MercyOne Genesis DeWitt Medical Center
MercyOne Genesis DeWitt Medical Center in Dewitt, IA publishes cash prices for 504 common procedures listed here, from its own machine-readable price file updated Mar 31, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Iowa median for 281 of 357 procedures and above it for 67. By typical cash price it ranks #14 of 90 Iowa hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1118 11th Street, DeWitt, IA 52742 Collected Sep 23, 2026 Source price file Check a bill from this hospital (563) 659-4200
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 161313 · CMS hospital register NPI 1649368523
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
MercyOne Genesis DeWitt Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/wo Contrast | $1,659.60 | $2,766.00 | $940.44–$2,019.18 | 15% below | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Adrenal w/wo Contrast | $1,077.60 | $1,796.00 | $610.64–$1,311.08 | — | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/wo Contrast | $1,659.60 | $2,766.00 | $940.44–$2,019.18 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen 2 Views | $183.60 | $306.00 | $104.04–$223.38 | — | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 Port Abdomen 2 | $183.60 | $306.00 | $104.04–$223.38 | — | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Routine Left | $186.60 | $311.00 | $105.74–$227.03 | 18% below | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Routine Right | $186.60 | $311.00 | $105.74–$227.03 | 18% below | 40% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 Ankle Routine, Bilat | $280.80 | $468.00 | $159.12–$341.64 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Routine Right | $186.60 | $311.00 | $105.74–$227.03 | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Routine Left | $186.60 | $311.00 | $105.74–$227.03 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI with Exercise | $144.60 | $241.00 | $81.94–$175.93 | 60% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ART Ankle/Arm Index | $144.60 | $241.00 | $81.94–$175.93 | 60% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI with Exercise | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ART Ankle/Arm Index | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Upr/L Xtremity Art 2 Levels 93922 | $198.60 | $331.00 | $928.00–$2,679.00 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper w/o Contrast-L | $1,163.40 | $1,939.00 | $659.26–$1,415.47 | 3% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Extremity Upper w/o contrast-R | $1,163.40 | $1,939.00 | $659.26–$1,415.47 | 3% below | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Extremity Upper w/o Contrast-L | $1,163.40 | $1,939.00 | $659.26–$1,415.47 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Extremity Upper w/o contrast-R | $1,163.40 | $1,939.00 | $659.26–$1,415.47 | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Extremity Upper w/o Contrast-Bil | $1,744.80 | $2,908.00 | $988.72–$2,122.84 | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 GI Esophagram | $321.60 | $536.00 | $182.24–$391.28 | 12% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 GI Esophagram | $321.60 | $536.00 | $182.24–$391.28 | — | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 GHS BR BREAST US L-SECOND LOOK | $327.60 | $546.00 | $185.64–$398.58 | 8% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 GHS BR BREAST US R-SECOND LOOK | $327.60 | $546.00 | $185.64–$398.58 | 8% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Left | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 BR Breast US R-Second Look | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 BR Breast US L-Second Look | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Right | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 BR Breast US R | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Echo Unilateral | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 BR Breast US L | $344.40 | $574.00 | $195.16–$419.02 | 4% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Ultrasound Bilat | $516.60 | $861.00 | $292.74–$628.53 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Bilateral | $516.60 | $861.00 | $292.74–$628.53 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 GHS BR BREAST US L-SECOND LOOK | $327.60 | $546.00 | $185.64–$398.58 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 GHS BR BREAST US R-SECOND LOOK | $327.60 | $546.00 | $185.64–$398.58 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US R-Second Look | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US L-Second Look | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US L | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US R | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 GHS BR BREAST US BIL-SECOND LOOK | $492.00 | $820.00 | $278.80–$598.60 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US Bil-Second Look | $516.60 | $861.00 | $292.74–$628.53 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 BR Breast US Bil | $516.60 | $861.00 | $292.74–$628.53 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Right | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Echo Unilateral | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Left | $344.40 | $574.00 | $195.16–$419.02 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 GHS CT ANGIO ABD/PELVIS W/WO CONT | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | 33% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen/Pelvis w C | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | 33% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Venogram | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | 33% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen/Pelvis w&wo Contrast | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | 33% below | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 GHS CT ANGIO ABD/PELVIS W/WO CONT | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen/Pelvis w C | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen/Pelvis w&wo Contrast | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Venogram | $1,978.20 | $3,297.00 | $1,120.98–$2,406.81 | — | 40% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Head | $1,656.60 | $2,761.00 | $938.74–$2,015.53 | 15% below | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Head | $1,656.60 | $2,761.00 | $938.74–$2,015.53 | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck | $1,656.60 | $2,761.00 | $938.74–$2,015.53 | 20% below | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck | $1,656.60 | $2,761.00 | $938.74–$2,015.53 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 GHS CT ANGIO CHEST | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w Contrast | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest for Pulmonary Emboli w C | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest w/wo Contrast | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | 24% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w/wo Contrast | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest for Pulmonary Emboli w C | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest w Contrast | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 GHS CT ANGIO CHEST | $1,627.20 | $2,712.00 | $922.08–$1,979.76 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd/Pel w Oral Contrast Only-Gastroview | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | 14% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis wo C | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | 14% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd/Pel w Oral Contrast Only- Barium | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | 14% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis- Stone Protocol | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | 14% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis- Stone Protocol | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis wo C | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd/Pel w Oral Contrast Only- Barium | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd/Pel w Oral Contrast Only-Gastroview | $2,240.40 | $3,734.00 | $1,269.56–$2,725.82 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w IV Contrast Only | $2,676.00 | $4,460.00 | $1,516.40–$3,255.80 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w C | $2,676.00 | $4,460.00 | $1,516.40–$3,255.80 | 16% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w IV Contrast Only | $2,676.00 | $4,460.00 | $1,516.40–$3,255.80 | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w C | $2,676.00 | $4,460.00 | $1,516.40–$3,255.80 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w/wo C | $3,022.80 | $5,038.00 | $1,712.92–$3,677.74 | 12% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $3,022.80 | $5,038.00 | $1,712.92–$3,677.74 | 12% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis w/wo C | $3,022.80 | $5,038.00 | $1,712.92–$3,677.74 | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM | $3,022.80 | $5,038.00 | $1,712.92–$3,677.74 | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w Contrast | $1,473.60 | $2,456.00 | $835.04–$1,792.88 | 11% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w Contrast | $1,473.60 | $2,456.00 | $835.04–$1,792.88 | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen wo Contrast | $1,077.60 | $1,796.00 | $610.64–$1,311.08 | 19% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen wo Contrast | $1,077.60 | $1,796.00 | $610.64–$1,311.08 | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus | $1,021.80 | $1,703.00 | $579.02–$1,243.19 | 21% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o contrast | $1,021.80 | $1,703.00 | $579.02–$1,243.19 | 21% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus Limited | $1,021.80 | $1,703.00 | $579.02–$1,243.19 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o contrast | $1,021.80 | $1,703.00 | $579.02–$1,243.19 | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus | $1,021.80 | $1,703.00 | $579.02–$1,243.19 | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Viewpoint Head wo Contrast | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | 12% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | 12% below | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o contrast | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | 12% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Viewpoint Head wo Contrast | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o contrast | $1,198.80 | $1,998.00 | $679.32–$1,458.54 | — | 40% |
| CT scan of the head with contrast CPT 70460 CT Viewpoint Head w Contrast | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | 15% below | 40% |
| CT scan of the head with contrast CPT 70460 CT Head w C - Stroke Alert | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | 15% below | 40% |
| CT scan of the head with contrast CPT 70460 CT Head w/ contrast | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | 15% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head w C - Stroke Alert | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Viewpoint Head w Contrast | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | — | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head w/ contrast | $1,263.60 | $2,106.00 | $716.04–$1,537.38 | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT Head w & w/o contrast | $1,509.00 | $2,515.00 | $855.10–$1,835.95 | 16% below | 40% |
| CT scan of the head without and with contrast CPT 70470 GHS CT HEAD W &W/O CONTRAST | $1,509.00 | $2,515.00 | $855.10–$1,835.95 | 16% below | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 GHS CT HEAD W &W/O CONTRAST | $1,509.00 | $2,515.00 | $855.10–$1,835.95 | — | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Head w & w/o contrast | $1,509.00 | $2,515.00 | $855.10–$1,835.95 | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-Spine wo Contrast | $1,414.80 | $2,358.00 | $801.72–$1,721.34 | 7% below | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-Spine wo Contrast | $1,414.80 | $2,358.00 | $801.72–$1,721.34 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine wo Contrast | $1,435.80 | $2,393.00 | $813.62–$1,746.89 | 5% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine Viewpoint | $1,435.80 | $2,393.00 | $813.62–$1,746.89 | 5% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine Viewpoint | $1,435.80 | $2,393.00 | $813.62–$1,746.89 | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine wo Contrast | $1,435.80 | $2,393.00 | $813.62–$1,746.89 | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w Contrast | $1,434.00 | $2,390.00 | $812.60–$1,744.70 | 16% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w Contrast | $1,434.00 | $2,390.00 | $812.60–$1,744.70 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Carotid Doppler Scan | $606.60 | $1,011.00 | $343.74–$738.03 | 31% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 VL Dup Carotid Artery | $606.60 | $1,011.00 | $343.74–$738.03 | 31% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Dup scan/extracran art/bilat/comp 93880 | $394.80 | $658.00 | $928.00–$2,679.00 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 VL Dup Carotid Artery | $606.60 | $1,011.00 | $343.74–$738.03 | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Carotid Doppler Scan | $606.60 | $1,011.00 | $343.74–$738.03 | — | 40% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/wo Contrast | $1,603.20 | $2,672.00 | $908.48–$1,950.56 | 16% below | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/wo Contrast | $1,603.20 | $2,672.00 | $908.48–$1,950.56 | — | 40% |
| Chest X-ray, 2 views CPT 71046 Chest Special View (Decubitus) | $160.80 | $268.00 | $91.12–$195.64 | 22% below | 40% |
| Chest X-ray, 2 views CPT 71046 CHEST ROUTINE PA/LAT | $191.40 | $319.00 | $108.46–$232.87 | 7% below | 40% |
| Chest X-ray, 2 views CPT 71046 CHEST, SPECIAL VIEW (DECUBITUS) | $201.60 | $336.00 | $114.24–$245.28 | 2% below | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest Special View (Decubitus) | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Chest Routine PA/Lat | $191.40 | $319.00 | $108.46–$232.87 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST ROUTINE PA/LAT | $191.40 | $319.00 | $108.46–$232.87 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST, SPECIAL VIEW (DECUBITUS) | $201.60 | $336.00 | $114.24–$245.28 | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 Port Chest 2 vws | $201.60 | $336.00 | $114.24–$245.28 | — | 40% |
| Chest X-ray, single view CPT 71045 Chest with Fluoroscopy | $129.00 | $215.00 | $73.10–$156.95 | 23% below | 40% |
| Chest X-ray, single view CPT 71045 CHEST 1 VIEW FRONTAL | $129.00 | $215.00 | $73.10–$156.95 | 23% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest Feeding Tube Placement | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest, Single View | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Port Feed Chest | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Port Chest 1 | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 Chest with Fluoroscopy | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW FRONTAL | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Right | $196.80 | $328.00 | $111.52–$239.44 | at median | 40% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Left | $196.80 | $328.00 | $111.52–$239.44 | at median | 40% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 Clavicle, Bilat | $295.20 | $492.00 | $167.28–$359.16 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Left | $196.80 | $328.00 | $111.52–$239.44 | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Right | $196.80 | $328.00 | $111.52–$239.44 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneum | $486.00 | $810.00 | $275.40–$591.30 | 20% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneum | $486.00 | $810.00 | $275.40–$591.30 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 CT Bone Mineral Central | $246.00 | $410.00 | $139.40–$299.30 | 38% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Densitometry-DEXA-Hip/Spine/Pelvis | $246.00 | $410.00 | $139.40–$299.30 | 38% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Densitometry Spine/Hips | $246.00 | $410.00 | $139.40–$299.30 | 38% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 CT Bone Mineral Central | $246.00 | $410.00 | $139.40–$299.30 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Densitometry-DEXA-Hip/Spine/Pelvis | $246.00 | $410.00 | $139.40–$299.30 | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Densitometry Spine/Hips | $246.00 | $410.00 | $139.40–$299.30 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Bone Densitometry Wrist/Heels | $229.20 | $382.00 | $129.88–$278.86 | 8% below | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 CT Bone Mineral Perip | $229.20 | $382.00 | $129.88–$278.86 | 8% below | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 CT Bone Mineral Perip | $229.20 | $382.00 | $129.88–$278.86 | — | 40% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Bone Densitometry Wrist/Heels | $229.20 | $382.00 | $129.88–$278.86 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Comp Sin Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | 44% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB CompTwin Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | 44% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB CompTriplet Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | 44% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Comp Sin Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB CompTriplet Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB CompTwin Gest w Detail Fetal | $361.80 | $603.00 | $205.02–$440.19 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT HIgh Resolution Chest | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | 17% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest wo Contrast | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | 17% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Diag Follow up- Low Dose | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | 17% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Limited | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT HIgh Resolution Chest | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest wo Contrast | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung Diag Follow up- Low Dose | $1,145.40 | $1,909.00 | $649.06–$1,393.57 | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/Contrast | $1,554.60 | $2,591.00 | $880.94–$1,891.43 | 13% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/Contrast | $1,554.60 | $2,591.00 | $880.94–$1,891.43 | — | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Mammography Diag Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | 76% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Mammography Screen to Diag Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | 76% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Digital Diag Mammogram Bil | $159.00 | $265.00 | $90.10–$193.45 | 55% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Digital Diag Mammogram Bil w CAD | $295.80 | $493.00 | $167.62–$359.89 | 15% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Digital A/V Mammogram Bil | $295.80 | $493.00 | $167.62–$359.89 | 15% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Digital Diag Mam Implants Bil w CAD | $295.80 | $493.00 | $167.62–$359.89 | 15% below | 40% |
| Diagnostic mammogram, both breasts CPT 77066 BR Digital Diag Mammo Bil w Tomo -CAD | $295.80 | $493.00 | $167.62–$359.89 | 15% below | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Mammography Diag Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Mammography Screen to Diag Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital Screen/Diag Mam Bil w CAD | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital Diag Mammogram Bil | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital Diag Mam Implants Bil w CAD | $295.80 | $493.00 | $167.62–$359.89 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital A/V Mammogram Bil | $295.80 | $493.00 | $167.62–$359.89 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital Diag Mammo Bil w Tomo -CAD | $295.80 | $493.00 | $167.62–$359.89 | — | 40% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 BR Digital Diag Mammogram Bil w CAD | $295.80 | $493.00 | $167.62–$359.89 | — | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammogram R | $123.60 | $206.00 | $70.04–$150.38 | 58% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammogram L | $123.60 | $206.00 | $70.04–$150.38 | 58% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital A/V Mammogram L | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital A/V Mammogram L w Tomo | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital A/V Mammogram R w Tomo | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammogram R w CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammo R w Tomo -CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammogram L w CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital Diag Mammo L w Tomo -CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast CPT 77065 BR Digital A/V Mammogram R | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 BR Mammography Diag Lt w CAD | $59.40 | $99.00 | $33.66–$72.27 | 80% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 BR Mammography Diag Rt w CAD | $59.40 | $99.00 | $33.66–$72.27 | 80% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 BR Digital Diag Mam Implants R w CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 BR Digital Diag Mam Implants L w CAD | $231.60 | $386.00 | $131.24–$281.78 | 21% below | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammogram L | $123.60 | $206.00 | $70.04–$150.38 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammogram R | $123.60 | $206.00 | $70.04–$150.38 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Screen/Diag Mam R w CAD | $128.40 | $214.00 | $72.76–$156.22 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Screen/Diag Mam L w CAD | $128.40 | $214.00 | $72.76–$156.22 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital A/V Mammogram L | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammo L w Tomo -CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital A/V Mammogram R | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammo R w Tomo -CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammogram L w CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mammogram R w CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mam Implants L w CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital Diag Mam Implants R w CAD | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital A/V Mammogram L w Tomo | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 BR Digital A/V Mammogram R w Tomo | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 BR Mammography Diag Rt w CAD | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 BR Mammography Diag Lt w CAD | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US ART Low Ext Bil | $535.20 | $892.00 | $303.28–$651.16 | 28% below | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dup scan/LE art/graft/bilat/comp 93925 | $483.00 | $805.00 | $928.00–$2,679.00 | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ART Low Ext Bil | $535.20 | $892.00 | $303.28–$651.16 | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Doppler Bilateral | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Ven Mapping Upper Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | 27% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Mapping Extremity Bil | $619.20 | $1,032.00 | $350.88–$753.36 | 27% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Doppler Low Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | 27% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Doppler Lower Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | 27% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Ven Mapping Lower Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | 27% below | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Dup scan/extremity vein/bilat/comp 93970 | $396.00 | $660.00 | $928.00–$2,679.00 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Doppler Bilateral | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Doppler Lower Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL No Inv Ext Vein Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Mapping Extremity Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Venous Doppler Low Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Ven Mapping Upper Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Ven Mapping Lower Ext Bil | $619.20 | $1,032.00 | $350.88–$753.36 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 GHS ECHO WITH DOPPLER/COLOR | $938.40 | $1,564.00 | $531.76–$1,141.72 | 39% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo w Doppler/Color | $938.40 | $1,564.00 | $531.76–$1,141.72 | 39% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Pediatric w Doppler/Color | $994.20 | $1,657.00 | $563.38–$1,209.61 | 35% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 GHS ECHO PEDIATRIC W DOPPLER/COLOR | $994.20 | $1,657.00 | $563.38–$1,209.61 | 35% below | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE 2D/M-mode/comp/spec/color flow 93306 | $411.00 | $685.00 | $928.00–$2,679.00 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 GHS ECHO WITH DOPPLER/COLOR | $938.40 | $1,564.00 | $531.76–$1,141.72 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo w Doppler/Color | $938.40 | $1,564.00 | $531.76–$1,141.72 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 GHS ECHO PEDIATRIC W DOPPLER/COLOR | $994.20 | $1,657.00 | $563.38–$1,209.61 | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Pediatric w Doppler/Color | $994.20 | $1,657.00 | $563.38–$1,209.61 | — | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP/Lat Right | $129.00 | $215.00 | $73.10–$156.95 | 22% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow AP/Lat Left | $129.00 | $215.00 | $73.10–$156.95 | 22% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 1 vw Right | $129.00 | $215.00 | $73.10–$156.95 | 22% below | 40% |
| Elbow X-ray, 2 views one side CPT 73070 Elbow 1vw Left | $129.00 | $215.00 | $73.10–$156.95 | 22% below | 40% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 Elbow AP/Lat, Bilat | $193.20 | $322.00 | $109.48–$235.06 | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 Elbow 1vw Bil | $193.20 | $322.00 | $109.48–$235.06 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 1 vw Right | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP/Lat Left | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow AP/Lat Right | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow 1vw Left | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Routine Left | $195.60 | $326.00 | $110.84–$237.98 | 10% below | 40% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow Routine Right | $195.60 | $326.00 | $110.84–$237.98 | 10% below | 40% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 Elbow Routine,Bilat | $293.40 | $489.00 | $166.26–$356.97 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Routine Left | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow Routine Right | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit/Sella/Fossa wo Contrast | $988.80 | $1,648.00 | $560.32–$1,203.04 | 25% below | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit/Sella/Fossa wo Contrast | $988.80 | $1,648.00 | $560.32–$1,203.04 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bones Routine | $294.60 | $491.00 | $166.94–$358.43 | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Zygomatic Arches | $294.60 | $491.00 | $166.94–$358.43 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Left | $193.20 | $322.00 | $109.48–$235.06 | 4% below | 40% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Right | $193.20 | $322.00 | $109.48–$235.06 | 4% below | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 Forearm, Bilat | $289.20 | $482.00 | $163.88–$351.86 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Right | $193.20 | $322.00 | $109.48–$235.06 | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Left | $193.20 | $322.00 | $109.48–$235.06 | — | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA/Lat Right | $141.00 | $235.00 | $79.90–$171.55 | 15% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand PA/Lat Left | $141.00 | $235.00 | $79.90–$171.55 | 15% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 1 vw Right | $141.00 | $235.00 | $79.90–$171.55 | 15% below | 40% |
| Hand X-ray, 2 views one side CPT 73120 Hand 1 vw Left | $141.00 | $235.00 | $79.90–$171.55 | 15% below | 40% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 Hand PA/Lat, Bilat | $210.60 | $351.00 | $119.34–$256.23 | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 Hand 1 vw Bil | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 1 vw Right | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA/Lat Right | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand 1 vw Left | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Hand X-ray, 2 views inpatient one side CPT 73120 Hand PA/Lat Left | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis 1 vw Left | $172.80 | $288.00 | $97.92–$210.24 | 2% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis (Heel) Left | $172.80 | $288.00 | $97.92–$210.24 | 2% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 O's Calcis (Heel) Right | $172.80 | $288.00 | $97.92–$210.24 | 2% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis 1 vw Right | $172.80 | $288.00 | $97.92–$210.24 | 2% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 Os Calsis (Heel), Bilat | $259.20 | $432.00 | $146.88–$315.36 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Os Calcis 1 vw Bil | $259.20 | $432.00 | $146.88–$315.36 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis 1 vw Left | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis (Heel) Left | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 O's Calcis (Heel) Right | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis 1 vw Right | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 GHS SLEEP STUDY UNATTENDED & RESP EFFORT | $1,183.20 | $1,972.00 | $670.48–$1,439.56 | 97% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Std Airflow Hrt Rate+O2 Sat Effort Unattn 95806 | $327.60 | $546.00 | $928.00–$2,679.00 | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 GHS SLEEP STUDY UNATTENDED & RESP EFFORT | $1,183.20 | $1,972.00 | $670.48–$1,439.56 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 GHS POLYSOMNOGRAM W CPAP | $3,262.80 | $5,438.00 | $1,848.92–$3,969.74 | 2% above | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnogram w/CPAP | $3,262.80 | $5,438.00 | $1,848.92–$3,969.74 | 2% above | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 GHS POLYSOMNOGRAM W CPAP | $3,262.80 | $5,438.00 | $1,848.92–$3,969.74 | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnogram w/CPAP | $3,262.80 | $5,438.00 | $1,848.92–$3,969.74 | — | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee Routine Left | $192.60 | $321.00 | $109.14–$234.33 | 15% below | 40% |
| Knee X-ray, 3 views one side CPT 73562 Knee Routine Right | $192.60 | $321.00 | $109.14–$234.33 | 15% below | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 Knee Routine, Bilat | $288.60 | $481.00 | $163.54–$351.13 | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 X-ray exam of knee 3 73562 | $57.00 | $95.00 | $928.00–$2,679.00 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee Routine Left | $192.60 | $321.00 | $109.14–$234.33 | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 Knee Routine Right | $192.60 | $321.00 | $109.14–$234.33 | — | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee w Merchants Left | $195.60 | $326.00 | $110.84–$237.98 | 29% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee w Patella Left | $195.60 | $326.00 | $110.84–$237.98 | 29% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee w Merchants Right | $195.60 | $326.00 | $110.84–$237.98 | 29% below | 40% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Knee w Patella Right | $195.60 | $326.00 | $110.84–$237.98 | 29% below | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-ray exam knee 4 or more 73564 | $65.40 | $109.00 | $928.00–$2,679.00 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 Knee w Patella Bil | $293.40 | $489.00 | $166.26–$356.97 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 Knee w Merchants Bil | $293.40 | $489.00 | $166.26–$356.97 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee w Patella Right | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee w Merchants Right | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee w Merchants Left | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee w Patella Left | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast-R | $1,116.00 | $1,860.00 | $632.40–$1,357.80 | 16% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast-L | $1,116.00 | $1,860.00 | $632.40–$1,357.80 | 16% below | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lower Extremity w/o Contrast-R | $1,116.00 | $1,860.00 | $632.40–$1,357.80 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lower Extremity w/o Contrast-L | $1,116.00 | $1,860.00 | $632.40–$1,357.80 | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Lower Extremity w/o Contrast-Bil | $1,674.00 | $2,790.00 | $948.60–$2,036.70 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Biliary Comp/Gb Cbd Pan Liv Spl | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pylorus | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdominal Limited | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Ascites Evaluation | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gall Bladder Fatty Meal | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Abd Lmt/Quad RT | $438.00 | $730.00 | $248.20–$532.90 | 7% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echo exam of abdomen 76705- | $225.60 | $376.00 | $928.00–$2,679.00 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gall Bladder Fatty Meal | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Ascites Evaluation | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdominal Limited | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pylorus | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Biliary Comp/Gb Cbd Pan Liv Spl | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Abd Lmt/Quad RT | $438.00 | $730.00 | $248.20–$532.90 | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Limited | $154.20 | $257.00 | $87.38–$187.61 | 56% below | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Limited | $154.20 | $257.00 | $87.38–$187.61 | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Does Lung Cancer Screening | $420.60 | $701.00 | $238.34–$511.73 | 4% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Does Lung Cancer Screening | $420.60 | $701.00 | $238.34–$511.73 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib 1 vw Left | $166.20 | $277.00 | $94.18–$202.21 | 15% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia & Fibula Right | $166.20 | $277.00 | $94.18–$202.21 | 15% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tibia & Fibula Left | $166.20 | $277.00 | $94.18–$202.21 | 15% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib 1 vw Right | $166.20 | $277.00 | $94.18–$202.21 | 15% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 Tibia & Fibula, Bilat | $249.00 | $415.00 | $141.10–$302.95 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-ray exam of lower leg 73590 | $165.00 | $275.00 | $928.00–$2,679.00 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Tib/Fib 1 vw Bil | $249.00 | $415.00 | $141.10–$302.95 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia & Fibula Right | $166.20 | $277.00 | $94.18–$202.21 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tibia & Fibula Left | $166.20 | $277.00 | $94.18–$202.21 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib 1 vw Left | $166.20 | $277.00 | $94.18–$202.21 | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib 1 vw Right | $166.20 | $277.00 | $94.18–$202.21 | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head wo Contrast | $1,755.60 | $2,926.00 | $994.84–$2,135.98 | 23% below | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Venography Head wo Contrast | $1,755.60 | $2,926.00 | $994.84–$2,135.98 | 23% below | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head wo Contrast | $1,755.60 | $2,926.00 | $994.84–$2,135.98 | — | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Venography Head wo Contrast | $1,755.60 | $2,926.00 | $994.84–$2,135.98 | — | 40% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MR Breast Bil w/wo Contrast | $1,685.40 | $2,809.00 | $955.06–$2,050.57 | 1% above | 40% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MR Breast Bil w/wo Contrast | $1,685.40 | $2,809.00 | $955.06–$2,050.57 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Hip Lmtd For Fracture wo Cntrst | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Hips wo Contrast | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Knee - L | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Ankle Joint w/o Contrast - L | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Hip wo Contrast- Left | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Knee - R | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Ankle Joint w/o Contrast - R | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Hip wo Contrast- Right | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | 22% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR Knee Bilateral | $2,627.40 | $4,379.00 | $1,488.86–$3,196.67 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Knee - R | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Ankle Joint w/o Contrast - L | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Hip Lmtd For Fracture wo Cntrst | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Ankle Joint w/o Contrast - R | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Hips wo Contrast | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Knee - L | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Ankle Joint w/o Contrast - Bil | $2,627.40 | $4,379.00 | $1,488.86–$3,196.67 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Knee - Bil | $2,653.20 | $4,422.00 | $1,503.48–$3,228.06 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR Hip wo Contrast- Left | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR Hip wo Contrast- Right | $1,751.40 | $2,919.00 | $992.46–$2,130.87 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Hips w/wo Contrast | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Hip Lmtd For Fracture w/wo Cont | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Knee w & w/o Contrast - R | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Hip w/wo Contrast Right | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Hip w/wo Contrast Left | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Ankle Joint w & w/o Contrast - R | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Knee w & w/o Contrast L | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Ankle Joint w & w/o Contrast - L | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | 23% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Ankle Joint w & w/o Contrast - R | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Hip Lmtd For Fracture w/wo Cont | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Knee w & w/o Contrast L | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Ankle Joint w & w/o Contrast - L | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Knee w & w/o Contrast - R | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Hips w/wo Contrast | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Knee w & wo Contrast Bil | $3,682.20 | $6,137.00 | $2,086.58–$4,480.01 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Ankle Joint w & w/o Contrast- Bil | $3,717.00 | $6,195.00 | $2,106.30–$4,522.35 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Knee w & w/o Contrast - Bil | $3,717.00 | $6,195.00 | $2,106.30–$4,522.35 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Ankle Jnt w/wo Contrast | $3,717.00 | $6,195.00 | $2,106.30–$4,522.35 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR Hip w/wo Contrast Left | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR Hip w/wo Contrast Right | $2,454.60 | $4,091.00 | $1,390.94–$2,986.43 | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MR Abdomen wo Contrast | $1,544.40 | $2,574.00 | $875.16–$1,879.02 | 26% below | 40% |
