Hospital San Francisco-Oakland-Fremont, CA

Stanford Health Care Tri-Valley

Stanford Health Care Tri-Valley in Pleasanton, CA publishes cash prices for 353 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the California median for 176 of 348 procedures and below it for 170. By typical cash price it ranks #127 of 226 California hospitals and #3 of 26 hospitals in the San Francisco, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

5555 West Las Positas Boulevard, Pleasanton, CA 94588,1111-1133 E. Stanley BLVD, Livermore, CA 94550 Collected Sep 23, 2026 Source price file Check a bill from this hospital (925) 847-3000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 5 of 5 CCN 050283 · CMS hospital register NPI 1144389941

Financial assistance

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

Stanford Health Care Tri-Valley 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.

State law

This state limits hospital bills for lower-income patients

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen WO/W Contrast	$2,400.80	$6,002.00	—	15% below	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen WO/W Contrast	$4,232.80	$10,582.00	—	—	60%
Abdominal X-ray, 2 views CPT 74019 X-Ray Exam Abdomen 2 Views	$449.60	$1,124.00	—	4% above	60%
Abdominal X-ray, 2 views inpatient CPT 74019 X-Ray Exam Abdomen 2 Views	$595.60	$1,489.00	—	—	60%
Ankle X-ray, complete, 3 or more views CPT 73610 Xr Ankle Min 3v	$298.40	$746.00	—	42% below	60%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Xr Ankle Min 3v	$513.60	$1,284.00	—	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Limit Bilatl Upr/L Xtremity Art 2 Levels	$464.80	$1,162.00	—	17% below	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Limit Bilatl Upr/L Xtremity Art 2 Levels	$464.80	$1,162.00	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Up Ext WO Contrast	$1,532.00	$3,830.00	—	33% below	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Up Ext WO Contrast	$2,206.40	$5,516.00	—	—	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagus Scout Chest, 1cntrst	$540.40	$1,351.00	—	11% below	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Xr Esophagus Scout Chest, 1cntrst	$993.60	$2,484.00	—	—	60%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Scan Whole Body	$1,115.20	$2,788.00	—	47% below	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Scan Whole Body	$2,916.80	$7,292.00	—	—	60%
Breast ultrasound, complete, one breast CPT 76641 US Breast Unil, Complete	$103.00	$354.00	—	85% below	71%
Breast ultrasound, complete, one breast inpatient CPT 76641 US Breast Unil, Complete	$103.00	$844.00	—	—	88%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Unil, Limited	$321.20	$803.00	—	40% below	60%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Unil, Limited	$321.20	$803.00	—	—	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd-Pelvis WO/W Cont	$4,732.00	$11,830.00	—	12% below	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd-Pelvis WO/W Cont	$4,732.00	$11,830.00	—	—	60%
CT angiography (CTA) of the head CPT 70496 CT Angio Head WO/W Contrast	$2,387.20	$5,968.00	—	20% below	60%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Head WO/W Contrast	$3,583.20	$8,958.00	—	—	60%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck WO/W Contrast	$2,392.40	$5,981.00	—	19% below	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck WO/W Contrast	$3,283.20	$8,208.00	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest WO/W Cont	$2,252.80	$5,632.00	—	34% below	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest WO/W Cont	$4,303.60	$10,759.00	—	—	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Cta Card W/Quan Eval of Coro C	$2,558.00	$6,395.00	—	5% below	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Cta Card W/Quan Eval of Coro C	$2,558.00	$6,395.00	—	—	60%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Coronary Calcium WO Contrast	$234.00	$1,162.00	—	38% below	80%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Coronary Calcium WO Contrast	$234.00	$1,162.00	—	—	80%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen-Pelvis WO Contrast	$3,722.80	$9,307.00	—	16% above	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen-Pelvis WO Contrast	$4,354.80	$10,887.00	—	—	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen-Pelvis W Contrast	$4,113.60	$10,284.00	—	at median	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen-Pelvis W Contrast	$5,715.60	$14,289.00	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen-Pelvis WO/W Contrast	$4,391.60	$10,979.00	—	7% below	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen-Pelvis WO/W Contrast	$7,113.20	$17,783.00	—	—	60%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W Contrast	$1,784.80	$4,462.00	—	29% below	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W Contrast	$3,015.20	$7,538.00	—	—	60%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen WO Contrast	$1,696.40	$4,241.00	—	11% below	60%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen WO Contrast	$2,952.80	$7,382.00	—	—	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial WO Contrast	$1,587.20	$3,968.00	—	27% below	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial WO Contrast	$2,299.60	$5,749.00	—	—	60%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head WO Contrast	$1,568.80	$3,922.00	—	31% below	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head WO Contrast	$2,370.80	$5,927.00	—	—	60%
CT scan of the head with contrast CPT 70460 CT Head/Brain W Contrast	$1,966.40	$4,916.00	—	27% below	60%
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W Contrast	$2,572.40	$6,431.00	—	—	60%
CT scan of the head without and with contrast CPT 70470 CT Head WO/W Contrast	$2,278.80	$5,697.00	—	26% below	60%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head WO/W Contrast	$3,861.60	$9,654.00	—	—	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-Spine WO Contrast	$1,854.00	$4,635.00	—	35% below	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-Spine WO Contrast	$2,322.40	$5,806.00	—	—	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine WO Contrast	$1,585.20	$3,963.00	—	46% below	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine WO Contrast	$3,016.00	$7,540.00	—	—	60%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W Contrast	$2,057.60	$5,144.00	—	19% below	60%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W Contrast	$2,996.00	$7,490.00	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid Dplx Bilat	$1,345.60	$3,364.00	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Carotid Dplx Bilat	$1,345.60	$3,364.00	—	—	60%
Chest CT scan without and with contrast CPT 71270 CT Thorax WO/W Cont	$1,972.80	$4,932.00	—	40% below	60%
Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax WO/W Cont	$3,757.60	$9,394.00	—	—	60%
Chest X-ray, 2 views CPT 71046 X-Ray Exam Chest 2 Views	$362.80	$907.00	—	11% below	60%
Chest X-ray, 2 views inpatient CPT 71046 X-Ray Exam Chest 2 Views	$540.40	$1,351.00	—	—	60%
Chest X-ray, single view CPT 71045 Xr Chest Single View	$292.80	$732.00	—	20% below	60%
Chest X-ray, single view inpatient CPT 71045 Xr Chest Single View	$392.40	$981.00	—	—	60%
Collarbone (clavicle) X-ray, complete CPT 73000 Xr Clavicle	$279.60	$699.00	—	42% below	60%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Xr Clavicle	$436.40	$1,091.00	—	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal	$833.20	$2,083.00	—	2% below	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal	$1,312.80	$3,282.00	—	—	60%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Density Dexa Axial	$448.80	$1,122.00	—	11% below	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Density Dexa Axial	$448.80	$1,122.00	—	—	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Density2 Appendicula	$309.60	$774.00	—	12% above	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Bone Density2 Appendicula	$375.60	$939.00	—	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax W/O Contrast	$1,456.40	$3,641.00	—	28% below	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax W/O Contrast	$1,456.40	$3,641.00	—	—	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax W Contrast	$1,883.60	$4,709.00	—	35% below	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax W Contrast	$3,111.20	$7,778.00	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 Digital Diag Mammography Bilat Incl Cad	$417.20	$1,043.00	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Digital Diag Mammography Bilat Incl Cad	$417.20	$1,043.00	—	—	60%
Diagnostic mammogram, one breast one side CPT 77065 Digital Diag Mammography Unilat Incl Cad	$318.80	$797.00	—	15% below	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Digital Diag Mammography Unilat Incl Cad	$318.80	$797.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Art Dplx Lower Ext Bilat	$2,039.20	$5,098.00	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Art Dplx Lower Ext Bilat	$2,039.20	$5,098.00	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Dplx Up&Lw Bilat	$1,453.20	$3,633.00	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Dplx Up&Lw Bilat	$1,453.20	$3,633.00	—	—	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W Doppler W Color	$2,834.00	$7,085.00	—	5% above	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte W Doppler W Color	$4,002.00	$10,005.00	—	—	60%
Elbow X-ray, 2 views CPT 73070 Xr Elbow 2v	$277.20	$693.00	—	30% below	60%
Elbow X-ray, 2 views inpatient CPT 73070 Xr Elbow 2v	$522.40	$1,306.00	—	—	60%
Elbow X-ray, complete, 3 or more views CPT 73080 Xr Elbow Min 3v	$351.20	$878.00	—	27% below	60%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Xr Elbow Min 3v	$629.60	$1,574.00	—	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orb Sell/Pst Fos WO Cont	$1,401.60	$3,504.00	—	39% below	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orb Sell/Pst Fos WO Cont	$2,774.80	$6,937.00	—	—	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones Min 3v	$372.80	$932.00	—	25% below	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Xr Facial Bones Min 3v	$437.20	$1,093.00	—	—	60%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Xr Forearm 2v	$312.40	$781.00	—	27% below	60%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Xr Forearm 2v	$481.20	$1,203.00	—	—	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary System Imaging	$2,160.80	$5,402.00	—	22% above	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary System Imaging	$2,160.80	$5,402.00	—	—	60%
Hand X-ray, 2 views CPT 73120 Xr Hand 2v	$236.80	$592.00	—	42% below	60%
Hand X-ray, 2 views inpatient CPT 73120 Xr Hand 2v	$408.40	$1,021.00	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Xr Calcaneus Min 2v	$240.80	$602.00	—	32% below	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Xr Calcaneus Min 2v	$433.60	$1,084.00	—	—	60%
Knee X-ray, 3 views CPT 73562 Xr Knee 3v	$323.60	$809.00	—	30% below	60%
Knee X-ray, 3 views inpatient CPT 73562 Xr Knee 3v	$486.80	$1,217.00	—	—	60%
