOCCAL VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VAC	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RH ADMIN INFLUENZA VACCINE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RH ADMIN VACCINE SINGLE	$28.86	$111.00	$59.27–$84.58	64% above	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VAC	$20.28	$78.00	$50.70–$58.19	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RH ADMIN VACCINE SINGLE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VAC M ADMIN INFLUENZA VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMOCCAL VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM; 1 VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE SINGLE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMOCOCCAL VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMO VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM 1 VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN HEPATITIS B VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMONIA VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VAC	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RH ADMIN INFLUENZA VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$28.86	$111.00	$72.15–$82.81	—	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM VACCINE EA ADDL-STATE SUPP	$5.61	$21.58	$11.52–$16.44	68% below	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RH ADM VACCINE EA ADDL-STATE	$5.61	$21.58	$11.52–$16.44	68% below	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN OTHER IMMUN VAC ADD	$9.88	$38.00	$20.29–$28.96	44% below	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM EA ADD VAC	$9.88	$38.00	$20.29–$28.96	44% below	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADDL	$9.88	$38.00	$20.29–$28.96	44% below	74%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RH ADMIN VACCINE EA ADDL	$9.88	$38.00	$20.29–$28.96	44% below	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RH ADM VACCINE EA ADDL-STATE	$5.61	$21.58	$14.03–$16.10	—	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADM VACCINE EA ADDL-STATE SUPP	$5.61	$21.58	$14.03–$16.10	—	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RH ADMIN VACCINE EA ADDL	$9.88	$38.00	$24.70–$28.35	—	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADDL	$9.88	$38.00	$24.70–$28.35	—	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM EA ADD VAC	$9.88	$38.00	$24.70–$28.35	—	74%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN OTHER IMMUN VAC ADD	$9.88	$38.00	$24.70–$28.35	—	74%

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://northernlighthealth.org/NLH/media/Price-Transparency/010211534_Mercy-hospital_standardcharges.csv