| MRI of the abdomen without contrast CPT 74181 MR Cholangiopancreatography | $1,544.40 | $2,574.00 | $875.16–$1,879.02 | 26% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MR Cholangiopancreatography | $1,544.40 | $2,574.00 | $875.16–$1,879.02 | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MR Abdomen wo Contrast | $1,544.40 | $2,574.00 | $875.16–$1,879.02 | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR Enterography w/wo Contrast | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | 10% below | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR Abdomen w/wo Contrast | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | 10% below | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR Cholangiopanc w and wo C | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | 10% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Cholangiopanc w and wo C | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Abdomen w/wo Contrast | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | — | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Enterography w/wo Contrast | $3,073.80 | $5,123.00 | $1,741.82–$3,739.79 | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR Posterior Fossa wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR Post Fossa wo Contrast w Diff | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR IAC wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR Brain wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR Brain w Diffusion wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MR Skullbase wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | 34% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Post Fossa wo Contrast w Diff | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Posterior Fossa wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Skullbase wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain w Diffusion wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain wo Contrast TX Plan | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR IAC wo Contrast | $1,509.60 | $2,516.00 | $855.44–$1,836.68 | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Posterior Fossa w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Post Fossa w/wo Contrast w Diff | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Skullbase w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR IAC w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Pituitary w/wo contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain w Perf w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain w Perf&Diff w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Sella w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | 14% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Post Fossa w/wo Contrast w Diff | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR IAC w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain w Perf w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain w Perf&Diff w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Sella w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Pituitary w/wo contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Posterior Fossa w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Skullbase w/wo Contrast | $2,997.60 | $4,996.00 | $1,698.64–$3,647.08 | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MR Lumbar Plexus wo Contrast | $1,179.00 | $1,965.00 | $668.10–$1,434.45 | 50% below | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MR Spine Lumbar wo Contrast | $1,750.80 | $2,918.00 | $992.12–$2,130.14 | 26% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Spinal Survey Lumbar wo Contrast | $1,179.00 | $1,965.00 | $668.10–$1,434.45 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Spinal Survey Lumbar w Contrast | $1,179.00 | $1,965.00 | $668.10–$1,434.45 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Lumbar Plexus wo Contrast | $1,179.00 | $1,965.00 | $668.10–$1,434.45 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 GHS MRI SPINE LUMBAR W/O C | $1,750.80 | $2,918.00 | $992.12–$2,130.14 | — | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Spine Lumbar wo Contrast | $1,750.80 | $2,918.00 | $992.12–$2,130.14 | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR Spine Lumbar w/wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | 32% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR Spinal Survey Lumbar w&wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 GHS MRI SPINE LUMBAR W/WO C | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR Spine Lumbar w/wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR Spine Thoracic wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | 23% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR Spinal Survey Thoracic wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 GHS MRI SPINE THORACIC W/O C | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR Spine Thoracic wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR Spine Cervical w/wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | 28% below | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR Spinal Survey Cervical w&wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 GHS MRI SPINE CERVICAL W/WO C | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR Spine Cervical w/wo Contrast | $2,361.60 | $3,936.00 | $1,338.24–$2,873.28 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR Spine Cervical wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | 23% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR Spine Cervical wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 GHS MRI SPINE CERVICAL W/O C | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR Spinal Survey Cervical wo Contrast | $1,741.80 | $2,903.00 | $987.02–$2,119.19 | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MR Pelvis w/wo Contrast | $2,391.00 | $3,985.00 | $1,354.90–$2,909.05 | 26% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 GHS MRI PELVIS W/WO CONTRAST | $2,391.00 | $3,985.00 | $1,354.90–$2,909.05 | 26% below | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MR Sacrum & Coccyx w/wo Contrast | $2,616.00 | $4,360.00 | $1,482.40–$3,182.80 | 19% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 GHS MRI PELVIS W/WO CONTRAST | $2,391.00 | $3,985.00 | $1,354.90–$2,909.05 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR Pelvis w/wo Contrast | $2,391.00 | $3,985.00 | $1,354.90–$2,909.05 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR Sacrum & Coccyx w/wo Contrast | $2,616.00 | $4,360.00 | $1,482.40–$3,182.80 | — | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR Pelvis w/wo Contrast TX plan | $2,616.00 | $4,360.00 | $1,482.40–$3,182.80 | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MR Pelvis wo Contrast | $1,576.80 | $2,628.00 | $893.52–$1,918.44 | 24% below | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MR Sacrum & Coccyx wo Contrast | $1,576.80 | $2,628.00 | $893.52–$1,918.44 | 24% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Pelvis wo Contrast Therapy Planning | $1,576.80 | $2,628.00 | $893.52–$1,918.44 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Sacrum & Coccyx wo Contrast | $1,576.80 | $2,628.00 | $893.52–$1,918.44 | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Pelvis wo Contrast | $1,576.80 | $2,628.00 | $893.52–$1,918.44 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Shoulder Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Wrist Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Elbow Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Shoulder Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Wrist Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Elbow Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | 33% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Elbow Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Wrist Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Shoulder Joint w/o Contrast-L | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Elbow Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Wrist Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Shoulder Joint w/o Contrast-R | $1,461.60 | $2,436.00 | $828.24–$1,778.28 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Shoulder Joint w/o Contrast-Bil | $2,193.60 | $3,656.00 | $1,243.04–$2,668.88 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Elbow Joint w/o Contrast-Bil | $2,193.60 | $3,656.00 | $1,243.04–$2,668.88 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Wrist Joint w/o Contrast-Bil | $2,193.60 | $3,656.00 | $1,243.04–$2,668.88 | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Shoulder w/wo Contrast Bil | $2,193.60 | $3,656.00 | $1,243.04–$2,668.88 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Spine Cervical 4 or 5 Vws | $263.40 | $439.00 | $149.26–$320.47 | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Spine Atlanto-Axial Series 4 or 5 Vws | $263.40 | $439.00 | $149.26–$320.47 | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w Contrast | $1,365.60 | $2,276.00 | $773.84–$1,661.48 | 15% below | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Soft Tissue Neck w Contrast | $1,365.60 | $2,276.00 | $773.84–$1,661.48 | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck wo Contrast | $1,053.00 | $1,755.00 | $596.70–$1,281.15 | 17% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck wo Contrast | $1,053.00 | $1,755.00 | $596.70–$1,281.15 | — | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 Neck Soft Tissue | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Pelvic CT scan without contrast CPT 72192 PELVIS W/O CONTRAST | $1,170.60 | $1,951.00 | $663.34–$1,424.23 | 9% below | 40% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis wo Contrast | $1,170.60 | $1,951.00 | $663.34–$1,424.23 | 9% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 PELVIS W/O CONTRAST | $1,170.60 | $1,951.00 | $663.34–$1,424.23 | — | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis wo Contrast | $1,170.60 | $1,951.00 | $663.34–$1,424.23 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Ltd | $213.60 | $356.00 | $121.04–$259.88 | 40% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Us exam pelvic limited 76857- | $168.00 | $280.00 | $928.00–$2,679.00 | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Ltd | $213.60 | $356.00 | $121.04–$259.88 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Trans Abd Pelvic | $373.80 | $623.00 | $211.82–$454.79 | 32% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Trans Abdominal Pelvic Complete | $373.80 | $623.00 | $211.82–$454.79 | 32% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us exam pelvic complete 76856- | $262.20 | $437.00 | $928.00–$2,679.00 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Trans Abdominal Pelvic Complete | $373.80 | $623.00 | $211.82–$454.79 | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Trans Abd Pelvic | $373.80 | $623.00 | $211.82–$454.79 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Comp SingleGest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | 18% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB CompTriplet Gest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | 18% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB CompTwin Gest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | 18% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB COMPLETE TWIN GESTATION >14 WKS | $451.80 | $753.00 | $256.02–$549.69 | 18% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Single more than 28 weeks | $451.80 | $753.00 | $256.02–$549.69 | 18% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob us >/= 14 wks sngl fetus 76805- | $299.40 | $499.00 | $928.00–$2,679.00 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB CompTwin Gest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB CompTriplet Gest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Comp SingleGest more than 14wk | $451.80 | $753.00 | $256.02–$549.69 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Single more than 28 weeks | $451.80 | $753.00 | $256.02–$549.69 | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB COMPLETE TWIN GESTATION >14 WKS | $451.80 | $753.00 | $256.02–$549.69 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB CompTriplet Gest less than 14wk | $379.20 | $632.00 | $214.88–$461.36 | 19% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Comp Single Gest < 14wk | $379.20 | $632.00 | $214.88–$461.36 | 19% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB CompTwin Gest less than 14wk | $379.20 | $632.00 | $214.88–$461.36 | 19% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ob us < 14 wks single fetus 76801- | $274.20 | $457.00 | $928.00–$2,679.00 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Comp Single Gest < 14wk | $379.20 | $632.00 | $214.88–$461.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB CompTriplet Gest less than 14wk | $379.20 | $632.00 | $214.88–$461.36 | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB CompTwin Gest less than 14wk | $379.20 | $632.00 | $214.88–$461.36 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited | $322.20 | $537.00 | $182.58–$392.01 | 5% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB less than 12 wks | $322.20 | $537.00 | $182.58–$392.01 | 5% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ob us limited fetus(s) 76815- | $193.20 | $322.00 | $928.00–$2,679.00 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited | $322.20 | $537.00 | $182.58–$392.01 | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB less than 12 wks | $322.20 | $537.00 | $182.58–$392.01 | — | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilateral Left | $243.60 | $406.00 | $138.04–$296.38 | 13% above | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Ribs Unilateral Right | $243.60 | $406.00 | $138.04–$296.38 | 13% above | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Unilateral Right | $243.60 | $406.00 | $138.04–$296.38 | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Unilateral Left | $243.60 | $406.00 | $138.04–$296.38 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIbs Right with PA Chest | $323.40 | $539.00 | $183.26–$393.47 | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIbs Left with PA Chest | $323.40 | $539.00 | $183.26–$393.47 | — | 40% |
| Screening mammogram, both breasts CPT 77067 BR Mammo Scrn Bil | $67.80 | $113.00 | $38.42–$82.49 | 78% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Mammo CHC Medicare Screen Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | 72% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Mammo CHC Screen Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | 72% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Mammography Screen Bil w CAD | $88.20 | $147.00 | $49.98–$107.31 | 71% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen HR MamBil w/CAD | $153.60 | $256.00 | $87.04–$186.88 | 50% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen Mammogram Bil woCAD | $153.60 | $256.00 | $87.04–$186.88 | 50% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen Mammogram Bil wCAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen Mam Bil w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen Mam Implants Bil w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts CPT 77067 BR Digital Screen Mam Implants Bil w CAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts one side CPT 77067 BR Mammo CHC Screen Left w CAD | $69.60 | $116.00 | $39.44–$84.68 | 77% below | 40% |
| Screening mammogram, both breasts one side CPT 77067 BR Mammo CHC Screen Right w CAD | $69.60 | $116.00 | $39.44–$84.68 | 77% below | 40% |
| Screening mammogram, both breasts one side CPT 77067 BR DIgital Screen Mam Implants R w CAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts one side CPT 77067 BR DIgital Screen Mam Implants L w CAD | $276.60 | $461.00 | $156.74–$336.53 | 10% below | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Mammo Scrn Bil | $67.80 | $113.00 | $38.42–$82.49 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Mammo CHC Screen Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Mammo CHC Medicare Screen Bil w CAD | $85.20 | $142.00 | $48.28–$103.66 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Mammography Screen Bil w CAD | $88.20 | $147.00 | $49.98–$107.31 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen HR Mam L w/CAD | $123.60 | $206.00 | $70.04–$150.38 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen HR Mam R w/CAD:CBH Mammo DTA | $123.60 | $206.00 | $70.04–$150.38 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen HR MamBil w/CAD | $153.60 | $256.00 | $87.04–$186.88 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mammogram Bil woCAD | $153.60 | $256.00 | $87.04–$186.88 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR DIgital Screen Mam Implants L w CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR DIgital Screen Mam Implants R w CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam Implants R w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam Implants L w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam Implants Bil w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam Bil w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam R w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam L w Tomo-CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mam Implants Bil w CAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mammogram R wCAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mammogram L wCAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 BR Digital Screen Mammogram Bil wCAD | $276.60 | $461.00 | $156.74–$336.53 | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 BR Mammography Screen Left w CAD | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 BR Mammo CHC Screen Right w CAD | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 BR Mammo CHC Screen Left w CAD | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 BR Mammography Screen Right w CAD | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Routine Left | $200.40 | $334.00 | $113.56–$243.82 | 12% below | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Routine Right | $200.40 | $334.00 | $113.56–$243.82 | 12% below | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 Shoulder Routine, Bilat | $300.60 | $501.00 | $170.34–$365.73 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Routine Right | $200.40 | $334.00 | $113.56–$243.82 | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Routine Left | $200.40 | $334.00 | $113.56–$243.82 | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses Paranasal Routine | $250.20 | $417.00 | $141.78–$304.41 | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull <4 Views | $165.00 | $275.00 | $93.50–$200.75 | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnogram, Neuro Dx | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | 5% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 GHS POLYSOMNOGRAM - DISCONTINUED | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | 5% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnogram - discontinued | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | 5% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 GHS POLYSOMNOGRAM | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | 5% above | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnogram - discontinued | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnogram, Neuro Dx | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 GHS POLYSOMNOGRAM | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | — | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 GHS POLYSOMNOGRAM - DISCONTINUED | $3,030.60 | $5,051.00 | $1,717.34–$3,687.23 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Function w Videoradiography | $295.20 | $492.00 | $167.28–$359.16 | 29% below | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Video Swallow Study | $295.20 | $492.00 | $167.28–$359.16 | 29% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Function w Videoradiography | $295.20 | $492.00 | $167.28–$359.16 | — | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Video Swallow Study | $295.20 | $492.00 | $167.28–$359.16 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Left min 2 vws | $154.20 | $257.00 | $87.38–$187.61 | 21% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Right min 2 vws | $154.20 | $257.00 | $87.38–$187.61 | 21% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 Femur, Bilat min 2 vws | $231.60 | $386.00 | $131.24–$281.78 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Right min 2 vws | $154.20 | $257.00 | $87.38–$187.61 | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Left min 2 vws | $154.20 | $257.00 | $87.38–$187.61 | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-Spine wo Contrast | $1,381.20 | $2,302.00 | $782.68–$1,680.46 | at median | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-Spine wo Contrast | $1,381.20 | $2,302.00 | $782.68–$1,680.46 | — | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toes 1 vw Right | $150.60 | $251.00 | $85.34–$183.23 | 12% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toes Right | $150.60 | $251.00 | $85.34–$183.23 | 12% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toes 1 vw Left | $150.60 | $251.00 | $85.34–$183.23 | 12% below | 40% |
| Toe X-ray, 2 or more views one side CPT 73660 Toes Left | $150.60 | $251.00 | $85.34–$183.23 | 12% below | 40% |
| Toe X-ray, 2 or more views inpatient both sides CPT 73660 Toes, Bilat | $226.20 | $377.00 | $128.18–$275.21 | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 Toes 1 vw Bil | $226.20 | $377.00 | $128.18–$275.21 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Left | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes 1 vw Left | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes 1 vw Right | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 Toes Right | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Trans Vaginal Pelvic Complete | $336.60 | $561.00 | $190.74–$409.53 | 35% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Trans Vag Pelvic | $336.60 | $561.00 | $190.74–$409.53 | 35% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Trans Vaginal Pelvic Limited | $368.40 | $614.00 | $208.76–$448.22 | 28% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal us non-ob 76830- | $265.80 | $443.00 | $928.00–$2,679.00 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Trans Vaginal Pelvic Complete | $336.60 | $561.00 | $190.74–$409.53 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Trans Vag Pelvic | $336.60 | $561.00 | $190.74–$409.53 | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Trans Vaginal Pelvic Limited | $368.40 | $614.00 | $208.76–$448.22 | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $384.00 | $640.00 | $217.60–$467.20 | 15% below | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvaginal us obstetric 76817- | $207.00 | $345.00 | $928.00–$2,679.00 | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $384.00 | $640.00 | $217.60–$467.20 | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdominal Complete | $708.60 | $1,181.00 | $401.54–$862.13 | 2% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Biliary with CCK | $708.60 | $1,181.00 | $401.54–$862.13 | 2% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Biliary with CCK | $708.60 | $1,181.00 | $401.54–$862.13 | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Complete | $708.60 | $1,181.00 | $401.54–$862.13 | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Testicular with A/V flow | $472.80 | $788.00 | $267.92–$575.24 | 10% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum | $472.80 | $788.00 | $267.92–$575.24 | 10% below | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular with A/V flow | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $351.00 | $585.00 | $198.90–$427.05 | 25% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $351.00 | $585.00 | $198.90–$427.05 | 25% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us exam of head and neck 76536- | $252.60 | $421.00 | $928.00–$2,679.00 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $351.00 | $585.00 | $198.90–$427.05 | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $351.00 | $585.00 | $198.90–$427.05 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI Upper w/Kub | $346.80 | $578.00 | $196.52–$421.94 | 20% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI Up Esoph Infant | $346.80 | $578.00 | $196.52–$421.94 | 20% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI Upper | $346.80 | $578.00 | $196.52–$421.94 | 20% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI Upper w/Small Bowel | $346.80 | $578.00 | $196.52–$421.94 | 20% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI Upper w/Kub | $346.80 | $578.00 | $196.52–$421.94 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI Upper w/Small Bowel | $346.80 | $578.00 | $196.52–$421.94 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI Upper | $346.80 | $578.00 | $196.52–$421.94 | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI Up Esoph Infant | $346.80 | $578.00 | $196.52–$421.94 | — | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Left | $187.20 | $312.00 | $106.08–$227.76 | 5% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 1 vw Left | $187.20 | $312.00 | $106.08–$227.76 | 5% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Right | $187.20 | $312.00 | $106.08–$227.76 | 5% below | 40% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus 1 vw Right | $187.20 | $312.00 | $106.08–$227.76 | 5% below | 40% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 Humerus, Bilat | $281.40 | $469.00 | $159.46–$342.37 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Humerus 1 vw Bil | $281.40 | $469.00 | $159.46–$342.37 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Right | $187.20 | $312.00 | $106.08–$227.76 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Left | $187.20 | $312.00 | $106.08–$227.76 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus 1 vw Left | $187.20 | $312.00 | $106.08–$227.76 | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus 1 vw Right | $187.20 | $312.00 | $106.08–$227.76 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Venous Doppler Low Ext L | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Venous Doppler Low Ext R | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Lt | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Ven Mapping Lt Lower Ext | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Ven Mapping Rt Lower Ext | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Ven Mapping Lt Upper Ext | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Ven Mapping Rt Upper Ext | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Unilateral | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Rt | $472.80 | $788.00 | $267.92–$575.24 | 27% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Venous Doppler Low Ext L | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Venous Doppler Low Ext R | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dup scan/extremity vein/unilat/ltd 93971 | $264.60 | $441.00 | $928.00–$2,679.00 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Rt | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Ven Mapping Rt Upper Ext | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Lt | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Ven Mapping Lt Upper Ext | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Unilateral | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Ven Mapping Lt Lower Ext | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Ven Mapping Rt Lower Ext | $472.80 | $788.00 | $267.92–$575.24 | — | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 1 vw Right | $122.40 | $204.00 | $69.36–$148.92 | 35% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist 1 vw Left | $122.40 | $204.00 | $69.36–$148.92 | 35% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist PA/Lat Left | $122.40 | $204.00 | $69.36–$148.92 | 35% below | 40% |
| Wrist X-ray, 2 views one side CPT 73100 Wrist PA/Lat Right | $122.40 | $204.00 | $69.36–$148.92 | 35% below | 40% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 Wrist PA/Lat, Bilat | $184.20 | $307.00 | $104.38–$224.11 | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 Wrist 1 vw Bil | $184.20 | $307.00 | $104.38–$224.11 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 1 vw Left | $122.40 | $204.00 | $69.36–$148.92 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist 1 vw Right | $122.40 | $204.00 | $69.36–$148.92 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist PA/Lat Right | $122.40 | $204.00 | $69.36–$148.92 | — | 40% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 Wrist PA/Lat Left | $122.40 | $204.00 | $69.36–$148.92 | — | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Routine Left | $176.40 | $294.00 | $99.96–$214.62 | 21% below | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Routine Right | $176.40 | $294.00 | $99.96–$214.62 | 21% below | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 Wrist Routine, Bilat | $264.60 | $441.00 | $149.94–$321.93 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-ray exam of wrist 73110 | $57.60 | $96.00 | $928.00–$2,679.00 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Routine Left | $176.40 | $294.00 | $99.96–$214.62 | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Routine Right | $176.40 | $294.00 | $99.96–$214.62 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Pelvis & Lat Hip Left | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2 Views Left | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Port Hip AP/Lat Right 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP AP/Lat During OR RT 2-3 Views:Extremity DTA | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip 2 Views Right | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP AP/Lat During OR LT 2-3 Views | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Pelvis & Lat Hip Right | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Port Hip AP/Lat Left 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | 50% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray exam hip uni 2-3 view 73502 | $66.00 | $110.00 | $928.00–$2,679.00 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Pelvis & Frogleg Child Bil 2 vws | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Pelvis & Lat Hip Left | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP AP/Lat During OR LT 2-3 Views | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP AP/Lat During OR RT 2-3 Views:Extremity DTA | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip/Pelvis Lt 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip/Pelvis Rt 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Port Hip AP/Lat Right 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2 Views Right | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Pelvis & Lat Hip Right | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Port Hip AP/Lat Left 2-3 vws | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip 2 Views Left | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 Port Abdomen Single View | $154.80 | $258.00 | $87.72–$188.34 | 14% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Single (KUB) | $154.80 | $258.00 | $87.72–$188.34 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Port Abdomen 1(Kub) | $154.80 | $258.00 | $87.72–$188.34 | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Port Abdomen Single View | $154.80 | $258.00 | $87.72–$188.34 | — | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 1 vw Left | $133.80 | $223.00 | $75.82–$162.79 | 22% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP/Lat Left | $133.80 | $223.00 | $75.82–$162.79 | 22% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle AP/Lat Right | $133.80 | $223.00 | $75.82–$162.79 | 22% below | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 Ankle 1 vw Right | $133.80 | $223.00 | $75.82–$162.79 | 22% below | 40% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 Ankle AP/Lat, Bilat | $200.40 | $334.00 | $113.56–$243.82 | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 Ankle 1 vw Bil | $200.40 | $334.00 | $113.56–$243.82 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 1 vw Right | $133.80 | $223.00 | $75.82–$162.79 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP/Lat Left | $133.80 | $223.00 | $75.82–$162.79 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle 1 vw Left | $133.80 | $223.00 | $75.82–$162.79 | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 Ankle AP/Lat Right | $133.80 | $223.00 | $75.82–$162.79 | — | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Fingers Right | $141.60 | $236.00 | $80.24–$172.28 | 16% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Fingers 1 vw Right | $141.60 | $236.00 | $80.24–$172.28 | 16% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Fingers 1 vw Left | $141.60 | $236.00 | $80.24–$172.28 | 16% below | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Fingers Left | $141.60 | $236.00 | $80.24–$172.28 | 16% below | 40% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 Fingers, Bilateral | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 Fingers 1 vw Bil | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Fingers 1 vw Left | $141.60 | $236.00 | $80.24–$172.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Fingers 1 vw Right | $141.60 | $236.00 | $80.24–$172.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Fingers Right | $141.60 | $236.00 | $80.24–$172.28 | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Fingers Left | $141.60 | $236.00 | $80.24–$172.28 | — | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP&Lat Left | $121.80 | $203.00 | $69.02–$148.19 | 26% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Foot AP&Lat Right | $121.80 | $203.00 | $69.02–$148.19 | 26% below | 40% |
| X-ray of the foot, 2 views one side CPT 73620 Extremity DTA | $121.80 | $203.00 | $69.02–$148.19 | 26% below | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot 1 View Bilateral | $183.00 | $305.00 | $103.70–$222.65 | — | 40% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 Foot AP/Lat, Bilat | $183.00 | $305.00 | $103.70–$222.65 | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 Extremity DTA | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP&Lat Right | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 Foot AP&Lat Left | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Routine Left | $186.60 | $311.00 | $105.74–$227.03 | 15% below | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Routine Right | $186.60 | $311.00 | $105.74–$227.03 | 15% below | 40% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 Foot Routine, Bilat | $280.80 | $468.00 | $159.12–$341.64 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Routine Left | $186.60 | $311.00 | $105.74–$227.03 | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Routine Right | $186.60 | $311.00 | $105.74–$227.03 | — | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Routine Right | $176.40 | $294.00 | $99.96–$214.62 | 14% below | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 Hand Routine Left | $176.40 | $294.00 | $99.96–$214.62 | 14% below | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 Hand Routint, Bilat | $264.60 | $441.00 | $149.94–$321.93 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Routine Left | $176.40 | $294.00 | $99.96–$214.62 | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Routine Right | $176.40 | $294.00 | $99.96–$214.62 | — | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 vw Left | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 2 Views Right | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 2 Views Left | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Port Knee AP/Lat Left | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Knee 1 vw Right | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Port/AP Lat Knee Right | $159.00 | $265.00 | $90.10–$193.45 | 19% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Port Knee AP/Lat, Bilat | $238.20 | $397.00 | $134.98–$289.81 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 Knee 2 Vwx, Bilat | $238.20 | $397.00 | $134.98–$289.81 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-ray exam of knee 1 or 2 73560 | $48.00 | $80.00 | $928.00–$2,679.00 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 Knee 1 vw Bil | $238.20 | $397.00 | $134.98–$289.81 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 2 Views Right | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 2 Views Left | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Port Knee AP/Lat Left | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 1 vw Right | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee 1 vw Left | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Port/AP Lat Knee Right | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-ray exam l-s spine 2/3 vws 72100 | $56.40 | $94.00 | $928.00–$2,679.00 | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Spine Lumbar Routine 2 or 3 Vws | $257.40 | $429.00 | $145.86–$313.17 | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine Lumbar 5 Vws | $355.20 | $592.00 | $201.28–$432.16 | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Spine Thoracic | $223.20 | $372.00 | $126.48–$271.56 | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bones | $197.40 | $329.00 | $111.86–$240.17 | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Spine Cervical Routine 2 or 3 Vws | $223.20 | $372.00 | $126.48–$271.56 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis 2 Views | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Port Pelvis | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis AP | $172.80 | $288.00 | $97.92–$210.24 | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx | $186.60 | $311.00 | $105.74–$227.03 | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH -Sendout | $136.20 | $227.00 | $77.18–$165.71 | 22% below | 40% |
| ACTH blood test CPT 82024 GHS ACTH | $186.00 | $310.00 | $105.40–$226.30 | 7% above | 40% |
| ACTH blood test CPT 82024 ACTH, Plasma- Quest | $199.20 | $332.00 | $112.88–$242.36 | 14% above | 40% |
| ACTH blood test inpatient CPT 82024 ACTH -Sendout | $136.20 | $227.00 | $77.18–$165.71 | — | 40% |
| ACTH blood test inpatient CPT 82024 GHS ACTH | $186.00 | $310.00 | $105.40–$226.30 | — | 40% |
| ACTH blood test inpatient CPT 82024 ACTH, Plasma- Quest | $199.20 | $332.00 | $112.88–$242.36 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) - Sendout | $18.60 | $31.00 | $10.54–$22.63 | 57% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 #HCV FIBROSURE-ALT | $24.60 | $41.00 | $13.94–$29.93 | 44% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 GHS SGPT TRANSAMINASE | $28.80 | $48.00 | $16.32–$35.04 | 34% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $34.80 | $58.00 | $19.72–$42.34 | 20% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase - Obstetrics | $35.40 | $59.00 | $20.06–$43.07 | 19% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase | $36.60 | $61.00 | $20.74–$44.53 | 16% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) - Sendout | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 #HCV FIBROSURE-ALT | $24.60 | $41.00 | $13.94–$29.93 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 #FIBRO-ALT | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 GHS SGPT TRANSAMINASE | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase - Obstetrics | $35.40 | $59.00 | $20.06–$43.07 | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 58% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 GHS SGOT TRANSAMINASE | $28.80 | $48.00 | $16.32–$35.04 | 33% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $44.40 | $74.00 | $25.16–$54.02 | 4% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase - Obstetric | $45.60 | $76.00 | $25.84–$55.48 | 7% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 #FIBRO-AST | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 GHS SGOT TRANSAMINASE | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase - Obstetric | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) - Sendout | $159.00 | $265.00 | $90.10–$193.45 | 30% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute - Quest | $163.80 | $273.00 | $92.82–$199.29 | 27% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL | $163.80 | $273.00 | $92.82–$199.29 | 27% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) - Sendout | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel - Sendout | $159.00 | $265.00 | $90.10–$193.45 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL | $163.80 | $273.00 | $92.82–$199.29 | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute - Quest | $163.80 | $273.00 | $92.82–$199.29 | — | 40% |
| Albumin blood test CPT 82040 #IGG INDEX-ALBUMIN,SERUM | $17.40 | $29.00 | $9.86–$21.17 | 59% below | 40% |
| Albumin blood test CPT 82040 GHS ALBUMIN, SERUM | $26.40 | $44.00 | $14.96–$32.12 | 38% below | 40% |
| Albumin blood test CPT 82040 Albumin | $31.20 | $52.00 | $17.68–$37.96 | 27% below | 40% |
| Albumin blood test CPT 82040 ALBUMIN, SERUM | $31.80 | $53.00 | $18.02–$38.69 | 26% below | 40% |
| Albumin blood test CPT 82040 #MS PNL-ALBUMIN,SERUM | $62.40 | $104.00 | $35.36–$75.92 | 46% above | 40% |
| Albumin blood test CPT 82040 GHS ALB CSF/SERUM | $97.20 | $162.00 | $55.08–$118.26 | 127% above | 40% |
| Albumin blood test inpatient CPT 82040 #IGG INDEX-ALBUMIN,SERUM | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Albumin blood test inpatient CPT 82040 GHS ALBUMIN, SERUM | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Albumin blood test inpatient CPT 82040 Albumin | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM | $31.80 | $53.00 | $18.02–$38.69 | — | 40% |
| Albumin blood test inpatient CPT 82040 #MS PNL-ALBUMIN,SERUM | $62.40 | $104.00 | $35.36–$75.92 | — | 40% |
| Albumin blood test inpatient CPT 82040 GHS ALB CSF/SERUM | $97.20 | $162.00 | $55.08–$118.26 | — | 40% |
| Aldosterone blood test CPT 82088 Aldosterone Ur-Sendout | $144.60 | $241.00 | $81.94–$175.93 | 13% below | 40% |
| Aldosterone blood test CPT 82088 #AldostLCMS | $144.60 | $241.00 | $81.94–$175.93 | 13% below | 40% |
| Aldosterone blood test CPT 82088 Aldosterone Serum - Quest | $150.60 | $251.00 | $85.34–$183.23 | 10% below | 40% |
| Aldosterone blood test CPT 82088 GHS ALDOSTERONE | $175.20 | $292.00 | $99.28–$213.16 | 5% above | 40% |
| Aldosterone blood test CPT 82088 Aldosterone, urine | $180.00 | $300.00 | $102.00–$219.00 | 8% above | 40% |