Knee X-ray, complete, 4 or more views CPT 73564 Xr Knee 4+V	$348.40	$871.00	—	41% below	60%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Xr Knee 4+V	$540.40	$1,351.00	—	—	60%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Lwr Ext WO Contrast	$1,664.00	$4,160.00	—	22% below	60%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lwr Ext WO Contrast	$2,220.40	$5,551.00	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$922.40	$2,306.00	—	11% above	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$922.40	$2,306.00	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US, Extremity, Nonvasc - Limited	$454.00	$1,135.00	—	17% below	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US, Extremity, Nonvasc - Limited	$746.40	$1,866.00	—	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Thorax Lung Cancer Scr C-	$396.00	$827.00	—	11% above	52%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Thorax Lung Cancer Scr C-	$396.00	$827.00	—	—	52%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Xr Tibia + Fibula 2v	$384.40	$961.00	—	11% below	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Xr Tibia + Fibula 2v	$523.20	$1,308.00	—	—	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRI Angio Head WO Contrast	$3,338.00	$8,345.00	—	15% above	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI Angio Head WO Contrast	$3,338.00	$8,345.00	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lwr Ext Jnt WO Contrast	$3,484.80	$8,712.00	—	15% above	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lwr Ext Jnt WO Contrast	$4,042.40	$10,106.00	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lwr Ext Jnt WO/W Contrast	$3,880.00	$9,700.00	—	16% below	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lwr Ext Jnt WO/W Contrast	$4,444.40	$11,111.00	—	—	60%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen WO Contrast	$3,724.80	$9,312.00	—	33% above	60%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen WO Contrast	$3,724.80	$9,312.00	—	—	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abddomen WO/W Cont	$6,458.80	$16,147.00	—	48% above	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abddomen WO/W Cont	$6,458.80	$16,147.00	—	—	60%
MRI of the brain, no contrast dye CPT 70551 MRI Brain WO Contrast	$2,769.20	$6,923.00	—	5% below	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO Contrast	$3,734.00	$9,335.00	—	—	60%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WO/W Contrst	$3,596.40	$8,991.00	—	17% below	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WO/W Contrst	$4,922.40	$12,306.00	—	—	60%
MRI of the lower back, no contrast dye CPT 72148 MRI L-Spine WO Contrast	$4,407.60	$11,019.00	—	44% above	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-Spine WO Contrast	$4,407.60	$11,019.00	—	—	60%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-Spine WO/W Cont	$6,292.40	$15,731.00	—	39% above	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-Spine WO/W Cont	$6,292.40	$15,731.00	—	—	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-Spine WO Contrast	$4,500.40	$11,251.00	—	55% above	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-Spine WO Contrast	$4,500.40	$11,251.00	—	—	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-Spine WO/W Cont	$4,962.00	$12,405.00	—	12% above	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-Spine WO/W Cont	$4,962.00	$12,405.00	—	—	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C Spine WO Contrast	$2,815.20	$7,038.00	—	6% below	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C Spine WO Contrast	$3,540.40	$8,851.00	—	—	60%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis WO/W Contrast	$4,522.00	$11,305.00	—	9% above	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis WO/W Contrast	$6,319.20	$15,798.00	—	—	60%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis WO Contrast	$3,892.80	$9,732.00	—	52% above	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis WO Contrast	$3,892.80	$9,732.00	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Up Ext Jnt WO Contrast	$3,862.80	$9,657.00	—	47% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Up Ext Jnt WO Contrast	$4,422.40	$11,056.00	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr C-Spine 4-5v	$538.40	$1,346.00	—	16% below	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Xr C-Spine 4-5v	$927.20	$2,318.00	—	—	60%
Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tiss Neck W Contrast	$2,793.60	$6,984.00	—	2% above	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tiss Neck W Contrast	$2,793.60	$6,984.00	—	—	60%
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tiss Neck WO Contrast	$2,514.00	$6,285.00	—	19% above	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tiss Neck WO Contrast	$2,514.00	$6,285.00	—	—	60%
Neck soft tissue X-ray CPT 70360 Xr Soft Tissue Neck	$294.80	$737.00	—	9% below	60%
Neck soft tissue X-ray inpatient CPT 70360 Xr Soft Tissue Neck	$436.40	$1,091.00	—	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocard Tomo Multi	$4,058.80	$10,147.00	—	at median	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocard Tomo Multi	$5,681.20	$14,203.00	—	—	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Petct Skull-Thigh	$5,643.20	$14,108.00	—	22% below	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Petct Skull-Thigh	$5,643.20	$14,108.00	—	—	60%
Pelvic CT scan without contrast CPT 72192 CT Pelvis WO Contrast	$2,019.60	$5,049.00	—	3% above	60%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis WO Contrast	$2,525.20	$6,313.00	—	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelv Non-OB Limited	$604.40	$1,511.00	—	12% above	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelv Non-OB Limited	$604.40	$1,511.00	—	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non-OB	$676.00	$1,690.00	—	28% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Non-OB	$1,178.00	$2,945.00	—	—	60%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus W/Eval >1tri	$657.60	$1,644.00	—	24% below	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus W/Eval >1tri	$680.40	$1,701.00	—	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Utrs W/Eval, 1st Tri	$599.20	$1,498.00	—	23% below	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg Utrs W/Eval, 1st Tri	$738.00	$1,845.00	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Uter Limited	$534.40	$1,336.00	—	12% below	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Utrs, Limited	$570.80	$1,427.00	—	6% below	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Utrs, Limited	$570.80	$1,427.00	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Uter Limited	$570.80	$1,427.00	—	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2v, Unilat	$280.00	$700.00	—	39% below	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Xr Ribs 2v, Unilat	$503.60	$1,259.00	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs W Chest Min 3v, Unilat	$389.60	$974.00	—	37% below	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Xr Ribs W Chest Min 3v, Unilat	$667.60	$1,669.00	—	—	60%
Screening mammogram, both breasts CPT 77067 Digital Screening Mammogram	$270.80	$677.00	—	14% below	60%
Screening mammogram, both breasts inpatient CPT 77067 Digital Screening Mammogram	$270.80	$677.00	—	—	60%
Shoulder X-ray, complete, 2 or more views CPT 73030 Xr Shoulder Min 2/V	$292.00	$730.00	—	47% below	60%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Xr Shoulder Min 2/V	$537.20	$1,343.00	—	—	60%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Paranasal Min 3v	$376.00	$940.00	—	18% below	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Xr Sinuses Paranasal Min 3v	$568.40	$1,421.00	—	—	60%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull <4v	$327.20	$818.00	—	19% below	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Xr Skull <4v	$548.80	$1,372.00	—	—	60%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Strs Ttew/Worx I&R W MD	$1,682.80	$4,207.00	—	47% below	60%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Strs Ttew/Worx I&R W MD	$1,682.80	$4,207.00	—	—	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Study W Scout Neck, Contrast	$652.00	$1,630.00	—	1% below	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Study W Scout Neck, Contrast	$1,140.40	$2,851.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Xr Femur 2v	$207.20	$518.00	—	49% below	60%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Xr Femur 2v	$207.20	$518.00	—	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-Spine WO Contrast	$1,637.60	$4,094.00	—	42% below	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-Spine WO Contrast	$3,111.20	$7,778.00	—	—	60%
Toe X-ray, 2 or more views CPT 73660 Xr Toe(S) Min 2v	$278.00	$695.00	—	16% below	60%
Toe X-ray, 2 or more views inpatient CPT 73660 Xr Toe(S) Min 2v	$427.60	$1,069.00	—	—	60%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$821.20	$2,053.00	—	15% above	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$821.20	$2,053.00	—	—	60%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uter, Transvaginal	$276.40	$691.00	—	59% below	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Uter, Transvaginal	$265.60	$664.00	—	—	60%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen	$848.40	$2,121.00	—	23% below	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen	$1,308.80	$3,272.00	—	—	60%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum	$687.60	$1,719.00	—	23% below	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum	$995.20	$2,488.00	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue of Head or Nec	$721.20	$1,803.00	—	13% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue of Head or Nec	$1,003.20	$2,508.00	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radxr GI Trc Upr +-Dlyd Flms 1 Contrast	$1,295.20	$3,238.00	—	110% above	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Radxr GI Trc Upr +-Dlyd Flms 1 Contrast	$1,295.20	$3,238.00	—	—	60%
Upper arm X-ray (humerus), 2 views CPT 73060 Xr Humerus Min 2v	$302.80	$757.00	—	29% below	60%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Xr Humerus Min 2v	$472.00	$1,180.00	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Venous Dplx Up&Lw Limited	$732.00	$1,830.00	—	19% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Venous Dplx Up&Lw Limited	$1,089.20	$2,723.00	—	—	60%
Wrist X-ray, 2 views CPT 73100 Xr Wrist 2v	$260.00	$650.00	—	33% below	60%
Wrist X-ray, 2 views inpatient CPT 73100 Xr Wrist 2v	$363.20	$908.00	—	—	60%
Wrist X-ray, complete, 3 or more views CPT 73110 Xr Wrist Min 3v	$328.00	$820.00	—	35% below	60%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Xr Wrist Min 3v	$548.80	$1,372.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip Unilat, W/WO Pelvis 2-3v	$238.40	$596.00	—	41% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Xr Hip Unilat, W/WO Pelvis 2-3v	$238.40	$596.00	—	—	60%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Ap	$324.40	$811.00	—	7% above	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 Xr Abdomen Ap	$432.80	$1,082.00	—	—	60%
X-ray of the ankle, 2 views CPT 73600 Xr Ankle 2v	$234.40	$586.00	—	40% below	60%
X-ray of the ankle, 2 views inpatient CPT 73600 Xr Ankle 2v	$399.60	$999.00	—	—	60%
X-ray of the finger(s), 2 or more views CPT 73140 Xr Finger(S) Min 2v	$255.20	$638.00	—	30% below	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Xr Finger(S) Min 2v	$444.00	$1,110.00	—	—	60%
X-ray of the foot, 2 views CPT 73620 Xr Foot 2v	$248.80	$622.00	—	39% below	60%
X-ray of the foot, 2 views inpatient CPT 73620 Xr Foot 2v	$378.00	$945.00	—	—	60%
X-ray of the foot, complete, 3 or more views CPT 73630 Xr Foot Min 3v	$297.20	$743.00	—	40% below	60%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Xr Foot Min 3v	$523.60	$1,309.00	—	—	60%
X-ray of the hand, 3 or more views CPT 73130 Xr Hand Min 3v	$315.20	$788.00	—	38% below	60%
X-ray of the hand, 3 or more views inpatient CPT 73130 Xr Hand Min 3v	$507.20	$1,268.00	—	—	60%
X-ray of the knee, 1 or 2 views CPT 73560 Xr Knee 1-2v	$275.60	$689.00	—	31% below	60%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Xr Knee 1-2v	$422.00	$1,055.00	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L-Spine 2-3v	$374.40	$936.00	—	21% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Xr L-Spine 2-3v	$466.80	$1,167.00	—	—	60%