| Aldosterone blood test inpatient CPT 82088 #ALDO/RENIN-ALDOSTERONE | $140.40 | $234.00 | $79.56–$170.82 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Ur-Sendout | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 #AldostLCMS | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Serum - Quest | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 GHS ALDOSTERONE | $175.20 | $292.00 | $99.28–$213.16 | — | 40% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone, urine | $180.00 | $300.00 | $102.00–$219.00 | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 #ALK-ALKALINE PHOSPHATASE-TOT. | $18.00 | $30.00 | $10.20–$21.90 | 58% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 GHS ALK PHOS TOTALS | $40.20 | $67.00 | $22.78–$48.91 | 6% below | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $47.40 | $79.00 | $26.86–$57.67 | 11% above | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE | $47.40 | $79.00 | $26.86–$57.67 | 11% above | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 GHS ALKALINE PHOSPHATASE | $47.40 | $79.00 | $26.86–$57.67 | 11% above | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 #ALK-ALKALINE PHOSPHATASE-TOT. | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 GHS ALK PHOS TOTALS | $40.20 | $67.00 | $22.78–$48.91 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 GHS ALKALINE PHOSPHATASE | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #ALL MILK-CASEIN | $16.80 | $28.00 | $9.52–$20.44 | 53% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Walnut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Grape - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Goose Feathers - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Gluten - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Garlic - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Formaldehyde - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Egg White - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Egg (Yolk) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Duck Feathers - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Dog Dander - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE D pteronyssinus-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cumin - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cranberry - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Crab - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cottonwood - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Corn - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Coriander/Cilantro - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Coconut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cashew Nut-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Carrot - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Aspergillus fumigatus - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Apple - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Amoxicilloyl - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Almond - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #FOODALL-FOOD ALLERGEN IGE | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #ALL-1ST ALLERGEN | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Onion - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Paprika - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Oregano - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Hazelnut (Filbert) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Latex - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Lime - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Lobster - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Mango - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Melon - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Peanut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Pecan Nut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Pistachio Nut-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Poppy Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Shrimp - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Soybean - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Strawberry-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Sunflower Pollen-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Sunflower Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Tomato - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Watermelon - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Wheat - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Whole Body Mosquito - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Yeast - Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #IGEALLER-ALLERGEN SPECIFIC IGE | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #IgECodfish | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Tilapia- Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cat Dander-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Cinnamon-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Common Silver Birch | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Ferret Epithelium | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Orange | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Ragweed Short-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Sesame Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Timothy Grass | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Tuna | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Wheat | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #IgEAspergNigM207 | $18.00 | $30.00 | $10.20–$21.90 | 50% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS W/IGE | $18.60 | $31.00 | $10.54–$22.63 | 48% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 #ALL+IGE-ALLERGEN SPECIFIC IGE | $18.60 | $31.00 | $10.54–$22.63 | 48% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Honey - Sendout | $18.60 | $31.00 | $10.54–$22.63 | 48% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Egg, Whole - Sendout | $18.60 | $31.00 | $10.54–$22.63 | 48% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY INDIVIDUAL ALLERGENS | $19.20 | $32.00 | $10.88–$23.36 | 47% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood (T14) IgE - Quest | $19.20 | $32.00 | $10.88–$23.36 | 47% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHILDHOOD ALLERGY INDIVIDUAL ALLERGEN | $19.20 | $32.00 | $10.88–$23.36 | 47% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGY INDIVIDUAL ALLERGEN | $19.20 | $32.00 | $10.88–$23.36 | 47% below | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Milk-Sendout | $22.20 | $37.00 | $12.58–$27.01 | 38% below | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN-IGE-SPECIFICADDTL | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN-IEG-SPECIFICIADDTL | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN-IEG-SPECIFICI | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN-IGE-SPECIFIC | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLSUMMERGRASS-1ST | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Green Pea - Sendout | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL PRF STING INSECT-IGE YELLOW JACKET | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL PRF STING INSECT-IGE YELLOW HORNET | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL PRF STING INSECT-IGE WHITE FACE HORNET | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL PRF STING INSECT-IGE PAPER WASP | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL PRF STING INSECT-IGE HONEY BEE | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLSPRINGTREES-1ST | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #HVAPROFILE-HBVCOMPAPIM2 | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #HVAPROFILE-HBVCOMPTAPIM1 | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #HVAPROFILE-HONEYBEEVENOMLGE | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALPGALIGEPNL-LAMB IGE | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALPGALIGEPNL-PORK IGE | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALPGALIGEPNL-BEEF IGE | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN PERENNIAL-ADDL | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERGEN PERENNIAL-1ST | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLSPRINGTREES-ADDL | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLFALLWEED-ADDL | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLFALLWEED-1ST | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLSUMMERGRASS-ADDL | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Halibut - Sendout | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Flounder - Sendout | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Catfish - Sendout | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE CANDIDA ALBICANS | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE ASPERGILLUS FUMIGATUS | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE ALTERNARIA ALTERNATA | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IGE EGG COMP-OVOMUCOID | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IGE EGG COMP-OVAALBUMIN | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE PENICILLIUM CHRYSOGEN | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE PHOMA BETAE | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE SETOMELANOMMA ROSTRAT | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE EPICOCCUM PURPUR | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE CLADOSPORIUM HERBARUM | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE AUREOBASIDI PULLULANS | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE STEMPHYLIUM HERBARUM | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Peanut IgE w/Reflexes-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE D farinae - Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE FUSARIUM PROLIFERATUM | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALLERG-IgE MUCOR RACEMOSUS | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Pecan, Hickory - Sendout | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Scallop - Sendout | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Clam - Sendout | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL MILK-CHEESE CHEDDAR | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL MILK-CHEESE BLUE | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL MILK-CASEIN | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Goose Feathers - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IgEAspergNigM207 | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Wheat | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Tuna | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Timothy Grass | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Sesame Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Ragweed Short-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Orange | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Ferret Epithelium | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Common Silver Birch | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cinnamon-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cat Dander-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Tilapia- Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IgECodfish | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IGEALLER-ADDITIONAL ALLERGENS | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #IGEALLER-ALLERGEN SPECIFIC IGE | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Yeast - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Whole Body Mosquito - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Wheat - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Watermelon - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Walnut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Tomato - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Sunflower Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Sunflower Pollen-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Strawberry-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Soybean - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Shrimp - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Poppy Seed-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Pistachio Nut-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Pecan Nut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Peanut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Melon - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Mango - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Lobster - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Lime - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Latex - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Hazelnut (Filbert) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Grape - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Oregano - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Paprika - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Onion - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL-1ST ALLERGEN | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL-ADDITIONAL ALLERGENS | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #FOODALL-FOOD ALLERGEN IGE | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #FOODALL- ADDITIONAL FOOD ALLERGEN IGE | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Almond - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Amoxicilloyl - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Apple - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Aspergillus fumigatus - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Carrot - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cashew Nut-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Coconut - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Coriander/Cilantro - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Corn - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cottonwood - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Crab - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cranberry - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Cumin - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE D pteronyssinus-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Dog Dander - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Duck Feathers - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Egg (Yolk) - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Egg White - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Formaldehyde - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Garlic - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Gluten - Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS W/IGE | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL+IGE-ALLERGEN SPECIFIC IGE | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 #ALL+IGE-ALLERGEN SPECIFIC IGE, ADDTL | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Honey - Sendout | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Egg, Whole - Sendout | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood (T14) IgE - Quest | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY INDIVIDUAL ALLERGENS | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILDHOOD ALLERGY INDIVIDUAL ALLERGEN | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESPIRATORY ALLERGY INDIVIDUAL ALLERGEN | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Milk-Sendout | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 GHS ALPHA FETOPROTEIN, TUMOR MARKER | $40.20 | $67.00 | $22.78–$48.91 | 57% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 GHS ALPHA FETOPROTEIN (IOWA) | $53.40 | $89.00 | $30.26–$64.97 | 43% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP Tumor Marker-Sendout | $56.40 | $94.00 | $31.96–$68.62 | 39% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP Open Spina Bifida - Sendout | $56.40 | $94.00 | $31.96–$68.62 | 39% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 #AFP-ALPHA FETO-PROT. | $57.60 | $96.00 | $32.64–$70.08 | 38% below | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN- SERUM | $99.60 | $166.00 | $56.44–$121.18 | 7% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker - Quest | $113.40 | $189.00 | $64.26–$137.97 | 22% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 GHS AFP MATERNAL-SERUM | $124.20 | $207.00 | $70.38–$151.11 | 33% above | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN-MATERNAL | $124.20 | $207.00 | $70.38–$151.11 | 33% above | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 GHS ALPHA FETOPROTEIN, TUMOR MARKER | $40.20 | $67.00 | $22.78–$48.91 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 GHS ALPHA FETOPROTEIN (IOWA) | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP Tumor Marker-Sendout | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP Open Spina Bifida - Sendout | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 #AFP-ALPHA FETO-PROT. | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN- SERUM | $99.60 | $166.00 | $56.44–$121.18 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein Tumor Marker - Quest | $113.40 | $189.00 | $64.26–$137.97 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN-MATERNAL | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 GHS AFP MATERNAL-SERUM | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Ammonia blood test CPT 82140 Ammonia -Sendout | $48.60 | $81.00 | $27.54–$59.13 | 45% below | 40% |
| Ammonia blood test CPT 82140 GHS AMMONIA, BLOOD | $86.40 | $144.00 | $48.96–$105.12 | 2% below | 40% |
| Ammonia blood test CPT 82140 Ammonia DCH BO | $91.80 | $153.00 | $52.02–$111.69 | 4% above | 40% |
| Ammonia blood test CPT 82140 Ammonia | $95.40 | $159.00 | $54.06–$116.07 | 8% above | 40% |
| Ammonia blood test CPT 82140 zlAmmonia | $95.40 | $159.00 | $54.06–$116.07 | 8% above | 40% |
| Ammonia blood test inpatient CPT 82140 Ammonia -Sendout | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Ammonia blood test inpatient CPT 82140 GHS AMMONIA, BLOOD | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Ammonia blood test inpatient CPT 82140 Ammonia DCH BO | $91.80 | $153.00 | $52.02–$111.69 | — | 40% |
| Ammonia blood test inpatient CPT 82140 Ammonia | $95.40 | $159.00 | $54.06–$116.07 | — | 40% |
| Ammonia blood test inpatient CPT 82140 zlAmmonia | $95.40 | $159.00 | $54.06–$116.07 | — | 40% |
| Amylase blood test CPT 82150 Amylase Body Fluid-Sendout | $22.20 | $37.00 | $12.58–$27.01 | 58% below | 40% |
| Amylase blood test CPT 82150 #AMY ISO-TOTAL AMYLASE | $22.80 | $38.00 | $12.92–$27.74 | 57% below | 40% |
| Amylase blood test CPT 82150 GHS URINE, AMYLASE, RANDOM UR | $30.00 | $50.00 | $17.00–$36.50 | 44% below | 40% |
| Amylase blood test CPT 82150 GHS AMYLASE, SERUM | $45.00 | $75.00 | $25.50–$54.75 | 16% below | 40% |
| Amylase blood test CPT 82150 Amylase Level | $59.40 | $99.00 | $33.66–$72.27 | 11% above | 40% |
| Amylase blood test CPT 82150 Amylase Level Body Fluid | $65.40 | $109.00 | $37.06–$79.57 | 22% above | 40% |
| Amylase blood test CPT 82150 Amylase Urine Timed | $65.40 | $109.00 | $37.06–$79.57 | 22% above | 40% |
| Amylase blood test CPT 82150 Amylase Urine Random | $65.40 | $109.00 | $37.06–$79.57 | 22% above | 40% |
| Amylase blood test CPT 82150 Amylase Fractionation | $121.20 | $202.00 | $68.68–$147.46 | 127% above | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Body Fluid-Sendout | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Amylase blood test inpatient CPT 82150 #AMY ISO-PANCREATIC AMYLASE | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Amylase blood test inpatient CPT 82150 #AMY ISO-TOTAL AMYLASE | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Amylase blood test inpatient CPT 82150 GHS URINE, AMYLASE, RANDOM UR | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Amylase blood test inpatient CPT 82150 GHS AMYLASE, SERUM | $45.00 | $75.00 | $25.50–$54.75 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Level | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Urine Random | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Level Body Fluid | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Urine Timed | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Amylase blood test inpatient CPT 82150 Amylase Fractionation | $121.20 | $202.00 | $68.68–$147.46 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Abs IgG/IgA-Sendout | $43.20 | $72.00 | $24.48–$52.56 | 45% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab - Quest | $60.60 | $101.00 | $34.34–$73.73 | 23% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Abs IgG/IgA-Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab - Quest | $60.60 | $101.00 | $34.34–$73.73 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibody Screen | $22.80 | $38.00 | $12.92–$27.74 | 68% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody | $22.80 | $38.00 | $12.92–$27.74 | 68% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Abs IFA-Sendout | $41.40 | $69.00 | $23.46–$50.37 | 43% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab Reflex Cascade - Sendout | $41.40 | $69.00 | $23.46–$50.37 | 43% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANAchoice Specific Antibody Cascading Reflex - Quest | $42.00 | $70.00 | $23.80–$51.10 | 42% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Total | $42.00 | $70.00 | $23.80–$51.10 | 42% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Centromere B Ab - Quest | $50.40 | $84.00 | $28.56–$61.32 | 30% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $59.40 | $99.00 | $33.66–$72.27 | 18% below | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 GHS ANTI-DS-DNA-ANTIBODIES | $102.60 | $171.00 | $58.14–$124.83 | 42% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NEUTROPHIL ANTIBODY | $158.40 | $264.00 | $89.76–$192.72 | 120% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 GHS ANA (SCREEN) INCLUDES TITER | $163.20 | $272.00 | $92.48–$198.56 | 127% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear antibody Screen | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct-Sendout | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab IFA Reflex Cascade-Sendout | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab Reflex Cascade - Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Abs IFA-Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANAchoice Specific Antibody Cascading Reflex - Quest | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Total | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Centromere B Ab - Quest | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 GHS ANTI-DS-DNA-ANTIBODIES | $102.60 | $171.00 | $58.14–$124.83 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NEUTROPHIL ANTIBODY | $158.40 | $264.00 | $89.76–$192.72 | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 GHS ANA (SCREEN) INCLUDES TITER | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 proBNP-Sendout | $94.80 | $158.00 | $53.72–$115.34 | 39% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 GHS PRO BNP | $144.00 | $240.00 | $81.60–$175.20 | 7% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP, N Terminal -Quest | $198.00 | $330.00 | $112.20–$240.90 | 27% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pro BNP | $198.00 | $330.00 | $112.20–$240.90 | 27% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 I-Stat BNP | $198.00 | $330.00 | $112.20–$240.90 | 27% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 proBNP-Sendout | $94.80 | $158.00 | $53.72–$115.34 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 #BNP | $99.00 | $165.00 | $56.10–$120.45 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 GHS PRO BNP | $144.00 | $240.00 | $81.60–$175.20 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 I-Stat BNP | $198.00 | $330.00 | $112.20–$240.90 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP, N Terminal -Quest | $198.00 | $330.00 | $112.20–$240.90 | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Pro BNP | $198.00 | $330.00 | $112.20–$240.90 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Bacterial Culture - Sendout | $29.40 | $49.00 | $16.66–$35.77 | 51% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Legionella Species Culture-Sendout | $29.40 | $49.00 | $16.66–$35.77 | 51% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 #LEG-LEGIONELLA CULT. | $30.00 | $50.00 | $17.00–$36.50 | 50% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GHS CULTURE, THROAT | $57.00 | $95.00 | $32.30–$69.35 | 6% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasopharyngeal Culture | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, AEROBIC | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Superficial Culture/Aer | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Bacterial | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Genital | $57.60 | $96.00 | $32.64–$70.08 | 5% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GHS CULTURE, NASAL | $60.60 | $101.00 | $34.34–$73.73 | at median | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GHS CULTURE, SPUTUM | $61.20 | $102.00 | $34.68–$74.46 | 1% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GHS CULTURE, EYE | $67.20 | $112.00 | $38.08–$81.76 | 11% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GHS CULTURE, OTHER SOURCE | $67.20 | $112.00 | $38.08–$81.76 | 11% above | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Upper Respiratory Culture-Sendout | $21.60 | $36.00 | $12.24–$26.28 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture, Sterile - Sendout | $24.00 | $40.00 | $13.60–$29.20 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Legionella Species Culture-Sendout | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Bacterial Culture - Sendout | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 #LEG-LEGIONELLA CULT. | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GHS CULTURE, THROAT | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Bacterial | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, AEROBIC | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Superficial Culture/Aer | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasopharyngeal Culture | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Genital | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GHS CULTURE, NASAL | $60.60 | $101.00 | $34.34–$73.73 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GHS CULTURE, SPUTUM | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GHS CULTURE, OTHER SOURCE | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GHS CULTURE, EYE | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 #BMP(8) | $28.80 | $48.00 | $16.32–$35.04 | 67% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 GHS BASIC METABOLIC PANEL (BMP) | $33.00 | $55.00 | $18.70–$40.15 | 62% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $55.20 | $92.00 | $31.28–$67.16 | 36% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC | $55.20 | $92.00 | $31.28–$67.16 | 36% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 #BMP(8) | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 GHS BASIC METABOLIC PANEL (BMP) | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC | $55.20 | $92.00 | $31.28–$67.16 | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $55.20 | $92.00 | $31.28–$67.16 | — | 40% |
| Bilirubin blood test, total CPT 82247 #HCV FIBROSURE-TOTAL BILIRUBIN | $24.60 | $41.00 | $13.94–$29.93 | 46% below | 40% |
| Bilirubin blood test, total CPT 82247 GHS BILIRUBIN, BODY FLUIDS | $27.00 | $45.00 | $15.30–$32.85 | 41% below | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total Body Fluid -Sendout | $33.00 | $55.00 | $18.70–$40.15 | 28% below | 40% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $36.60 | $61.00 | $20.74–$44.53 | 20% below | 40% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN, TOTAL | $36.60 | $61.00 | $20.74–$44.53 | 20% below | 40% |
| Bilirubin blood test, total CPT 82247 Cord Bilirubin Total | $36.60 | $61.00 | $20.74–$44.53 | 20% below | 40% |
| Bilirubin blood test, total CPT 82247 GHS BILIRUBIN, TOTAL | $36.60 | $61.00 | $20.74–$44.53 | 20% below | 40% |
| Bilirubin blood test, total inpatient CPT 82247 #HCV FIBROSURE-TOTAL BILIRUBIN | $24.60 | $41.00 | $13.94–$29.93 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 GHS BILIRUBIN, BODY FLUIDS | $27.00 | $45.00 | $15.30–$32.85 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 #FIBRO-BILIRUBIN TOTAL | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total Body Fluid -Sendout | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Cord Bilirubin Total | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN, TOTAL | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 GHS BILIRUBIN, TOTAL | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Specimen Lvl 4, bill-only | $64.20 | $107.00 | $36.38–$78.11 | 64% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Bill Surg Level IV | $64.20 | $107.00 | $36.38–$78.11 | 64% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $64.20 | $107.00 | $36.38–$78.11 | 64% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 GHS PATH - LEVEL 4 | $71.40 | $119.00 | $40.46–$86.87 | 60% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 Bill Surg Level IV | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology Specimen Lvl 4, bill-only | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GHS PATH - LEVEL 4 | $71.40 | $119.00 | $40.46–$86.87 | — | 40% |
| Blood culture for bacteria CPT 87040 GHS CULTURE, BLOOD | $103.80 | $173.00 | $58.82–$126.29 | 13% above | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture 15-Day Hold | $106.20 | $177.00 | $60.18–$129.21 | 16% above | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture | $112.20 | $187.00 | $63.58–$136.51 | 22% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 GHS CULTURE, BLOOD | $103.80 | $173.00 | $58.82–$126.29 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture 15-Day Hold | $106.20 | $177.00 | $60.18–$129.21 | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $112.20 | $187.00 | $63.58–$136.51 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Contracts venipuncture | $6.60 | $11.00 | $3.74–$8.03 | 67% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $12.60 | $21.00 | $7.14–$15.33 | 38% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Bill only | $12.60 | $21.00 | $7.14–$15.33 | 38% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Specimen Collection: Venous | $12.60 | $21.00 | $7.14–$15.33 | 38% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Radiology | $15.00 | $25.00 | $8.50–$18.25 | 26% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture- Radiology Draw | $15.00 | $25.00 | $8.50–$18.25 | 26% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 GHS DRAWING FEE | $17.40 | $29.00 | $9.86–$21.17 | 14% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 GHS SHIPPING CHARGE (NO DRAW FEE) | $27.60 | $46.00 | $15.64–$33.58 | 36% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Contracts venipuncture | $6.60 | $11.00 | $3.74–$8.03 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Bill only | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Specimen Collection: Venous | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection of venous blood by venipuncture 36415 | $13.80 | $23.00 | $928.00–$2,679.00 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Radiology | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture- Radiology Draw | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 GHS DRAWING FEE | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 GHS SHIPPING CHARGE (NO DRAW FEE) | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose 2HR Post Prandial | $26.40 | $44.00 | $14.96–$32.12 | 27% below | 40% |
| Blood glucose (sugar) test CPT 82947 GHS GLUCOSE, (FASTING & RANDOM) | $26.40 | $44.00 | $14.96–$32.12 | 27% below | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $27.60 | $46.00 | $15.64–$33.58 | 24% below | 40% |
| Blood glucose (sugar) test CPT 82947 GHS GLUCOSE TOLERANCE SERUM (3 HR) | $41.40 | $69.00 | $23.46–$50.37 | 14% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose 2HR Post Prandial | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GHS GLUCOSE, (FASTING & RANDOM) | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Tolerance Fasting Nongestational (75g) | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 #FIBRO-GLUCOSE | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Wellness Screen - Aledo | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 GHS GLUCOSE TOLERANCE SERUM (3 HR) | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Blood lead test CPT 83655 LEAD,BLOOD | $39.60 | $66.00 | $22.44–$48.18 | 28% below | 40% |
| Blood lead test CPT 83655 Lead Blood (Pediatric 0-15yrs) - Sendout | $41.40 | $69.00 | $23.46–$50.37 | 25% below | 40% |
| Blood lead test CPT 83655 Lead Blood (Adult)-Sendout | $41.40 | $69.00 | $23.46–$50.37 | 25% below | 40% |
| Blood lead test CPT 83655 Lead Blood Pediatric Capillary - Sendout | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 Lead level | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 zl Lead, Blood (OSHA)- Quest | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 #HMURII-LEAD | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 #HMBLD-LEAD, BLOOD | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 DCH Lead Blood | $42.00 | $70.00 | $23.80–$51.10 | 24% below | 40% |
| Blood lead test CPT 83655 GHS LEAD, BLOOD | $60.60 | $101.00 | $34.34–$73.73 | 10% above | 40% |
| Blood lead test CPT 83655 GHS LEAD | $81.00 | $135.00 | $45.90–$98.55 | 47% above | 40% |
| Blood lead test CPT 83655 LEAD, URINE | $81.00 | $135.00 | $45.90–$98.55 | 47% above | 40% |
| Blood lead test inpatient CPT 83655 #HMUR-LEAD, UR. | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Blood lead test inpatient CPT 83655 #LEAD PROF-LEAD | $34.20 | $57.00 | $19.38–$41.61 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD,BLOOD | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Blood (Adult)-Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Blood (Pediatric 0-15yrs) - Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Blood lead test inpatient CPT 83655 DCH Lead Blood | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 #HMBLD-LEAD, BLOOD | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 zl Lead, Blood (OSHA)- Quest | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 #HMURII-LEAD | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 Lead level | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 Lead Blood Pediatric Capillary - Sendout | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Blood lead test inpatient CPT 83655 GHS LEAD, BLOOD | $60.60 | $101.00 | $34.34–$73.73 | — | 40% |
| Blood lead test inpatient CPT 83655 GHS LEAD | $81.00 | $135.00 | $45.90–$98.55 | — | 40% |
| Blood lead test inpatient CPT 83655 LEAD, URINE | $81.00 | $135.00 | $45.90–$98.55 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Preg test ED | $52.80 | $88.00 | $29.92–$64.24 | 15% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test | $52.80 | $88.00 | $29.92–$64.24 | 15% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GHS HCG, QUALITATIVE | $63.00 | $105.00 | $35.70–$76.65 | 1% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Preg Test Qualitative, bill only | $66.00 | $110.00 | $37.40–$80.30 | 6% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Rapid HCG - Serum | $66.00 | $110.00 | $37.40–$80.30 | 6% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy, Qualitative Serum | $66.00 | $110.00 | $37.40–$80.30 | 6% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Preg test ED | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GHS HCG, QUALITATIVE | $63.00 | $105.00 | $35.70–$76.65 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy, Qualitative Serum | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Preg Test Qualitative, bill only | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Rapid HCG - Serum | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 #ABO/RH-ABO GROUPING | $10.20 | $17.00 | $5.78–$12.41 | 82% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BABY | $29.40 | $49.00 | $16.66–$35.77 | 49% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO | $29.40 | $49.00 | $16.66–$35.77 | 49% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB-ABO GROUPING | $30.00 | $50.00 | $17.00–$36.50 | 47% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Verification | $31.20 | $52.00 | $17.68–$37.96 | 45% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Type and RH | $31.20 | $52.00 | $17.68–$37.96 | 45% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 #ABO/RH-ABO GROUPING | $10.20 | $17.00 | $5.78–$12.41 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING, ABO | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BABY | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB-ABO GROUPING | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Type and RH | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Verification | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 GHS BUN | $27.60 | $46.00 | $15.64–$33.58 | 32% below | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Blood | $31.20 | $52.00 | $17.68–$37.96 | 23% below | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Dialysate | $34.80 | $58.00 | $19.72–$42.34 | 14% below | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 GHS BUN | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Blood | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Dialysate | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| C-peptide blood test CPT 84681 GHS C-PEPTIDE | $59.40 | $99.00 | $33.66–$72.27 | 43% below | 40% |
| C-peptide blood test CPT 84681 #CPeptide | $69.60 | $116.00 | $39.44–$84.68 | 33% below | 40% |
| C-peptide blood test CPT 84681 C-Peptide -Quest | $115.20 | $192.00 | $65.28–$140.16 | 10% above | 40% |
| C-peptide blood test inpatient CPT 84681 GHS C-PEPTIDE | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| C-peptide blood test inpatient CPT 84681 #CPeptide | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| C-peptide blood test inpatient CPT 84681 C-Peptide -Quest | $115.20 | $192.00 | $65.28–$140.16 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein Qn-Sendout | $18.00 | $30.00 | $10.20–$21.90 | 69% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 GHS C-REACTIVE PROTEIN | $28.20 | $47.00 | $15.98–$34.31 | 52% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein - Quest | $41.40 | $69.00 | $23.46–$50.37 | 29% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP Quantitative | $48.00 | $80.00 | $27.20–$58.40 | 18% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein, Semi Quant- GHG | $61.20 | $102.00 | $34.68–$74.46 | 5% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein Qn-Sendout | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 GHS C-REACTIVE PROTEIN | $28.20 | $47.00 | $15.98–$34.31 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein - Quest | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP Quantitative | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein, Semi Quant- GHG | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C difficile Toxin Gene NAA-Sendout | $117.60 | $196.00 | $66.64–$143.08 | 1% above | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Toxin B by PCR | $132.60 | $221.00 | $75.14–$161.33 | 14% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile Toxin Gene NAA-Sendout | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Toxin B by PCR | $132.60 | $221.00 | $75.14–$161.33 | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 #CA199 | $73.80 | $123.00 | $41.82–$89.79 | 24% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen-G1 Fluid - Sendout | $73.80 | $123.00 | $41.82–$89.79 | 24% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9, CSF - Quest | $78.00 | $130.00 | $44.20–$94.90 | 20% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9, Pericardial Fluid - Quest | $78.00 | $130.00 | $44.20–$94.90 | 20% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9, Pleural Fluid - Quest | $78.00 | $130.00 | $44.20–$94.90 | 20% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen 19-9 - Quest | $111.00 | $185.00 | $62.90–$135.05 | 14% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 GHS CA 19-9 (MAYO) | $141.60 | $236.00 | $80.24–$172.28 | 45% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen-G1 Fluid - Sendout | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 #CA199 | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca 19-9, Pleural Fluid - Quest | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca 19-9, Pericardial Fluid - Quest | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9, CSF - Quest | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen 19-9 - Quest | $111.00 | $185.00 | $62.90–$135.05 | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 GHS CA 19-9 (MAYO) | $141.60 | $236.00 | $80.24–$172.28 | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125-Sendout | $69.60 | $116.00 | $39.44–$84.68 | 39% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 - Quest | $136.80 | $228.00 | $77.52–$166.44 | 19% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 GHS CA125 | $189.00 | $315.00 | $107.10–$229.95 | 65% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125-Sendout | $69.60 | $116.00 | $39.44–$84.68 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 - Quest | $136.80 | $228.00 | $77.52–$166.44 | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 GHS CA125 | $189.00 | $315.00 | $107.10–$229.95 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 _SARS CoV2, NAA 2 Day TAT-Sendout | $17.40 | $29.00 | $9.86–$21.17 | 85% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 InHouse PCR | $67.20 | $112.00 | $38.08–$81.76 | 44% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 _SARS CoV2, NAA 2 Day TAT-Sendout | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19IA | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19IL | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 InHouse PCR | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 #SARS-Co-2NAA | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 Saliva | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 #COVID19RSV-COVID19 | $136.80 | $228.00 | $77.52–$166.44 | — | 40% |
| Calcium blood test, total CPT 82310 Calcium Level | $16.80 | $28.00 | $9.52–$20.44 | 61% below | 40% |
| Calcium blood test, total CPT 82310 #PTH+CA-CALCIUM | $18.00 | $30.00 | $10.20–$21.90 | 58% below | 40% |
| Calcium blood test, total CPT 82310 GHS CALCIUM-PTH, LOCAL | $36.00 | $60.00 | $20.40–$43.80 | 16% below | 40% |
| Calcium blood test, total CPT 82310 GHS CALCIUM, BLOOD | $36.60 | $61.00 | $20.74–$44.53 | 14% below | 40% |
| Calcium blood test, total CPT 82310 CALCIUM, BLOOD | $36.60 | $61.00 | $20.74–$44.53 | 14% below | 40% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 #PTH+CA-CALCIUM | $18.00 | $30.00 | $10.20–$21.90 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 GHS CALCIUM-PTH, LOCAL | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM, BLOOD | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Calcium blood test, total inpatient CPT 82310 GHS CALCIUM, BLOOD | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA-Sendout | $63.00 | $105.00 | $35.70–$76.65 | 40% below | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 GHS CEA | $82.20 | $137.00 | $46.58–$100.01 | 21% below | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen - Quest | $102.00 | $170.00 | $57.80–$124.10 | 2% below | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen | $102.00 | $170.00 | $57.80–$124.10 | 2% below | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA Fluid - Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA-Sendout | $63.00 | $105.00 | $35.70–$76.65 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 GHS CEA | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen - Quest | $102.00 | $170.00 | $57.80–$124.10 | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic antigen | $102.00 | $170.00 | $57.80–$124.10 | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab IgG-Sendout | $43.20 | $72.00 | $24.48–$52.56 | 30% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab IgM-Sendout | $43.20 | $72.00 | $24.48–$52.56 | 30% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus IgG Ab CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | 29% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 #VZV-IGG | $44.40 | $74.00 | $25.16–$54.02 | 28% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 GHS VARICELLA ZOSTER ANTIBODY IGM | $48.60 | $81.00 | $27.54–$59.13 | 21% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus IgM Ab CSF - Sendout | $55.80 | $93.00 | $31.62–$67.89 | 10% below | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Virus IgG Ab - Quest | $75.60 | $126.00 | $42.84–$91.98 | 22% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 GHS VARICELLA IGG | $81.00 | $135.00 | $45.90–$98.55 | 31% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB | $81.00 | $135.00 | $45.90–$98.55 | 31% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus Ab, IgM - Quest | $87.00 | $145.00 | $49.30–$105.85 | 41% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 GHS VARICELLA ZOSTER ANTIBODY IGG | $115.80 | $193.00 | $65.62–$140.89 | 87% above | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab IgG-Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab IgM-Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus IgG Ab CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 #VZV-IGG | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 #VZV-IGM | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 GHS VARICELLA ZOSTER ANTIBODY IGM | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus IgM Ab CSF - Sendout | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Virus IgG Ab - Quest | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB | $81.00 | $135.00 | $45.90–$98.55 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 GHS VARICELLA IGG | $81.00 | $135.00 | $45.90–$98.55 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus Ab, IgM - Quest | $87.00 | $145.00 | $49.30–$105.85 | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 GHS VARICELLA ZOSTER ANTIBODY IGG | $115.80 | $193.00 | $65.62–$140.89 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS DNA PCR | $85.80 | $143.00 | $48.62–$104.39 | 25% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. Trachomatis, DNA, SDA | $85.80 | $143.00 | $48.62–$104.39 | 25% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GHS CHLAMYDIA PCR(ONLY-LOCAL) | $85.80 | $143.00 | $48.62–$104.39 | 25% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis NAA - Sendout | $117.60 | $196.00 | $66.64–$143.08 | 3% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Ct NAA Pharyngeal - Sendout | $117.60 | $196.00 | $66.64–$143.08 | 3% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #CHL/GC-CHLAMYDIA AMP PROBE | $117.60 | $196.00 | $66.64–$143.08 | 3% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #VG+-CHLAMYDIA TRACHOMATIS | $120.60 | $201.00 | $68.34–$146.73 | 6% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Conjunctiva NAA | $120.60 | $201.00 | $68.34–$146.73 | 6% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #CH/GCPHAR-CHYLMYDIA AMP PROBE | $120.60 | $201.00 | $68.34–$146.73 | 6% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #NUSWAB STD(3)-CHLAMYDIA TRACHOMATIS,NAA | $121.20 | $202.00 | $68.68–$147.46 | 6% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 #NUSWAB STD(4)-CHLAMYDIA TRACHOMATIS,NAA | $121.20 | $202.00 | $68.68–$147.46 | 6% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS, RNA | $125.40 | $209.00 | $71.06–$152.57 | 10% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHAMATIS DNA, SDA | $135.60 | $226.00 | $76.84–$164.98 | 19% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 _C trachomatis NAA Confirm | $151.20 | $252.00 | $85.68–$183.96 | 33% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GHS CHLAMYDIA PCR(ONLY-LOCAL) | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. Trachomatis, DNA, SDA | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS DNA PCR | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #NUSWAB VG+CAND 6SP-CHLAMYDIA TRACH | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #VG+ HSV-CHLAMYDIA TRACH NAA | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #CHL/GC-CHLAMYDIA AMP PROBE | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Ct NAA Pharyngeal - Sendout | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis NAA - Sendout | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #CH/GCPHAR-CHYLMYDIA AMP PROBE | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #CHLAM/GC RECTAL-CHLAM | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #VG+-CHLAMYDIA TRACHOMATIS | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Conjunctiva NAA | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #NUSWAB STD(4)-CHLAMYDIA TRACHOMATIS,NAA | $121.20 | $202.00 | $68.68–$147.46 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 #NUSWAB STD(3)-CHLAMYDIA TRACHOMATIS,NAA | $121.20 | $202.00 | $68.68–$147.46 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS, RNA | $125.40 | $209.00 | $71.06–$152.57 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHAMATIS DNA, SDA | $135.60 | $226.00 | $76.84–$164.98 | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 _C trachomatis NAA Confirm | $151.20 | $252.00 | $85.68–$183.96 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/ Reflex Direct LDL | $39.60 | $66.00 | $22.44–$48.18 | 55% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel - Aledo | $39.60 | $66.00 | $22.44–$48.18 | 55% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile | $39.60 | $66.00 | $22.44–$48.18 | 55% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 #NMR LIPO-LIPID PROFILE | $46.20 | $77.00 | $26.18–$56.21 | 47% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (eldridge) | $53.40 | $89.00 | $30.26–$64.97 | 39% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $53.40 | $89.00 | $30.26–$64.97 | 39% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel DCH | $53.40 | $89.00 | $30.26–$64.97 | 39% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ Reflex Direct LDL | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel - Aledo | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 #NMR LIPO-LIPID PROFILE | $46.20 | $77.00 | $26.18–$56.21 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (eldridge) | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel DCH | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 Bill only - CBC, platelet, automated differential | $34.80 | $58.00 | $19.72–$42.34 | 47% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 GHS CBC (COMPLETE BLOOD COUNT) | $36.00 | $60.00 | $20.40–$43.80 | 45% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 GHS CBC WITH MANUAL DIFF | $53.40 | $89.00 | $30.26–$64.97 | 19% below | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Bill only - CBC, platelet, automated differential | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 GHS CBC (COMPLETE BLOOD COUNT) | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 GHS CBC WITH MANUAL DIFF | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 #CBCPltNoDiff | $21.60 | $36.00 | $12.24–$26.28 | 56% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM (CBC, PLT, W/O DIFF) | $33.00 | $55.00 | $18.70–$40.15 | 32% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 Bill only - Hemogram w/platelet | $34.80 | $58.00 | $19.72–$42.34 | 29% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 GHS HEMOGRAM | $36.00 | $60.00 | $20.40–$43.80 | 26% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 GHS CBC(NO DIFFERENTIAL, HEMOGRAM) | $398.40 | $664.00 | $225.76–$484.72 | 717% above | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 #CBCPltNoDiff | $21.60 | $36.00 | $12.24–$26.28 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM (CBC, PLT, W/O DIFF) | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Bill only - Hemogram w/platelet | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 GHS HEMOGRAM | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 GHS CBC(NO DIFFERENTIAL, HEMOGRAM) | $398.40 | $664.00 | $225.76–$484.72 | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $102.00 | $170.00 | $57.80–$124.10 | 17% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL (CMP) | $108.00 | $180.00 | $61.20–$131.40 | 13% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 GHS COMPREHENSIVE METABOLIC PANEL (CMP) | $108.00 | $180.00 | $61.20–$131.40 | 13% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel - Obstetric | $110.40 | $184.00 | $62.56–$134.32 | 11% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $102.00 | $170.00 | $57.80–$124.10 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 GHS COMPREHENSIVE METABOLIC PANEL (CMP) | $108.00 | $180.00 | $61.20–$131.40 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL (CMP) | $108.00 | $180.00 | $61.20–$131.40 | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel - Obstetric | $110.40 | $184.00 | $62.56–$134.32 | — | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL BASELINE | $50.40 | $84.00 | $28.56–$61.32 | 48% below | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL 30 MINUTE | $50.40 | $84.00 | $28.56–$61.32 | 48% below | 40% |