X-ray of the lower back, 4 or more views CPT 72110 Xr L-Spine Min 4v	$457.60	$1,144.00	—	30% below	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Xr L-Spine Min 4v	$772.00	$1,930.00	—	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr T-Spine 2v	$547.60	$1,369.00	—	19% above	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Xr T-Spine 2v	$547.60	$1,369.00	—	—	60%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Min 3v	$363.60	$909.00	—	16% below	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Xr Nasal Bones Min 3v	$453.60	$1,134.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C-Spine 2-3v	$556.80	$1,392.00	—	24% above	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Xr C-Spine 2-3v	$556.80	$1,392.00	—	—	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1-2v	$309.60	$774.00	—	20% below	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Xr Pelvis 1-2v	$404.80	$1,012.00	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum Coccyx Min 2v	$292.80	$732.00	—	38% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Xr Sacrum Coccyx Min 2v	$504.00	$1,260.00	—	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ACTH blood test CPT 82024 HC Acth	$144.00	$360.00	—	113% above	60%
ACTH blood test inpatient CPT 82024 HC Acth	$144.00	$360.00	—	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt/Alt	$108.80	$272.00	—	152% above	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Sgpt/Alt	$108.80	$272.00	—	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Sgot/Ast	$100.00	$250.00	—	120% above	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Sgot/Ast	$100.00	$250.00	—	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel	$277.20	$693.00	—	2% above	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel	$391.20	$978.00	—	—	60%
Albumin blood test CPT 82040 Albumin Serm(Prtof Csfigg	$7.59	$18.97	—	70% below	60%
Albumin blood test CPT 82040 HC Albumin	$53.20	$133.00	—	113% above	60%
Albumin blood test CPT 82040 Cpie Albumin	$53.20	$133.00	—	113% above	60%
Albumin blood test inpatient CPT 82040 Albumin Serm(Prtof Csfigg	$7.59	$18.97	—	—	60%
Albumin blood test inpatient CPT 82040 HC Albumin	$98.80	$247.00	—	—	60%
Albumin blood test inpatient CPT 82040 Cpie Albumin	$98.80	$247.00	—	—	60%
Aldosterone blood test CPT 82088 HC 6956 11070r Aldosterone	$9.00	$22.50	—	70% below	60%
Aldosterone blood test inpatient CPT 82088 HC 6956 11070r Aldosterone	$9.00	$22.50	—	—	60%
Alkaline phosphatase (ALP) blood test CPT 84075 HC 6959 12401r Alk Phos Total	$3.68	$9.19	—	90% below	60%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Alk Phos Total	$57.60	$144.00	—	56% above	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC 6959 12401r Alk Phos Total	$3.68	$9.19	—	—	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alk Phos Total	$94.00	$235.00	—	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC 7055 12680r Alrgn Ige Qntea	$2.00	$5.00	—	60% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 6959 Alrgn Ige Qntea	$2.00	$5.00	—	60% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Bronch Asper Allergic-86003	$2.57	$6.43	—	49% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Alrgn Ige Qntea	$5.98	$14.96	—	20% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Peanut Components	$10.50	$26.25	—	110% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Alpha-Gal	$18.00	$45.00	—	260% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Ige	$20.40	$51.00	—	308% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen;Parrots Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Cat Dander Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst: Alder Tree Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Bermuda Grass Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Duck Weed Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Alternari Mld Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Anti Dsdna Ab	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Dust Mite-Df Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 Labmall Mountain Cedar	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:West Ragweed Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Oak Tree Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Cockroach Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Olive Tree Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Cladospor Mld Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Dog Dander Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Peanut Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen;Parakeets Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Aspergill Mld Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Misc Allergen 1 Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Rye Grass Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Sage Wd Mugwort Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Alrgy Tst:Timothy Grass Ige	$22.80	$57.00	—	356% above	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC 7055 12680r Alrgn Ige Qntea	$2.00	$5.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 6959 Alrgn Ige Qntea	$2.00	$5.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bronch Asper Allergic-86003	$2.57	$6.43	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alrgn Ige Qntea	$5.98	$14.96	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Peanut Components	$10.50	$26.25	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Alpha-Gal	$18.00	$45.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Ige	$20.40	$51.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Sage Wd Mugwort Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Rye Grass Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Oak Tree Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Alternari Mld Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Aspergill Mld Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Labmall Mountain Cedar	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Dust Mite-Df Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Anti Dsdna Ab	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst: Alder Tree Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Bermuda Grass Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen;Parrots Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Cat Dander Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen;Parakeets Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Cladospor Mld Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:West Ragweed Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Duck Weed Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Timothy Grass Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Peanut Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Dog Dander Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Olive Tree Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Alrgy Tst:Cockroach Ige	$22.80	$57.00	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Misc Allergen 1 Ige	$22.80	$57.00	—	—	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha Fetoprotein	$76.80	$192.00	—	at median	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha Fetoprotein	$76.80	$192.00	—	—	60%
Ammonia blood test CPT 82140 HC Bld Ammonia Test	$282.40	$706.00	—	56% above	60%
Ammonia blood test inpatient CPT 82140 HC Bld Ammonia Test	$335.20	$838.00	—	—	60%
Amylase blood test CPT 82150 HC Amylase Test	$198.40	$496.00	—	288% above	60%
Amylase blood test CPT 82150 HC Amylase Body Fluid	$270.80	$677.00	—	430% above	60%
Amylase blood test inpatient CPT 82150 HC Amylase Test	$270.80	$677.00	—	—	60%
Amylase blood test inpatient CPT 82150 HC Amylase Body Fluid	$270.80	$677.00	—	—	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Anti-Nuc Ab (Fana)	$59.20	$148.00	—	84% above	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Anti-Nuc Ab (Fana)	$59.20	$148.00	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Nt-Probnp	$331.60	$829.00	—	79% above	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Nt-Probnp	$531.20	$1,328.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Wound Clt	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Cathr Tip Culture	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Respiratry Cultr	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Fluid Cult	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Genital Cult	$305.60	$764.00	—	153% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Cystic Fib Resp Cult	$361.60	$904.00	—	200% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CSF Culture	$361.60	$904.00	—	200% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Cathr Tip Culture	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Wound Clt	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Genital Cult	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Cystic Fib Resp Cult	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Respiratry Cultr	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CSF Culture	$361.60	$904.00	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Fluid Cult	$361.60	$904.00	—	—	60%
Basic metabolic panel (blood test) CPT 80048 HC Metabolic Pnl Basic	$185.60	$464.00	—	6% below	60%
Basic metabolic panel (blood test) inpatient CPT 80048 HC Metabolic Pnl Basic	$366.40	$916.00	—	—	60%
Bilirubin blood test, total CPT 82247 HC Bmt I T Bili	$48.80	$122.00	—	8% above	60%
Bilirubin blood test, total CPT 82247 Bilirubin, Total, Fluid	$89.20	$223.00	—	97% above	60%
Bilirubin blood test, total CPT 82247 HC Bilirubin, Total	$95.60	$239.00	—	111% above	60%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total, Fluid	$89.20	$223.00	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin, Total	$95.60	$239.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cyto Cell Block-Lv4	$341.20	$853.00	—	162% above	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path Exm-Compl-Lv4	$341.20	$853.00	—	162% above	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Path Exm-Compl-Lv4	$341.20	$853.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Cyto Cell Block-Lv4	$341.20	$853.00	—	—	60%
Blood culture for bacteria CPT 87040 HC Blood Culture	$301.60	$754.00	—	11% above	60%
Blood culture for bacteria inpatient CPT 87040 HC Blood Culture	$596.40	$1,491.00	—	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture	$40.80	$102.00	—	94% above	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Venipuncture	$40.80	$102.00	—	—	60%
Blood glucose (sugar) test CPT 82947 HC Glucose, Serum/Plasma	$56.80	$142.00	—	51% above	60%
Blood glucose (sugar) test CPT 82947 HC Glucose, Serum/Plasma	$91.20	$228.00	—	143% above	60%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose, Serum/Plasma	$91.20	$228.00	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose, Serum/Plasma	$91.20	$228.00	—	—	60%
Blood lead test CPT 83655 6959 Lead Level	$4.71	$11.78	—	54% below	60%
Blood lead test CPT 83655 Lead Urine	$5.08	$12.71	—	50% below	60%
Blood lead test inpatient CPT 83655 6959 Lead Level	$4.71	$11.78	—	—	60%
Blood lead test inpatient CPT 83655 Lead Urine	$5.08	$12.71	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Labpcupreg Hcg Qual	$114.80	$287.00	—	28% below	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Serum Pregnancy Scr	$137.60	$344.00	—	14% below	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Urine	$137.60	$344.00	—	14% below	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Labpcupreg Hcg Qual	$221.20	$553.00	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Serum Pregnancy Scr	$221.20	$553.00	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Urine	$221.20	$553.00	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Typing	$131.20	$328.00	—	28% above	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Typing	$131.20	$328.00	—	28% above	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Typing	$131.20	$328.00	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Typing	$131.20	$328.00	—	—	60%
Blood urea nitrogen (BUN) test CPT 84520 HC Urea Nitrogen	$115.60	$289.00	—	249% above	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Urea Nitrogen	$115.60	$289.00	—	—	60%
C-peptide blood test CPT 84681 HC C Peptide	$71.20	$178.00	—	12% above	60%