| Cortisol blood test, total CPT 82533 CORTISOL 60 MINUTE | $50.40 | $84.00 | $28.56–$61.32 | 48% below | 40% |
| Cortisol blood test, total CPT 82533 Salivary CortisolMS - Sendout | $55.20 | $92.00 | $31.28–$67.16 | 43% below | 40% |
| Cortisol blood test, total CPT 82533 #Cortisol | $55.20 | $92.00 | $31.28–$67.16 | 43% below | 40% |
| Cortisol blood test, total CPT 82533 Dexamethasone Suppression 8AM-Sendout | $55.20 | $92.00 | $31.28–$67.16 | 43% below | 40% |
| Cortisol blood test, total CPT 82533 #SAL CORT2-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | 42% below | 40% |
| Cortisol blood test, total CPT 82533 #SAL CORT4-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | 42% below | 40% |
| Cortisol blood test, total CPT 82533 #SAL CORT3-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | 42% below | 40% |
| Cortisol blood test, total CPT 82533 #CBG+CORT-CORTISOL | $56.40 | $94.00 | $31.96–$68.62 | 42% below | 40% |
| Cortisol blood test, total CPT 82533 Dexamethasone Suppression - One Specimen | $57.00 | $95.00 | $32.30–$69.35 | 41% below | 40% |
| Cortisol blood test, total CPT 82533 #CORTSTIM-CORTISOL POST STIMULATION | $72.00 | $120.00 | $40.80–$87.60 | 26% below | 40% |
| Cortisol blood test, total CPT 82533 #CORTSTIM-CORTISOL BASELINE | $72.00 | $120.00 | $40.80–$87.60 | 26% below | 40% |
| Cortisol blood test, total CPT 82533 GHS CORTISOL PLASMA | $150.60 | $251.00 | $85.34–$183.23 | 55% above | 40% |
| Cortisol blood test, total CPT 82533 GHS CORTISOL(MAYO) | $152.40 | $254.00 | $86.36–$185.42 | 56% above | 40% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol AM-Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #ACTHSTIM-CORTISOL3 | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 60 MINUTE | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL 30 MINUTE | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL BASELINE | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #Cortisol | $55.20 | $92.00 | $31.28–$67.16 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 Salivary CortisolMS - Sendout | $55.20 | $92.00 | $31.28–$67.16 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 Dexamethasone Suppression 8AM-Sendout | $55.20 | $92.00 | $31.28–$67.16 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT3-CORTISOL 3 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #CBG+CORT-CORTISOL | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT4-CORTISOL 4 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT4-CORTISOL 3 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT4-CORTISOL 2 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT4-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT3-CORTISOL 2 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT3-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT2-CORTISOL 2 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #SAL CORT2-CORTISOL 1 | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 Dexamethasone Suppression - One Specimen | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #CORTSTIM-CORTISOL BASELINE | $72.00 | $120.00 | $40.80–$87.60 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 #CORTSTIM-CORTISOL POST STIMULATION | $72.00 | $120.00 | $40.80–$87.60 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 GHS CORTISOL PLASMA | $150.60 | $251.00 | $85.34–$183.23 | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 GHS CORTISOL(MAYO) | $152.40 | $254.00 | $86.36–$185.42 | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 #CKTOT+ISO-CK,TOT. | $22.20 | $37.00 | $12.58–$27.01 | 60% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 GHS CPK (PLUS MB IF CPK>80) | $49.20 | $82.00 | $27.88–$59.86 | 11% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK Total | $56.40 | $94.00 | $31.96–$68.62 | 2% above | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 #CKTOT+ISO-CK,TOT. | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 GHS CPK (PLUS MB IF CPK>80) | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK Total | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Creatinine blood test CPT 82565 Creatinine | $28.80 | $48.00 | $16.32–$35.04 | 32% below | 40% |
| Creatinine blood test CPT 82565 GHS CREATININE, BLOOD | $29.40 | $49.00 | $16.66–$35.77 | 30% below | 40% |
| Creatinine blood test CPT 82565 LAB RAD CREATININE POST CNTRST | $31.20 | $52.00 | $17.68–$37.96 | 26% below | 40% |
| Creatinine blood test CPT 82565 Creatinine - POC | $35.40 | $59.00 | $20.06–$43.07 | 16% below | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| Creatinine blood test inpatient CPT 82565 GHS CREATININE, BLOOD | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Creatinine blood test inpatient CPT 82565 LAB RAD CREATININE POST CNTRST | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Creatinine blood test inpatient CPT 82565 Creatinine - POC | $35.40 | $59.00 | $20.06–$43.07 | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Screening, Blood Bank | $27.00 | $45.00 | $15.30–$32.85 | 60% below | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 #PRENAT INF-CMV AB | $49.20 | $82.00 | $27.88–$59.86 | 27% below | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AB | $50.40 | $84.00 | $28.56–$61.32 | 25% below | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab IgG-Sendout | $51.60 | $86.00 | $29.24–$62.78 | 23% below | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Ab IgG CSF - Sendout | $51.60 | $86.00 | $29.24–$62.78 | 23% below | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS, IGG- SERUM | $94.80 | $158.00 | $53.72–$115.34 | 41% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus, IgG | $99.00 | $165.00 | $56.10–$120.45 | 47% above | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Screening, Blood Bank | $27.00 | $45.00 | $15.30–$32.85 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 #PREG INF DIS-CMV AB | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 #PRENATAL INF DIS-CMV AB | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 #PRENAT INF-CMV AB | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AB | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab IgG-Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Ab IgG CSF - Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS, IGG- SERUM | $94.80 | $158.00 | $53.72–$115.34 | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus, IgG | $99.00 | $165.00 | $56.10–$120.45 | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 #THROMBOSIS-FIBRIN DEGRADATION QUAN. | $47.40 | $79.00 | $26.86–$57.67 | 44% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quantitative | $80.40 | $134.00 | $45.56–$97.82 | 6% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 #THROMBOSIS-FIBRIN DEGRADATION QUAN. | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Quantitative | $80.40 | $134.00 | $45.56–$97.82 | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate-Sendout | $74.40 | $124.00 | $42.16–$90.52 | 33% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate - Quest | $79.20 | $132.00 | $44.88–$96.36 | 28% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE | $133.20 | $222.00 | $75.48–$162.06 | 21% above | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 GHS DHEA-SULFATE | $133.20 | $222.00 | $75.48–$162.06 | 21% above | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate-Sendout | $74.40 | $124.00 | $42.16–$90.52 | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate - Quest | $79.20 | $132.00 | $44.88–$96.36 | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE | $133.20 | $222.00 | $75.48–$162.06 | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 GHS DHEA-SULFATE | $133.20 | $222.00 | $75.48–$162.06 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol, Saliva | $17.40 | $29.00 | $9.86–$21.17 | 87% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 #MEC-CONFIRMATION | $54.00 | $90.00 | $30.60–$65.70 | 59% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cotinine | $54.60 | $91.00 | $30.94–$66.43 | 59% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol, urine | $56.40 | $94.00 | $31.96–$68.62 | 58% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepine Screen - Sendout | $61.80 | $103.00 | $35.02–$75.19 | 54% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Comprehensive Urine Quest | $85.80 | $143.00 | $48.62–$104.39 | 36% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid (THC) Screen, Urine | $109.20 | $182.00 | $61.88–$132.86 | 18% below | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse 7 | $154.80 | $258.00 | $87.72–$188.34 | 16% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse 9 | $163.20 | $272.00 | $92.48–$198.56 | 23% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse | $163.20 | $272.00 | $92.48–$198.56 | 23% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 _Ketamine GC/MS Level Retest - Sendout | $179.40 | $299.00 | $101.66–$218.27 | 35% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 10+Oxycodone+Crt-Scr-Sendout | $199.80 | $333.00 | $113.22–$243.09 | 50% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Flunitrazepam (Rohypnol) Scr Ur-Sendout | $205.80 | $343.00 | $116.62–$250.39 | 55% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Comprehensive Drug Profile Urine - Sendout | $205.80 | $343.00 | $116.62–$250.39 | 55% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Urine-Sendout | $205.80 | $343.00 | $116.62–$250.39 | 55% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium 5 Panel-Sendout | $205.80 | $343.00 | $116.62–$250.39 | 55% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Cocaine Screen - Sendout | $205.80 | $343.00 | $116.62–$250.39 | 55% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ketamine - Sendout | $208.20 | $347.00 | $117.98–$253.31 | 56% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Comprehensive | $210.00 | $350.00 | $119.00–$255.50 | 58% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Screen 10 Whole Blood-Sendout | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 #CANN/CRE-CANNABINOID | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse 8 WB-Sendout | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tricyclic Antidepressant Urine-Sendout | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturate Screen Urine | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine Urine | $211.80 | $353.00 | $120.02–$257.69 | 59% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 THC Quantitative | $213.00 | $355.00 | $120.70–$259.15 | 60% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CordStat9 - Sendout | $301.20 | $502.00 | $170.68–$366.46 | 126% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 #CORD13-DRUG PANEL | $310.20 | $517.00 | $175.78–$377.41 | 133% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 #CORD12-DRUG PANEL | $310.20 | $517.00 | $175.78–$377.41 | 133% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 #DRUGSCNCOMP-INITIAL | $543.00 | $905.00 | $307.70–$660.65 | 308% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol, Saliva | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #MEC-CONFIRMATION | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cotinine | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol, urine | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen - Sendout | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Comprehensive Urine Quest | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid (THC) Screen, Urine | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse 7 | $154.80 | $258.00 | $87.72–$188.34 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone Screen&Cnfm Ur-Sendout | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Oxycodone/Oxymorphone Scrn Ur-Sendout | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Profile, Ur(7 Drugs+Alcohol)-Sendout | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC Screen w/Rflx Confrim WB-Sendout | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse 9 | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse | $163.20 | $272.00 | $92.48–$198.56 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 _Ketamine GC/MS Level Retest - Sendout | $179.40 | $299.00 | $101.66–$218.27 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cotinine Level - Sendout | $181.20 | $302.00 | $102.68–$220.46 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #DrugProf14 | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 10+Oxycodone+Crt-Scr-Sendout | $199.80 | $333.00 | $113.22–$243.09 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse 7 Scr ONLY WB-Sendout | $201.00 | $335.00 | $113.90–$244.55 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #ExpDrugScr+Bup | $202.80 | $338.00 | $114.92–$246.74 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethyl Glucuronide Screen UC - Sendout | $202.80 | $338.00 | $114.92–$246.74 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite Urine-Sendout | $205.80 | $343.00 | $116.62–$250.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium 5 Panel-Sendout | $205.80 | $343.00 | $116.62–$250.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Flunitrazepam (Rohypnol) Scr Ur-Sendout | $205.80 | $343.00 | $116.62–$250.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Cocaine Screen - Sendout | $205.80 | $343.00 | $116.62–$250.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Comprehensive Drug Profile Urine - Sendout | $205.80 | $343.00 | $116.62–$250.39 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ketamine - Sendout | $208.20 | $347.00 | $117.98–$253.31 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Comprehensive | $210.00 | $350.00 | $119.00–$255.50 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturate Screen Urine | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tricyclic Antidepressant Urine-Sendout | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethanol Urine-Sendout | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine Urine | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse 8 WB-Sendout | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Screen 10 Whole Blood-Sendout | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #CANN/CRE-CANNABINOID | $211.80 | $353.00 | $120.02–$257.69 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC Quantitative | $213.00 | $355.00 | $120.70–$259.15 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 11 w/Confirm S-Sendout | $217.80 | $363.00 | $123.42–$264.99 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 12 w/Confirm S-Sendout | $226.80 | $378.00 | $128.52–$275.94 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #EthylGlucUr | $288.60 | $481.00 | $163.54–$351.13 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CordStat9 - Sendout | $301.20 | $502.00 | $170.68–$366.46 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #CORD12-DRUG PANEL | $310.20 | $517.00 | $175.78–$377.41 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #CORD13-DRUG PANEL | $310.20 | $517.00 | $175.78–$377.41 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #PainMgmtPrfl(13)Ur | $501.00 | $835.00 | $283.90–$609.55 | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 #DRUGSCNCOMP-INITIAL | $543.00 | $905.00 | $307.70–$660.65 | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 GHS ELECTROLYTES PANEL (EP) | $41.40 | $69.00 | $23.46–$50.37 | 45% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $49.20 | $82.00 | $27.88–$59.86 | 35% below | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 GHS ELECTROLYTES PANEL (EP) | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR-VCA IGG/IGM | $56.40 | $94.00 | $31.96–$68.62 | 22% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 #EB-EBVCA IGG | $62.40 | $104.00 | $35.36–$75.92 | 13% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 VCA ANTIBODY | $64.80 | $108.00 | $36.72–$78.84 | 10% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA IgM - Sendout | $65.40 | $109.00 | $37.06–$79.57 | 9% below | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 #EBV ACUTE ABS-VCA IGG | $66.60 | $111.00 | $37.74–$81.03 | 8% below | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EBV AB PROF-VCA IGG | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EBV AB PROF-VCA IGM | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR-VCA IGG/IGM | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EB-EBVCA IGG | $62.40 | $104.00 | $35.36–$75.92 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EB-EBVCA IGM | $62.40 | $104.00 | $35.36–$75.92 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 VCA ANTIBODY | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA IgM - Sendout | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EBV ACUTE ABS-VCA IGG | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 #EBV ACUTE ABS-VCA IGM | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Estradiol blood test CPT 82670 #Estradiol | $39.00 | $65.00 | $22.10–$47.45 | 69% below | 40% |
| Estradiol blood test CPT 82670 Estradiol Sensitive - Sendout | $39.00 | $65.00 | $22.10–$47.45 | 69% below | 40% |
| Estradiol blood test CPT 82670 Estradiol serum | $85.80 | $143.00 | $48.62–$104.39 | 32% below | 40% |
| Estradiol blood test CPT 82670 Estradiol, Ultrasensitive - Quest | $167.40 | $279.00 | $94.86–$203.67 | 33% above | 40% |
| Estradiol blood test CPT 82670 GHS ESTRADIOL, SERUM | $204.00 | $340.00 | $115.60–$248.20 | 62% above | 40% |
| Estradiol blood test inpatient CPT 82670 #Estradiol | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol Sensitive - Sendout | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol serum | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol, Ultrasensitive - Quest | $167.40 | $279.00 | $94.86–$203.67 | — | 40% |
| Estradiol blood test inpatient CPT 82670 GHS ESTRADIOL, SERUM | $204.00 | $340.00 | $115.60–$248.20 | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 #FSH | $61.80 | $103.00 | $35.02–$75.19 | 40% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH Pediatric - Sendout | $61.80 | $103.00 | $35.02–$75.19 | 40% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 GHS FSH | $91.80 | $153.00 | $52.02–$111.69 | 11% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, Pediatric - Quest | $95.40 | $159.00 | $54.06–$116.07 | 8% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH - Quest | $99.60 | $166.00 | $56.44–$121.18 | 4% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH Pediatric - Sendout | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 #FSH | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 GHS FSH | $91.80 | $153.00 | $52.02–$111.69 | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Pediatric - Quest | $95.40 | $159.00 | $54.06–$116.07 | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH - Quest | $99.60 | $166.00 | $56.44–$121.18 | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal-Sendout | $142.20 | $237.00 | $80.58–$173.01 | 15% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal-Sendout | $142.20 | $237.00 | $80.58–$173.01 | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin, Serum | $34.80 | $58.00 | $19.72–$42.34 | 62% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin -Sendout | $48.00 | $80.00 | $27.20–$58.40 | 48% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 GHS FERRITIN, SERUM | $78.00 | $130.00 | $44.20–$94.90 | 15% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $97.20 | $162.00 | $55.08–$118.26 | 6% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin, Serum | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin -Sendout | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 GHS FERRITIN, SERUM | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $97.20 | $162.00 | $55.08–$118.26 | — | 40% |
| Fibrinogen blood test CPT 85384 #FIBRIN-FIBRINOGEN ACTIVITY | $33.00 | $55.00 | $18.70–$40.15 | 50% below | 40% |
| Fibrinogen blood test CPT 85384 GHS FIBRINOGEN | $42.00 | $70.00 | $23.80–$51.10 | 36% below | 40% |
| Fibrinogen blood test CPT 85384 Fibrinogen OB Quantitative | $61.80 | $103.00 | $35.02–$75.19 | 6% below | 40% |
| Fibrinogen blood test CPT 85384 Fibrinogen Quantitative | $65.40 | $109.00 | $37.06–$79.57 | 1% below | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity- Sendout | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 #FIBRIN-FIBRINOGEN ACTIVITY | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 GHS FIBRINOGEN | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen OB Quantitative | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Quantitative | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Folate (folic acid) blood test CPT 82746 Folate (Folic Acid), Serum | $37.20 | $62.00 | $21.08–$45.26 | 58% below | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $51.60 | $86.00 | $29.24–$62.78 | 42% below | 40% |
| Folate (folic acid) blood test CPT 82746 #VITB12FOL-FOLATE | $54.60 | $91.00 | $30.94–$66.43 | 39% below | 40% |
| Folate (folic acid) blood test CPT 82746 Folate Level - Quest | $54.60 | $91.00 | $30.94–$66.43 | 39% below | 40% |
| Folate (folic acid) blood test CPT 82746 Folate (Folic Acid) -Sendout | $54.60 | $91.00 | $30.94–$66.43 | 39% below | 40% |
| Folate (folic acid) blood test CPT 82746 GHS FOLATE, BLOOD | $71.40 | $119.00 | $40.46–$86.87 | 20% below | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid), Serum | $37.20 | $62.00 | $21.08–$45.26 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid) -Sendout | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 #VITB12FOL-FOLATE | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level - Quest | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 GHS FOLATE, BLOOD | $71.40 | $119.00 | $40.46–$86.87 | — | 40% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine Free-Sendout | $39.00 | $65.00 | $22.10–$47.45 | 62% below | 40% |
| Free T3 thyroid hormone test CPT 84481 T3, Free | $183.00 | $305.00 | $103.70–$222.65 | 76% above | 40% |
| Free T3 thyroid hormone test CPT 84481 T3 free Radioimmunoassay | $183.00 | $305.00 | $103.70–$222.65 | 76% above | 40% |
| Free T3 thyroid hormone test CPT 84481 GHS T3 FREE (FT3) | $240.60 | $401.00 | $136.34–$292.73 | 132% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine Free-Sendout | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 _T3,Free - Sendout | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 free Radioimmunoassay | $183.00 | $305.00 | $103.70–$222.65 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3, Free | $183.00 | $305.00 | $103.70–$222.65 | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 GHS T3 FREE (FT3) | $240.60 | $401.00 | $136.34–$292.73 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 _T4F - Sendout | $31.20 | $52.00 | $17.68–$37.96 | 52% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free - Aledo | $41.40 | $69.00 | $23.46–$50.37 | 37% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 | $43.80 | $73.00 | $24.82–$53.29 | 33% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE | $43.80 | $73.00 | $24.82–$53.29 | 33% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $43.80 | $73.00 | $24.82–$53.29 | 33% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 GHS T4 FREE (FT4) | $73.80 | $123.00 | $41.82–$89.79 | 12% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _T4,Free(Direct) - Sendout | $25.20 | $42.00 | $14.28–$30.66 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, Free (Direct) - Sendout | $25.20 | $42.00 | $14.28–$30.66 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _T4 Free(Direct) - Sendout | $25.20 | $42.00 | $14.28–$30.66 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _T4F - Sendout | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free - Aledo | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 GHS T4 FREE (FT4) | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 by Dialysis/Mass Spec-Sendout | $151.20 | $252.00 | $85.68–$183.96 | — | 40% |
| Free testosterone test CPT 84402 #TESTFR+T-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | 13% below | 40% |
| Free testosterone test CPT 84402 #TESTFR+WK+T LC/MS-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | 13% below | 40% |
| Free testosterone test CPT 84402 Testosterone Free Direct -Sendout | $87.60 | $146.00 | $49.64–$106.58 | 13% below | 40% |
| Free testosterone test CPT 84402 #TESTFR+T LC/MS-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | 13% below | 40% |
| Free testosterone test CPT 84402 Testosterone, free | $116.40 | $194.00 | $65.96–$141.62 | 15% above | 40% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $160.80 | $268.00 | $91.12–$195.64 | 59% above | 40% |
| Free testosterone test CPT 84402 GHS TESTOSTERONE FREE | $160.80 | $268.00 | $91.12–$195.64 | 59% above | 40% |
| Free testosterone test inpatient CPT 84402 #TESTFR+WK+T LC/MS-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | — | 40% |
| Free testosterone test inpatient CPT 84402 #TESTFR+T-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free Direct -Sendout | $87.60 | $146.00 | $49.64–$106.58 | — | 40% |
| Free testosterone test inpatient CPT 84402 #TESTFR+T LC/MS-FREE TESTOST. | $87.60 | $146.00 | $49.64–$106.58 | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone, free | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Free testosterone test inpatient CPT 84402 GHS TESTOSTERONE FREE | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 #HCV FIBROSURE-GGT | $24.60 | $41.00 | $13.94–$29.93 | 52% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $47.40 | $79.00 | $26.86–$57.67 | 8% below | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GHS GAMMA GT | $54.00 | $90.00 | $30.60–$65.70 | 4% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 #HCV FIBROSURE-GGT | $24.60 | $41.00 | $13.94–$29.93 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 #FIBRO-GGT | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GHS GAMMA GT | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gest. Diabetes 1-Hr Screen - Sendout | $16.80 | $28.00 | $9.52–$20.44 | 61% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GHS GLUCOSE, POST PRANDIAL | $26.40 | $44.00 | $14.96–$32.12 | 38% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 2Hr Nongest (75g) | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Post Prandial | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 1Hr Gestational (50g) | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, Post Glucola | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 hour | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Gest. Diabetes 1-Hr Screen - Sendout | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GHS GLUCOSE, POST PRANDIAL | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Post Prandial | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance 2Hr Nongest (75g) | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 hour | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose, Post Glucola | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance 1Hr Gestational (50g) | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2 Hr Gestational (75g) | $75.00 | $125.00 | $42.50–$91.25 | 17% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $75.00 | $125.00 | $42.50–$91.25 | 17% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 3 Hr Gestational (100g) | $75.00 | $125.00 | $42.50–$91.25 | 17% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR | $75.00 | $125.00 | $42.50–$91.25 | 17% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, FIRST 3 SAMPLES | $75.00 | $125.00 | $42.50–$91.25 | 17% below | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2 Hr Gestational (75g) | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 HR | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 3 Hr Gestational (100g) | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, FIRST 3 SAMPLES | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. Gonorrhoeae, DNA, SDA | $58.20 | $97.00 | $32.98–$70.81 | 46% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE DNA, SDA | $58.20 | $97.00 | $32.98–$70.81 | 46% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GHS GONORRHEA-LOCAL PCR(ONLY) | $86.40 | $144.00 | $48.96–$105.12 | 20% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONNORHEA PCR | $86.40 | $144.00 | $48.96–$105.12 | 20% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #CH/GCPHAR-GC AMP PROBE | $120.60 | $201.00 | $68.34–$146.73 | 11% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #VG+-NEISSERIA GONORRHOEAE | $120.60 | $201.00 | $68.34–$146.73 | 11% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NAA Pharyngeal - Sendout | $124.20 | $207.00 | $70.38–$151.11 | 14% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #CHL/GC-N.GONORRHOEAE AMP PROBE | $124.20 | $207.00 | $70.38–$151.11 | 14% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #NUSWAB STD(3)-NEISSERIA GONORRHOEAE,NAA | $129.00 | $215.00 | $73.10–$156.95 | 19% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 #NUSWAB STD(4)-NEISSERIA GONORRHOEAE,NAA | $129.00 | $215.00 | $73.10–$156.95 | 19% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE, RNA | $133.20 | $222.00 | $75.48–$162.06 | 23% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. Gonorrhoeae, DNA, SDA | $58.20 | $97.00 | $32.98–$70.81 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE DNA, SDA | $58.20 | $97.00 | $32.98–$70.81 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONNORHEA PCR | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GHS GONORRHEA-LOCAL PCR(ONLY) | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae NAA - Sendout | $98.40 | $164.00 | $55.76–$119.72 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #NUSWAB VG+CAND 6SP-N. GONORRHOEAE | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #VG+ HSV-N. GONORRHOEAE NAA | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #VG+-NEISSERIA GONORRHOEAE | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #CH/GCPHAR-GC AMP PROBE | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #CHLAM/GC RECTAL-GC | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NAA Pharyngeal - Sendout | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #CHL/GC-N.GONORRHOEAE AMP PROBE | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #NUSWAB STD(4)-NEISSERIA GONORRHOEAE,NAA | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 #NUSWAB STD(3)-NEISSERIA GONORRHOEAE,NAA | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE, RNA | $133.20 | $222.00 | $75.48–$162.06 | — | 40% |
| H. pylori antibody blood test CPT 86677 H. pylori IgG Abs-Sendout | $48.60 | $81.00 | $27.54–$59.13 | 38% below | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter pylori IgM Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | 38% below | 40% |
| H. pylori antibody blood test CPT 86677 #HPYL-IGG | $49.80 | $83.00 | $28.22–$60.59 | 37% below | 40% |
| H. pylori antibody blood test CPT 86677 GHS HELICOBACTER PYLORI, IGG (LOCAL) | $93.00 | $155.00 | $52.70–$113.15 | 18% above | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody | $194.40 | $324.00 | $110.16–$236.52 | 147% above | 40% |
| H. pylori antibody blood test inpatient CPT 86677 #H PYLORI ABS-IGM | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 #H PYLORI ABS-IGG | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 #H PYLORI ABS-IGA | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 H. pylori IgG Abs-Sendout | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori IgM Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 #HPYL-IGG | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 #HPYL-IGA | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 GHS HELICOBACTER PYLORI, IGG (LOCAL) | $93.00 | $155.00 | $52.70–$113.15 | — | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody | $194.40 | $324.00 | $110.16–$236.52 | — | 40% |
| H. pylori stool antigen test CPT 87338 H. pylori Stool Ag EIA-Sendout | $48.00 | $80.00 | $27.20–$58.40 | 58% below | 40% |
| H. pylori stool antigen test CPT 87338 H. pylori Ag, Stool - Quest | $58.20 | $97.00 | $32.98–$70.81 | 49% below | 40% |
| H. pylori stool antigen test CPT 87338 GHS HELICOBACTER PYLORI ANTIGEN,STOOL | $183.60 | $306.00 | $104.04–$223.38 | 61% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag EIA-Sendout | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Ag, Stool - Quest | $58.20 | $97.00 | $32.98–$70.81 | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 GHS HELICOBACTER PYLORI ANTIGEN,STOOL | $183.60 | $306.00 | $104.04–$223.38 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 _HIV1 RNA Ql - Sendout | $275.40 | $459.00 | $156.06–$335.07 | 1% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 RNA Real Time PCR (Non-Graph)-Sendout | $300.60 | $501.00 | $170.34–$365.73 | 10% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 _HIV Qn RNA PCR-Sendout | $301.20 | $502.00 | $170.68–$366.46 | 10% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR (NonGraph) rfx/Geno-Sendout | $309.60 | $516.00 | $175.44–$376.68 | 14% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA Qn Real Time PCR - Quest | $310.20 | $517.00 | $175.78–$377.41 | 14% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA, Quantitative, PCR with Reflex to Genotype - Quest | $310.80 | $518.00 | $176.12–$378.14 | 14% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 _HIV1 RNA Ql - Sendout | $275.40 | $459.00 | $156.06–$335.07 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 RNA Real Time PCR (Non-Graph)-Sendout | $300.60 | $501.00 | $170.34–$365.73 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 _HIV Qn RNA PCR-Sendout | $301.20 | $502.00 | $170.68–$366.46 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR (NonGraph) rfx/Geno-Sendout | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA Qn Real Time PCR - Quest | $310.20 | $517.00 | $175.78–$377.41 | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA, Quantitative, PCR with Reflex to Genotype - Quest | $310.80 | $518.00 | $176.12–$378.14 | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 Rapid Screen (OB or Needlestick Only) | $41.40 | $69.00 | $23.46–$50.37 | 24% below | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV bill-only | $41.40 | $69.00 | $23.46–$50.37 | 24% below | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 GHS HIV ANTIBODY | $58.80 | $98.00 | $33.32–$71.54 | 7% above | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV bill-only | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 Rapid Screen (OB or Needlestick Only) | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 GHS HIV ANTIBODY | $58.80 | $98.00 | $33.32–$71.54 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 TESTINGHIV-1/2 Antigen and Antibodies, 4th Generation, with | $83.40 | $139.00 | $47.26–$101.47 | 10% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Antigen Antibody Combo w/Rfx - Sendout | $85.80 | $143.00 | $48.62–$104.39 | 13% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 TESTINGHIV-1/2 Antigen and Antibodies, 4th Generation, with | $83.40 | $139.00 | $47.26–$101.47 | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Antigen Antibody Combo w/Rfx - Sendout | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA RISK | $124.20 | $207.00 | $70.38–$151.11 | 7% above | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA RISK | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GlyHgb A1c - Aledo | $36.00 | $60.00 | $20.40–$43.80 | 45% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GHS HEMOGLOBIN AIC | $50.40 | $84.00 | $28.56–$61.32 | 22% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycosylated Hemoglobin A1c | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GlyHgb A1c - Aledo | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GHS HEMOGLOBIN AIC | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Hemoglobin blood test CPT 85018 #G6PD BLD+HGB-HEMOGLOBIN | $8.40 | $14.00 | $4.76–$10.22 | 71% below | 40% |
| Hemoglobin blood test CPT 85018 GHS HEMOGLOBIN | $28.80 | $48.00 | $16.32–$35.04 | 1% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 #G6PD BLD+HGB-HEMOGLOBIN | $8.40 | $14.00 | $4.76–$10.22 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin Level | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 GHS HEMOGLOBIN | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $28.80 | $48.00 | $16.32–$35.04 | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 #HEP B PROF-HEP B CORE AB TOTAL | $40.80 | $68.00 | $23.12–$49.64 | 43% below | 40% |
| Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab Tot-Sendout | $41.40 | $69.00 | $23.46–$50.37 | 42% below | 40% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody - Quest | $51.60 | $86.00 | $29.24–$62.78 | 28% below | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB | $52.80 | $88.00 | $29.92–$64.24 | 26% below | 40% |
| Hepatitis B core antibody test (total) CPT 86704 GHS HB CORE ANTIBODY (ANTI HBC) | $102.60 | $171.00 | $58.14–$124.83 | 44% above | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 #HEP B PROF-HEP B CORE AB TOTAL | $40.80 | $68.00 | $23.12–$49.64 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab Tot-Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 #HBV CORE IGG | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Antibody - Quest | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 GHS HB CORE ANTIBODY (ANTI HBC) | $102.60 | $171.00 | $58.14–$124.83 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Qualitative - Quest | $16.80 | $28.00 | $9.52–$20.44 | 76% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 #HEP B PROF-HEP B SURFACE AB | $36.60 | $61.00 | $20.74–$44.53 | 47% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab-Sendout | $37.80 | $63.00 | $21.42–$45.99 | 45% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 GHS ANTI-HBS | $57.00 | $95.00 | $32.30–$69.35 | 17% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B, SURFACE AB QUANT | $116.40 | $194.00 | $65.96–$141.62 | 69% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Ab Quant - Quest | $121.20 | $202.00 | $68.68–$147.46 | 76% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody Qualitative - Quest | $16.80 | $28.00 | $9.52–$20.44 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 #HEP B PROF-HEP B SURFACE AB | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab-Sendout | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 GHS ANTI-HBS | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B, SURFACE AB QUANT | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Ab Quant - Quest | $121.20 | $202.00 | $68.68–$147.46 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS SURF AG | $41.40 | $69.00 | $23.46–$50.37 | 41% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 #HEP B PROF-HEP B SURFACE AG | $42.60 | $71.00 | $24.14–$51.83 | 39% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen - Quest | $43.80 | $73.00 | $24.82–$53.29 | 38% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 GHS HBSAG | $65.40 | $109.00 | $37.06–$79.57 | 7% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Ag - Sendout | $37.20 | $62.00 | $21.08–$45.26 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS SURF AG | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 #HEP B PROF-HEP B SURFACE AG | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen - Quest | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 GHS HBSAG | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab-Sendout | $51.60 | $86.00 | $29.24–$62.78 | 34% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Rflx to Verification-Sendout | $51.60 | $86.00 | $29.24–$62.78 | 34% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody - Quest | $77.40 | $129.00 | $43.86–$94.17 | 1% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody w/Rflx to Hepatitis C Virus RNA, Qua | $77.40 | $129.00 | $43.86–$94.17 | 1% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Rflx to Hepatitis C RNA PCR Qn - Sendout | $83.40 | $139.00 | $47.26–$101.47 | 6% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 GHS HEPATITIS C VIRUS | $195.60 | $326.00 | $110.84–$237.98 | 149% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab Rfx to Quant PCR - Sendout | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody Rflx NAA - Sendout | $36.00 | $60.00 | $20.40–$43.80 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab w/Rflx to Verification-Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab-Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody - Quest | $77.40 | $129.00 | $43.86–$94.17 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody w/Rflx to Hepatitis C Virus RNA, Qua | $77.40 | $129.00 | $43.86–$94.17 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab w/Rflx to Hepatitis C RNA PCR Qn - Sendout | $83.40 | $139.00 | $47.26–$101.47 | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 GHS HEPATITIS C VIRUS | $195.60 | $326.00 | $110.84–$237.98 | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV Quant PCR Reflex-Sendout | $147.00 | $245.00 | $83.30–$178.85 | 47% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C RNA PCR, Quant | $148.20 | $247.00 | $83.98–$180.31 | 47% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Quant Real Time PCR-Quest | $148.20 | $247.00 | $83.98–$180.31 | 47% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 GHS HCV RNA QUANT BY PCR (LOCAL) | $472.20 | $787.00 | $267.58–$574.51 | 69% above | 40% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR Quant (Non-Graph)-Sendout | $145.80 | $243.00 | $82.62–$177.39 | 48% below | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Diagnosis,NAA-Sendout | $108.00 | $180.00 | $61.20–$131.40 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV Quant PCR Reflex-Sendout | $147.00 | $245.00 | $83.30–$178.85 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C RNA PCR, Quant | $148.20 | $247.00 | $83.98–$180.31 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Quant Real Time PCR-Quest | $148.20 | $247.00 | $83.98–$180.31 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 GHS HCV RNA QUANT BY PCR (LOCAL) | $472.20 | $787.00 | $267.58–$574.51 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 _HCV RT-PCR Quant (Non-Graph)-Sendout | $108.00 | $180.00 | $61.20–$131.40 | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR Quant (Non-Graph)-Sendout | $145.80 | $243.00 | $82.62–$177.39 | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1-Specific Ab IgG-Sendout | $44.40 | $74.00 | $25.16–$54.02 | 34% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG OR IGM | $47.40 | $79.00 | $26.86–$57.67 | 30% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 #PRENAT INF-HSV TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | 29% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 #HSV 1/2 IGM-HERPES SIMPLEX TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | 29% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 #HSV 1/2 IGG-HERPES SIMPLEX TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | 29% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 Igm Titer - Quest | $48.60 | $81.00 | $27.54–$59.13 | 28% below | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG Index: | $49.20 | $82.00 | $27.88–$59.86 | 27% below | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 #PRENATAL INF DIS-HSV1 | $33.60 | $56.00 | $19.04–$40.88 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 #HSV 1 SPEC IGG | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1-Specific Ab IgG-Sendout | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGG OR IGM | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 #PRENAT INF-HSV TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 #HSV 1/2 IGM-HERPES SIMPLEX TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 #HSV 1/2 IGG-HERPES SIMPLEX TYPE 1 | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 Igm Titer - Quest | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG Index: | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 #PRENAT INF-HSV TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | 15% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 #HSV 1/2 IGG-HERPES SIMPLEX TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | 15% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 #HSV 1/2 IGM-HERPES SIMPLEX TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | 15% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2-Specific Ab IgG-Sendout | $68.40 | $114.00 | $38.76–$83.22 | 18% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Igm Titer - Quest | $71.40 | $119.00 | $40.46–$86.87 | 23% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG Index: | $71.40 | $119.00 | $40.46–$86.87 | 23% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG OR IGM | $73.80 | $123.00 | $41.82–$89.79 | 28% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 GHS VIRUS-HSVI&II,IgG/IgM | $75.00 | $125.00 | $42.50–$91.25 | 30% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 #PRENATAL INF DIS-HSV2 | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 _HSV 2 IgG Supplemental Test-Sendout | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 #HSV 2 SPEC IGG | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Type Specific Ab, IgG w/Rfx-Sendout | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 #HSV 1/2 IGG-HERPES SIMPLEX TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 #PRENAT INF-HSV TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 #HSV 1/2 IGM-HERPES SIMPLEX TYPE 2 | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2-Specific Ab IgG-Sendout | $68.40 | $114.00 | $38.76–$83.22 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IgG Index: | $71.40 | $119.00 | $40.46–$86.87 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Igm Titer - Quest | $71.40 | $119.00 | $40.46–$86.87 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG OR IGM | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 GHS VIRUS-HSVI&II,IgG/IgM | $75.00 | $125.00 | $42.50–$91.25 | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Cardiac - Sendout | $43.20 | $72.00 | $24.48–$52.56 | 46% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP Cardio | $45.60 | $76.00 | $25.84–$55.48 | 43% below | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 hsCRP DCH BO | $51.60 | $86.00 | $29.24–$62.78 | 36% below | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Cardiac - Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP Cardio | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 hsCRP DCH BO | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Homocysteine blood test CPT 83090 Homocyst(e)ine -Sendout | $57.00 | $95.00 | $32.30–$69.35 | 41% below | 40% |
| Homocysteine blood test CPT 83090 Homocysteine Non Cardiac-Sendout | $57.00 | $95.00 | $32.30–$69.35 | 41% below | 40% |
| Homocysteine blood test CPT 83090 #THROM VKA-HOMOCYSTEINE | $82.20 | $137.00 | $46.58–$100.01 | 14% below | 40% |
| Homocysteine blood test CPT 83090 Homocysteine, Nutritional and Congenital - Quest | $163.80 | $273.00 | $92.82–$199.29 | 71% above | 40% |
| Homocysteine blood test CPT 83090 Homocysteine, Cardiovascular - Quest | $163.80 | $273.00 | $92.82–$199.29 | 71% above | 40% |
| Homocysteine blood test CPT 83090 GHS HOMOCYSTEINE, TOTAL, LOCAL | $216.00 | $360.00 | $122.40–$262.80 | 125% above | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine Non Cardiac-Sendout | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine -Sendout | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 #THROM VKA-HOMOCYSTEINE | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine, Nutritional and Congenital - Quest | $163.80 | $273.00 | $92.82–$199.29 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine, Cardiovascular - Quest | $163.80 | $273.00 | $92.82–$199.29 | — | 40% |
| Homocysteine blood test inpatient CPT 83090 GHS HOMOCYSTEINE, TOTAL, LOCAL | $216.00 | $360.00 | $122.40–$262.80 | — | 40% |
| Insulin blood test CPT 83525 GHS INSULIN, FASTING | $34.20 | $57.00 | $19.38–$41.61 | 55% below | 40% |
| Insulin blood test CPT 83525 Insulin-Sendout | $39.00 | $65.00 | $22.10–$47.45 | 49% below | 40% |
| Insulin blood test CPT 83525 Insulin - radioimmunoassay | $43.20 | $72.00 | $24.48–$52.56 | 44% below | 40% |
| Insulin blood test CPT 83525 Insulin, Total | $43.20 | $72.00 | $24.48–$52.56 | 44% below | 40% |
| Insulin blood test CPT 83525 INSULIN, TOTAL | $43.20 | $72.00 | $24.48–$52.56 | 44% below | 40% |
| Insulin blood test CPT 83525 #INSULIN-TOTAL | $90.60 | $151.00 | $51.34–$110.23 | 18% above | 40% |
| Insulin blood test inpatient CPT 83525 GHS INSULIN, FASTING | $34.20 | $57.00 | $19.38–$41.61 | — | 40% |
| Insulin blood test inpatient CPT 83525 Insulin-Sendout | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Insulin blood test inpatient CPT 83525 Insulin, Total | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Insulin blood test inpatient CPT 83525 Insulin - radioimmunoassay | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Insulin blood test inpatient CPT 83525 INSULIN, TOTAL | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Insulin blood test inpatient CPT 83525 #INSULIN-TOTAL | $90.60 | $151.00 | $51.34–$110.23 | — | 40% |
| Iron blood test (serum iron) CPT 83540 #IRON/TIBC-IRON | $22.20 | $37.00 | $12.58–$27.01 | 51% below | 40% |
| Iron blood test (serum iron) CPT 83540 IRON (SERUM) | $49.80 | $83.00 | $28.22–$60.59 | 10% above | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $49.80 | $83.00 | $28.22–$60.59 | 10% above | 40% |
| Iron blood test (serum iron) CPT 83540 GHS IRON (SERUM) | $49.80 | $83.00 | $28.22–$60.59 | 10% above | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Liver Tissue-Sendout | $108.00 | $180.00 | $61.20–$131.40 | 139% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 #IRON/TIBC-IRON | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON (SERUM) | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 GHS IRON (SERUM) | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Liver Tissue-Sendout | $108.00 | $180.00 | $61.20–$131.40 | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 #IRON/TIBC-IRON BINDING | $30.60 | $51.00 | $17.34–$37.23 | 38% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 GHS TIBC (IRON BINDING CAPACITY) | $49.80 | $83.00 | $28.22–$60.59 | at median | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $49.80 | $83.00 | $28.22–$60.59 | at median | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 #IRON/TIBC-IRON BINDING | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 GHS TIBC (IRON BINDING CAPACITY) | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $28.20 | $47.00 | $15.98–$34.31 | 68% below | 40% |
| Kidney function blood test panel CPT 80069 #RenalPnl(10) | $29.40 | $49.00 | $16.66–$35.77 | 67% below | 40% |
| Kidney function blood test panel CPT 80069 GHS RENAL FUNCTION PANEL | $57.60 | $96.00 | $32.64–$70.08 | 35% below | 40% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $28.20 | $47.00 | $15.98–$34.31 | — | 40% |
| Kidney function blood test panel inpatient CPT 80069 #RenalPnl(10) | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Kidney function blood test panel inpatient CPT 80069 GHS RENAL FUNCTION PANEL | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH) - Sendout | $61.80 | $103.00 | $35.02–$75.19 | 31% below | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Pediatric-Sendout | $61.80 | $103.00 | $35.02–$75.19 | 31% below | 40% |
| LH (luteinizing hormone) test CPT 83002 GHS LH | $91.80 | $153.00 | $52.02–$111.69 | 3% above | 40% |
| LH (luteinizing hormone) test CPT 83002 LH, Pediatric - Quest | $100.80 | $168.00 | $57.12–$122.64 | 13% above | 40% |
| LH (luteinizing hormone) test CPT 83002 Leuteinizing hormone - Quest | $105.60 | $176.00 | $59.84–$128.48 | 18% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone(LH) - Sendout | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone Pediatric-Sendout | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 GHS LH | $91.80 | $153.00 | $52.02–$111.69 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH, Pediatric - Quest | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Leuteinizing hormone - Quest | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 GHS LACTIC ACID | $67.20 | $112.00 | $38.08–$81.76 | 18% below | 40% |
| Lactate (lactic acid) blood test CPT 83605 Lactate | $84.00 | $140.00 | $47.60–$102.20 | 3% above | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 GHS LACTIC ACID | $67.20 | $112.00 | $38.08–$81.76 | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactate | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 #LD ISO-LDH,TOT. | $21.00 | $35.00 | $11.90–$25.55 | 53% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 GHS LDH | $33.00 | $55.00 | $18.70–$40.15 | 26% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SERUM | $34.80 | $58.00 | $19.72–$42.34 | 22% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $36.60 | $61.00 | $20.74–$44.53 | 18% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase, Cerebrospinal Fluid | $43.80 | $73.00 | $24.82–$53.29 | 2% below | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Body Fluid | $43.80 | $73.00 | $24.82–$53.29 | 2% below | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 #LD ISO-LDH,TOT. | $21.00 | $35.00 | $11.90–$25.55 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 GHS LDH | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH SERUM | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase, Cerebrospinal Fluid | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Body Fluid | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase-Sendout | $23.40 | $39.00 | $13.26–$28.47 | 64% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Fluid - Sendout | $23.40 | $39.00 | $13.26–$28.47 | 64% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 GHS LIPASE | $42.00 | $70.00 | $23.80–$51.10 | 35% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $60.00 | $100.00 | $34.00–$73.00 | 8% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase DCH BO | $79.20 | $132.00 | $44.88–$96.36 | 22% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase-Sendout | $23.40 | $39.00 | $13.26–$28.47 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Fluid - Sendout | $23.40 | $39.00 | $13.26–$28.47 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 GHS LIPASE | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $60.00 | $100.00 | $34.00–$73.00 | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase DCH BO | $79.20 | $132.00 | $44.88–$96.36 | — | 40% |
| Liver function blood test panel CPT 80076 Hepatic Function | $58.20 | $97.00 | $32.98–$70.81 | 34% below | 40% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel - Obstetric | $59.40 | $99.00 | $33.66–$72.27 | 33% below | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function | $58.20 | $97.00 | $32.98–$70.81 | — | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel - Obstetric | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Lyme disease antibody test CPT 86618 #LYME AB-LYME DISEASE IGG | $58.80 | $98.00 | $33.32–$71.54 | 33% below | 40% |
| Lyme disease antibody test CPT 86618 GHS LYME DISEASE | $125.40 | $209.00 | $71.06–$152.57 | 43% above | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease w/refl IgG, IgM - Quest | $139.80 | $233.00 | $79.22–$170.09 | 59% above | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease antibody | $139.80 | $233.00 | $79.22–$170.09 | 59% above | 40% |
| Lyme disease antibody test CPT 86618 Lyme Antibody Screen - Quest | $139.80 | $233.00 | $79.22–$170.09 | 59% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology w Rfx-Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 #_LYME IGG | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 #_LYME IGM | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 #LYME AB-LYME DISEASE IGG | $58.80 | $98.00 | $33.32–$71.54 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 #LYME AB-LYMES DISEASE IGM | $58.80 | $98.00 | $33.32–$71.54 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 GHS LYME DISEASE | $125.40 | $209.00 | $71.06–$152.57 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease antibody | $139.80 | $233.00 | $79.22–$170.09 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease w/refl IgG, IgM - Quest | $139.80 | $233.00 | $79.22–$170.09 | — | 40% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Antibody Screen - Quest | $139.80 | $233.00 | $79.22–$170.09 | — | 40% |
| Magnesium blood test CPT 83735 Magnesium Urine - Sendout | $22.20 | $37.00 | $12.58–$27.01 | 56% below | 40% |
| Magnesium blood test CPT 83735 Magnesium, 24-Hour Urine (W/O Creatinine) - Quest | $24.00 | $40.00 | $13.60–$29.20 | 52% below | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $61.20 | $102.00 | $34.68–$74.46 | 21% above | 40% |
| Magnesium blood test CPT 83735 GHS MAGNESIUM | $61.20 | $102.00 | $34.68–$74.46 | 21% above | 40% |
| Magnesium blood test CPT 83735 Magnesium Level | $61.20 | $102.00 | $34.68–$74.46 | 21% above | 40% |
| Magnesium blood test CPT 83735 Magnesium Level - OB | $61.20 | $102.00 | $34.68–$74.46 | 21% above | 40% |
| Magnesium blood test CPT 83735 GHS MAGNESIUM, 24HR URINE | $64.80 | $108.00 | $36.72–$78.84 | 29% above | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine - Sendout | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium, 24-Hour Urine (W/O Creatinine) - Quest | $24.00 | $40.00 | $13.60–$29.20 | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium RBC - Sendout | $34.80 | $58.00 | $19.72–$42.34 | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level - OB | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| Magnesium blood test inpatient CPT 83735 GHS MAGNESIUM | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $61.20 | $102.00 | $34.68–$74.46 | — | 40% |
| Magnesium blood test inpatient CPT 83735 GHS MAGNESIUM, 24HR URINE | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Abs IgG-Sendout | $43.20 | $72.00 | $24.48–$52.56 | 32% below | 40% |
| Measles (rubeola) antibody test CPT 86765 #MMR- RUBEOLA AB | $44.40 | $74.00 | $25.16–$54.02 | 30% below | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles IgG Antibody (Rubeoloa)-Quest | $45.00 | $75.00 | $25.50–$54.75 | 29% below | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles IgM Antibody - Quest | $54.60 | $91.00 | $30.94–$66.43 | 14% below | 40% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG AB | $91.80 | $153.00 | $52.02–$111.69 | 45% above | 40% |
| Measles (rubeola) antibody test CPT 86765 GHS RUBEOLA-IGG ANTIBODY | $93.00 | $155.00 | $52.70–$113.15 | 46% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Abs IgG-Sendout | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 #MMR- RUBEOLA AB | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles IgG Antibody (Rubeoloa)-Quest | $45.00 | $75.00 | $25.50–$54.75 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles IgM Antibody - Quest | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM AB | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG AB | $91.80 | $153.00 | $52.02–$111.69 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 GHS RUBEOLA-IGG ANTIBODY | $93.00 | $155.00 | $52.70–$113.15 | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Abs IgM-Sendout | $156.60 | $261.00 | $88.74–$190.53 | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 GHS MONONUCLEOSIS TEST | $28.20 | $47.00 | $15.98–$34.31 | 46% below | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis screen | $28.20 | $47.00 | $15.98–$34.31 | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 GHS MONONUCLEOSIS TEST | $28.20 | $47.00 | $15.98–$34.31 | — | 40% |
| Mumps immunity blood test CPT 86735 Mumps Abs IgG-Sendout | $43.80 | $73.00 | $24.82–$53.29 | 20% below | 40% |
| Mumps immunity blood test CPT 86735 Mumps Abs IgM-Sendout | $43.80 | $73.00 | $24.82–$53.29 | 20% below | 40% |
| Mumps immunity blood test CPT 86735 Mumps Virus Ab IgG CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | 20% below | 40% |
| Mumps immunity blood test CPT 86735 Mumps Virus Ab IgM CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | 20% below | 40% |
| Mumps immunity blood test CPT 86735 #MMR- MUMPS AB | $45.00 | $75.00 | $25.50–$54.75 | 18% below | 40% |
| Mumps immunity blood test CPT 86735 Mumps IgM - Quest | $65.40 | $109.00 | $37.06–$79.57 | 19% above | 40% |
| Mumps immunity blood test CPT 86735 Mumps Virus IgG Ab by EIA - Quest | $65.40 | $109.00 | $37.06–$79.57 | 19% above | 40% |
| Mumps immunity blood test CPT 86735 MUMPS, AB, IGG | $65.40 | $109.00 | $37.06–$79.57 | 19% above | 40% |
| Mumps immunity blood test CPT 86735 GHS MUMPS ANTIBODIES, IGM | $100.80 | $168.00 | $57.12–$122.64 | 84% above | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Abs IgM-Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Abs IgG-Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab IgM CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus Ab IgG CSF - Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 #MMR- MUMPS AB | $45.00 | $75.00 | $25.50–$54.75 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Virus IgG Ab by EIA - Quest | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Mumps IgM - Quest | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS, AB, IGG | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 GHS MUMPS ANTIBODIES, IGM | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Obstetric blood test panel CPT 80055 Obstetric Panel | $84.00 | $140.00 | $47.60–$102.20 | 27% below | 40% |
| Obstetric blood test panel CPT 80055 Bill only - Obstetric Panel | $84.00 | $140.00 | $47.60–$102.20 | 27% below | 40% |
| Obstetric blood test panel inpatient CPT 80055 Bill only - Obstetric Panel | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Obstetric blood test panel inpatient CPT 80055 Obstetric Panel | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 _%fPSA Reflex-Sendout | $61.80 | $103.00 | $35.02–$75.19 | 33% below | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 #PSA T+F-PSA FREE | $64.20 | $107.00 | $36.38–$78.11 | 30% below | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $64.80 | $108.00 | $36.72–$78.84 | 30% below | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 _%fPSA Reflex-Sendout | $61.80 | $103.00 | $35.02–$75.19 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 #PSA T+F-PSA FREE | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 #PSA T+F-PSA TOT. | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen w/o Reflex - Aledo | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Bill Only - PSA | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Total w/reflx to PSA Free (Diag or Non-Medicare) -Quest | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total w/o Reflex - Aledo | $64.20 | $107.00 | $36.38–$78.11 | 34% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen - DCH | $66.00 | $110.00 | $37.40–$80.30 | 32% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC ANTIGEN | $66.00 | $110.00 | $37.40–$80.30 | 32% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag - Sendout | $67.80 | $113.00 | $38.42–$82.49 | 30% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 GHS PSA (PROSTATE SPECIFIC ANTIGEN) | $82.20 | $137.00 | $46.58–$100.01 | 15% below | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen w/o Reflex - Aledo | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 #PSA T+F-PSA TOT. | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total w/o Reflex - Aledo | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Total w/reflx to PSA Free (Diag or Non-Medicare) -Quest | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Bill Only - PSA | $64.20 | $107.00 | $36.38–$78.11 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen - DCH | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC ANTIGEN | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag - Sendout | $67.80 | $113.00 | $38.42–$82.49 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 GHS PSA (PROSTATE SPECIFIC ANTIGEN) | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free)-Sendout | $125.40 | $209.00 | $71.06–$152.57 | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 GHS PARATHYROID HORMONE | $125.40 | $209.00 | $71.06–$152.57 | 30% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTHIntact | $129.00 | $215.00 | $73.10–$156.95 | 28% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact-Sendout | $138.00 | $230.00 | $78.20–$167.90 | 23% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intraoperative | $142.20 | $237.00 | $80.58–$173.01 | 20% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 #PTH+CA-PARTHYROID HORMONE | $142.20 | $237.00 | $80.58–$173.01 | 20% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone w/Ca - Quest | $151.20 | $252.00 | $85.68–$183.96 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone | $151.20 | $252.00 | $85.68–$183.96 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH - Intact Recall | $151.20 | $252.00 | $85.68–$183.96 | 15% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 GHS PTH-LOCAL | $232.80 | $388.00 | $131.92–$283.24 | 30% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone (PTH) Intact, Aspirate-Sendout | $125.40 | $209.00 | $71.06–$152.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 GHS PARATHYROID HORMONE | $125.40 | $209.00 | $71.06–$152.57 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTHIntact | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact-Sendout | $138.00 | $230.00 | $78.20–$167.90 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intraoperative | $142.20 | $237.00 | $80.58–$173.01 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 #PTH+CA-PARTHYROID HORMONE | $142.20 | $237.00 | $80.58–$173.01 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone w/Ca - Quest | $151.20 | $252.00 | $85.68–$183.96 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH - Intact Recall | $151.20 | $252.00 | $85.68–$183.96 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone | $151.20 | $252.00 | $85.68–$183.96 | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 GHS PTH-LOCAL | $232.80 | $388.00 | $131.92–$283.24 | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 GHS MIXING STUDY, PTT (INHIBITOR ASSAY) | $23.40 | $39.00 | $13.26–$28.47 | 52% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #APTT MIX-APTT | $33.00 | $55.00 | $18.70–$40.15 | 32% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $37.20 | $62.00 | $21.08–$45.26 | 23% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $39.60 | $66.00 | $22.44–$48.18 | 19% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 GHS PTT | $39.60 | $66.00 | $22.44–$48.18 | 19% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $39.60 | $66.00 | $22.44–$48.18 | 19% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOSIS- APTT | $47.40 | $79.00 | $26.86–$57.67 | 2% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROM VKA-APTT | $78.00 | $130.00 | $44.20–$94.90 | 60% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #VONWILL SCRN- APTT | $98.40 | $164.00 | $55.76–$119.72 | 102% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #APSPROF-PTT | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 GHS MIXING STUDY, PTT (INHIBITOR ASSAY) | $23.40 | $39.00 | $13.26–$28.47 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #APTT MIX-APTT | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $37.20 | $62.00 | $21.08–$45.26 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 GHS PTT | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #THROMBOSIS- APTT | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #THROM VKA-APTT | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #VONWILL SCRN- APTT | $98.40 | $164.00 | $55.76–$119.72 | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $37.80 | $63.00 | $21.42–$45.99 | 10% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS,INORGANIC | $37.80 | $63.00 | $21.42–$45.99 | 10% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 GHS PHOSPHORUS, INORGANIC | $37.80 | $63.00 | $21.42–$45.99 | 10% below | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 GHS PHOSPHORUS, INORGANIC | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS,INORGANIC | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Potassium blood test CPT 84132 GHS POTASSIUM (K) | $26.40 | $44.00 | $14.96–$32.12 | 36% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM, SERUM | $31.80 | $53.00 | $18.02–$38.69 | 23% below | 40% |
| Potassium blood test CPT 84132 POTASSIUM, CSF | $54.00 | $90.00 | $30.60–$65.70 | 31% above | 40% |
| Potassium blood test inpatient CPT 84132 GHS POTASSIUM (K) | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM, SERUM | $31.80 | $53.00 | $18.02–$38.69 | — | 40% |
| Potassium blood test inpatient CPT 84132 POTASSIUM, CSF | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 informaSeq Prenatal Test-Sendout | $729.60 | $1,216.00 | $413.44–$887.68 | 8% below | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 informaSeq(SM)with XY Analysis - Sendout | $751.80 | $1,253.00 | $426.02–$914.69 | 5% below | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 informaSeq Prenatal Test-Sendout | $729.60 | $1,216.00 | $413.44–$887.68 | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 informaSeq(SM)with XY Analysis - Sendout | $751.80 | $1,253.00 | $426.02–$914.69 | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MaterniT21 PLUS Core NO Gender-Sendout | $2,027.40 | $3,379.00 | $1,148.86–$2,466.67 | — | 40% |
| Progesterone blood test CPT 84144 Progesterone-Sendout | $70.20 | $117.00 | $39.78–$85.41 | 28% below | 40% |
| Progesterone blood test CPT 84144 Progesterone LCMS Endo Sci - Sendout | $70.20 | $117.00 | $39.78–$85.41 | 28% below | 40% |
| Progesterone blood test CPT 84144 Progesterone Level - Quest | $102.00 | $170.00 | $57.80–$124.10 | 4% above | 40% |
| Progesterone blood test CPT 84144 GHS PROGESTERONE, SERUM | $109.80 | $183.00 | $62.22–$133.59 | 12% above | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone-Sendout | $70.20 | $117.00 | $39.78–$85.41 | — | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone LCMS Endo Sci - Sendout | $70.20 | $117.00 | $39.78–$85.41 | — | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone Level - Quest | $102.00 | $170.00 | $57.80–$124.10 | — | 40% |
| Progesterone blood test inpatient CPT 84144 GHS PROGESTERONE, SERUM | $109.80 | $183.00 | $62.22–$133.59 | — | 40% |
| Prolactin blood test CPT 84146 #Prolactin | $64.80 | $108.00 | $36.72–$78.84 | 38% below | 40% |
| Prolactin blood test CPT 84146 #MACROPRO-PROLACTIN | $66.60 | $111.00 | $37.74–$81.03 | 36% below | 40% |
| Prolactin blood test CPT 84146 Prolactin Level - Quest | $115.20 | $192.00 | $65.28–$140.16 | 11% above | 40% |
| Prolactin blood test CPT 84146 GHS PROLACTIN, SERUM | $118.20 | $197.00 | $66.98–$143.81 | 13% above | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin, Serum (ICMA)-Sendout | $54.60 | $91.00 | $30.94–$66.43 | — | 40% |
| Prolactin blood test inpatient CPT 84146 #Prolactin | $64.80 | $108.00 | $36.72–$78.84 | — | 40% |
| Prolactin blood test inpatient CPT 84146 #MACROPRO-PROLACTIN | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Prolactin blood test inpatient CPT 84146 #MACROPRO-MONOMERIC PROLACTIN | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin Level - Quest | $115.20 | $192.00 | $65.28–$140.16 | — | 40% |
| Prolactin blood test inpatient CPT 84146 GHS PROLACTIN, SERUM | $118.20 | $197.00 | $66.98–$143.81 | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 GHS PROTHROMBIN TIME (INR) | $31.20 | $52.00 | $17.68–$37.96 | 5% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (INR) | $31.20 | $52.00 | $17.68–$37.96 | 5% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 #THROMBOSIS-PROTHROMBIN TIME | $47.40 | $79.00 | $26.86–$57.67 | 44% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 #APSPRO-PT | $11.40 | $19.00 | $6.46–$13.87 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (INR) | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR - POC | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 GHS PROTHROMBIN TIME (INR) | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 #THROMBOSIS-PROTHROMBIN TIME | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug of Abuse Screen Urine | $12.60 | $21.00 | $7.14–$15.33 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A SCREEN | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B SCREEN | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep Screen Throat Only | $34.20 | $57.00 | $19.38–$41.61 | — | 40% |
| Renin blood test CPT 84244 Renin Activity -Sendout | $73.80 | $123.00 | $41.82–$89.79 | 30% below | 40% |
| Renin blood test CPT 84244 Renin, Plasma Activity - Quest | $136.80 | $228.00 | $77.52–$166.44 | 29% above | 40% |
| Renin blood test CPT 84244 GHS RENIN ACTIVITY | $165.00 | $275.00 | $93.50–$200.75 | 56% above | 40% |
| Renin blood test inpatient CPT 84244 Renin Activity -Sendout | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Renin blood test inpatient CPT 84244 #ALDO/RENIN-RENIN | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Renin blood test inpatient CPT 84244 Renin, Plasma Activity - Quest | $136.80 | $228.00 | $77.52–$166.44 | — | 40% |
| Renin blood test inpatient CPT 84244 GHS RENIN ACTIVITY | $165.00 | $275.00 | $93.50–$200.75 | — | 40% |
| Rh blood typing CPT 86901 #ABO/RH-RHO (D) TYPING | $10.20 | $17.00 | $5.78–$12.41 | 77% below | 40% |
| Rh blood typing CPT 86901 BB-RH TYPING | $19.80 | $33.00 | $11.22–$24.09 | 56% below | 40% |
| Rh blood typing CPT 86901 RH (D) | $19.80 | $33.00 | $11.22–$24.09 | 56% below | 40% |
| Rh blood typing CPT 86901 Rh Blood Type Only | $21.00 | $35.00 | $11.90–$25.55 | 53% below | 40% |
| Rh blood typing inpatient CPT 86901 #ABO/RH-RHO (D) TYPING | $10.20 | $17.00 | $5.78–$12.41 | — | 40% |
| Rh blood typing inpatient CPT 86901 RH (D) | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rh blood typing inpatient CPT 86901 BB-RH TYPING | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rh blood typing inpatient CPT 86901 Rh Blood Type Only | $21.00 | $35.00 | $11.90–$25.55 | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 #RF IG/M/A-RF IGG | $19.80 | $33.00 | $11.22–$24.09 | 64% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor-Sendout | $19.80 | $33.00 | $11.22–$24.09 | 64% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) IgM-Sendout | $19.80 | $33.00 | $11.22–$24.09 | 64% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) IgG-Sendout | $19.80 | $33.00 | $11.22–$24.09 | 64% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) IgA-Sendout | $19.80 | $33.00 | $11.22–$24.09 | 64% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (IGA, IGG, IGM) | $46.80 | $78.00 | $26.52–$56.94 | 15% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR,QUANT (ANA PANL) | $49.20 | $82.00 | $27.88–$59.86 | 10% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor | $49.80 | $83.00 | $28.22–$60.59 | 9% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative - Quest | $49.80 | $83.00 | $28.22–$60.59 | 9% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, QUANTITATIVE | $59.40 | $99.00 | $33.66–$72.27 | 9% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor IgM by EIA(RDL)-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor IgA by EIA(RDL)-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor IgG by EIA(RDL)-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF IG/M/A-RF IGA | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) IgM-Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF IG/M/A-RF IGM | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF IG/M/A-RF IGG | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor-Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) IgA-Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) IgG-Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF ISO-IGA | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF ISO-IGM | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 #RF ISO-IGG | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR (IGA, IGG, IGM) | $46.80 | $78.00 | $26.52–$56.94 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR,QUANT (ANA PANL) | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantitative - Quest | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, QUANTITATIVE | $59.40 | $99.00 | $33.66–$72.27 | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 GHS RUBELLA TITER | $37.80 | $63.00 | $21.42–$45.99 | 41% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 GHS RUBELLA ANTIBODY (IGG) SCREEN | $37.80 | $63.00 | $21.42–$45.99 | 41% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Screen | $41.40 | $69.00 | $23.46–$50.37 | 35% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB | $42.00 | $70.00 | $23.80–$51.10 | 34% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Abs IgG-Sendout | $48.00 | $80.00 | $27.20–$58.40 | 25% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Abs IgM-Sendout | $48.00 | $80.00 | $27.20–$58.40 | 25% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB | $48.00 | $80.00 | $27.20–$58.40 | 25% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 #PRENAT INF-RUBELLA AB | $49.20 | $82.00 | $27.88–$59.86 | 23% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 #MMR-RUBELLA AB | $49.20 | $82.00 | $27.88–$59.86 | 23% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgG - Quest | $50.40 | $84.00 | $28.56–$61.32 | 21% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubeola, IgM, Antibody | $86.40 | $144.00 | $48.96–$105.12 | 35% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubeola, IgG Antibody | $94.80 | $158.00 | $53.72–$115.34 | 48% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgM - Quest | $198.60 | $331.00 | $112.54–$241.63 | 210% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 #PRENATAL INF DIS-RUBELLA | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 GHS RUBELLA ANTIBODY (IGG) SCREEN | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 GHS RUBELLA TITER | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG AB | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Abs IgM-Sendout | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Abs IgG-Sendout | $48.00 | $80.00 | $27.20–$58.40 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 #PRENAT INF-RUBELLA AB | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 #MMR-RUBELLA AB | $49.20 | $82.00 | $27.88–$59.86 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG - Quest | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubeola, IgM, Antibody | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubeola, IgG Antibody | $94.80 | $158.00 | $53.72–$115.34 | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgM - Quest | $198.60 | $331.00 | $112.54–$241.63 | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $18.60 | $31.00 | $10.54–$22.63 | 49% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis, complete | $77.40 | $129.00 | $43.86–$94.17 | at median | 40% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 GHS SEMEN ANALYSIS FERT. | $124.80 | $208.00 | $70.72–$151.84 | 61% above | 40% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen analysis, complete | $77.40 | $129.00 | $43.86–$94.17 | — | 40% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 GHS SEMEN ANALYSIS FERT. | $124.80 | $208.00 | $70.72–$151.84 | — | 40% |
| Sodium blood test CPT 84295 GHS SODIUM (NA) | $26.40 | $44.00 | $14.96–$32.12 | 33% below | 40% |
| Sodium blood test CPT 84295 SODIUM, BLOOD | $31.20 | $52.00 | $17.68–$37.96 | 21% below | 40% |
| Sodium blood test CPT 84295 Sodium Level | $33.00 | $55.00 | $18.70–$40.15 | 17% below | 40% |
| Sodium blood test CPT 84295 Sodium Level Body Fluid | $45.60 | $76.00 | $25.84–$55.48 | 15% above | 40% |
| Sodium blood test CPT 84295 Sodium Level Cerebrospinal Fluid | $46.80 | $78.00 | $26.52–$56.94 | 18% above | 40% |
| Sodium blood test inpatient CPT 84295 GHS SODIUM (NA) | $26.40 | $44.00 | $14.96–$32.12 | — | 40% |
| Sodium blood test inpatient CPT 84295 SODIUM, BLOOD | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Sodium blood test inpatient CPT 84295 Sodium Level Body Fluid | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Sodium blood test inpatient CPT 84295 Sodium Level Cerebrospinal Fluid | $46.80 | $78.00 | $26.52–$56.94 | — | 40% |
| Stool ova and parasites exam CPT 87177 #O+P-SMEARS | $30.00 | $50.00 | $17.00–$36.50 | 38% below | 40% |
| Stool ova and parasites exam CPT 87177 #GIAR+O/P-O/P | $30.60 | $51.00 | $17.34–$37.23 | 37% below | 40% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITE CONCENTRATE/SMEAR | $31.80 | $53.00 | $18.02–$38.69 | 34% below | 40% |