C-peptide blood test inpatient CPT 84681 HC C Peptide	$71.20	$178.00	—	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C Reactive Protein	$150.00	$375.00	—	178% above	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C Reactive Protein	$178.00	$445.00	—	—	60%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Cdtpcr C Diff Toxin Amp Stl	$327.20	$818.00	—	114% above	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Cdtpcr C Diff Toxin Amp Stl	$327.20	$818.00	—	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 HC Cancer Ag 19-9	$77.60	$194.00	—	55% above	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Cancer Ag 19-9	$77.60	$194.00	—	—	60%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Ca125 (C125)	$168.40	$421.00	—	22% above	60%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Ca125 (C125)	$168.40	$421.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-Cov-2 Covid-19 by Naa	$38.00	$95.00	—	60% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Labstatcovrespcr Cov-19	$126.40	$316.00	—	34% above	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Labcovrespcr Cov-19	$126.40	$316.00	—	34% above	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-Cov-2 Pcr	$126.40	$316.00	—	34% above	60%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 Labcovid19 Coronavirus Rt Pcr	$126.40	$316.00	—	34% above	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars-Cov-2 Covid-19 by Naa	$38.00	$95.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars-Cov-2 Pcr	$126.40	$316.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Labcovrespcr Cov-19	$126.40	$316.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Labstatcovrespcr Cov-19	$126.40	$316.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 Labcovid19 Coronavirus Rt Pcr	$126.40	$316.00	—	—	60%
Calcium blood test, total CPT 82310 HC Calcium Total	$66.00	$165.00	—	7% above	60%
Calcium blood test, total inpatient CPT 82310 HC Calcium Total	$115.20	$288.00	—	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea	$134.40	$336.00	—	61% above	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea	$134.40	$336.00	—	—	60%
Chickenpox (varicella) immunity blood test CPT 86787 Antibody-Varic-Zoster(Enc	$7.48	$18.71	—	78% below	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Antibody-Varic-Zoster(Enc	$7.48	$18.71	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chl Trach Amp Probe Naat	$166.80	$417.00	—	205% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Gc/Chlamydia Trach Molec Det	$166.80	$417.00	—	205% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Gc/Chlamydia Trach Molec Det	$166.80	$417.00	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chl Trach Amp Probe Naat	$166.80	$417.00	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel - Calculated Ld	$126.00	$315.00	—	24% above	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel - Calculated Ld	$237.20	$593.00	—	—	60%
Complete blood count (CBC) with differential CPT 85025 HC Cbc W/Auto Diff	$105.60	$264.00	—	5% below	60%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc W/Auto Diff	$155.60	$389.00	—	—	60%
Complete blood count (CBC), no differential CPT 85027 HC Complete Blood Count	$72.80	$182.00	—	17% below	60%
Complete blood count (CBC), no differential inpatient CPT 85027 HC Complete Blood Count	$127.60	$319.00	—	—	60%
Comprehensive metabolic panel (blood test) CPT 80053 HC Metabolic Pnl Comp	$195.60	$489.00	—	23% below	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Metabolic Pnl Comp	$492.80	$1,232.00	—	—	60%
Cortisol blood test, total CPT 82533 6959 Salcor Cortisol Tot Saliva	$17.09	$42.73	—	82% below	60%
Cortisol blood test, total CPT 82533 Cortisol Lc/Ms Pl	$32.55	$81.38	—	66% below	60%
Cortisol blood test, total CPT 82533 HC Cortisol Total	$194.00	$485.00	—	103% above	60%
Cortisol blood test, total inpatient CPT 82533 6959 Salcor Cortisol Tot Saliva	$17.09	$42.73	—	—	60%
Cortisol blood test, total inpatient CPT 82533 Cortisol Lc/Ms Pl	$32.55	$81.38	—	—	60%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Total	$194.00	$485.00	—	—	60%
Creatine kinase (CK) blood test, total CPT 82550 HC Creatinine Kinase Total	$178.80	$447.00	—	105% above	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Creatinine Kinase Total	$178.80	$447.00	—	—	60%
Creatinine blood test CPT 82565 HC Creatinine Blood	$95.60	$239.00	—	106% above	60%
Creatinine blood test CPT 82565 HC Creatinine POC	$95.60	$239.00	—	106% above	60%
Creatinine blood test inpatient CPT 82565 HC Creatinine Blood	$95.60	$239.00	—	—	60%
Creatinine blood test inpatient CPT 82565 HC Creatinine POC	$95.60	$239.00	—	—	60%
D-dimer blood test (blood clot marker) CPT 85379 HC D Dimer Lia	$151.20	$378.00	—	5% above	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D Dimer Lia	$317.60	$794.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Panel Umbilical Qual-80304	$42.59	$106.48	—	31% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Test Prsmv Chem Anlyzr	$118.40	$296.00	—	91% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Labdoa Drug Tst Prsmv Anlyzr	$118.40	$296.00	—	91% above	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Panel Umbilical Qual-80304	$42.59	$106.48	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Labdoa Drug Tst Prsmv Anlyzr	$118.40	$296.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Test Prsmv Chem Anlyzr	$118.40	$296.00	—	—	60%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel	$118.00	$295.00	—	40% above	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel	$294.00	$735.00	—	—	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Vcaigg Ebv Vca Igg	$116.00	$290.00	—	338% above	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Ebvpan Ebv Vca Igg Igm	$116.00	$290.00	—	338% above	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Ebvpan Ebv Vca Igg Igm	$116.00	$290.00	—	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Vcaigg Ebv Vca Igg	$116.00	$290.00	—	—	60%
Estradiol blood test CPT 82670 Assay Estradiol Labe2ms	$125.20	$313.00	—	42% above	60%
Estradiol blood test CPT 82670 HC Estradiol (Estdl)	$125.20	$313.00	—	42% above	60%
Estradiol blood test inpatient CPT 82670 Assay Estradiol Labe2ms	$125.20	$313.00	—	—	60%
Estradiol blood test inpatient CPT 82670 HC Estradiol (Estdl)	$125.20	$313.00	—	—	60%
FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh (Fshor)	$114.80	$287.00	—	13% above	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh (Fshor)	$177.20	$443.00	—	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 HC 6956 12798r Calprotectin	$40.00	$100.00	—	45% below	60%
Fecal calprotectin (stool inflammation test) CPT 83993 Fcalpro Calprotectin, Fecal	$79.20	$198.00	—	9% above	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC 6956 12798r Calprotectin	$40.00	$100.00	—	—	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Fcalpro Calprotectin, Fecal	$79.20	$198.00	—	—	60%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin	$231.60	$579.00	—	117% above	60%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin	$268.80	$672.00	—	—	60%
Fibrinogen blood test CPT 85384 HC Fibrinogen Semiquan	$124.40	$311.00	—	7% below	60%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Semiquan	$206.40	$516.00	—	—	60%
Folate (folic acid) blood test CPT 82746 HC Folate-Serum	$226.80	$567.00	—	108% above	60%
Folate (folic acid) blood test inpatient CPT 82746 HC Folate-Serum	$226.80	$567.00	—	—	60%
Free T3 thyroid hormone test CPT 84481 HC Free T3	$139.20	$348.00	—	72% above	60%
Free T3 thyroid hormone test inpatient CPT 84481 HC Free T3	$139.20	$348.00	—	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC 6959 Free T4 Equilib Dialysis	$10.80	$27.00	—	84% below	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Free T4	$184.00	$460.00	—	170% above	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC 6959 Free T4 Equilib Dialysis	$10.80	$27.00	—	—	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC Free T4	$230.00	$575.00	—	—	60%
Free testosterone test CPT 84402 HC 6956 Testosterone, Free	$12.00	$30.00	—	56% below	60%
Free testosterone test CPT 84402 HC Testoterone Bio/Free	$37.60	$94.00	—	37% above	60%
Free testosterone test inpatient CPT 84402 HC 6956 Testosterone, Free	$12.00	$30.00	—	—	60%
Free testosterone test inpatient CPT 84402 HC Testoterone Bio/Free	$37.60	$94.00	—	—	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Gamma Glutamyl Tran	$70.80	$177.00	—	56% above	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Gamma Glutamyl Tran	$120.80	$302.00	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Toler(75g Glu)	$113.60	$284.00	—	118% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Toler(75g Glu)	$113.60	$284.00	—	—	60%
Glucose tolerance test, 3 samples CPT 82951 HC Gdmtol Gtt 1 to 3 Spec	$314.40	$786.00	—	129% above	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Gdmtol Gtt 1 to 3 Spec	$314.40	$786.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Neisseria Gonorrhoeae, Gc Lcr	$127.20	$318.00	—	113% above	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonor Amp Probe Naat	$127.20	$318.00	—	113% above	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonor Amp Probe Naat	$127.20	$318.00	—	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Neisseria Gonorrhoeae, Gc Lcr	$127.20	$318.00	—	—	60%
H. pylori stool antigen test CPT 87338 HC Heli Pyl Ag Stool	$124.00	$310.00	—	56% above	60%
H. pylori stool antigen test inpatient CPT 87338 HC Heli Pyl Ag Stool	$124.00	$310.00	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 by Quant Naat	$34.00	$85.00	—	66% below	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv Rna Pcr Quant	$145.20	$363.00	—	44% above	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 by Quant Naat	$34.00	$85.00	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv Rna Pcr Quant	$145.20	$363.00	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1,2 Ag/Ab Eia W/Reflx	$9.51	$23.78	—	89% below	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Antigen W/Hiv 1-2 Ab	$184.40	$461.00	—	111% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1,2 Ag/Ab Eia W/Reflx	$9.51	$23.78	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 Antigen W/Hiv 1-2 Ab	$184.40	$461.00	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Glycolated Hemoglobin	$126.00	$315.00	—	93% above	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Glycolated Hemoglobin	$126.00	$315.00	—	—	60%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$62.80	$157.00	—	56% above	60%
Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin	$62.80	$157.00	—	—	60%
Hepatitis B core antibody test (total) CPT 86704 HC Hep B Cr Total Ab	$101.20	$253.00	—	188% above	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Cr Total Ab	$101.20	$253.00	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hbsql Hep B Surf Ab Qualitative	$95.20	$238.00	—	123% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hbsqt Hep B Surf Ab Quant	$95.20	$238.00	—	123% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hbsql Hep B Surf Ab Qualitative	$150.40	$376.00	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hbsqt Hep B Surf Ab Quant	$150.40	$376.00	—	—	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hepat BS Ag-Eia	$90.00	$225.00	—	25% above	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hepat BS Ag-Eia	$118.80	$297.00	—	—	60%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hcva Hepatitis C Ab	$90.40	$226.00	—	65% above	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hcva Hepatitis C Ab	$143.20	$358.00	—	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv by Quantitative Naat	$36.00	$90.00	—	59% below	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hcv Rna Quant Assay	$181.20	$453.00	—	106% above	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hcv by Quantitative Naat	$36.00	$90.00	—	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hcv Rna Quant Assay	$181.20	$453.00	—	—	60%