| Stool ova and parasites exam CPT 87177 GHS OVA & PARASITES | $65.40 | $109.00 | $37.06–$79.57 | 35% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova&Parasite Exam,Formalin Only-Sendout | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 #O+P-SMEARS | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 #GIAR+O/P-O/P | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE CONCENTRATE/SMEAR | $31.80 | $53.00 | $18.02–$38.69 | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 GHS OVA & PARASITES | $65.40 | $109.00 | $37.06–$79.57 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 GHS OCCULT BLOOD, FECE | $19.20 | $32.00 | $10.88–$23.36 | 42% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Workup - Screening | $30.60 | $51.00 | $17.34–$37.23 | 7% below | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 GHS OCCULT BLOOD, FECE | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Workup - Screening | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Globin By Immunochemistry -Quest | $57.60 | $96.00 | $32.64–$70.08 | 2% below | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Fecal IA-Sendout | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Immunochemical | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Globin By Immunochemistry -Quest | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 _FTAAbs-RPR Qn-Sendout | $43.80 | $73.00 | $24.82–$53.29 | 20% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Abs - Sendout | $44.40 | $74.00 | $25.16–$54.02 | 19% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab (FTA-Ab)-Sendout | $44.40 | $74.00 | $25.16–$54.02 | 19% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 #RPR QUAN-TREPONEMA PALLID | $45.60 | $76.00 | $25.84–$55.48 | 17% below | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum (Syphilis) Screening Cascade-Sendout | $41.40 | $69.00 | $23.46–$50.37 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 _FTAAbs-RPR Qn-Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Abs - Sendout | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab (FTA-Ab)-Sendout | $44.40 | $74.00 | $25.16–$54.02 | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 #RPR QUAN-TREPONEMA PALLID | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin(RPR),Qual-Sendout | $15.00 | $25.00 | $8.50–$18.25 | 69% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR-Sendout | $15.00 | $25.00 | $8.50–$18.25 | 69% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 #VDRLCSF | $15.00 | $25.00 | $8.50–$18.25 | 69% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR w/Rfx Treponemal Ab- Sendout | $15.00 | $25.00 | $8.50–$18.25 | 69% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Serum - Quest | $16.20 | $27.00 | $9.18–$19.71 | 67% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR w/Reflex Titer - Quest | $30.00 | $50.00 | $17.00–$36.50 | 38% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, cerebrospinal fluid | $33.00 | $55.00 | $18.70–$40.15 | 32% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Non-Treponemal Screening VDRL-Sendout | $53.40 | $89.00 | $30.26–$64.97 | 10% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 _RPR Ql - Sendout | $13.80 | $23.00 | $7.82–$16.79 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin(RPR),Qual-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR w/Rfx Treponemal Ab- Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR-Sendout | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 #VDRLCSF | $15.00 | $25.00 | $8.50–$18.25 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Serum - Quest | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR w/Reflex Titer - Quest | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, cerebrospinal fluid | $33.00 | $55.00 | $18.70–$40.15 | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Non-Treponemal Screening VDRL-Sendout | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold Plus-Sendout | $206.40 | $344.00 | $116.96–$251.12 | 34% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON Client Incubated-Sendout | $206.40 | $344.00 | $116.96–$251.12 | 34% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon - TB Gold - Quest | $213.60 | $356.00 | $121.04–$259.88 | 38% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon - TB Gold (unincubated)- Quest | $213.60 | $356.00 | $121.04–$259.88 | 38% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON TB Gold Plus-Sendout | $206.40 | $344.00 | $116.96–$251.12 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON(TB +) Client Incubated-Sendout | $206.40 | $344.00 | $116.96–$251.12 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON Client Incubated-Sendout | $206.40 | $344.00 | $116.96–$251.12 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon - TB Gold (unincubated)- Quest | $213.60 | $356.00 | $121.04–$259.88 | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon - TB Gold - Quest | $213.60 | $356.00 | $121.04–$259.88 | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 GHS TESTOSTERONE F&T FEMALE/CHILD | $58.80 | $98.00 | $33.32–$71.54 | 41% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone-Sendout | $86.40 | $144.00 | $48.96–$105.12 | 14% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 #TESTFR+WK+T LC/MS-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | 11% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 #TESTFR+T LC/MS-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | 11% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 #TESTFR+T-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | 11% below | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total (Female/Child) - Quest | $116.40 | $194.00 | $65.96–$141.62 | 16% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total - Quest | $116.40 | $194.00 | $65.96–$141.62 | 16% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $160.80 | $268.00 | $91.12–$195.64 | 60% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 GHS TESTOSTERONE TOTAL | $160.80 | $268.00 | $91.12–$195.64 | 60% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 GHS TESTOSTERONE | $160.80 | $268.00 | $91.12–$195.64 | 60% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 GHS TESTOSTERONE F&T FEMALE/CHILD | $58.80 | $98.00 | $33.32–$71.54 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone-Sendout | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 #TESTFR+WK+T LC/MS-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 #TESTFR+T LC/MS-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 #TESTFR+T-TOT. TESTOST. | $89.40 | $149.00 | $50.66–$108.77 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total - Quest | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total (Female/Child) - Quest | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 GHS TESTOSTERONE | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 GHS TESTOSTERONE TOTAL | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL | $160.80 | $268.00 | $91.12–$195.64 | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | 37% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | 37% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 #THYR-THYROID PEROXIDASE | $49.80 | $83.00 | $28.22–$60.59 | 35% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID MICROSOMAL | $82.20 | $137.00 | $46.58–$100.01 | 7% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsomal Antibody | $83.40 | $139.00 | $47.26–$101.47 | 8% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 zl-Thyroid Peroxidase Antibodies-Quest | $86.40 | $144.00 | $48.96–$105.12 | 12% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-Thyroid Peroxidase Ab - Sendout | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 _Thyroid Peroxidase(TPO) Abs - Sendout | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab-Sendout | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 #THYR-THYROID PEROXIDASE | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-TPO Ab (RDL) - Sendout | $66.00 | $110.00 | $37.40–$80.30 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID MICROSOMAL | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Kidney Microsomal Antibody | $83.40 | $139.00 | $47.26–$101.47 | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 zl-Thyroid Peroxidase Antibodies-Quest | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH-Sendout | $56.40 | $94.00 | $31.96–$68.62 | 43% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Rfx on Abnormal to Free T4 - Sendout | $56.40 | $94.00 | $31.96–$68.62 | 43% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Thyroid Function Reflexes | $62.40 | $104.00 | $35.36–$75.92 | 37% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/Reflex Free T4 | $62.40 | $104.00 | $35.36–$75.92 | 37% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $63.00 | $105.00 | $35.70–$76.65 | 37% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone, sensitive | $66.60 | $111.00 | $37.74–$81.03 | 33% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Sensitive STH | $66.60 | $111.00 | $37.74–$81.03 | 33% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 GHS THYROID STIM HORMONE | $82.20 | $137.00 | $46.58–$100.01 | 17% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE | $82.20 | $137.00 | $46.58–$100.01 | 17% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 GHS TSH W/FT4 REFLEX | $82.20 | $137.00 | $46.58–$100.01 | 17% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile - Sendout | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH-Sendout | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Rfx on Abnormal to Free T4 - Sendout | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Reflex Free T4 | $62.40 | $104.00 | $35.36–$75.92 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/Thyroid Function Reflexes | $62.40 | $104.00 | $35.36–$75.92 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $63.00 | $105.00 | $35.70–$76.65 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid stimulating hormone, sensitive | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Sensitive STH | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 GHS TSH W/FT4 REFLEX | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 GHS THYROID STIM HORMONE | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Total IgE blood test CPT 82785 Immunoglobulin E Total-Sendout | $55.80 | $93.00 | $31.62–$67.89 | 33% below | 40% |
| Total IgE blood test CPT 82785 #IGEALLER-IGE | $57.00 | $95.00 | $32.30–$69.35 | 32% below | 40% |
| Total IgE blood test CPT 82785 #IMMGAM-IGE | $57.00 | $95.00 | $32.30–$69.35 | 32% below | 40% |
| Total IgE blood test CPT 82785 #ALL+IGE-IGE ASSAY | $57.00 | $95.00 | $32.30–$69.35 | 32% below | 40% |
| Total IgE blood test CPT 82785 Respiratory Allergy Profile Interpretation - Quest | $57.60 | $96.00 | $32.64–$70.08 | 31% below | 40% |
| Total IgE blood test CPT 82785 Food Allergy Profile - Quest | $81.60 | $136.00 | $46.24–$99.28 | 2% below | 40% |
| Total IgE blood test CPT 82785 Immunoglobulin E - Quest | $83.40 | $139.00 | $47.26–$101.47 | at median | 40% |
| Total IgE blood test CPT 82785 IGE IMMUNOGLOBULIN E | $124.20 | $207.00 | $70.38–$151.11 | 49% above | 40% |
| Total IgE blood test CPT 82785 GHS IGE, IMMUNOGLOBULIN E | $124.20 | $207.00 | $70.38–$151.11 | 49% above | 40% |
| Total IgE blood test inpatient CPT 82785 #ALLERGEN-IGE-Assay | $39.60 | $66.00 | $22.44–$48.18 | — | 40% |
| Total IgE blood test inpatient CPT 82785 #ALPGALIGEPNL-IMUNOGLOBULIN E | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E Total-Sendout | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Total IgE blood test inpatient CPT 82785 #IGEALLER-IGE | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Total IgE blood test inpatient CPT 82785 #IMMGAM-IGE | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Total IgE blood test inpatient CPT 82785 #ALL+IGE-IGE ASSAY | $57.00 | $95.00 | $32.30–$69.35 | — | 40% |
| Total IgE blood test inpatient CPT 82785 Respiratory Allergy Profile Interpretation - Quest | $57.60 | $96.00 | $32.64–$70.08 | — | 40% |
| Total IgE blood test inpatient CPT 82785 Food Allergy Profile - Quest | $81.60 | $136.00 | $46.24–$99.28 | — | 40% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E - Quest | $83.40 | $139.00 | $47.26–$101.47 | — | 40% |
| Total IgE blood test inpatient CPT 82785 IGE IMMUNOGLOBULIN E | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Total IgE blood test inpatient CPT 82785 GHS IGE, IMMUNOGLOBULIN E | $124.20 | $207.00 | $70.38–$151.11 | — | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL, TOTAL | $19.20 | $32.00 | $10.88–$23.36 | 54% below | 40% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $20.40 | $34.00 | $11.56–$24.82 | 51% below | 40% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $29.40 | $49.00 | $16.66–$35.77 | 29% below | 40% |
| Total cholesterol blood test CPT 82465 GHS CHOLESTEROL | $29.40 | $49.00 | $16.66–$35.77 | 29% below | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL, TOTAL | $19.20 | $32.00 | $10.88–$23.36 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $20.40 | $34.00 | $11.56–$24.82 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 #FIBRO-CHOLESTEROL | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 GHS CHOLESTEROL | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL | $29.40 | $49.00 | $16.66–$35.77 | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4)-Sendout | $22.80 | $38.00 | $12.92–$27.74 | 58% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine | $45.00 | $75.00 | $25.50–$54.75 | 16% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 T4 (Throxine) Total - Quest | $45.00 | $75.00 | $25.50–$54.75 | 16% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 GHS T4 | $46.80 | $78.00 | $26.52–$56.94 | 13% below | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4)-Sendout | $22.80 | $38.00 | $12.92–$27.74 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine | $45.00 | $75.00 | $25.50–$54.75 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 (Throxine) Total - Quest | $45.00 | $75.00 | $25.50–$54.75 | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 GHS T4 | $46.80 | $78.00 | $26.52–$56.94 | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3)-Sendout | $37.20 | $62.00 | $21.08–$45.26 | 52% below | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 Total - Quest | $68.40 | $114.00 | $38.76–$83.22 | 12% below | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3)-Sendout | $37.20 | $62.00 | $21.08–$45.26 | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total - Quest | $68.40 | $114.00 | $38.76–$83.22 | — | 40% |
| Transferrin blood test CPT 84466 Transferrin - Sendout | $45.60 | $76.00 | $25.84–$55.48 | 40% below | 40% |
| Transferrin blood test CPT 84466 Transferrin | $60.60 | $101.00 | $34.34–$73.73 | 21% below | 40% |
| Transferrin blood test CPT 84466 GHS TRANSFERRIN, LOCAL | $81.60 | $136.00 | $46.24–$99.28 | 7% above | 40% |
| Transferrin blood test inpatient CPT 84466 Transferrin - Sendout | $45.60 | $76.00 | $25.84–$55.48 | — | 40% |
| Transferrin blood test inpatient CPT 84466 Transferrin | $60.60 | $101.00 | $34.34–$73.73 | — | 40% |
| Transferrin blood test inpatient CPT 84466 GHS TRANSFERRIN, LOCAL | $81.60 | $136.00 | $46.24–$99.28 | — | 40% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis NAA -Sendout | $127.80 | $213.00 | $72.42–$155.49 | 12% above | 40% |
| Trichomonas test (NAAT) CPT 87661 #VG+-TRICHOMONAS VAGINALIS | $127.80 | $213.00 | $72.42–$155.49 | 12% above | 40% |
| Trichomonas test (NAAT) CPT 87661 #VG,NUWSWAB-TRICHOMONAS VAGINALIS | $129.00 | $215.00 | $73.10–$156.95 | 13% above | 40% |
| Trichomonas test (NAAT) CPT 87661 #NUSWAB STD(4)-TRICHOMONONAS VAGINALIS,NAA | $129.00 | $215.00 | $73.10–$156.95 | 13% above | 40% |
| Trichomonas test (NAAT) CPT 87661 #NUSWAB STD(3)-TRICHOMONAS VAGINALIS,NAA | $129.00 | $215.00 | $73.10–$156.95 | 13% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #NUSWAB VG+CAND 6SP-TRICH VAG | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #NUSWAB VG CAND6-TRICH VAG | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #VG HSV-TRICH VAG NAA | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #VG+ HSV-TRICH VAG NAA | $109.20 | $182.00 | $61.88–$132.86 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis NAA -Sendout | $127.80 | $213.00 | $72.42–$155.49 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #VG+-TRICHOMONAS VAGINALIS | $127.80 | $213.00 | $72.42–$155.49 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #VG,NUWSWAB-TRICHOMONAS VAGINALIS | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #NUSWAB STD(3)-TRICHOMONAS VAGINALIS,NAA | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 #NUSWAB STD(4)-TRICHOMONONAS VAGINALIS,NAA | $129.00 | $215.00 | $73.10–$156.95 | — | 40% |
| Triglycerides blood test CPT 84478 Triglycerides - Sendout | $19.80 | $33.00 | $11.22–$24.09 | 54% below | 40% |
| Triglycerides blood test CPT 84478 Triglycerides Fluid-Sendout | $19.80 | $33.00 | $11.22–$24.09 | 54% below | 40% |
| Triglycerides blood test CPT 84478 #VAP CHOL-TRIGLYCERIDES | $22.20 | $37.00 | $12.58–$27.01 | 48% below | 40% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES, BLOOD | $42.60 | $71.00 | $24.14–$51.83 | at median | 40% |
| Triglycerides blood test CPT 84478 Triglyceride | $42.60 | $71.00 | $24.14–$51.83 | at median | 40% |
| Triglycerides blood test CPT 84478 Triglycerides | $42.60 | $71.00 | $24.14–$51.83 | at median | 40% |
| Triglycerides blood test CPT 84478 GHS TRIGLYCERIDES, BLOOD | $42.60 | $71.00 | $24.14–$51.83 | at median | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Fluid-Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides - Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 #VAP CHOL-TRIGLYCERIDES | $22.20 | $37.00 | $12.58–$27.01 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 #FIBRO-TRIGLYCERIDES | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Trig BF w/reflex to Chylomicron-Sendout | $42.00 | $70.00 | $23.80–$51.10 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES, BLOOD | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 Triglyceride | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| Triglycerides blood test inpatient CPT 84478 GHS TRIGLYCERIDES, BLOOD | $42.60 | $71.00 | $24.14–$51.83 | — | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN-I | $78.00 | $130.00 | $44.20–$94.90 | 36% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin High Sensitivity | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin-I | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 I-Stat Troponin | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin-I, ER Only | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin T | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin T w/Courtesy Call | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 Troponin T (High Sensitivity) | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 TROPONIN-T | $82.20 | $137.00 | $46.58–$100.01 | 32% below | 40% |
| Troponin test, quantitative CPT 84484 GHS TROPONIN-I | $112.80 | $188.00 | $63.92–$137.24 | 7% below | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN-I | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN-T | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T (High Sensitivity) | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 I-Stat Troponin | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I, ER Only | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T w/Courtesy Call | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Troponin High Sensitivity | $82.20 | $137.00 | $46.58–$100.01 | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 GHS TROPONIN-I | $112.80 | $188.00 | $63.92–$137.24 | — | 40% |
| Uric acid blood test CPT 84550 Uric Acid - Sendout | $16.20 | $27.00 | $9.18–$19.71 | 62% below | 40% |
| Uric acid blood test CPT 84550 GHS URIC ACID | $30.00 | $50.00 | $17.00–$36.50 | 30% below | 40% |
| Uric acid blood test CPT 84550 Uric Acid | $31.20 | $52.00 | $17.68–$37.96 | 27% below | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid - Sendout | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Uric acid blood test inpatient CPT 84550 GHS URIC ACID | $30.00 | $50.00 | $17.00–$36.50 | — | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $31.20 | $52.00 | $17.68–$37.96 | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 UA w/microscopic, bill-only | $21.00 | $35.00 | $11.90–$25.55 | 52% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 GHS URINALYSIS, WITH MICROSCOPIC | $27.00 | $45.00 | $15.30–$32.85 | 39% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 UA Routine w/ Micro & Culture if Indicated (IRIS) | $27.60 | $46.00 | $15.64–$33.58 | 38% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Microscopic | $27.60 | $46.00 | $15.64–$33.58 | 38% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urine Reflex Micro | $27.60 | $46.00 | $15.64–$33.58 | 38% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Auto w/Micro/Comp POC | $20.40 | $34.00 | $928.00–$2,679.00 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w/microscopic, bill-only | $21.00 | $35.00 | $11.90–$25.55 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 GHS URINALYSIS, WITH MICROSCOPIC | $27.00 | $45.00 | $15.30–$32.85 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urine Reflex Micro | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Routine w/ Micro & Culture if Indicated (IRIS) | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Microscopic | $27.60 | $46.00 | $15.64–$33.58 | — | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA w/Micro/Comp POC | $8.40 | $14.00 | $928.00–$2,679.00 | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA Routine w/ Reflex - Aledo | $17.40 | $29.00 | $9.86–$21.17 | 42% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine | $17.40 | $29.00 | $9.86–$21.17 | 42% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 U Macro Only | $17.40 | $29.00 | $9.86–$21.17 | 42% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA Routine - Aledo | $17.40 | $29.00 | $9.86–$21.17 | 42% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 GHS ROUTINE URINALYSIS | $21.00 | $35.00 | $11.90–$25.55 | 30% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 GHS URINE, DIP STICK ONLY | $21.00 | $35.00 | $11.90–$25.55 | 30% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 U Macro Only | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Single Component Ketones | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Routine - Aledo | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Single Component Protein | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Macroscopic (dipstick-no reflex) | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Single Component pH | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Macroscopic with Reflex | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Routine w/ Reflex - Aledo | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Single Component Glucose | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA macroscopic, bill-only | $17.40 | $29.00 | $9.86–$21.17 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GHS URINE, DIP STICK ONLY | $21.00 | $35.00 | $11.90–$25.55 | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GHS ROUTINE URINALYSIS | $21.00 | $35.00 | $11.90–$25.55 | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 DCH VALIDITY TESTS | $5.40 | $9.00 | $3.06–$6.57 | 77% below | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DCH VALIDITY TESTS | $5.40 | $9.00 | $3.06–$6.57 | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dip without Micro POC | $9.60 | $16.00 | $928.00–$2,679.00 | — | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Macroscopic w/Reflex to C&S | $12.00 | $20.00 | $6.80–$14.60 | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture/Colony Count | $43.80 | $73.00 | $24.82–$53.29 | 25% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $43.80 | $73.00 | $24.82–$53.29 | 25% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 GHS CULTURE, URINE | $47.40 | $79.00 | $26.86–$57.67 | 19% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture/Colony Count | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Routine-Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Comprehensive-Sendout | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $43.80 | $73.00 | $24.82–$53.29 | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 GHS CULTURE, URINE | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 #MICALB-MICROALBUMIN,UR. | $18.60 | $31.00 | $10.54–$22.63 | 66% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Random, Ur - Quest | $105.60 | $176.00 | $59.84–$128.48 | 93% above | 40% |
| Urine microalbumin (albumin) test CPT 82043 GHS URINE, MICROALBUMINURIA 24 HR-MAYO | $121.80 | $203.00 | $69.02–$148.19 | 122% above | 40% |
| Urine microalbumin (albumin) test CPT 82043 GHS MICRO ALBUMIN, RANDOM, QUANT-LOCAL | $130.80 | $218.00 | $74.12–$159.14 | 139% above | 40% |
| Urine microalbumin (albumin) test CPT 82043 GHS URINE, MICROALBUMINURIA 10HR-LOCAL | $184.20 | $307.00 | $104.38–$224.11 | 236% above | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 #MICALB-MICROALBUMIN,UR. | $18.60 | $31.00 | $10.54–$22.63 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Random Urine - Sendout | $19.80 | $33.00 | $11.22–$24.09 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin/Creatinine Ratio | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Timed | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Random, Ur - Quest | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 24Hr | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 GHS URINE, MICROALBUMINURIA 24 HR-MAYO | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 GHS MICRO ALBUMIN, RANDOM, QUANT-LOCAL | $130.80 | $218.00 | $74.12–$159.14 | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 GHS URINE, MICROALBUMINURIA 10HR-LOCAL | $184.20 | $307.00 | $104.38–$224.11 | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 GHS HCG,URINE (AFTER SERUM HCG POSITIVE) | $36.60 | $61.00 | $20.74–$44.53 | 13% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy, Urine | $52.20 | $87.00 | $29.58–$63.51 | 24% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG Urine POC | $18.00 | $30.00 | $928.00–$2,679.00 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 GHS HCG,URINE (AFTER SERUM HCG POSITIVE) | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy, Urine | $52.20 | $87.00 | $29.58–$63.51 | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 GHS VIT B12-ANEMIA | $37.80 | $63.00 | $21.42–$45.99 | 56% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 | $39.00 | $65.00 | $22.10–$47.45 | 55% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $52.80 | $88.00 | $29.92–$64.24 | 39% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 #VitB12 | $55.80 | $93.00 | $31.62–$67.89 | 36% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level - Quest | $55.80 | $93.00 | $31.62–$67.89 | 36% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 #VITB12FOL-B12 | $55.80 | $93.00 | $31.62–$67.89 | 36% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 GHS VITAMIN B12 LEVEL RIA | $73.80 | $123.00 | $41.82–$89.79 | 15% below | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 GHS VIT B12-ANEMIA | $37.80 | $63.00 | $21.42–$45.99 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level - Quest | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 #VITB12FOL-B12 | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 #VitB12 | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 GHS VITAMIN B12 LEVEL RIA | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy | $73.80 | $123.00 | $41.82–$89.79 | 49% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-OH Vitamin D D2+D3-Sendout | $99.00 | $165.00 | $56.10–$120.45 | 32% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25 OH - Aledo | $104.40 | $174.00 | $59.16–$127.02 | 29% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy - Quest | $104.40 | $174.00 | $59.16–$127.02 | 29% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 | $104.40 | $174.00 | $59.16–$127.02 | 29% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy - Sendout | $105.60 | $176.00 | $59.84–$128.48 | 28% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-OH Vitamin D D2+D3-Sendout | $99.00 | $165.00 | $56.10–$120.45 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25 OH - Aledo | $104.40 | $174.00 | $59.16–$127.02 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 | $104.40 | $174.00 | $59.16–$127.02 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy - Quest | $104.40 | $174.00 | $59.16–$127.02 | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy - Sendout | $105.60 | $176.00 | $59.84–$128.48 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol(125 di-OH Vit D)-Sendout | $136.20 | $227.00 | $77.18–$165.71 | 21% below | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1,25 | $288.00 | $480.00 | $163.20–$350.40 | 67% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(125 di-OH Vit D)-Sendout | $136.20 | $227.00 | $77.18–$165.71 | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1,25 | $288.00 | $480.00 | $163.20–$350.40 | — | 40% |
| Zinc blood test CPT 84630 Zinc -Sendout | $39.00 | $65.00 | $22.10–$47.45 | 26% below | 40% |
| Zinc blood test CPT 84630 Zinc RBC - Sendout | $51.60 | $86.00 | $29.24–$62.78 | 2% below | 40% |
| Zinc blood test CPT 84630 Zinc, Whole Blood - Sendout | $63.00 | $105.00 | $35.70–$76.65 | 19% above | 40% |
| Zinc blood test CPT 84630 GHS ZINC | $85.80 | $143.00 | $48.62–$104.39 | 63% above | 40% |
| Zinc blood test inpatient CPT 84630 Zinc -Sendout | $39.00 | $65.00 | $22.10–$47.45 | — | 40% |
| Zinc blood test inpatient CPT 84630 Zinc RBC - Sendout | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Zinc blood test inpatient CPT 84630 Zinc, Whole Blood - Sendout | $63.00 | $105.00 | $35.70–$76.65 | — | 40% |
| Zinc blood test inpatient CPT 84630 GHS ZINC | $85.80 | $143.00 | $48.62–$104.39 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GHS GONADOTROPIN-AFP | $48.60 | $81.00 | $27.54–$59.13 | 46% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCGBeta Subunit Qnt -Sendout | $50.40 | $84.00 | $28.56–$61.32 | 44% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 #AFP-HCG | $52.20 | $87.00 | $29.58–$63.51 | 42% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Total, Qn - Quest | $85.20 | $142.00 | $48.28–$103.66 | 6% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GHS HCG FOR PREGNANCY, S/P | $86.40 | $144.00 | $48.96–$105.12 | 5% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TOTAL HCG-AFP-4 MARKER | $90.00 | $150.00 | $51.00–$109.50 | 1% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GHS TOTAL HCG-AFP-4 MARKER SC | $90.00 | $150.00 | $51.00–$109.50 | 1% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG - QUANT | $90.60 | $151.00 | $51.34–$110.23 | at median | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Preg Test Quantitative, bill only | $95.40 | $159.00 | $54.06–$116.07 | 5% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta HCG Quantitative | $95.40 | $159.00 | $54.06–$116.07 | 5% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GHS GONADOTROPIN-AFP | $48.60 | $81.00 | $27.54–$59.13 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCGBeta Subunit Qnt -Sendout | $50.40 | $84.00 | $28.56–$61.32 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 #AFP-HCG | $52.20 | $87.00 | $29.58–$63.51 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Total, Qn - Quest | $85.20 | $142.00 | $48.28–$103.66 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GHS HCG FOR PREGNANCY, S/P | $86.40 | $144.00 | $48.96–$105.12 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GHS TOTAL HCG-AFP-4 MARKER SC | $90.00 | $150.00 | $51.00–$109.50 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TOTAL HCG-AFP-4 MARKER | $90.00 | $150.00 | $51.00–$109.50 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG - QUANT | $90.60 | $151.00 | $51.34–$110.23 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta HCG Quantitative | $95.40 | $159.00 | $54.06–$116.07 | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Preg Test Quantitative, bill only | $95.40 | $159.00 | $54.06–$116.07 | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 Adenoidectomy/primary/<12 yrs 42830 | $412.80 | $688.00 | $928.00–$2,679.00 | — | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 Arthrodesis/discect/decompres/cerv/below C2 22551 | $3,213.60 | $5,356.00 | $928.00–$2,679.00 | — | 40% |
| Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 Appendectomy/open/rup/w/absc/peri 44960 | $1,644.60 | $2,741.00 | $928.00–$2,679.00 | — | 40% |
| Appendectomy, open surgery inpatient CPT 44950 Appendectomy 44950 | $1,209.60 | $2,016.00 | $928.00–$2,679.00 | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 Sinus endo w/dilat maxillary 31295 | $4,049.40 | $6,749.00 | $928.00–$2,679.00 | — | 40% |
| Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv Musc Migraine 64615 | $265.20 | $442.00 | $928.00–$2,679.00 | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Treatment Of Ankle Fracture 27786 | $594.00 | $990.00 | $928.00–$2,679.00 | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Clsd tx/metatarsal fx w/o manip 28470 | $401.40 | $669.00 | $928.00–$2,679.00 | — | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 Correc Bunion W/Metatrsl Osteoto 28296 | $1,375.20 | $2,292.00 | $928.00–$2,679.00 | — | 40% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 Correct bunion/Keller/McBride/Mayo 28292 | $1,511.40 | $2,519.00 | $928.00–$2,679.00 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 GHS CARDIOVERSION | $724.20 | $1,207.00 | $410.38–$881.11 | 17% below | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion/elective/external 92960 | $426.60 | $711.00 | $928.00–$2,679.00 | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 GHS CARDIOVERSION | $724.20 | $1,207.00 | $410.38–$881.11 | — | 40% |
| Carpal tunnel release, open surgery inpatient both sides CPT 64721 Bilateral Carpal Tunnel Surgery 64721 | $808.80 | $1,348.00 | $928.00–$2,679.00 | — | 40% |
| Cervical biopsy inpatient CPT 57500 Biopsy CervixSingle/Multiple 57500 | $248.40 | $414.00 | $928.00–$2,679.00 | — | 40% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Total Ob Care;Cesarean Delivery 59510 | $4,721.40 | $7,869.00 | $928.00–$2,679.00 | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circumcise/surg/> 28 days of age 54161 | $388.80 | $648.00 | $928.00–$2,679.00 | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CircumcisionClamp/Oth Device 54150 | $406.80 | $678.00 | $928.00–$2,679.00 | — | 40% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcise/surg/28 days or < 54160 | $435.60 | $726.00 | $928.00–$2,679.00 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 GHS CLSD TX DISTAL RADIAL FX W/O MANIP | $426.60 | $711.00 | $241.74–$519.03 | 3% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 GHS CLSD TX DISTAL RADIAL FX W/O MANIP | $426.60 | $711.00 | $241.74–$519.03 | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Clsd Tx fx radius/ulna dist w/o manip 25600 | $597.60 | $996.00 | $928.00–$2,679.00 | — | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colonoscopy w/ endoscopic US 45391 | $554.40 | $924.00 | $928.00–$2,679.00 | — | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w/lesion removal snare 45385 | $377.40 | $629.00 | $928.00–$2,679.00 | — | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy and biopsy 45380 | $337.80 | $563.00 | $928.00–$2,679.00 | — | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic colonoscopy 45378 | $516.00 | $860.00 | $928.00–$2,679.00 | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Bx Of Cervix W/Scope Leep 57460 | $554.40 | $924.00 | $928.00–$2,679.00 | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Bx/Curett Of Cervix W/Scope 57454 | $594.00 | $990.00 | $928.00–$2,679.00 | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy 52000 | $398.40 | $664.00 | $928.00–$2,679.00 | — | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D&C/diagnostic/therapeutic/non OB 58120 | $639.60 | $1,066.00 | $928.00–$2,679.00 | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destroy Premlg Lesns;1st Lesn 17000 | $154.80 | $258.00 | $928.00–$2,679.00 | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 Tympanostomy/vent tube/gen anest 69436 | $318.00 | $530.00 | $928.00–$2,679.00 | — | 40% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy/ven tube/loc/top anes 69433 | $779.40 | $1,299.00 | $928.00–$2,679.00 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 GHS REMOVE IMPACTED CERUMEN IRRIG/LAVAGE | $116.40 | $194.00 | $65.96–$141.62 | 68% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation 69209 | $24.00 | $40.00 | $928.00–$2,679.00 | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 GHS REMOVE IMPACTED CERUMEN IRRIG/LAVAGE | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 GHS CERUMEN REMOVAL | $92.40 | $154.00 | $52.36–$112.42 | 9% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 GHS CERUMEN REMOVAL | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Ear Wax 69210 | $99.00 | $165.00 | $928.00–$2,679.00 | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 EMB w/o cervical dilation 58100 | $213.00 | $355.00 | $928.00–$2,679.00 | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 nasal/sinus endo w/ethmoidectomy tot 31255 | $1,179.60 | $1,966.00 | $928.00–$2,679.00 | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 nasal/sinus endo w/front sinus expl 31276 | $1,129.20 | $1,882.00 | $928.00–$2,679.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 nasal/sinus endo w/maxil antrostomy 31256 | $517.80 | $863.00 | $928.00–$2,679.00 | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 nasal/sinus Endo maxil w/tiss exc 31267 | $796.80 | $1,328.00 | $928.00–$2,679.00 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS CERVICAL EPIDURAL STEROID AND ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS THORACIC EPIDURAL STEROID AND ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS INJ CERVICAL EPIDURAL ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS INJ EPIDURAL STEROID THORACIC | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS INJ EPIDURAL STEROID CERVICAL | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 GHS INJ THORACIC EPIDURAL ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | 54% below | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Inj diag/therap substance w/imag 62321 | $205.80 | $343.00 | $928.00–$2,679.00 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS INJ THORACIC EPIDURAL ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS CERVICAL EPIDURAL STEROID AND ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS THORACIC EPIDURAL STEROID AND ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS INJ EPIDURAL STEROID CERVICAL | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS INJ EPIDURAL STEROID THORACIC | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 GHS INJ CERVICAL EPIDURAL ANESTH | $610.80 | $1,018.00 | $346.12–$743.14 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 GHS PARAVERT FACET/NERVE LUMB SINGLE UNI | $1,088.40 | $1,814.00 | $616.76–$1,324.22 | 20% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Paravert F Jnt L/S 1 Lev 64493 | $235.20 | $392.00 | $928.00–$2,679.00 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 GHS PARAVERT FACET/NERVE LUMB SINGLE UNI | $1,088.40 | $1,814.00 | $616.76–$1,324.22 | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 GHS PARAVERT FACET/NERVE LUMB SINGLE BIL | $1,632.60 | $2,721.00 | $925.14–$1,986.33 | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 Rpr aa hrn 1st 3-10 rdc 49593 | $797.40 | $1,329.00 | $928.00–$2,679.00 | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 Rpr aa hrn 1st > 10 rdc 49595 | $1,072.80 | $1,788.00 | $928.00–$2,679.00 | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 Rpr aa hrn 1st < 3 cm rdc 49591 | $476.40 | $794.00 | $928.00–$2,679.00 | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Diagnostic sigmoidoscopy 45330 | $103.20 | $172.00 | $928.00–$2,679.00 | — | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Laparascopic Cholecystectomy 47562 | $1,407.60 | $2,346.00 | $928.00–$2,679.00 | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 Lapchol w/cholangiography 47563 | $1,349.40 | $2,249.00 | $928.00–$2,679.00 | — | 40% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 Removal Of Gallbladder 47600 | $2,032.80 | $3,388.00 | $928.00–$2,679.00 | — | 40% |
| Hammertoe correction surgery inpatient CPT 28285 Repair Of Hammertoe 28285 | $1,003.20 | $1,672.00 | $928.00–$2,679.00 | — | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Hemorrhoidectomy Ligation int 46221 | $501.60 | $836.00 | $928.00–$2,679.00 | — | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 Hemorrhoidectomy int/ext 1 group 46255 | $943.20 | $1,572.00 | $928.00–$2,679.00 | — | 40% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 Tot abd hysterect w/w/o tubes/ovar 58150 | $1,941.00 | $3,235.00 | $928.00–$2,679.00 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Inj Hysterosonography | $244.80 | $408.00 | $138.72–$297.84 | 22% below | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PROC HYSTEROGRAPHY | $244.80 | $408.00 | $138.72–$297.84 | 22% below | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Inj Hysterosonography | $244.80 | $408.00 | $138.72–$297.84 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PROC HYSTEROGRAPHY | $244.80 | $408.00 | $138.72–$297.84 | — | 40% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Cath/saline/contrast/SIS/hysteosal 58340 | $667.20 | $1,112.00 | $928.00–$2,679.00 | — | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HysteroscopyAblation 58563 | $3,272.40 | $5,454.00 | $928.00–$2,679.00 | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HysteroscopyBiopsy 58558 | $730.80 | $1,218.00 | $928.00–$2,679.00 | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 Insert Intrauterine Device 58300 | $129.60 | $216.00 | $928.00–$2,679.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 GHS ABSCESS SUBCUTANEOUS IANDD SIMPLE | $242.40 | $404.00 | $137.36–$294.92 | 4% below | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin AbscessSimple/Sngl 10060 | $217.20 | $362.00 | $928.00–$2,679.00 | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 GHS ABSCESS SUBCUTANEOUS IANDD SIMPLE | $242.40 | $404.00 | $137.36–$294.92 | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Repair ing/hern init reduc >5 yr 49505 | $977.40 | $1,629.00 | $928.00–$2,679.00 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 GHS INJ TENDON SHEATH LIGAMENT | $348.00 | $580.00 | $197.20–$423.40 | 10% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inject sg tend sheath/lig/aponeuro 20550 | $111.00 | $185.00 | $928.00–$2,679.00 | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 GHS INJ TENDON SHEATH LIGAMENT | $348.00 | $580.00 | $197.20–$423.40 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 GHS INJ/ASP MAJ JOINT SHOULDER HIP KNE | $354.00 | $590.00 | $200.60–$430.70 | at median | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 GHS INJ MAJOR JOINT OR BURSA | $354.00 | $590.00 | $200.60–$430.70 | at median | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentes/maj jnt/bursa/w/o US 20610 | $133.80 | $223.00 | $928.00–$2,679.00 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 GHS INJ/ASP MAJ JOINT SHOULDER HIP KNE | $354.00 | $590.00 | $200.60–$430.70 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 GHS INJ MAJOR JOINT OR BURSA | $354.00 | $590.00 | $200.60–$430.70 | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 GHS INJ MAJOR JOINT OR BURSA BIL | $531.00 | $885.00 | $300.90–$646.05 | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert Drug Implant Device 11981 | $257.40 | $429.00 | $928.00–$2,679.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 GHS INJ INTERM JOINT BURSA GANG | $348.00 | $580.00 | $197.20–$423.40 | 1% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 GHS INJ/ASP MED JOINT WRIST ELB ANKLE | $348.00 | $580.00 | $197.20–$423.40 | 1% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Fluoro Asp/Inj of Joint/Bursa | $348.00 | $580.00 | $197.20–$423.40 | 1% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentes/intm jnt/bursa/w/o US 20605 | $110.40 | $184.00 | $928.00–$2,679.00 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Fluoro Asp/Inj of Joint/Bursa | $348.00 | $580.00 | $197.20–$423.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 GHS INJ/ASP MED JOINT WRIST ELB ANKLE | $348.00 | $580.00 | $197.20–$423.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 GHS INJ INTERM JOINT BURSA GANG | $348.00 | $580.00 | $197.20–$423.40 | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CT Steroid Inj Sternoclavicular Jt Bil | $522.00 | $870.00 | $295.80–$635.10 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 GHS INJ SM JOINT BURSA GANG CYS | $291.00 | $485.00 | $164.90–$354.05 | 4% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 GHS INJ/ASP SMALL JOINT FINGERS TOES | $291.00 | $485.00 | $164.90–$354.05 | 4% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis/sm jnt/bursa/w/o US 20600 | $104.40 | $174.00 | $928.00–$2,679.00 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 GHS INJ/ASP SMALL JOINT FINGERS TOES | $291.00 | $485.00 | $164.90–$354.05 | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 GHS INJ SM JOINT BURSA GANG CYS | $291.00 | $485.00 | $164.90–$354.05 | — | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Knee arthroscopy/surgery 29881 | $755.40 | $1,259.00 | $928.00–$2,679.00 | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 Knee arthroscopy/surgery 29880 | $784.20 | $1,307.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 Lap gastric bypass/roux-en-y 43644 | $3,167.40 | $5,279.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 Laparoscopy appendectomy 44970 | $1,126.80 | $1,878.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 Lap/surg/esophagogas fundoplasty 43280 | $2,041.80 | $3,403.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 Laparoscopy/hysterec/uterus <250g 58570 | $1,805.40 | $3,009.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 Laparoscopy/hysterec/<250g/tube/ov 58571 | $2,007.00 | $3,345.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 Lap ing hernia repair init 49650 | $802.80 | $1,338.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 Lap ing hernia repair recur 49651 | $1,045.20 | $1,742.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 Lap remove gastr adj all parts 43774 | $1,814.40 | $3,024.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LaparoscopyRemove Adnexa 58661 | $1,254.60 | $2,091.00 | $928.00–$2,679.00 | — | 40% |
| Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 Lap sleeve gastrectomy 43775 | $2,071.80 | $3,453.00 | $928.00–$2,679.00 | — | 40% |
| Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 GHS YAG LASER LEFT EYE | $678.00 | $1,130.00 | $384.20–$824.90 | at median | 40% |
| Laser treatment of clouding after cataract surgery (YAG) one side CPT 66821 GHS YAG LASER RT EYE | $678.00 | $1,130.00 | $384.20–$824.90 | at median | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 GHS YAG LASER BOTH EYES | $1,017.00 | $1,695.00 | $576.30–$1,237.35 | — | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient one side CPT 66821 GHS YAG LASER LEFT EYE | $678.00 | $1,130.00 | $384.20–$824.90 | — | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient one side CPT 66821 GHS YAG LASER RT EYE | $678.00 | $1,130.00 | $384.20–$824.90 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 GHS LAYER CLOSURE 2.5 CM OR LESS - 12031 | $295.20 | $492.00 | $167.28–$359.16 | 18% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 GHS LAYER CLOSURE 2.5 CM OR LESS - 12031 | $295.20 | $492.00 | $167.28–$359.16 | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Int rp scalp/ax/trunk/ext 2.5 or < 12031 | $445.20 | $742.00 | $928.00–$2,679.00 | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS RACZ CAUDEL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS RACZ CAUDEL-STEROID INJECTION | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS CAUDEL EPIDURAL STEROID | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS LUMBAR EPIDURAL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS CAUDEL EPIDURAL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS INJ EPIDURAL STEROID LUMBAR | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 GHS INJ LUMBAR EPIDURAL ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | 49% below | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj diag/thera sub lumbar/sacral w/imag 62323 | $188.40 | $314.00 | $928.00–$2,679.00 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS RACZ CAUDEL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS RACZ CAUDEL-STEROID INJECTION | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS LUMBAR EPIDURAL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS INJ LUMBAR EPIDURAL ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS INJ EPIDURAL STEROID LUMBAR | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS CAUDEL EPIDURAL STEROID AND ANESTH | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 GHS CAUDEL EPIDURAL STEROID | $639.60 | $1,066.00 | $362.44–$778.18 | — | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inj diag/ther sub lumb/sacral w/o imag 62322 | $164.40 | $274.00 | $928.00–$2,679.00 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 GHS INJ TRANSFORAMINAL LUMB SINGLE UNI | $1,231.80 | $2,053.00 | $698.02–$1,498.69 | 16% below | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 Bilateral Inj Foramen Epidural L/S 64483 | $462.60 | $771.00 | $928.00–$2,679.00 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 GHS INJ TRANSFORAMINAL LUMB SINGLE UNI | $1,231.80 | $2,053.00 | $698.02–$1,498.69 | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 GHS INJ TRANSFORAMINAL LUMB SINGLE BIL | $1,848.00 | $3,080.00 | $1,047.20–$2,248.40 | — | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 Low Back Disk Surgery 63030 | $2,107.80 | $3,513.00 | $928.00–$2,679.00 | — | 40% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level inpatient CPT 22633 Arthrodesis/combine app/sng/lumbar 22633 | $3,481.20 | $5,802.00 | $928.00–$2,679.00 | — | 40% |
| Lumbar interbody fusion (PLIF or TLIF), one level inpatient CPT 22630 Arthrodesis/post interbdy/sng/lum 22630 | $2,886.00 | $4,810.00 | $928.00–$2,679.00 | — | 40% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 Removal Of Spinal Lamina 63047 | $2,326.20 | $3,877.00 | $928.00–$2,679.00 | — | 40% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 Arthrodesis/single level/lumbar 22612 | $2,995.20 | $4,992.00 | $928.00–$2,679.00 | — | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 Partial mastectomy 19301 | $1,211.40 | $2,019.00 | $928.00–$2,679.00 | — | 40% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 Mast simple complete 19303 | $1,876.80 | $3,128.00 | $928.00–$2,679.00 | — | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Care Of Miscarriage 59820 | $780.00 | $1,300.00 | $928.00–$2,679.00 | — | 40% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 Mohs 1 stage h/n/hf/g 17311 | $1,000.20 | $1,667.00 | $928.00–$2,679.00 | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc benign tal 0.5 < cm 11400 | $231.00 | $385.00 | $928.00–$2,679.00 | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Ben+marg excep skin tag FEENLM <0.5cm 11440 | $252.60 | $421.00 | $928.00–$2,679.00 | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 GHS NAIL PLATE AVULSION SINGLE | $242.40 | $404.00 | $137.36–$294.92 | 20% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Of Nail Plate part/comp single 11730 | $186.00 | $310.00 | $928.00–$2,679.00 | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 GHS NAIL PLATE AVULSION SINGLE | $242.40 | $404.00 | $137.36–$294.92 | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 GHS NERVE BLOCK OCCIPITAL/SUBOCCIPITAL | $388.20 | $647.00 | $219.98–$472.31 | 29% below | 40% |
| Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 Bilateral N Block Inj Occipital 64405 | $183.00 | $305.00 | $928.00–$2,679.00 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 GHS NERVE BLOCK OCCIPITAL/SUBOCCIPITAL | $388.20 | $647.00 | $219.98–$472.31 | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 GHS NERVE BLOCK OCCIPITAL/SUBOCCIPITAL BIL | $582.60 | $971.00 | $330.14–$708.83 | — | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 Insert new or repl PPM w/A&V leads 33208 | $1,269.00 | $2,115.00 | $928.00–$2,679.00 | — | 40% |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis | $1,054.20 | $1,757.00 | $597.38–$1,282.61 | at median | 40% |
| Paracentesis with imaging guidance CPT 49083 GHS ED ABD PARACENTISIS DX OR TX W GUIDANCE | $1,102.20 | $1,837.00 | $624.58–$1,341.01 | 5% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 Abd paracentesis/w image guide 49083 | $619.20 | $1,032.00 | $928.00–$2,679.00 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis | $1,054.20 | $1,757.00 | $597.38–$1,282.61 | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 GHS ED ABD PARACENTISIS DX OR TX W GUIDANCE | $1,102.20 | $1,837.00 | $624.58–$1,341.01 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 GHS REMOVAL NAIL BED | $465.60 | $776.00 | $263.84–$566.48 | 9% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Ex nail/matrix part/comp perm 11750 | $420.00 | $700.00 | $928.00–$2,679.00 | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 GHS REMOVAL NAIL BED | $465.60 | $776.00 | $263.84–$566.48 | — | 40% |
| Prostate biopsy CPT 55700 US BX Prostate | $1,000.20 | $1,667.00 | $566.78–$1,216.91 | 47% below | 40% |
| Prostate biopsy inpatient CPT 55700 US BX Prostate | $1,000.20 | $1,667.00 | $566.78–$1,216.91 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 GHS DESTROY LUMB/SAC FACET JNT W IG UNIL | $2,295.00 | $3,825.00 | $1,300.50–$2,792.25 | 4% below | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destroy LumbSac Facet Jnt 64635 | $784.20 | $1,307.00 | $928.00–$2,679.00 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 GHS DESTROY LUMB/SAC FACET JNT W IG UNIL | $2,295.00 | $3,825.00 | $1,300.50–$2,792.25 | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 GHS DESTROY LUMB/SAC FACET JNT W IG BIL | $3,442.80 | $5,738.00 | $1,950.92–$4,188.74 | — | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Exc of breast lesion open 1/> 19120 | $913.80 | $1,523.00 | $928.00–$2,679.00 | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 GHS FOREIGN BODY REMOVAL - SUBCUTANEOUS | $348.60 | $581.00 | $197.54–$424.13 | 19% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc/remov foreign body subq simple10120 | $265.80 | $443.00 | $928.00–$2,679.00 | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 GHS FOREIGN BODY REMOVAL - SUBCUTANEOUS | $348.60 | $581.00 | $197.54–$424.13 | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 Partial Removal Of Thyroid 60220 | $1,367.40 | $2,279.00 | $928.00–$2,679.00 | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colon ca scrn not hi rsk ind G0121 | $643.20 | $1,072.00 | $928.00–$2,679.00 | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colorectal scrn; hi risk ind G0105 | $643.20 | $1,072.00 | $928.00–$2,679.00 | — | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 septoplasty/submucous resect septum 30520 | $1,209.60 | $2,016.00 | $928.00–$2,679.00 | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 GHS APPLICATION SHORT ARM CAST | $296.40 | $494.00 | $167.96–$360.62 | 27% above | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 Application Of Forearm Cast 29075 | $169.20 | $282.00 | $928.00–$2,679.00 | — | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 GHS APPLICATION SHORT ARM CAST | $296.40 | $494.00 | $167.96–$360.62 | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 GHS APPLICATION SHORT ARM SPLINT - 29125 | $211.20 | $352.00 | $119.68–$256.96 | 22% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 App of short arm splint/static 29125 | $121.20 | $202.00 | $928.00–$2,679.00 | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 GHS APPLICATION SHORT ARM SPLINT - 29125 | $211.20 | $352.00 | $119.68–$256.96 | — | 40% |
| Short leg cast (below the knee) CPT 29405 GHS SHORT LEG CAST APPLICATION | $212.40 | $354.00 | $120.36–$258.42 | 10% below | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast 29405 | $156.60 | $261.00 | $928.00–$2,679.00 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 GHS SHORT LEG CAST APPLICATION | $212.40 | $354.00 | $120.36–$258.42 | — | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 GHS PT SHORT LEG CAST | $212.40 | $354.00 | $120.36–$258.42 | — | 40% |
| Short leg splint (calf to foot) CPT 29515 GHS APPLICATION SHORT LEG SPLINT - 29515 | $226.20 | $377.00 | $128.18–$275.21 | 27% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application Lower Leg Splint 29515 | $135.00 | $225.00 | $928.00–$2,679.00 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 GHS APPLICATION SHORT LEG SPLINT - 29515 | $226.20 | $377.00 | $128.18–$275.21 | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 GHS APPLY SHORT LEG SPLINT | $226.20 | $377.00 | $128.18–$275.21 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 GHS SIMPLE REPAIR 2.5 CM OR LESS - 12001 | $295.20 | $492.00 | $167.28–$359.16 | 23% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rep Superfic Wound 2.5Cm Less 12001 | $213.60 | $356.00 | $928.00–$2,679.00 | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 GHS SIMPLE REPAIR 2.5 CM OR LESS - 12001 | $295.20 | $492.00 | $167.28–$359.16 | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Punch biopsy of skin; first lesion 11104 | $201.60 | $336.00 | $928.00–$2,679.00 | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc malig tal <0.5cm 11600 | $359.40 | $599.00 | $928.00–$2,679.00 | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal Of Skin Tags <= 15 Tags 11200 | $164.40 | $274.00 | $928.00–$2,679.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 GHS LUMBAR PUNCTURE | $1,052.40 | $1,754.00 | $596.36–$1,280.42 | 74% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture 62270 | $298.20 | $497.00 | $928.00–$2,679.00 | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 GHS LUMBAR PUNCTURE | $1,052.40 | $1,754.00 | $596.36–$1,280.42 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 GHS SIMPLE REPAIR 2.6 - 7.5 CM - 12002 | $309.60 | $516.00 | $175.44–$376.68 | 20% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rep Superfic Wound 2.6-7.5Cm 12002 | $212.40 | $354.00 | $928.00–$2,679.00 | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 GHS SIMPLE REPAIR 2.6 - 7.5 CM - 12002 | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 GHS SIMPLE REPAIR 2.5 CM OR LESS - 12011 | $296.40 | $494.00 | $167.96–$360.62 | 16% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair feenlm 2.5 or < 12011 | $238.80 | $398.00 | $928.00–$2,679.00 | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 GHS SIMPLE REPAIR 2.5 CM OR LESS - 12011 | $296.40 | $494.00 | $167.96–$360.62 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential biopsy of skin (eg.shave); first lesion 11102 | $160.80 | $268.00 | $928.00–$2,679.00 | — | 40% |
| Thoracentesis with imaging guidance both sides CPT 32555 PULM Thoracentesis, Bilateral | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 PULM Thoracentesis, Right | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 Thoracentesis Left (Endo) | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 GHS THORACENTESIS/CHEST TUBE W GUIDANCE L | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 GHS OP THORACENTESIS - RT | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS LEFT | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 GHS THORACENTESIS/CHEST TUBE W GUIDANCE R | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 GHS OP THORACENTESIS - LT | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 US Thoracentesis Left | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 PULM Thoracentesis, Left | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 Thoracentesis Right (Endo) | $739.20 | $1,232.00 | $418.88–$899.36 | 25% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS RIGHT | $858.60 | $1,431.00 | $486.54–$1,044.63 | 13% below | 40% |
| Thoracentesis with imaging guidance one side CPT 32555 US Thoracentesis Right | $858.60 | $1,431.00 | $486.54–$1,044.63 | 13% below | 40% |
| Thoracentesis with imaging guidance inpatient both sides CPT 32555 PULM Thoracentesis, Bilateral | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient both sides CPT 32555 Thoracentesis Bilateral (Endo) | $1,108.20 | $1,847.00 | $627.98–$1,348.31 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/ Imaging 32555 | $221.40 | $369.00 | $928.00–$2,679.00 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 GHS THORACENTESIS/CHEST TUBE W GUIDANCE L | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 GHS THORACENTESIS/CHEST TUBE W GUIDANCE R | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 GHS OP THORACENTESIS - BIL | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 GHS THORACENTESIS/CHEST TUBE W GUIDANCE BIL | $1,108.20 | $1,847.00 | $627.98–$1,348.31 | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis Bil | $1,287.60 | $2,146.00 | $729.64–$1,566.58 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 PULM Thoracentesis, Right | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 Thoracentesis Left (Endo) | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US Thoracentesis Left | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 Thoracentesis Right (Endo) | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 PULM Thoracentesis, Left | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 GHS OP THORACENTESIS - LT | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS LEFT | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 GHS OP THORACENTESIS - RT | $739.20 | $1,232.00 | $418.88–$899.36 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS RIGHT | $858.60 | $1,431.00 | $486.54–$1,044.63 | — | 40% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US Thoracentesis Right | $858.60 | $1,431.00 | $486.54–$1,044.63 | — | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T & A/12 yrs or > 42821 | $597.60 | $996.00 | $928.00–$2,679.00 | — | 40% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 T & A < 12 yrs 42820 | $576.60 | $961.00 | $928.00–$2,679.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 Tonsillectomy/pri/sec/12 yrs or > 42826 | $499.20 | $832.00 | $928.00–$2,679.00 | — | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 Tonsillectomy/pri/sec/<12 yrs 42825 | $481.80 | $803.00 | $928.00–$2,679.00 | — | 40% |
| Total hip replacement inpatient CPT 27130 Total hip arthroplasty 27130 | $1,771.80 | $2,953.00 | $928.00–$2,679.00 | — | 40% |
| Total knee replacement inpatient CPT 27447 Revision of thigh muscles 27447 | $1,770.00 | $2,950.00 | $928.00–$2,679.00 | — | 40% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 Thyroidectomy total complete 60240 | $1,954.20 | $3,257.00 | $928.00–$2,679.00 | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 Incise finger tendon sheath 26055 | $1,060.20 | $1,767.00 | $928.00–$2,679.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 GHS INJ SING/MULT TRIGGER 1-2 MUSCLE | $363.60 | $606.00 | $206.04–$442.38 | 15% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 GHS INJ SING/MULT TRIGGER 1-2 MUSCLE GRP | $363.60 | $606.00 | $206.04–$442.38 | 15% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 CT Guide Inj Sin/Mult Trigger 1-2 Muscle Grp | $363.60 | $606.00 | $206.04–$442.38 | 15% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj/sng/mult trigger pt/1-2 muscle 20552 | $103.80 | $173.00 | $928.00–$2,679.00 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 GHS INJ SING/MULT TRIGGER 1-2 MUSCLE | $363.60 | $606.00 | $206.04–$442.38 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CT Guide Inj Sin/Mult Trigger 1-2 Muscle Grp | $363.60 | $606.00 | $206.04–$442.38 | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 GHS INJ SING/MULT TRIGGER 1-2 MUSCLE GRP | $363.60 | $606.00 | $206.04–$442.38 | — | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LaparoscopyTubal Cautery 58670 | $711.00 | $1,185.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Esoph Endoscopy Dilation 43249 | $226.80 | $378.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Upper Gi Endoscopy Biopsy 43239 | $204.60 | $341.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Uppr gi scope w/submuc inj 43236 | $661.80 | $1,103.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD/remove tumor/polyp/w snare 43251 | $290.40 | $484.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD/dilator over guide wire 43248 | $246.00 | $410.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD/flex/transoral/diag 43235 | $181.20 | $302.00 | $928.00–$2,679.00 | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 Egd w/transmural drng cyst 43240 | $777.60 | $1,296.00 | $928.00–$2,679.00 | — | 40% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Vbac Delivery 59610 | $4,470.60 | $7,451.00 | $928.00–$2,679.00 | — | 40% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 Obstetrical Care 59400 | $4,263.60 | $7,106.00 | $928.00–$2,679.00 | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Removal Of Sperm Duct(S) 55250 | $771.60 | $1,286.00 | $928.00–$2,679.00 | — | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endo abl/incom vein/ext/rad fre/#1 36475 | $3,432.00 | $5,720.00 | $928.00–$2,679.00 | — | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 Dest ben lesion(wart) 1-14 17110 | $210.60 | $351.00 | $928.00–$2,679.00 | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrid subq epi/derm first 20 sq cm11042 | $206.40 | $344.00 | $928.00–$2,679.00 | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 Optx dst rd xartc fx/epi sep 25607 | $1,034.40 | $1,724.00 | $928.00–$2,679.00 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 GHS BLOOD TRANSFUSION | $474.00 | $790.00 | $268.60–$576.70 | 14% below | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 GHS BLOOD COMPONENT-TRANSFUSION | $474.00 | $790.00 | $268.60–$576.70 | 14% below | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 GHS BLOOD COMPONENT TRANSFUSION | $545.40 | $909.00 | $309.06–$663.57 | 1% below | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusion 36430 | $70.80 | $118.00 | $928.00–$2,679.00 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 GHS BLOOD TRANSFUSION | $474.00 | $790.00 | $268.60–$576.70 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 GHS BLOOD COMPONENT-TRANSFUSION | $474.00 | $790.00 | $268.60–$576.70 | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 GHS BLOOD COMPONENT TRANSFUSION | $545.40 | $909.00 | $309.06–$663.57 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Continuous Nebulizer > 4 Hrs | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Induced Sputum | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 GHS HHN ADDTL TX | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 GHS MDI SUBSEQ TX | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN 1st Tx | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 GHS HHN 1ST TX | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PEP Mask Initial Treatment | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Incentive Spirometry 1st Tx & Instruct | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 GHS ER HHN INITIAL TREATMENT W MEDICATIO | $100.80 | $168.00 | $57.12–$122.64 | 15% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Amb Nebulizer Admin 94640 | $33.00 | $55.00 | $928.00–$2,679.00 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 GHS ER HHN INITIAL TREATMENT W MEDICATIO | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PEP Mask Initial Treatment | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI Subsequent Treatment | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 GHS MDI SUBSEQ TX | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Incentive Spirometry Subsequent Tx | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Incentive Spirometry 1st Tx & Instruct | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Induced Sputum | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 GHS HHN 1ST TX | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN 1st Tx | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 GHS HHN ADDTL TX | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN Additional Tx | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Continuous Nebulizer > 4 Hrs | $100.80 | $168.00 | $57.12–$122.64 | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 GHS CHEMO INFUSION - 1 HOUR | $376.80 | $628.00 | $213.52–$458.44 | 31% below | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 GHS Chemo Infusion - 1 hour | $376.80 | $628.00 | $213.52–$458.44 | 31% below | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 GHS CHEMO INFUSION, I HOUR | $402.00 | $670.00 | $227.80–$489.10 | 26% below | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo iv infusion 1 hr 96413 | $197.40 | $329.00 | $928.00–$2,679.00 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 GHS CHEMO INFUSION - 1 HOUR | $376.80 | $628.00 | $213.52–$458.44 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 GHS Chemo Infusion - 1 hour | $376.80 | $628.00 | $213.52–$458.44 | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 GHS CHEMO INFUSION, I HOUR | $402.00 | $670.00 | $227.80–$489.10 | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 GHS CRIT CARE W/O PROC - 99291 | $1,356.00 | $2,260.00 | $768.40–$1,649.80 | 7% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 GHS NEONATAL(UNDER 31 DAYS)CRITICAL CARE | $1,653.00 | $2,755.00 | $936.70–$2,011.15 | 30% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care first hour 99291 | $519.60 | $866.00 | $928.00–$2,679.00 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 GHS CRITICAL CARE W DIAG/THER PRO | $1,356.00 | $2,260.00 | $768.40–$1,649.80 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 GHS CRIT CARE W/O PROC - 99291 | $1,356.00 | $2,260.00 | $768.40–$1,649.80 | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 GHS NEONATAL(UNDER 31 DAYS)CRITICAL CARE | $1,653.00 | $2,755.00 | $936.70–$2,011.15 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 GHS EEG AWAKE AND DROWSY | $697.80 | $1,163.00 | $395.42–$848.99 | 8% above | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 GHS EEG AWAKE AND DROWSY | $697.80 | $1,163.00 | $395.42–$848.99 | — | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG monitor/record/awake/drowsy 95816 | $790.20 | $1,317.00 | $928.00–$2,679.00 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG POC | $94.80 | $158.00 | $928.00–$2,679.00 | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 12 lead ECG w/interp/report 93000 | $94.80 | $158.00 | $928.00–$2,679.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $120.60 | $201.00 | $68.34–$146.73 | 24% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead | $120.60 | $201.00 | $68.34–$146.73 | 24% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ER EKG | $120.60 | $201.00 | $68.34–$146.73 | 24% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead | $120.60 | $201.00 | $68.34–$146.73 | 24% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 GHS EKG 12 LEAD | $120.60 | $201.00 | $68.34–$146.73 | 24% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram Tracing 93005 | $27.00 | $45.00 | $928.00–$2,679.00 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ER EKG | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 GHS EKG 12 LEAD | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Electroconvulsive Therapy 90870 | $279.60 | $466.00 | $928.00–$2,679.00 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 GHS EMERGENCY CARE LEVEL 1 | $245.40 | $409.00 | $139.06–$298.57 | 35% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 GHS EMERGENCY CARE 1 W DIAG/THER PROC | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 GHS EMERGENCY CARE LEVEL 1 | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 GHS EMERGENCY CARE LEVEL 2 | $375.60 | $626.00 | $212.84–$456.98 | 28% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 GHS EMERGENCY CARE 2 W DIAG/THER PROC | $375.60 | $626.00 | $212.84–$456.98 | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 GHS EMERGENCY CARE LEVEL 2 | $375.60 | $626.00 | $212.84–$456.98 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 GHS ASSAULT EXAMINATION | $267.00 | $445.00 | $151.30–$324.85 | 39% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 GHS ASSAULT EXAMINOR | $373.20 | $622.00 | $211.48–$454.06 | 15% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 GHS EMERGENCY CARE LEVEL 3 | $448.20 | $747.00 | $253.98–$545.31 | 2% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 GHS ASSAULT EXAMINATION | $267.00 | $445.00 | $151.30–$324.85 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 GHS ASSAULT EXAMINOR | $373.20 | $622.00 | $211.48–$454.06 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 GHS EMERGENCY CARE 3 W DIAG/THER PROC | $448.20 | $747.00 | $253.98–$545.31 | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 GHS EMERGENCY CARE LEVEL 3 | $448.20 | $747.00 | $253.98–$545.31 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 GHS EMERGENCY CARE LEVEL 4 | $719.40 | $1,199.00 | $407.66–$875.27 | 3% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Department Visit High/Urgent Severity 99284 | $226.20 | $377.00 | $928.00–$2,679.00 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 GHS EMERGENCY CARE 4 W DIAG/THER PROC | $719.40 | $1,199.00 | $407.66–$875.27 | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 GHS EMERGENCY CARE LEVEL 4 | $719.40 | $1,199.00 | $407.66–$875.27 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 GHS PSA - INTENSIVE > 60 MINUTES | $577.80 | $963.00 | $327.42–$702.99 | 45% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 GHS EMERGENCY CARE LEVEL 5 | $899.40 | $1,499.00 | $509.66–$1,094.27 | 14% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Dept Visit High Severity+Threat Funcj 99285 | $380.40 | $634.00 | $928.00–$2,679.00 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 GHS PSA - INTENSIVE > 60 MINUTES | $577.80 | $963.00 | $327.42–$702.99 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 GHS EMERGENCY CARE 5 W DIAG/THER PROC | $899.40 | $1,499.00 | $509.66–$1,094.27 | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 GHS EMERGENCY CARE LEVEL 5 | $899.40 | $1,499.00 | $509.66–$1,094.27 | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress, Dobutamine w/Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 IV Adenosine Stress | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise, Cardiac Perfusion | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Adenosine with Cardiolyte | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress, Adenosine w/Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Cardiolyte | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 IV Dobutomine Stress | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Dobutamine | $460.20 | $767.00 | $260.78–$559.91 | 32% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test, Cardiovascular | $582.60 | $971.00 | $330.14–$708.83 | 15% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test Cardiovascular | $582.60 | $971.00 | $330.14–$708.83 | 15% below | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 GHS CARDIAC STRESS TEST | $582.60 | $971.00 | $330.14–$708.83 | 15% below | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Dobutamine | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Cardiolyte | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 IV Adenosine Stress | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress, Dobutamine w/Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 IV Dobutomine Stress | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Exercise, Cardiac Perfusion | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Adenosine with Cardiolyte | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress, Adenosine w/Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Cardiolite | $460.20 | $767.00 | $260.78–$559.91 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test Cardiovascular | $582.60 | $971.00 | $330.14–$708.83 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 GHS CARDIAC STRESS TEST | $582.60 | $971.00 | $330.14–$708.83 | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test, Cardiovascular | $582.60 | $971.00 | $330.14–$708.83 | — | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy with Patient 50 min 90847 | $174.00 | $290.00 | $928.00–$2,679.00 | — | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy W/O Pt 50min 90846 | $114.00 | $190.00 | $928.00–$2,679.00 | — | 40% |
| Group psychotherapy session inpatient CPT 90853 Group psychotherapy 90853 | $36.60 | $61.00 | $928.00–$2,679.00 | — | 40% |
| Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 Ext ECG/48 hr rec/scan/rept/interp 93224 | $282.60 | $471.00 | $928.00–$2,679.00 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS Hydration 1 hour | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS OB IV INFUSION HYDRATION INIT 1 HR | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS IV INFUSION HYDRATION, INITIAL 1 HR | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS IV INFUSION HYDRATION, INITIAL 1 HOUR | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS OPCC IV INFUSION HYDRATION, INITIAL HR | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 GHS CHEMO HYDRATION 1 HOUR | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion Hydration, Initial Hr, OPCC | $297.00 | $495.00 | $168.30–$361.35 | 6% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV hydration/init 31 min to 1 hr 96360 | $93.00 | $155.00 | $928.00–$2,679.00 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS IV INFUSION HYDRATION, INITIAL 1 HR | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS IV INFUSION HYDRATION, INITIAL 1 HOUR | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS CHEMO HYDRATION 1 HOUR | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Infusion Hydration, Initial Hr, OPCC | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS Hydration 1 hour | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS OB IV INFUSION HYDRATION INIT 1 HR | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 GHS OPCC IV INFUSION HYDRATION, INITIAL HR | $297.00 | $495.00 | $168.30–$361.35 | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 IV Infusion Therap/Diag Initial Hr, OPCC | $277.20 | $462.00 | $157.08–$337.26 | 13% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 GHS OPCC IV INFUSION THERAPEUTIC/DIAG, INITIAL HR | $277.20 | $462.00 | $157.08–$337.26 | 13% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 GHS IV INF THERAPEUTIC OR DIAG, INITIAL HOUR | $309.60 | $516.00 | $175.44–$376.68 | 3% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 GHS OB IV INF THERAPY OR DIAG INIT 1 HR | $309.60 | $516.00 | $175.44–$376.68 | 3% below | 40% |
| IV infusion of a medicine, first hour CPT 96365 GHS IV INFUSION THERAPUETIC OR DIAG, INITIAL 1 HOUR | $309.60 | $516.00 | $175.44–$376.68 | 3% below | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV infusion/initial/up to 1 hr 96365 | $126.00 | $210.00 | $928.00–$2,679.00 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 GHS OPCC IV INFUSION THERAPEUTIC/DIAG, INITIAL HR | $277.20 | $462.00 | $157.08–$337.26 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therap/Diag Initial Hr, OPCC | $277.20 | $462.00 | $157.08–$337.26 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 GHS IV INF THERAPEUTIC OR DIAG, INITIAL HOUR | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 GHS IV INFUSION THERAPUETIC OR DIAG, INITIAL 1 HOUR | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 GHS OB IV INF THERAPY OR DIAG INIT 1 HR | $309.60 | $516.00 | $175.44–$376.68 | — | 40% |
| IV push of a medicine, first drug CPT 96374 GHS HF IV PUSH INITIAL | $157.20 | $262.00 | $89.08–$191.26 | 15% below | 40% |
| IV push of a medicine, first drug CPT 96374 GHS IV PUSH, INITIAL | $157.20 | $262.00 | $89.08–$191.26 | 15% below | 40% |
| IV push of a medicine, first drug CPT 96374 IV Push, Initial, OPCC | $157.20 | $262.00 | $89.08–$191.26 | 15% below | 40% |
| IV push of a medicine, first drug CPT 96374 GHS OPCC IV PUSH, INITIAL | $157.20 | $262.00 | $89.08–$191.26 | 15% below | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 Thera/proph/diag/IVP/sng/init drug 96374 | $91.20 | $152.00 | $928.00–$2,679.00 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 GHS HF IV PUSH INITIAL | $157.20 | $262.00 | $89.08–$191.26 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 IV Push, Initial, OPCC | $157.20 | $262.00 | $89.08–$191.26 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 GHS OPCC IV PUSH, INITIAL | $157.20 | $262.00 | $89.08–$191.26 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 GHS IV PUSH, INITIAL | $157.20 | $262.00 | $89.08–$191.26 | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 GHS OB IV PUSH INIT | $157.20 | $262.00 | $89.08–$191.26 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS SUB-Q INJECTION-PER INJECTION | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS IM INJECTION-PER INJECTION | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS ADMIN FEE: RH IMMUNE GLOBULIN | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS IM OR SUB-Q INJECTION | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection IM/SUBQ, OPCC | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS OPCC INJECTION IM/SUBQ | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS OPCC INJECTION RHOGAM | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Rhogam Admin, OPCC | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 GHS OPCC ADMIN FEE- RH IMMUNE GLOBULIN | $73.20 | $122.00 | $41.48–$89.06 | 18% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS IM/SubQ Med Administration | $40.80 | $68.00 | $928.00–$2,679.00 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic Prophylactic/Dx Injection Subq/Im 96372 | $40.80 | $68.00 | $928.00–$2,679.00 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS SUB-Q INJECTION-PER INJECTION | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Rhogam Admin, OPCC | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS IM INJECTION-PER INJECTION | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS ADMIN FEE: RH IMMUNE GLOBULIN | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS IM OR SUB-Q INJECTION | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS OPCC ADMIN FEE- RH IMMUNE GLOBULIN | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS INJECTION SQ OR IM | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS OPCC INJECTION IM/SUBQ | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection IM/SUBQ, OPCC | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 GHS OPCC INJECTION RHOGAM | $73.20 | $122.00 | $41.48–$89.06 | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval W/O Med Mgmt 90791 | $217.20 | $362.00 | $928.00–$2,679.00 | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve conduction study/7-8 study 95910 | $260.40 | $434.00 | $928.00–$2,679.00 | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 GHS Co-Treatment - Hospital, OT | $36.60 | $61.00 | $20.74–$44.53 | 60% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Co-Treatment - Hospital, OT | $36.60 | $61.00 | $20.74–$44.53 | 60% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Co-Treatment - Home, OT | $36.60 | $61.00 | $20.74–$44.53 | 60% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 GHS Co-Treatment - Home, OT | $36.60 | $61.00 | $20.74–$44.53 | 60% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Sensory Motor Charges, OT | $66.60 | $111.00 | $37.74–$81.03 | 28% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges | $68.40 | $114.00 | $38.76–$83.22 | 26% below | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Balance/Vestibular Charges | $78.00 | $130.00 | $44.20–$94.90 | 15% below | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Co-Treatment - Hospital, OT | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS Co-Treatment - Home, OT | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Co-Treatment - Home, OT | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS Co-Treatment - Hospital, OT | $36.60 | $61.00 | $20.74–$44.53 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular reedu/ea 15 min 97112 | $52.20 | $87.00 | $928.00–$2,679.00 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS OT NEUROMUSCULAR RE-ED | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuro Rehab, OT | $55.80 | $93.00 | $31.62–$67.89 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS SENSORY MOTOR INDIV\15 MIN | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Sensory Motor Charges, OT | $66.60 | $111.00 | $37.74–$81.03 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS PT NEUROMUSCULAR RE-ED/15 MIN | $68.40 | $114.00 | $38.76–$83.22 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges | $68.40 | $114.00 | $38.76–$83.22 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS PT NEURO RE-ED - KX | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS PT BALANCE VESTIBULAR RETRAINING | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Balance/Vestibular Charges | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 GHS OT NEURO RE-ED - KX | $81.00 | $135.00 | $45.90–$98.55 | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 GHS NEW PT LEVEL 3 | $102.60 | $171.00 | $58.14–$124.83 | 36% below | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 GHS NEW PT LEVEL 3 | $102.60 | $171.00 | $58.14–$124.83 | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Visit Level 3 New | $145.80 | $243.00 | $928.00–$2,679.00 | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 GHS NEW PT LEVEL 4 | $168.60 | $281.00 | $95.54–$205.13 | 27% below | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 GHS NEW PT LEVEL 4 | $168.60 | $281.00 | $95.54–$205.13 | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office Visit Level 4 New | $223.20 | $372.00 | $928.00–$2,679.00 | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 GHS NEW PT LEVEL 5 | $170.40 | $284.00 | $96.56–$207.32 | 45% below | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 GHS NEW PT LEVEL 5 | $170.40 | $284.00 | $96.56–$207.32 | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office Visit Level 5 New | $277.80 | $463.00 | $928.00–$2,679.00 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GHS NEW PT LEVEL 2 | $90.60 | $151.00 | $51.34–$110.23 | 4% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GHS NEW PT LEVEL 1 | $90.60 | $151.00 | $51.34–$110.23 | 4% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GHS NEW PT LEVEL 1 | $90.60 | $151.00 | $51.34–$110.23 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GHS NEW PT LEVEL 2 | $90.60 | $151.00 | $51.34–$110.23 | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office Visit Level 2 New | $100.80 | $168.00 | $928.00–$2,679.00 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 GHS CANCER CTR INITIAL OP ASSESS RD | $40.80 | $68.00 | $23.12–$49.64 | 8% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 GHS IP MNT INITIAL ASSESS PER 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Education, RD | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Inp Initial Asessment, RD | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 GHS CANCER CTR INITIAL OP ASSESSMENT RD | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 GHS IP MNT EDUCATION 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 GHS OP MNT INITIAL ASSESS PER 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | 3% below | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHGSM MNT Initial 15min 97802GSM | $19.20 | $32.00 | $928.00–$2,679.00 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHS CANCER CTR INITIAL OP ASSESS RD | $40.80 | $68.00 | $23.12–$49.64 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHS IP MNT INITIAL ASSESS PER 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Education, RD | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHS IP MNT EDUCATION 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHS CANCER CTR INITIAL OP ASSESSMENT RD | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Inp Initial Asessment, RD | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GHS OP MNT INITIAL ASSESS PER 15 MIN | $43.20 | $72.00 | $24.48–$52.56 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 GCM Med nutri tx/initial/ind pt/15 min 97802GCM | $88.20 | $147.00 | $928.00–$2,679.00 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med nutri tx/initial/ind pt/15 min 97802 | $88.20 | $147.00 | $928.00–$2,679.00 | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 ACO Med nutria tx/intial/ind pt/15 min 97802ACO | $88.20 | $147.00 | $928.00–$2,679.00 | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 GHS OT EVAL =<15 MIN, LOW | $87.00 | $145.00 | $49.30–$105.85 | 52% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 GHS OT EVAL =<30 MIN, LOW | $120.60 | $201.00 | $68.34–$146.73 | 33% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 GHS OT EVAL =<45 MIN, LOW | $175.80 | $293.00 | $99.62–$213.89 | 2% below | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 GHS OT EVAL =<60 MIN, LOW | $213.00 | $355.00 | $120.70–$259.15 | 19% above | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<15 MIN, LOW KX | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =<15 MIN, LOW | $87.00 | $145.00 | $49.30–$105.85 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<15 MIN, LOW | $87.00 | $145.00 | $49.30–$105.85 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<30 MIN, LOW KX | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =<30 MIN, LOW | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<30 MIN, LOW | $120.60 | $201.00 | $68.34–$146.73 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<45 MIN, LOW KX | $169.80 | $283.00 | $96.22–$206.59 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =<45 MIN, LOW | $175.80 | $293.00 | $99.62–$213.89 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<45 MIN, LOW | $175.80 | $293.00 | $99.62–$213.89 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<60 MIN, LOW | $213.00 | $355.00 | $120.70–$259.15 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =<60 MIN, LOW | $213.00 | $355.00 | $120.70–$259.15 | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 GHS OT EVAL =/<60 MIN, LOW KX | $213.00 | $355.00 | $120.70–$259.15 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 GHS PT EVAL =<15 MIN, HIGH | $104.40 | $174.00 | $59.16–$127.02 | 51% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 GHS PT EVAL =<30 MIN, HIGH | $155.40 | $259.00 | $88.06–$189.07 | 27% below | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 GHS PT EVAL =<45 MIN, HIGH | $224.40 | $374.00 | $127.16–$273.02 | 6% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 GHS PT EVAL =<60 MIN, HIGH | $272.40 | $454.00 | $154.36–$331.42 | 28% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical therapy evaluation; high complexity 97163 | $79.80 | $133.00 | $928.00–$2,679.00 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<15 MIN, HIGH KX | $100.20 | $167.00 | $56.78–$121.91 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<15 MIN, HIGH | $104.40 | $174.00 | $59.16–$127.02 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =<15 MIN, HIGH | $104.40 | $174.00 | $59.16–$127.02 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<30 MIN, HIGH KX | $149.40 | $249.00 | $84.66–$181.77 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<30 MIN, HIGH | $155.40 | $259.00 | $88.06–$189.07 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =<30 MIN, HIGH | $155.40 | $259.00 | $88.06–$189.07 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<45 MIN, HIGH KX | $216.60 | $361.00 | $122.74–$263.53 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =<45 MIN, HIGH | $224.40 | $374.00 | $127.16–$273.02 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<45 MIN, HIGH | $224.40 | $374.00 | $127.16–$273.02 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<60 MIN, HIGH KX | $272.40 | $454.00 | $154.36–$331.42 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =<60 MIN, HIGH | $272.40 | $454.00 | $154.36–$331.42 | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 GHS PT EVAL =/<60 MIN, HIGH | $272.40 | $454.00 | $154.36–$331.42 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 GHS PT EVAL =<15 MIN, LOW | $94.80 | $158.00 | $53.72–$115.34 | 50% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 GHS PT EVAL =<30 MIN, LOW | $141.00 | $235.00 | $79.90–$171.55 | 26% below | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 GHS PT EVAL =<45 MIN, LOW | $196.80 | $328.00 | $111.52–$239.44 | 3% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 GHS PT EVAL =<60 MIN, LOW | $233.40 | $389.00 | $132.26–$283.97 | 22% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<15 MIN, LOW KX | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =<15 MIN, LOW | $94.80 | $158.00 | $53.72–$115.34 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<15 MIN, LOW | $94.80 | $158.00 | $53.72–$115.34 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical therapy evaluation; low complexity 97161 | $133.80 | $223.00 | $928.00–$2,679.00 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<30 MIN, LOW KX | $135.60 | $226.00 | $76.84–$164.98 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<30 MIN, LOW | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =<30 MIN, LOW | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =<45 MIN, LOW | $196.80 | $328.00 | $111.52–$239.44 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<45 MIN, LOW | $196.80 | $328.00 | $111.52–$239.44 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<45 MIN, LOW KX | $196.80 | $328.00 | $111.52–$239.44 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =<60 MIN, LOW | $233.40 | $389.00 | $132.26–$283.97 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<60 MIN, LOW KX | $233.40 | $389.00 | $132.26–$283.97 | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 GHS PT EVAL =/<60 MIN, LOW | $233.40 | $389.00 | $132.26–$283.97 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 GHS PT EVAL =<15 MIN, MODERATE | $99.00 | $165.00 | $56.10–$120.45 | 50% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 GHS PT EVAL =<30 MIN, MODERATE | $147.60 | $246.00 | $83.64–$179.58 | 25% below | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 GHS PT EVAL =<60 MIN, MODERATE | $245.40 | $409.00 | $139.06–$298.57 | 25% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<15 MIN, MODERATE KX | $96.00 | $160.00 | $54.40–$116.80 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =<15 MIN, MODERATE | $99.00 | $165.00 | $56.10–$120.45 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<15 MIN, MODERATE | $99.00 | $165.00 | $56.10–$120.45 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical therapy evaluation; moderate complexity 97162 | $133.80 | $223.00 | $928.00–$2,679.00 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<30 MIN, MODERATE | $147.60 | $246.00 | $83.64–$179.58 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<30 MIN, MODERATE KX | $147.60 | $246.00 | $83.64–$179.58 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =<30 MIN, MODERATE | $147.60 | $246.00 | $83.64–$179.58 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<45 MIN, MODERATE KX | $207.00 | $345.00 | $117.30–$251.85 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<45 MIN, MODERATE | $207.00 | $345.00 | $117.30–$251.85 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =<45 MIN, MODERATE | $207.00 | $345.00 | $117.30–$251.85 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<60 MIN, MODERATE | $233.40 | $389.00 | $132.26–$283.97 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =/<60 MIN, MODERATE KX | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 GHS PT EVAL =<60 MIN, MODERATE | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 GHS Manual Therapy Charges, OT | $92.40 | $154.00 | $52.36–$112.42 | 5% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charges | $92.40 | $154.00 | $52.36–$112.42 | 5% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charges, OT | $92.40 | $154.00 | $52.36–$112.42 | 5% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual therapy/1> areas/ea 15 min 97140 | $51.00 | $85.00 | $928.00–$2,679.00 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS Manual Therapy Charges, OT | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charges | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS MANUAL THERAPY\ 15 MIN | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS PT MANUAL THERAPY - KX | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS OT MANUAL THERAPY PER 15MIN | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charges, OT | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS OT MANUAL THERAPY - KX | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 GHS MANUAL THERAPY PER 15MIN | $92.40 | $154.00 | $52.36–$112.42 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 GHS Therapeutic Exercise Charges, OT | $69.00 | $115.00 | $39.10–$83.95 | 28% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges, OT | $69.00 | $115.00 | $39.10–$83.95 | 28% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges | $91.20 | $152.00 | $51.68–$110.96 | 5% below | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic exercise/ea 15 min 97110 | $52.20 | $87.00 | $928.00–$2,679.00 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS HAND REHAB (REHAB) | $56.40 | $94.00 | $31.96–$68.62 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges, OT | $69.00 | $115.00 | $39.10–$83.95 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS Therapeutic Exercise Charges, OT | $69.00 | $115.00 | $39.10–$83.95 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS PT - INTERDISCIPLINARY CO-TREAT/15 MIN | $69.00 | $115.00 | $39.10–$83.95 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS OT THERAPEUTIC EX - KX | $69.00 | $115.00 | $39.10–$83.95 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Ex, PT - KX | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS PT THERAPEUTIC EXERCIS\15 MIN | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS PT THERAPEUTIC EX - KX | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 GHS OT THER EXERCISE | $91.20 | $152.00 | $51.68–$110.96 | — | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 Initial Comp Preventive Med 18 to 39 years New | $174.60 | $291.