Herpes blood test, HSV-1 antibody CPT 86695 HC 6942 Hsv Ab Type 1	$8.55	$21.38	—	56% below	60%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv Ab Igg CSF	$10.05	$25.13	—	48% below	60%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsvigg Hsv Ab Type 1	$37.20	$93.00	—	92% above	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC 6942 Hsv Ab Type 1	$8.55	$21.38	—	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv Ab Igg CSF	$10.05	$25.13	—	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsvigg Hsv Ab Type 1	$37.20	$93.00	—	—	60%
Herpes blood test, HSV-2 antibody CPT 86696 HC 6942 Herpes Select 2 Igg	$7.95	$19.88	—	66% below	60%
Herpes blood test, HSV-2 antibody CPT 86696 HC Hsvigg Hsv Ab Type 2	$46.40	$116.00	—	97% above	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC 6942 Herpes Select 2 Igg	$7.95	$19.88	—	—	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Hsvigg Hsv Ab Type 2	$46.40	$116.00	—	—	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, High	$8.16	$20.40	—	87% below	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC High Sensitive Crp	$123.60	$309.00	—	103% above	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, High	$8.16	$20.40	—	—	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC High Sensitive Crp	$123.60	$309.00	—	—	60%
Homocysteine blood test CPT 83090 HC Homocysteine	$212.40	$531.00	—	179% above	60%
Homocysteine blood test inpatient CPT 83090 HC Homocysteine	$212.40	$531.00	—	—	60%
Iron blood test (serum iron) CPT 83540 HC Iron Ttl Serum	$118.40	$296.00	—	104% above	60%
Iron blood test (serum iron) inpatient CPT 83540 HC Iron Ttl Serum	$118.40	$296.00	—	—	60%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity	$110.40	$276.00	—	51% above	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity	$135.20	$338.00	—	—	60%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$142.80	$357.00	—	at median	60%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$344.80	$862.00	—	—	60%
LH (luteinizing hormone) test CPT 83002 HC Lh (Lhor)	$143.20	$358.00	—	38% above	60%
LH (luteinizing hormone) test inpatient CPT 83002 HC Lh (Lhor)	$214.80	$537.00	—	—	60%
Lactate (lactic acid) blood test CPT 83605 HC Splac Lactate Sepsis Protcl	$142.80	$357.00	—	7% above	60%
Lactate (lactic acid) blood test CPT 83605 HC Lactate	$142.80	$357.00	—	7% above	60%
Lactate (lactic acid) blood test CPT 83605 HC Lacwb Lactate	$142.80	$357.00	—	7% above	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Splac Lactate Sepsis Protcl	$142.80	$357.00	—	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lacwb Lactate	$142.80	$357.00	—	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactate	$142.80	$357.00	—	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh Fluid	$64.80	$162.00	—	79% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh Total	$64.80	$162.00	—	79% above	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh Total	$105.20	$263.00	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh Fluid	$105.20	$263.00	—	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase	$167.20	$418.00	—	73% above	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase	$244.80	$612.00	—	—	60%
Liver function blood test panel CPT 80076 HC Hepatic Fxn Panel	$180.40	$451.00	—	19% above	60%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Fxn Panel	$344.40	$861.00	—	—	60%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody	$22.05	$55.13	—	4% above	60%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody	$22.05	$55.13	—	—	60%
Magnesium blood test CPT 83735 HC Magnesium Serum/Pl	$159.60	$399.00	—	152% above	60%
Magnesium blood test inpatient CPT 83735 HC Magnesium Serum/Pl	$254.80	$637.00	—	—	60%
Measles (rubeola) antibody test CPT 86765 Measles,Rubeola,Antibody,Igm	$5.48	$13.70	—	83% below	60%
Measles (rubeola) antibody test CPT 86765 Antibody-Rubeola (Encephp	$7.48	$18.71	—	76% below	60%
Measles (rubeola) antibody test CPT 86765 Vir Antibdy Measles	$50.00	$125.00	—	60% above	60%
Measles (rubeola) antibody test inpatient CPT 86765 Measles,Rubeola,Antibody,Igm	$5.48	$13.70	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 Antibody-Rubeola (Encephp	$7.48	$18.71	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 Vir Antibdy Measles	$50.00	$125.00	—	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 HC Infect Mono Scrn	$54.80	$137.00	—	47% below	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Infect Mono Scrn	$124.40	$311.00	—	—	60%
Mumps immunity blood test CPT 86735 Mumps Ab Igm	$5.02	$12.55	—	69% below	60%
Mumps immunity blood test CPT 86735 Antibody-Mumps (Encephp)	$7.48	$18.71	—	53% below	60%
Mumps immunity blood test CPT 86735 HC Mumpsg Mumps Ab Igg	$50.40	$126.00	—	215% above	60%
Mumps immunity blood test inpatient CPT 86735 Mumps Ab Igm	$5.02	$12.55	—	—	60%
Mumps immunity blood test inpatient CPT 86735 Antibody-Mumps (Encephp)	$7.48	$18.71	—	—	60%
Mumps immunity blood test inpatient CPT 86735 HC Mumpsg Mumps Ab Igg	$50.40	$126.00	—	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa Total	$227.60	$569.00	—	281% above	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa Ultrasensitive	$227.60	$569.00	—	281% above	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa Ultrasensitive	$227.60	$569.00	—	—	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa Total	$227.60	$569.00	—	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 HC Pth (Pth)	$223.60	$559.00	—	103% above	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Pth (Pth)	$409.60	$1,024.00	—	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt-D	$4.69	$11.73	—	92% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Inhibitor Assay, Ptt	$4.94	$12.35	—	92% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Ptt Inhibitor Scr-85730	$5.01	$12.53	—	92% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$5.82	$14.55	—	91% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial	$14.00	$35.00	—	78% below	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromplas Ptt	$111.20	$278.00	—	78% above	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt-D	$4.69	$11.73	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Inhibitor Assay, Ptt	$4.94	$12.35	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ptt Inhibitor Scr-85730	$5.01	$12.53	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$5.82	$14.55	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial	$14.00	$35.00	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromplas Ptt	$158.00	$395.00	—	—	60%
Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus Serum/	$79.20	$198.00	—	5% above	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus Serum/	$148.80	$372.00	—	—	60%
Potassium blood test CPT 84132 HC Potassium	$66.80	$167.00	—	9% below	60%
Potassium blood test CPT 84132 HC Potassium POC	$123.20	$308.00	—	69% above	60%
Potassium blood test CPT 84132 HC Bmt II Potassium	$123.20	$308.00	—	69% above	60%
Potassium blood test CPT 84132 HC Potassium Custom	$132.00	$330.00	—	81% above	60%
Potassium blood test inpatient CPT 84132 HC Potassium POC	$123.20	$308.00	—	—	60%
Potassium blood test inpatient CPT 84132 HC Bmt II Potassium	$123.20	$308.00	—	—	60%
Potassium blood test inpatient CPT 84132 HC Potassium	$132.00	$330.00	—	—	60%
Potassium blood test inpatient CPT 84132 HC Potassium Custom	$132.00	$330.00	—	—	60%
Progesterone blood test CPT 84144 HC Progesterone (Pgn)	$146.80	$367.00	—	78% above	60%
Progesterone blood test inpatient CPT 84144 HC Progesterone (Pgn)	$146.80	$367.00	—	—	60%
Prolactin blood test CPT 84146 HC Prolactin	$167.60	$419.00	—	56% above	60%
Prolactin blood test inpatient CPT 84146 HC Prolactin	$234.40	$586.00	—	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 PT-D	$4.69	$11.73	—	91% below	60%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$5.82	$14.55	—	89% below	60%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time	$93.20	$233.00	—	70% above	60%
Prothrombin time (PT/INR) clotting test CPT 85610 Labaclpt Prothrombin Time	$142.00	$355.00	—	159% above	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT-D	$4.69	$11.73	—	—	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$5.82	$14.55	—	—	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Labaclpt Prothrombin Time	$142.00	$355.00	—	—	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time	$142.00	$355.00	—	—	60%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep a Test	$17.20	$43.00	—	84% below	60%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep a Test	$17.20	$43.00	—	—	60%
Rh blood typing CPT 86901 Rh Typing	$54.00	$135.00	—	3% below	60%
Rh blood typing CPT 86901 HC Rh Typing	$54.00	$135.00	—	3% below	60%
Rh blood typing inpatient CPT 86901 Rh Typing	$93.20	$233.00	—	—	60%
Rh blood typing inpatient CPT 86901 HC Rh Typing	$93.20	$233.00	—	—	60%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quant	$77.60	$194.00	—	488% above	60%
Rheumatoid factor (RF) test inpatient CPT 86431 Ra - Part of Lupus Collag	$5.07	$12.68	—	—	60%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Quant	$77.60	$194.00	—	—	60%
Rubella antibody test (immunity check) CPT 86762 HC Rubell Antibody	$62.80	$157.00	—	24% above	60%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubell Antibody	$98.40	$246.00	—	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Esr Automated	$54.00	$135.00	—	4% below	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Esr Automated	$94.00	$235.00	—	—	60%
Sodium blood test CPT 84295 HC Sodium	$66.80	$167.00	—	2% above	60%
Sodium blood test CPT 84295 Sodium POC	$119.60	$299.00	—	83% above	60%
Sodium blood test CPT 84295 HC Sodium Arterial Lytes	$119.60	$299.00	—	83% above	60%
Sodium blood test inpatient CPT 84295 Sodium POC	$119.60	$299.00	—	—	60%
Sodium blood test inpatient CPT 84295 HC Sodium	$119.60	$299.00	—	—	60%
Sodium blood test inpatient CPT 84295 HC Sodium Arterial Lytes	$119.60	$299.00	—	—	60%
Stool ova and parasites exam CPT 87177 Parasitology Stain-87015	$5.33	$13.32	—	74% below	60%
Stool ova and parasites exam CPT 87177 Laboape Ova & Parasites	$13.35	$33.38	—	36% below	60%
Stool ova and parasites exam inpatient CPT 87177 Parasitology Stain-87015	$5.33	$13.32	—	—	60%
Stool ova and parasites exam inpatient CPT 87177 Laboape Ova & Parasites	$13.35	$33.38	—	—	60%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Occult Bld Guaiac Col Scrn	$90.00	$225.00	—	131% above	60%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Occult Bld Guaiac Col Scrn	$90.00	$225.00	—	—	60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Bld Immuno Diag	$89.60	$224.00	—	83% above	60%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Bld Immuno Diag	$132.80	$332.00	—	—	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC 6942 Fsfta Trpnma Paldm Ifa	$4.35	$10.88	—	73% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Mhatp	$5.62	$14.05	—	65% below	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Quall Treponema Pallidum	$54.40	$136.00	—	236% above	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Syphilis Treponemal Scr	$54.40	$136.00	—	236% above	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC 6942 Fsfta Trpnma Paldm Ifa	$4.35	$10.88	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Mhatp	$5.62	$14.05	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Quall Treponema Pallidum	$85.60	$214.00	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Syphilis Treponemal Scr	$85.60	$214.00	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl CSF or Serum	$3.21	$8.03	—	76% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rprqlt Rpr Qual	$50.00	$125.00	—	273% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl CSF or Serum	$3.21	$8.03	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rprqlt Rpr Qual	$50.00	$125.00	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon - TB	$14.00	$35.00	—	84% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Quantiferon	$324.80	$812.00	—	283% above	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon - TB	$14.00	$35.00	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Quantiferon	$324.80	$812.00	—	—	60%
Testosterone blood test, total (not free testosterone) CPT 84403 Tesftp Testosterone Total	$92.00	$230.00	—	130% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone (Tes) Total	$102.40	$256.00	—	156% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone Total	$102.40	$256.00	—	156% above	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Tesftp Testosterone Total	$92.00	$230.00	—	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone Total	$102.40	$256.00	—	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone (Tes) Total	$102.40	$256.00	—	—	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC 6959 Liver Kid Microsome-1	$6.28	$15.70	—	73% below	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 Lablkm1ab Micro Anti Ea	$8.70	$21.76	—	62% below	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC 6959 Liver Kid Microsome-1	$6.28	$15.70	—	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Lablkm1ab Micro Anti Ea	$8.70	$21.76	—	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tshft4 Tsh	$204.40	$511.00	—	121% above	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Highly Sensitiv Tsh	$204.40	$511.00	—	121% above	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tshft4 Tsh	$258.40	$646.00	—	—	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Highly Sensitiv Tsh	$258.40	$646.00	—	—	60%
Total cholesterol blood test CPT 82465 HC Cholesterol	$47.60	$119.00	—	13% above	60%
Total cholesterol blood test CPT 82465 HC Cholesterol Total	$47.60	$119.00	—	13% above	60%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol Total	$93.20	$233.00	—	—	60%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol	$93.20	$233.00	—	—	60%
Total thyroxine (T4) blood test CPT 84436 HC Thyroxine(T4) Total	$42.40	$106.00	—	8% above	60%
Total thyroxine (T4) blood test inpatient CPT 84436 HC Thyroxine(T4) Total	$42.40	$106.00	—	—	60%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 Total	$132.80	$332.00	—	70% above	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T3 Total	$155.20	$388.00	—	—	60%
Triglycerides blood test CPT 84478 6911lab320 Triglycerides	$5.47	$13.68	—	87% below	60%
Triglycerides blood test CPT 84478 HC Triglycerides, Non Pleu	$7.20	$18.00	—	82% below	60%
Triglycerides blood test CPT 84478 HC Triglycerides-Blood	$53.60	$134.00	—	30% above	60%
Triglycerides blood test inpatient CPT 84478 6911lab320 Triglycerides	$5.47	$13.68	—	—	60%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides, Non Pleu	$7.20	$18.00	—	—	60%
Triglycerides blood test inpatient CPT 84478 HC Triglycerides-Blood	$141.20	$353.00	—	—	60%
Troponin test, quantitative CPT 84484 HC Labhstni High Sens Tropinin I	$191.60	$479.00	—	7% above	60%
Troponin test, quantitative CPT 84484 Troponin T	$230.00	$575.00	—	28% above	60%
Troponin test, quantitative inpatient CPT 84484 HC Labhstni High Sens Tropinin I	$379.20	$948.00	—	—	60%
Troponin test, quantitative inpatient CPT 84484 Troponin T	$379.20	$948.00	—	—	60%
Uric acid blood test CPT 84550 HC Uric Acid Serum/Pl	$92.80	$232.00	—	40% above	60%
Uric acid blood test inpatient CPT 84550 HC Uric Acid Serum/Pl	$148.80	$372.00	—	—	60%
Urinalysis with microscope exam, automated CPT 81001 HC Urine Routine-Micro	$136.00	$340.00	—	64% above	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urine Routine-Micro	$136.00	$340.00	—	—	60%
Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis Auto	$32.80	$82.00	—	41% below	60%
Urinalysis without microscope exam, automated CPT 81003 Urn Screen POC	$34.00	$85.00	—	39% below	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis Auto	$32.80	$82.00	—	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urn Screen POC	$34.00	$85.00	—	—	60%
Urinalysis without microscope exam, manual CPT 81002 HC Specific Gravity	$25.20	$63.00	—	26% below	60%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC Specific Gravity	$25.20	$63.00	—	—	60%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Screen	$104.80	$262.00	—	19% above	60%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Screen	$104.80	$262.00	—	—	60%
Vitamin B12 (cobalamin) blood test CPT 82607 HC B12-Serum	$178.80	$447.00	—	90% above	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC B12-Serum	$221.20	$553.00	—	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vit D 25-Hydroxy	$205.60	$514.00	—	221% above	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vit D 25-Hydroxy	$296.80	$742.00	—	—	60%
Zinc blood test CPT 84630 ZINC	$4.12	$10.30	—	63% below	60%
Zinc blood test inpatient CPT 84630 ZINC	$4.12	$10.30	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Bhcg Beta Hcg Quant	$179.60	$449.00	—	at median	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Bhcg Beta Hcg Quant	$266.40	$666.00	—	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Brst, 1st Lesion,Stereo Guide	$3,534.40	$8,836.00	—	19% below	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx Brst, 1st Lesion,Stereo Guide	$3,534.40	$8,836.00	—	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Tx Fx Fibular Distal W/O Manip Closed	$364.80	$912.00	—	32% below	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Tx Fx Fibular Distal W/O Manip Closed	$364.80	$912.00	—	—	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed Tx Metatarsal Fracture W/O Manipulation	$237.60	$594.00	—	56% below	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed Tx Metatarsal Fracture W/O Manipulation	$237.60	$594.00	—	—	60%
Cardiac catheterization with coronary angiogram CPT 93458 Cath Place L& Vgram	$21,282.40	$53,206.00	—	65% above	60%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Cath Place L& Vgram	$21,282.40	$53,206.00	—	—	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective	$4,974.00	$12,435.00	—	160% above	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Elective	$4,974.00	$12,435.00	—	—	60%
Catheter ablation for atrial fibrillation CPT 93656 Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation	$44,570.00	$111,425.00	—	33% above	60%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation	$44,570.00	$111,425.00	—	—	60%
Cervical biopsy CPT 57500 Biopsy of Cervix	$2,623.20	$6,558.00	—	35% above	60%
Cervical biopsy inpatient CPT 57500 Biopsy of Cervix	$2,623.20	$6,558.00	—	—	60%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Clsd Tx Dist Rad Fx W/O Man	$375.20	$938.00	—	33% below	60%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Clsd Tx Dist Rad Fx W/O Man	$375.20	$938.00	—	—	60%
Colonoscopy with polyp removal CPT 45385 Colsc Flx Prox Splenic Flxr Rmvl Les Snare Tq	$3,668.40	$9,171.00	—	60% above	60%
Colonoscopy with polyp removal inpatient CPT 45385 Colsc Flx Prox Splenic Flxr Rmvl Les Snare Tq	$3,668.40	$9,171.00	—	—	60%
Colonoscopy with tissue sample CPT 45380 Scope of Colon With Biopsy	$4,170.40	$10,426.00	—	79% above	60%
Colonoscopy with tissue sample inpatient CPT 45380 Scope of Colon With Biopsy	$4,170.40	$10,426.00	—	—	60%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Diagnostic	$2,664.00	$6,660.00	—	28% above	60%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Diagnostic	$2,664.00	$6,660.00	—	—	60%
Coronary stent placement, one artery CPT 92928 Pt Stent W/Ptca Corn Art	$16,644.00	$41,610.00	—	11% above	60%
Coronary stent placement, one artery inpatient CPT 92928 Pt Stent W/Ptca Corn Art	$16,644.00	$41,610.00	—	—	60%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy Simple	$1,285.20	$3,213.00	—	21% below	60%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy Simple	$1,285.20	$3,213.00	—	—	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Rem Impctd Ear Wax, Irr/Lav	$268.00	$670.00	—	51% above	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Rem Impctd Ear Wax, Irr/Lav	$268.00	$670.00	—	—	60%
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Ear Wax Unil	$294.00	$735.00	—	56% above	60%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Ear Wax Unil	$294.00	$735.00	—	—	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of Uterus Lining	$452.80	$1,132.00	—	17% below	60%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Biopsy of Uterus Lining	$452.80	$1,132.00	—	—	60%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Exploration Maxillary Sinus	$7,254.00	$18,135.00	—	9% above	60%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 Exploration Maxillary Sinus	$7,254.00	$18,135.00	—	—	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Dx	$1,829.60	$4,574.00	—	at median	60%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Sigmoidoscopy Dx	$1,829.60	$4,574.00	—	—	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Cathj&Intro Saline Nfs Shg/Hsg	$507.60	$1,269.00	—	19% below	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Cathj&Intro Saline Nfs Shg/Hsg	$507.60	$1,269.00	—	—	60%
Hysteroscopy with endometrial ablation CPT 58563 Hystsc Endometrial Abltj	$3,877.60	$9,694.00	—	39% below	60%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Hystsc Endometrial Abltj	$3,877.60	$9,694.00	—	—	60%
IUD insertion (the device itself billed separately) CPT 58300 Insert Iud	$454.00	$1,135.00	—	23% below	60%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insert Iud	$454.00	$1,135.00	—	—	60%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess Smpl	$1,057.20	$2,643.00	—	126% above	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess Smpl	$1,057.20	$2,643.00	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection Treatment	$582.40	$1,456.00	—	12% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection Treatment	$582.40	$1,456.00	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain Joint/Bursa Major W/O US Guidance	$1,081.20	$2,703.00	—	14% above	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain Joint/Bursa Major W/O US Guidance	$1,081.20	$2,703.00	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain Joint/Bursa Intermed W/O US Guidance	$1,025.20	$2,563.00	—	69% above	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain Joint/Bursa Intermed W/O US Guidance	$1,025.20	$2,563.00	—	—	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthro, Aspir Jnt Sml	$599.20	$1,498.00	—	18% below	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthro, Aspir Jnt Sml	$599.20	$1,498.00	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Clse Sc/Ax/Trk/Ext <2.6c	$1,091.20	$2,728.00	—	26% above	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layer Clse Sc/Ax/Trk/Ext <2.6c	$1,091.20	$2,728.00	—	—	60%
Left heart catheterization, diagnostic one side CPT 93452 Left Heart Cath	$4,816.80	$12,042.00	—	51% below	60%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Heart Cath	$4,816.80	$12,042.00	—	—	60%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Dx/Ther Sbst Epid/Subrach Lumb/Sacr W/Img	$2,435.60	$6,089.00	—	10% above	60%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Dx/Ther Sbst Epid/Subrach Lumb/Sacr W/Img	$2,435.60	$6,089.00	—	—	60%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Dx/Ther Sbst Epidural/Subarach Lumb/Sacral	$1,400.00	$3,500.00	—	22% below	60%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Dx/Ther Sbst Epidural/Subarach Lumb/Sacral	$1,400.00	$3,500.00	—	—	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Rem Benign Lsn F/E/E/N/L<0.5cm	$790.80	$1,977.00	—	46% below	60%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Rem Benign Lsn F/E/E/N/L<0.5cm	$790.80	$1,977.00	—	—	60%
Nail removal (partial or complete), one nail CPT 11730 Remove Nail Plate Smpl	$587.20	$1,468.00	—	17% above	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 Remove Nail Plate Smpl	$587.20	$1,468.00	—	—	60%
Occipital nerve block (injection for headaches) CPT 64405 Injs Anes Agnts/Strd Great Occipital	$706.40	$1,766.00	—	20% below	60%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injs Anes Agnts/Strd Great Occipital	$706.40	$1,766.00	—	—	60%
Pacemaker implant (dual chamber) CPT 33208 Perm Pcmkr Imp a/V Leads	$20,190.00	$50,475.00	—	8% above	60%
Pacemaker implant (dual chamber) inpatient CPT 33208 Perm Pcmkr Imp a/V Leads	$20,190.00	$50,475.00	—	—	60%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging	$2,056.80	$5,142.00	—	12% above	60%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging	$2,056.80	$5,142.00	—	—	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Rmvl of Nail Bed	$1,535.60	$3,839.00	—	19% above	60%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Rmvl of Nail Bed	$1,535.60	$3,839.00	—	—	60%
Prostate biopsy CPT 55700 Biopsy of Prostate	$3,148.80	$7,872.00	—	48% below	60%
Prostate biopsy inpatient CPT 55700 Biopsy of Prostate	$3,148.80	$7,872.00	—	—	60%
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body Smpl	$923.60	$2,309.00	—	6% below	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body Smpl	$923.60	$2,309.00	—	—	60%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon Ca Scrn Not Hi Rsk Ind	$2,862.40	$7,156.00	—	21% above	60%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colon Ca Scrn Not Hi Rsk Ind	$2,862.40	$7,156.00	—	—	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal Scrn; Hi Risk Ind	$3,492.00	$8,730.00	—	45% above	60%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colorectal Scrn; Hi Risk Ind	$3,492.00	$8,730.00	—	—	60%
Short arm cast (elbow to hand) CPT 29075 Apply Short Arm Cast	$445.20	$1,113.00	—	11% below	60%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Short Arm Cast	$445.20	$1,113.00	—	—	60%
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint Static	$642.00	$1,605.00	—	53% above	60%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint Static	$642.00	$1,605.00	—	—	60%
Short leg cast (below the knee) CPT 29405 Apply Short Leg Cast	$668.00	$1,670.00	—	34% above	60%
Short leg cast (below the knee) inpatient CPT 29405 Apply Short Leg Cast	$668.00	$1,670.00	—	—	60%
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint	$714.40	$1,786.00	—	45% above	60%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint	$714.40	$1,786.00	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr Lac Smp Scalp <2.5 Cm	$867.20	$2,168.00	—	57% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr Lac Smp Scalp <2.5 Cm	$867.20	$2,168.00	—	—	60%
Skin tag removal, up to 15 tags CPT 11200 Remove Skn Tags 1-15 Lsns	$307.60	$769.00	—	22% below	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 Remove Skn Tags 1-15 Lsns	$307.60	$769.00	—	—	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Dx	$1,502.40	$3,756.00	—	14% above	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Dx	$1,502.40	$3,756.00	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repr Wnd Super Nonface 2.6-7.5	$912.80	$2,282.00	—	22% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repr Wnd Super Nonface 2.6-7.5	$912.80	$2,282.00	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr Lac Smp Face <2.5 Cm	$956.80	$2,392.00	—	45% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr Lac Smp Face <2.5 Cm	$956.80	$2,392.00	—	—	60%
Thoracentesis with imaging guidance CPT 32555 Thoracentis W/Image Guide	$2,956.00	$7,390.00	—	45% above	60%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentis W/Image Guide	$2,956.00	$7,390.00	—	—	60%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Pt 1-2 Muscle(S)	$570.00	$1,425.00	—	11% below	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Pt 1-2 Muscle(S)	$570.00	$1,425.00	—	—	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Brst, 1st Lesion, US Guide	$3,010.80	$7,527.00	—	6% below	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Brst, 1st Lesion, US Guide	$3,010.80	$7,527.00	—	—	60%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Endoscopy/Balloon	$4,154.00	$10,385.00	—	69% above	60%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Endoscopy/Balloon	$4,154.00	$10,385.00	—	—	60%
Upper endoscopy (EGD) with biopsy CPT 43239 Upper Stomach-Intestine Scope for Biopsy	$4,006.80	$10,017.00	—	127% above	60%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Upper Stomach-Intestine Scope for Biopsy	$4,006.80	$10,017.00	—	—	60%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Egd Submucosal Inj	$4,154.00	$10,385.00	—	122% above	60%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Egd Submucosal Inj	$4,154.00	$10,385.00	—	—	60%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Up Endosc/Polypectm	$3,951.20	$9,878.00	—	21% above	60%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Up Endosc/Polypectm	$3,951.20	$9,878.00	—	—	60%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Endscpy Savry Dilat	$4,363.20	$10,908.00	—	133% above	60%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Endscpy Savry Dilat	$4,363.20	$10,908.00	—	—	60%
Upper endoscopy (EGD), diagnostic CPT 43235 Upper Stomach-Intestine Scope for Diagnosis	$3,788.40	$9,471.00	—	102% above	60%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Upper Stomach-Intestine Scope for Diagnosis	$3,788.40	$9,471.00	—	—	60%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Egd W/Drain Cyst	$7,734.40	$19,336.00	—	8% above	60%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 Egd W/Drain Cyst	$7,734.40	$19,336.00	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skn & Sq Tissue 1st 20 Cm	$1,725.60	$4,314.00	—	153% above	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skn & Sq Tissue 1st 20 Cm	$1,725.60	$4,314.00	—	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-10 Hr	$1,168.80	$2,922.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-1 Hr	$1,573.20	$3,933.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-4 Hr	$1,573.20	$3,933.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-3 Hr	$1,573.20	$3,933.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-2 Hr	$1,573.20	$3,933.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-5 Hr	$1,624.00	$4,060.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-6 Hr	$1,647.60	$4,119.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood	$1,647.60	$4,119.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-9 Hr	$1,647.60	$4,119.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-8 Hr	$1,647.60	$4,119.00	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood-7 Hr	$1,647.60	$4,119.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ipv Tx Subsequent	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhaler Tx Initial	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhaler Tx Sub	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ipv Tx Init	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Tx Initial	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Tx Init Ihhn	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Tx Init Sputum Ind	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation Tx Init Mdi	$594.00	$1,485.00	—	84% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Tx Initial	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation Tx Init Mdi	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation Tx Init Sputum Ind	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation Tx Init Ihhn	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ipv Tx Init	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ipv Tx Subsequent	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhaler Tx Initial	$594.00	$1,485.00	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhaler Tx Sub	$594.00	$1,485.00	—	—	60%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Infusion Up to 1hr	$661.20	$1,653.00	—	24% below	60%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Infusion Up to 1hr	$661.20	$1,653.00	—	—	60%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care 30-74 Min	$4,738.40	$11,846.00	—	14% below	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care 30-74 Min	$4,738.40	$11,846.00	—	—	60%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg-Awake	$472.00	$1,180.00	—	54% below	60%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg-Awake	$472.00	$1,180.00	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg Hosp	$472.40	$1,181.00	—	40% above	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ecg Hosp	$472.40	$1,181.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB Emergency Care Level 1 Proc	$442.80	$1,107.00	—	5% above	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB Emergency Care Level 1	$442.80	$1,107.00	—	5% above	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Care Level 1 Proc	$451.60	$1,129.00	—	7% above	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Care Level 1	$451.60	$1,129.00	—	7% above	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 OB Emergency Care Level 1 Proc	$442.80	$1,107.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 OB Emergency Care Level 1	$442.80	$1,107.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Care Level 1	$451.60	$1,129.00	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Care Level 1 Proc	$451.60	$1,129.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB Emergency Care Level 2	$661.60	$1,654.00	—	24% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB Emergency Care Level 2 Proc	$661.60	$1,654.00	—	24% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Care Lev2	$755.60	$1,889.00	—	13% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Care Level 2 Proc	$755.60	$1,889.00	—	13% below	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 OB Emergency Care Level 2 Proc	$661.60	$1,654.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 OB Emergency Care Level 2	$661.60	$1,654.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Care Lev2	$755.60	$1,889.00	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Care Level 2 Proc	$755.60	$1,889.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB Emergency Care Level 3	$1,244.40	$3,111.00	—	17% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB Emergency Care Level 3 Proc	$1,244.40	$3,111.00	—	17% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Care Level 3 Proc	$1,403.60	$3,509.00	—	6% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Care Lev3	$1,403.60	$3,509.00	—	6% below	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 OB Emergency Care Level 3 Proc	$1,244.40	$3,111.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 OB Emergency Care Level 3	$1,244.40	$3,111.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Care Lev3	$1,403.60	$3,509.00	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Care Level 3 Proc	$1,403.60	$3,509.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB Emergency Care Level 4 Proc	$2,480.40	$6,201.00	—	9% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB Emergency Care Level 4	$2,480.40	$6,201.00	—	9% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Care Level 4 Proc	$2,704.40	$6,761.00	—	at median	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Care Lev4	$2,704.40	$6,761.00	—	at median	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 OB Emergency Care Level 4 Proc	$2,480.40	$6,201.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 OB Emergency Care Level 4	$2,480.40	$6,201.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Care Lev4	$2,704.40	$6,761.00	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Care Level 4 Proc	$2,704.40	$6,761.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB Emergency Care Level 5 Proc	$3,891.60	$9,729.00	—	10% above	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB Emergency Care Level 5	$3,891.60	$9,729.00	—	10% above	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Care Lev5	$4,370.80	$10,927.00	—	23% above	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Care Level 5 Proc	$4,370.80	$10,927.00	—	23% above	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 OB Emergency Care Level 5	$3,891.60	$9,729.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 OB Emergency Care Level 5 Proc	$3,891.60	$9,729.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Care Lev5	$4,370.80	$10,927.00	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Care Level 5 Proc	$4,370.80	$10,927.00	—	—	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Hosp	$1,710.00	$4,275.00	—	21% above	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular Stre	$1,710.00	$4,275.00	—	21% above	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 Pharm Stress Test	$1,710.00	$4,275.00	—	21% above	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Pharm Stress Test	$1,710.00	$4,275.00	—	—	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Hosp	$1,710.00	$4,275.00	—	—	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular Stre	$1,710.00	$4,275.00	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration Infusion Up to 1hr	$575.60	$1,439.00	—	16% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration Infusion Up to 1hr	$575.60	$1,439.00	—	—	60%
IV infusion of a medicine, first hour CPT 96365 IV Infusion-Therapeutic-1st Hr	$602.00	$1,505.00	—	3% above	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion-Therapeutic-1st Hr	$602.00	$1,505.00	—	—	60%
IV push of a medicine, first drug CPT 96374 Therapypro/Dx Ivp Initial	$279.60	$699.00	—	21% below	60%
IV push of a medicine, first drug CPT 96374 2nd Enctr Tx/Dx Injection: Initial	$279.60	$699.00	—	21% below	60%
IV push of a medicine, first drug inpatient CPT 96374 2nd Enctr Tx/Dx Injection: Initial	$279.60	$699.00	—	—	60%
IV push of a medicine, first drug inpatient CPT 96374 Therapypro/Dx Ivp Initial	$279.60	$699.00	—	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therap/Pro/Dx Inj Sq/Im	$325.20	$813.00	—	81% above	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therap/Pro/Dx Inj Sq/Im	$325.20	$813.00	—	—	60%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromusc Re-ED Ea 15	$76.00	$265.00	—	40% below	71%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neurosmusc Re-Educ Ea 15	$76.00	$265.00	—	40% below	71%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromusc ED Ea 15 Min	$106.00	$265.00	—	17% below	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Ot Neuromusc Re-ED Ea 15	$76.00	$600.00	—	—	87%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Pt Neurosmusc Re-Educ Ea 15	$76.00	$600.00	—	—	87%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromusc ED Ea 15 Min	$240.00	$600.00	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Assessmt 15 Min	$118.40	$296.00	—	19% above	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Initial Assessmt 15 Min	$118.40	$296.00	—	—	60%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min	$84.00	$583.00	—	68% below	86%
Occupational therapy evaluation, low complexity CPT 97165 Ot Ped Eval Low Complex	$108.00	$750.00	—	58% below	86%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complexity	$233.20	$583.00	—	10% below	60%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min	$84.00	$583.00	—	—	86%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Ped Eval Low Complex	$108.00	$750.00	—	—	86%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complexity	$233.20	$583.00	—	—	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Min	$387.60	$969.00	—	1% below	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Ped Eval High Complex	$449.60	$1,124.00	—	15% above	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Min	$387.60	$969.00	—	—	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Ped Eval High Complex	$449.60	$1,124.00	—	—	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Min	$84.00	$583.00	—	64% below	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Ped Eval Low Complex	$108.00	$750.00	—	54% below	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Min	$84.00	$583.00	—	—	86%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Ped Eval Low Complex	$108.00	$750.00	—	—	86%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Min	$300.00	$750.00	—	15% below	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Ped Eval Mod Complex	$387.60	$969.00	—	9% above	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Min	$300.00	$750.00	—	—	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Ped Eval Mod Complex	$387.60	$969.00	—	—	60%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Ea 15	$76.00	$328.00	—	37% below	77%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Tech 15	$76.00	$328.00	—	37% below	77%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Soft Tissue Mob Ea 15 Min	$131.20	$328.00	—	9% above	60%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Ot Manual Therapy Ea 15	$76.00	$328.00	—	—	77%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Pt Manual Therapy Tech 15	$76.00	$328.00	—	—	77%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Soft Tissue Mob Ea 15 Min	$131.20	$328.00	—	—	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Pt Exer/Str/Rom Ea 15	$76.00	$253.00	—	41% below	70%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ot Strength/Rom Tx Ea 15	$76.00	$253.00	—	41% below	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Pt Exer/Str/Rom Ea 15	$76.00	$540.00	—	—	86%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ot Strength/Rom Tx Ea 15	$76.00	$540.00	—	—	86%
Speech and language evaluation CPT 92523 Sp Eval Snd Prd W/Lang Eval	$496.80	$1,242.00	—	9% above	60%
Speech and language evaluation inpatient CPT 92523 Sp Eval Snd Prd W/Lang Eval	$496.80	$1,242.00	—	—	60%
Speech therapy session, individual CPT 92507 Sp Indiv Speech Rx per Tx	$92.00	$1,253.00	—	67% below	93%
Speech therapy session, individual inpatient CPT 92507 Sp Indiv Speech Rx per Tx	$92.00	$1,253.00	—	—	93%
Spirometry (breathing test) CPT 94010 Spirometry W/Svc Mvv	$523.20	$1,308.00	—	37% above	60%
Spirometry (breathing test) CPT 94010 Spirometry	$523.20	$1,308.00	—	37% above	60%
Spirometry (breathing test) CPT 94010 Spirometry W Mip/Mep	$523.20	$1,308.00	—	37% above	60%
Spirometry (breathing test) inpatient CPT 94010 Spirometry W Mip/Mep	$523.20	$1,308.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 Spirometry W/Svc Mvv	$523.20	$1,308.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$523.20	$1,308.00	—	—	60%
Spirometry before and after a bronchodilator CPT 94060 Spiro B/a Bronkodltr	$996.00	$2,490.00	—	24% above	60%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spiro B/a Bronkodltr	$996.00	$2,490.00	—	—	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Ther Activ Ea 15 Min	$76.00	$217.00	—	45% below	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 Funct Act Trn Ea 15 Min	$76.00	$217.00	—	45% below	65%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Tx Activities Direct Ea 15	$86.80	$217.00	—	37% below	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 Tx Act-Direct Ea 15	$216.00	$540.00	—	57% above	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Ot Ther Activ Ea 15 Min	$76.00	$540.00	—	—	86%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Funct Act Trn Ea 15 Min	$76.00	$540.00	—	—	86%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Tx Act-Direct Ea 15	$216.00	$540.00	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Ot Tx Activities Direct Ea 15	$216.00	$540.00	—	—	60%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Therapeutic	$174.40	$436.00	—	46% below	60%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, Therapeutic	$174.40	$436.00	—	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza Vac Splt Pf, Tri 0.5ml Dose,65 Yrs+	$419.20	$1,048.00	—	197% above	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VAC 2025 65UP-ADJMF59C(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$491.00	$1,227.49	—	248% above	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza Vac Splt Pf, Tri 0.5ml Dose,65 Yrs+	$419.20	$1,048.00	—	—	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VAC 2025 65UP-ADJMF59C(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$491.00	$1,227.49	—	—	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SC SUSR	$1,099.20	$2,748.00	—	251% above	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1,350 UNIT/0.5 ML SC SUSR	$1,099.20	$2,748.00	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$86.06	$215.16	—	101% above	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Vac Splt Pf, Tri 0.5ml Dose	$105.60	$264.00	—	147% above	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VAC TS 2025-26(6MOS UP)-PF 45 MCG (15 MCG X 3)/0.5 ML IM SYRG	$86.06	$215.16	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Vac Splt Pf, Tri 0.5ml Dose	$105.60	$264.00	—	—	60%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG	$804.71	$2,011.78	—	274% above	60%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG	$804.71	$2,011.78	—	—	60%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG	$510.16	$1,275.41	—	266% above	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG	$510.16	$1,275.41	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG	$427.07	$1,067.67	—	248% above	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG	$427.07	$1,067.67	—	—	60%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG	$948.31	$2,370.78	—	271% above	60%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG	$948.31	$2,370.78	—	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG	$168.63	$421.57	—	192% above	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG	$168.63	$421.57	—	—	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR	$75.59	$188.98	—	81% above	60%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR	$75.59	$188.98	—	—	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SC SUSR	$549.93	$1,374.83	—	293% above	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 10EXP3.4-4.2- 3.3CCID50/0.5ML SC SUSR	$549.93	$1,374.83	—	—	60%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT	$1,010.70	$2,526.76	—	287% above	60%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT	$1,010.70	$2,526.76	—	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	$1,768.46	$4,421.16	—	240% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG	$1,768.46	$4,421.16	—	—	60%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP	$2,703.18	$6,757.96	—	2880% above	60%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJ SUSP	$2,703.18	$6,757.96	—	—	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG	$3,418.04	$8,545.09	—	261% above	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML IM SYRG	$3,418.04	$8,545.09	—	—	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG	$3,418.02	$8,545.06	—	253% above	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML IM SYRG	$3,418.02	$8,545.06	—	—	60%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR	$2,496.40	$6,241.00	—	253% above	60%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNIT IM SUSR	$2,496.40	$6,241.00	—	—	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP	$255.11	$637.77	—	213% above	60%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP	$255.11	$637.77	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$275.09	$687.72	—	138% above	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG	$275.09	$687.72	—	—	60%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG	$928.23	$2,320.58	—	432% above	60%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG	$928.23	$2,320.58	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin One Vacc	$105.20	$263.00	—	1% above	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immun Admin One Vacc	$105.20	$263.00	—	—	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin Ea Add Vacc	$32.80	$82.00	—	59% below	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Admin Ea Add Vacc	$32.80	$82.00	—	—	60%

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://stanfordhealthcare.org/content/dam/valleycare/patients-visitors/941429628_stanford-health-care---tri-valley_standardcharges.json