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 Initial Comp Preventive Med 40 to 64 years New | $229.20 | $382.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 Initial Preventive Medicine New Patient 65Yrs+Greater than | $270.00 | $450.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 Periodic Comp Preventive Med 18 to 39 years Est | $155.40 | $259.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Flight Physical (age 40-64) 99396FLT | $88.80 | $148.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 Periodic Comp Preventive Med 40 to 64 years Est | $166.20 | $277.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Flight Physical (65 and older) 99397FLT | $88.80 | $148.00 | $928.00–$2,679.00 | — | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Periodic Comp Preventive Med 65+ years Est | $184.20 | $307.00 | $928.00–$2,679.00 | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Psych Diagnostic Eval With Med Mgmt 90792 | $178.80 | $298.00 | $928.00–$2,679.00 | — | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psych test eval; first hour 96130 | $248.40 | $414.00 | $928.00–$2,679.00 | — | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Crisis Psychotherapy 90839 | $146.40 | $244.00 | $928.00–$2,679.00 | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy 30 Minutes 90832 | $58.80 | $98.00 | $928.00–$2,679.00 | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy 45 Minutes 90834 | $114.00 | $190.00 | $928.00–$2,679.00 | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy (Add-on to 90837) | $146.40 | $244.00 | $928.00–$2,679.00 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation < 10 Min/Session | $16.20 | $27.00 | $9.18–$19.71 | 62% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 GHS SMOKING CESSATION <10 MIN/SESSION | $16.20 | $27.00 | $9.18–$19.71 | 62% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Cessation, <10 Minute Session | $16.20 | $27.00 | $9.18–$19.71 | 62% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation, <10 Minute Session | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation < 10 Min/Session | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 GHS SMOKING CESSATION <10 MIN/SESSION | $16.20 | $27.00 | $9.18–$19.71 | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes 99406 | $27.60 | $46.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 GHS EST PT LEVEL 5 | $181.20 | $302.00 | $102.68–$220.46 | 17% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 GHS EST PT LEVEL 5 | $181.20 | $302.00 | $102.68–$220.46 | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Level 5 Est | $196.20 | $327.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GHS EST PT LEVEL 3 | $117.60 | $196.00 | $66.64–$143.08 | 1% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GHS PAIN MGMT INITIAL VISIT | $117.60 | $196.00 | $66.64–$143.08 | 1% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established patient - Sleep Clinic | $117.60 | $196.00 | $66.64–$143.08 | 1% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GHS ESTABLISHED PATIENT - SLEEP CLINIC | $117.60 | $196.00 | $66.64–$143.08 | 1% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 GHS INITIAL VISIT - HEADACHE CLINIC | $117.60 | $196.00 | $66.64–$143.08 | 1% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office Visit Level 3 Est | $97.80 | $163.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GHS INITIAL VISIT - HEADACHE CLINIC | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Established patient - Sleep Clinic | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GHS ESTABLISHED PATIENT - SLEEP CLINIC | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GHS PAIN MGMT INITIAL VISIT W PROC | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GHS PAIN MGMT INITIAL VISIT | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 GHS EST PT LEVEL 3 | $117.60 | $196.00 | $66.64–$143.08 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 New Patient - Sleep Clinic | $137.40 | $229.00 | $77.86–$167.17 | 16% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GHS EST PT LEVEL 4 | $137.40 | $229.00 | $77.86–$167.17 | 16% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 GHS NEW PATIENT - SLEEP CLINIC | $137.40 | $229.00 | $77.86–$167.17 | 16% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 New Patient - Sleep Clinic | $137.40 | $229.00 | $77.86–$167.17 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GHS NEW PATIENT - SLEEP CLINIC | $137.40 | $229.00 | $77.86–$167.17 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 GHS EST PT LEVEL 4 | $137.40 | $229.00 | $77.86–$167.17 | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office Visit Level 4 Est | $145.80 | $243.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GHS CARDIAC CLINIC EST PATIENT LVL 2 | $73.80 | $123.00 | $41.82–$89.79 | 10% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 GHS EST PT LEVEL 2 | $78.00 | $130.00 | $44.20–$94.90 | 5% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Sports Physical-Cash Only | $25.20 | $42.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office Visit Level 2 Est | $58.80 | $98.00 | $928.00–$2,679.00 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GHS CARDIAC CLINIC EST PATIENT LVL 2 | $73.80 | $123.00 | $41.82–$89.79 | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 GHS EST PT LEVEL 2 | $78.00 | $130.00 | $44.20–$94.90 | — | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consult Level 3 99243 | $183.00 | $305.00 | $928.00–$2,679.00 | — | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office Consult Level 4 99244 | $273.60 | $456.00 | $928.00–$2,679.00 | — | 40% |
| Speech and language evaluation CPT 92523 SLP Eval Sound Prod Comp Expres I, ST | $121.80 | $203.00 | $69.02–$148.19 | 60% below | 40% |
| Speech and language evaluation CPT 92523 SLP Eval Sound Prod Comp Expres II, ST | $168.00 | $280.00 | $95.20–$204.40 | 45% below | 40% |
| Speech and language evaluation CPT 92523 SLP Eval Sound Prod Comp Expres III, ST | $245.40 | $409.00 | $139.06–$298.57 | 20% below | 40% |
| Speech and language evaluation CPT 92523 SLP Eval Sound Prod Comp Expres IV, ST | $303.60 | $506.00 | $172.04–$369.38 | 1% below | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 15 MIN | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 15 MIN KX | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<15 MIN KX | $84.00 | $140.00 | $47.60–$102.20 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 30 MIN KX | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 30 MIN | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<30 MIN KX | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Sound Prod Comp Expres I, ST | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<15 MIN | $121.80 | $203.00 | $69.02–$148.19 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Sound Prod Comp Expres II, ST | $168.00 | $280.00 | $95.20–$204.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<30 MIN | $168.00 | $280.00 | $95.20–$204.40 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 45 MIN | $169.80 | $283.00 | $96.22–$206.59 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 45 MIN KX | $169.80 | $283.00 | $96.22–$206.59 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<45 MIN KX | $204.00 | $340.00 | $115.60–$248.20 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 60 MIN KX | $225.60 | $376.00 | $127.84–$274.48 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL LANGUAGE ONLY =< 60 MIN | $225.60 | $376.00 | $127.84–$274.48 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 Eval speech sound product lang comprehen 92523 | $241.80 | $403.00 | $928.00–$2,679.00 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Sound Prod Comp Expres III, ST | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<45 MIN | $245.40 | $409.00 | $139.06–$298.57 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<60 MIN KX | $271.20 | $452.00 | $153.68–$329.96 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Sound Prod Comp Expres IV, ST | $303.60 | $506.00 | $172.04–$369.38 | — | 40% |
| Speech and language evaluation inpatient CPT 92523 GHS SP EVAL SOUND PROD W COMP & EXPRESS =/<60 MIN | $303.60 | $506.00 | $172.04–$369.38 | — | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat I, ST | $54.00 | $90.00 | $30.60–$65.70 | 75% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat II, ST | $99.60 | $166.00 | $56.44–$121.18 | 54% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat III, ST - KX | $144.60 | $241.00 | $81.94–$175.93 | 33% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat III, ST | $150.00 | $250.00 | $85.00–$182.50 | 31% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat IV, ST - KX | $192.60 | $321.00 | $109.14–$234.33 | 11% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat IV, ST | $199.80 | $333.00 | $113.22–$243.09 | 8% below | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat V, ST | $236.40 | $394.00 | $133.96–$287.62 | 9% above | 40% |
| Speech therapy session, individual CPT 92507 GHS SLP Treat V, ST | $236.40 | $394.00 | $133.96–$287.62 | 9% above | 40% |
| Speech therapy session, individual CPT 92507 GHS SLP Treat VI, ST | $283.20 | $472.00 | $160.48–$344.56 | 31% above | 40% |
| Speech therapy session, individual CPT 92507 SLP Treat VI, ST | $283.20 | $472.00 | $160.48–$344.56 | 31% above | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ST - COMMUNICATION SKILLS | $34.20 | $57.00 | $19.38–$41.61 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS VOICE TREAT =/< 15 MIN | $47.40 | $79.00 | $26.86–$57.67 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS APRAXIA TREATMENT | $51.60 | $86.00 | $29.24–$62.78 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ALARYNGEAL TREATMENT | $52.20 | $87.00 | $29.58–$63.51 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS APHASIA TREATMENT | $53.40 | $89.00 | $30.26–$64.97 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ST - TREAT =/<15 MINUTES | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat I, ST | $54.00 | $90.00 | $30.60–$65.70 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS SP TREAT =/<30 MIN - KX | $96.60 | $161.00 | $54.74–$117.53 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ST - TREAT =/<30 MINUTES | $99.60 | $166.00 | $56.44–$121.18 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat II, ST | $99.60 | $166.00 | $56.44–$121.18 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 Tx speech/lang/voice/aud/ea indiv 92507 | $103.20 | $172.00 | $928.00–$2,679.00 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS SP TREAT =/<45 MIN - KX | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat III, ST - KX | $144.60 | $241.00 | $81.94–$175.93 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat III, ST | $150.00 | $250.00 | $85.00–$182.50 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ST - TREAT =/<45 MINUTES | $150.00 | $250.00 | $85.00–$182.50 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS SP TREATMENT=/< 60 MIN KX | $192.60 | $321.00 | $109.14–$234.33 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat IV, ST - KX | $192.60 | $321.00 | $109.14–$234.33 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS ST - TREAT =/<60 MINUTES | $199.80 | $333.00 | $113.22–$243.09 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat IV, ST | $199.80 | $333.00 | $113.22–$243.09 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS SLP Treat V, ST | $236.40 | $394.00 | $133.96–$287.62 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat V, ST | $236.40 | $394.00 | $133.96–$287.62 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 GHS SLP Treat VI, ST | $283.20 | $472.00 | $160.48–$344.56 | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Treat VI, ST | $283.20 | $472.00 | $160.48–$344.56 | — | 40% |
| Spirometry (breathing test) CPT 94010 Maximum Expiratory Flow | $116.40 | $194.00 | $65.96–$141.62 | 42% below | 40% |
| Spirometry (breathing test) CPT 94010 GHS COMPLETE PFT | $221.40 | $369.00 | $125.46–$269.37 | 11% above | 40% |
| Spirometry (breathing test) CPT 94010 Pulmonary Function Test | $221.40 | $369.00 | $125.46–$269.37 | 11% above | 40% |
| Spirometry (breathing test) CPT 94010 Complete PFT | $221.40 | $369.00 | $125.46–$269.37 | 11% above | 40% |
| Spirometry (breathing test) CPT 94010 GHS Pulmonary Function Test | $221.40 | $369.00 | $125.46–$269.37 | 11% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry 94010 | $69.60 | $116.00 | $928.00–$2,679.00 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry POC | $69.60 | $116.00 | $928.00–$2,679.00 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS PR PFT Screening | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Maximum Expiratory Flow | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS PR PFT SCREENING | $116.40 | $194.00 | $65.96–$141.62 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS Pulmonary Function Test Bedside Screening | $132.60 | $221.00 | $75.14–$161.33 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Bedside Screening | $132.60 | $221.00 | $75.14–$161.33 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry/Bedside PFT Screening | $132.60 | $221.00 | $75.14–$161.33 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 PFT Spirometry | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS Pulmonary Function Test Screening | $141.00 | $235.00 | $79.90–$171.55 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test | $221.40 | $369.00 | $125.46–$269.37 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Complete PFT | $221.40 | $369.00 | $125.46–$269.37 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS COMPLETE PFT | $221.40 | $369.00 | $125.46–$269.37 | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 GHS Pulmonary Function Test | $221.40 | $369.00 | $125.46–$269.37 | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PFT Screening Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | 44% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 GHS PFT SPIROMETRY PRE/POST | $222.00 | $370.00 | $125.80–$270.10 | 44% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 PFT Spirometry Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | 44% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 GHS PFT Screening Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | 44% below | 40% |
| Spirometry before and after a bronchodilator CPT 94060 GHS Complete Pulmonary Function Test With Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | at median | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Complete Pulmonary Function Test With Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | at median | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Complete PFT Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | at median | 40% |
| Spirometry before and after a bronchodilator CPT 94060 GHS COMPLETE PFT PRE/POST | $394.20 | $657.00 | $223.38–$479.61 | at median | 40% |
| Spirometry before and after a bronchodilator CPT 94060 Disability PFT | $444.00 | $740.00 | $251.60–$540.20 | 13% above | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Spiro w/ Bronch 94060 | $116.40 | $194.00 | $928.00–$2,679.00 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS Pulmonary Function Test Bedside Pre/Post | $175.20 | $292.00 | $99.28–$213.16 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS BEDSIDE SCREENING PRE/POST | $175.20 | $292.00 | $99.28–$213.16 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Bedside Screening Pre/Post | $175.20 | $292.00 | $99.28–$213.16 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Bedside Pre/Post | $175.20 | $292.00 | $99.28–$213.16 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS PFT SPIROMETRY PRE/POST | $222.00 | $370.00 | $125.80–$270.10 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Screening Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS PFT Screening Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Spirometry Pre/Post | $222.00 | $370.00 | $125.80–$270.10 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS COMPLETE PFT PRE/POST | $394.20 | $657.00 | $223.38–$479.61 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Complete PFT Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Complete Pulmonary Function Test With Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS Complete Pulmonary Function Test With Pre/Post | $394.20 | $657.00 | $223.38–$479.61 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS PR PFT PRE/POST SCREENING | $444.00 | $740.00 | $251.60–$540.20 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Disability PFT | $444.00 | $740.00 | $251.60–$540.20 | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 GHS PR PFT Pre/Post Screening | $444.00 | $740.00 | $251.60–$540.20 | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 GHS PT FUNCT ACTIVITIES | $75.60 | $126.00 | $42.84–$91.98 | 26% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 GHS Therapeutic Activities Charge, OT | $75.60 | $126.00 | $42.84–$91.98 | 26% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge, OT | $75.60 | $126.00 | $42.84–$91.98 | 26% below | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge | $75.60 | $126.00 | $42.84–$91.98 | 26% below | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic activ/direct/ea 15 min 97530 | $45.60 | $76.00 | $928.00–$2,679.00 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS PT - THERAPEUTIC ACTIVITIES\15 MIN | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS PT FUNCT ACTIVITIES | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS PT THERAPEUTIC ACT - KX | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS Therapeutic Activities Charge, OT | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS OT PROF INSTRUCTION | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS OT THER ACTIVITY | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge, OT | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS PT PROFESS. INSTRCT | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 GHS OT THERAPEUTIC ACT - KX | $75.60 | $126.00 | $42.84–$91.98 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 GHS OPCC PHLEBOTOMY THERAPEUTIC PER UNIT | $159.60 | $266.00 | $90.44–$194.18 | 13% below | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, per Unit, OPCC | $159.60 | $266.00 | $90.44–$194.18 | 13% below | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 GHS OPCC PHLEBOTOMY THERAPEUTIC PER UNIT | $159.60 | $266.00 | $90.44–$194.18 | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, per Unit, OPCC | $159.60 | $266.00 | $90.44–$194.18 | — | 40% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CV stress/cont ECG/superv/int/rpt 93015 | $196.20 | $327.00 | $928.00–$2,679.00 | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine (Fluad), inactivated adjuvanted PF TIV 0 | $142.36 | $237.26 | $80.67–$173.20 | 152% above | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine (Fluad), inactivated adjuvanted PF TIV 0 | $142.36 | $237.26 | $80.67–$173.20 | 152% above | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine (Fluad), inactivated adjuvanted PF TIV 0 | $142.36 | $237.26 | $80.67–$173.20 | — | 40% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine (Fluad), inactivated adjuvanted PF TIV 0 | $142.36 | $237.26 | $80.67–$173.20 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) PF 50 mcg/0.5 m | $263.57 | $439.29 | $149.36–$320.68 | at median | 40% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) PF 50 mcg/0.5 m | $263.57 | $439.29 | $149.36–$320.68 | at median | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) PF 50 mcg/0.5 m | $263.57 | $439.29 | $149.36–$320.68 | — | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 312) PF 50 mcg/0.5 m | $263.57 | $439.29 | $149.36–$320.68 | — | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 309) PF 30 mcg/0.3 m | $274.01 | $456.68 | $155.27–$333.38 | 87% above | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 309) PF 30 mcg/0.3 m | $274.01 | $456.68 | $155.27–$333.38 | 87% above | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 309) PF 30 mcg/0.3 m | $274.01 | $456.68 | $155.27–$333.38 | — | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARS-CoV-2 (COVID-19) mRNA-LNP vaccine (cvx 309) PF 30 mcg/0.3 m | $274.01 | $456.68 | $155.27–$333.38 | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vaccine Inj 0.5 ml | $336.55 | $560.92 | $190.71–$409.47 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphth-Pertussis,acel-Tetanus-Polio Inj 0.5 ml | $106.49 | $177.49 | $60.35–$129.57 | 23% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphth-Pertussis,acel-Tetanus-Polio Inj 0.5 ml | $106.49 | $177.49 | $60.35–$129.57 | 23% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphtheria-acel Pertussis-Tetanus-Polio 0.5 ml Inj | $126.79 | $211.31 | $71.85–$154.26 | 46% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Diphtheria-acel Pertussis-Tetanus-Polio 0.5 ml Inj | $126.79 | $211.31 | $71.85–$154.26 | 46% above | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Diphth-Pertussis,acel-Tetanus-Polio Inj 0.5 ml | $106.49 | $177.49 | $60.35–$129.57 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Diphth-Pertussis,acel-Tetanus-Polio Inj 0.5 ml | $106.49 | $177.49 | $60.35–$129.57 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Diphtheria-acel Pertussis-Tetanus-Polio 0.5 ml Inj | $126.79 | $211.31 | $71.85–$154.26 | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Diphtheria-acel Pertussis-Tetanus-Polio 0.5 ml Inj | $126.79 | $211.31 | $71.85–$154.26 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 0.5 ml Inj | $64.83 | $108.05 | $36.74–$78.88 | 47% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 0.5 ml Inj | $64.83 | $108.05 | $36.74–$78.88 | 47% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 15 units-5 units-23 mcg | $66.25 | $110.41 | $37.54–$80.60 | 50% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 15 units-5 units-23 mcg | $66.25 | $110.41 | $37.54–$80.60 | 50% above | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 0.5 ml Inj | $64.83 | $108.05 | $36.74–$78.88 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 0.5 ml Inj | $64.83 | $108.05 | $36.74–$78.88 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 15 units-5 units-23 mcg | $66.25 | $110.41 | $37.54–$80.60 | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria-Tetanus-Pertussis (DTaP) Peds 15 units-5 units-23 mcg | $66.25 | $110.41 | $37.54–$80.60 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphth-Hep B-Pertussis,acel-Polio-Tetanus 0.5 ml | $131.03 | $218.39 | $74.25–$159.42 | 12% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphth-Hep B-Pertussis,acel-Polio-Tetanus 0.5 ml | $131.03 | $218.39 | $74.25–$159.42 | 12% above | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Diphth-Hep B-Pertussis,acel-Polio-Tetanus 0.5 ml | $131.03 | $218.39 | $74.25–$159.42 | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Diphth-Hep B-Pertussis,acel-Polio-Tetanus 0.5 ml | $131.03 | $218.39 | $74.25–$159.42 | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diph-Haem B-Pertussis-Tetanus-Polio Inj | $199.37 | $332.29 | $112.98–$242.57 | 91% above | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diph-Haem B-Pertussis-Tetanus-Polio Inj | $199.37 | $332.29 | $112.98–$242.57 | 91% above | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Diph-Haem B-Pertussis-Tetanus-Polio Inj | $199.37 | $332.29 | $112.98–$242.57 | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Diph-Haem B-Pertussis-Tetanus-Polio Inj | $199.37 | $332.29 | $112.98–$242.57 | — | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Su | $270.73 | $451.22 | $153.41–$329.39 | 75% above | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Su | $270.73 | $451.22 | $153.41–$329.39 | 75% above | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Su | $270.73 | $451.22 | $153.41–$329.39 | — | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 diphtheria/haem/hepB/pert,acel/polio/tetan - Su | $270.73 | $451.22 | $153.41–$329.39 | — | 40% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza Virus Vaccine, inact hemagglutinin TIV PF Inj | $73.99 | $123.31 | $41.93–$90.02 | 7% below | 40% |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza Virus Vaccine, inact hemagglutinin TIV PF Inj | $73.99 | $123.31 | $41.93–$90.02 | 7% below | 40% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 Influenza Virus Vaccine, inact hemagglutinin TIV PF Inj | $73.99 | $123.31 | $41.93–$90.02 | — | 40% |
| Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 Influenza Virus Vaccine, inact hemagglutinin TIV PF Inj | $73.99 | $123.31 | $41.93–$90.02 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine, inactivated 0.5 ml Inj | $28.63 | $47.71 | $16.22–$34.83 | 28% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine, inactivated 0.5 ml Inj | $28.63 | $47.71 | $16.22–$34.83 | 28% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vaccine, inactivated 0.5 ml Inj | $28.63 | $47.71 | $16.22–$34.83 | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vaccine, inactivated 0.5 ml Inj | $28.63 | $47.71 | $16.22–$34.83 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus Vaccine 9-valent Susp 0.5 ml | $557.26 | $928.76 | $315.78–$677.99 | 77% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus Vaccine 9-valent Susp 0.5 ml | $557.26 | $928.76 | $315.78–$677.99 | 77% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus Vaccine 9-valent Susp 0.5 ml | $557.26 | $928.76 | $315.78–$677.99 | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus Vaccine 9-valent Susp 0.5 ml | $557.26 | $928.76 | $315.78–$677.99 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A-Hepatitis B (720--20) Vaccine-PF 1 ml | $116.72 | $194.53 | $66.14–$142.01 | 6% below | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hepatitis A-Hepatitis B (720--20) Vaccine-PF 1 ml | $116.72 | $194.53 | $66.14–$142.01 | 6% below | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hepatitis A-Hepatitis B (720--20) Vaccine-PF 1 ml | $116.72 | $194.53 | $66.14–$142.01 | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hepatitis A-Hepatitis B (720--20) Vaccine-PF 1 ml | $116.72 | $194.53 | $66.14–$142.01 | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 1,440 units/ml Inj-PF | $122.86 | $204.76 | $69.62–$149.47 | at median | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 1,440 units/ml Inj-PF | $122.86 | $204.76 | $69.62–$149.47 | at median | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 50 units/ml Inj | $156.45 | $260.75 | $88.66–$190.35 | 27% above | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 50 units/ml Inj | $156.45 | $260.75 | $88.66–$190.35 | 27% above | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 1,440 units/ml Inj-PF | $122.86 | $204.76 | $69.62–$149.47 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 1,440 units/ml Inj-PF | $122.86 | $204.76 | $69.62–$149.47 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 50 units/ml Inj | $156.45 | $260.75 | $88.66–$190.35 | — | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 50 units/ml Inj | $156.45 | $260.75 | $88.66–$190.35 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine-Pediatric 25 units/0.5 ml Inj | $81.22 | $135.37 | $46.03–$98.82 | 57% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine-Pediatric 25 units/0.5 ml Inj | $81.22 | $135.37 | $46.03–$98.82 | 57% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine-Pediatric 720 Units/0.5 ml Inj-PF | $144.41 | $240.68 | $81.83–$175.70 | 179% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine-Pediatric 720 Units/0.5 ml Inj-PF | $144.41 | $240.68 | $81.83–$175.70 | 179% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine-Pediatric 25 units/0.5 ml Inj | $81.22 | $135.37 | $46.03–$98.82 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine-Pediatric 25 units/0.5 ml Inj | $81.22 | $135.37 | $46.03–$98.82 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine-Pediatric 720 Units/0.5 ml Inj-PF | $144.41 | $240.68 | $81.83–$175.70 | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine-Pediatric 720 Units/0.5 ml Inj-PF | $144.41 | $240.68 | $81.83–$175.70 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine 20 mcg/ml-Adult | $104.08 | $173.47 | $58.98–$126.63 | 5% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine 20 mcg/ml-Adult | $104.08 | $173.47 | $58.98–$126.63 | 5% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine 10 mcg/ml Inj-Adult | $134.30 | $223.83 | $76.10–$163.40 | 23% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine 10 mcg/ml Inj-Adult | $134.30 | $223.83 | $76.10–$163.40 | 23% above | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine 20 mcg/ml-Adult | $104.08 | $173.47 | $58.98–$126.63 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine 20 mcg/ml-Adult | $104.08 | $173.47 | $58.98–$126.63 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine 10 mcg/ml Inj-Adult | $134.30 | $223.83 | $76.10–$163.40 | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine 10 mcg/ml Inj-Adult | $134.30 | $223.83 | $76.10–$163.40 | — | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL | $273.90 | $456.50 | $155.21–$333.25 | 12% below | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL | $273.90 | $456.50 | $155.21–$333.25 | 12% below | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL | $273.90 | $456.50 | $155.21–$333.25 | — | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 hepatitis B adult vaccine 20 mcg/0.5 mL | $273.90 | $456.50 | $155.21–$333.25 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 10 mcg/0.5 ml-Peds | $48.28 | $80.47 | $27.36–$58.74 | 19% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 10 mcg/0.5 ml-Peds | $48.28 | $80.47 | $27.36–$58.74 | 19% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 5 mcg/0.5 ml Inj-Peds/Adolescent | $61.85 | $103.08 | $35.05–$75.25 | 4% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 5 mcg/0.5 ml Inj-Peds/Adolescent | $61.85 | $103.08 | $35.05–$75.25 | 4% above | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 10 mcg/0.5 ml-Peds | $48.28 | $80.47 | $27.36–$58.74 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 10 mcg/0.5 ml-Peds | $48.28 | $80.47 | $27.36–$58.74 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 5 mcg/0.5 ml Inj-Peds/Adolescent | $61.85 | $103.08 | $35.05–$75.25 | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 5 mcg/0.5 ml Inj-Peds/Adolescent | $61.85 | $103.08 | $35.05–$75.25 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus b Conj Vaccine 7.5-125mcg/0.5ml | $65.04 | $108.40 | $36.86–$79.13 | 19% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus b Conj Vaccine 7.5-125mcg/0.5ml | $65.04 | $108.40 | $36.86–$79.13 | 19% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Haemophilus b Conj Vaccine 7.5-125mcg/0.5ml | $65.04 | $108.40 | $36.86–$79.13 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Haemophilus b Conj Vaccine 7.5-125mcg/0.5ml | $65.04 | $108.40 | $36.86–$79.13 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus b Conjugate (PRP-T) Vaccine 0.5 ml | $63.25 | $105.41 | $35.84–$76.95 | 71% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus b Conjugate (PRP-T) Vaccine 0.5 ml | $63.25 | $105.41 | $35.84–$76.95 | 71% above | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus b Conjugate (PRP-T) Vaccine 0.5 ml | $63.25 | $105.41 | $35.84–$76.95 | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus b Conjugate (PRP-T) Vaccine 0.5 ml | $63.25 | $105.41 | $35.84–$76.95 | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vaccine-High-Dose-PF Inj 0.5 ml | $152.43 | $254.05 | $86.38–$185.46 | 103% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vaccine-High-Dose-PF Inj 0.5 ml | $152.43 | $254.05 | $86.38–$185.46 | 103% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vaccine-High-Dose-PF Inj 0.5 ml | $152.43 | $254.05 | $86.38–$185.46 | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vaccine-High-Dose-PF Inj 0.5 ml | $152.43 | $254.05 | $86.38–$185.46 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles-Mumps-Rubella Virus Vaccine | $181.04 | $301.73 | $102.59–$220.26 | 37% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles-Mumps-Rubella Virus Vaccine | $181.04 | $301.73 | $102.59–$220.26 | 37% above | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles-Mumps-Rubella Virus Vaccine | $181.04 | $301.73 | $102.59–$220.26 | — | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles-Mumps-Rubella Virus Vaccine | $181.04 | $301.73 | $102.59–$220.26 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Measles-Mumps-Rubella-Varicella Virus Vaccine 0.5 ml Inj | $370.92 | $618.20 | $210.19–$451.29 | at median | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Measles-Mumps-Rubella-Varicella Virus Vaccine 0.5 ml Inj | $370.92 | $618.20 | $210.19–$451.29 | at median | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Measles-Mumps-Rubella-Varicella Virus Vaccine 0.5 ml Inj | $370.92 | $618.20 | $210.19–$451.29 | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Measles-Mumps-Rubella-Varicella Virus Vaccine 0.5 ml Inj | $370.92 | $618.20 | $210.19–$451.29 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Oligosaccharide Conj Vaccine 0.5 ml Inj | $307.76 | $512.94 | $174.40–$374.45 | 33% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine group ACYW 0.5 mL Inj | $307.76 | $512.94 | $174.40–$374.45 | 33% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine group ACYW 0.5 mL Inj | $307.76 | $512.94 | $174.40–$374.45 | 33% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Oligosaccharide Conj Vaccine 0.5 ml Inj | $307.76 | $512.94 | $174.40–$374.45 | 33% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Conjugate Vaccine 4 mcg/0.5 ml | $513.94 | $856.56 | $291.23–$625.29 | 122% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Conjugate Vaccine 4 mcg/0.5 ml | $513.94 | $856.56 | $291.23–$625.29 | 122% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine group ACYW 0.5 mL Inj | $307.76 | $512.94 | $174.40–$374.45 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Oligosaccharide Conj Vaccine 0.5 ml Inj | $307.76 | $512.94 | $174.40–$374.45 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Oligosaccharide Conj Vaccine 0.5 ml Inj | $307.76 | $512.94 | $174.40–$374.45 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine group ACYW 0.5 mL Inj | $307.76 | $512.94 | $174.40–$374.45 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Conjugate Vaccine 4 mcg/0.5 ml | $513.94 | $856.56 | $291.23–$625.29 | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Conjugate Vaccine 4 mcg/0.5 ml | $513.94 | $856.56 | $291.23–$625.29 | — | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid gr | $317.02 | $528.36 | $179.64–$385.70 | 112% above | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid gr | $317.02 | $528.36 | $179.64–$385.70 | 112% above | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid gr | $317.02 | $528.36 | $179.64–$385.70 | — | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 meningococcal conjugate vaccine polysaccharide tetanus toxoid gr | $317.02 | $528.36 | $179.64–$385.70 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Group B Vaccine 0.5 ml | $432.42 | $720.70 | $245.04–$526.11 | 77% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Group B Vaccine 0.5 ml | $432.42 | $720.70 | $245.04–$526.11 | 77% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Group B Vaccine 0.5 ml | $432.42 | $720.70 | $245.04–$526.11 | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Group B Vaccine 0.5 ml | $432.42 | $720.70 | $245.04–$526.11 | — | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal Group B (recombinant) Vaccine 0.5 ml Inj | $354.77 | $591.28 | $201.04–$431.63 | 101% above | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal Group B (recombinant) Vaccine 0.5 ml Inj | $354.77 | $591.28 | $201.04–$431.63 | 101% above | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Meningococcal Group B (recombinant) Vaccine 0.5 ml Inj | $354.77 | $591.28 | $201.04–$431.63 | — | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Meningococcal Group B (recombinant) Vaccine 0.5 ml Inj | $354.77 | $591.28 | $201.04–$431.63 | — | 40% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza Virus Vaccine, live trivalent intranasal | $23.81 | $39.69 | $13.49–$28.97 | 26% below | 40% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza Virus Vaccine, live trivalent intranasal | $23.81 | $39.69 | $13.49–$28.97 | 26% below | 40% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Influenza Virus Vaccine, live trivalent intranasal | $23.81 | $39.69 | $13.49–$28.97 | — | 40% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Influenza Virus Vaccine, live trivalent intranasal | $23.81 | $39.69 | $13.49–$28.97 | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal 13-Valent Conj Vaccine 0.5 ml | $412.15 | $686.91 | $233.55–$501.44 | 4% below | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal 13-Valent Conj Vaccine 0.5 ml | $412.15 | $686.91 | $233.55–$501.44 | 4% below | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal 13-Valent Conj Vaccine 0.5 ml | $412.15 | $686.91 | $233.55–$501.44 | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pneumococcal 13-Valent Conj Vaccine 0.5 ml | $412.15 | $686.91 | $233.55–$501.44 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL Inj | $512.71 | $854.52 | $290.54–$623.80 | at median | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL Inj | $512.71 | $854.52 | $290.54–$623.80 | at median | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL Inj | $512.71 | $854.52 | $290.54–$623.80 | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL Inj | $512.71 | $854.52 | $290.54–$623.80 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine 0.5 ml | $219.79 | $366.32 | $124.55–$267.41 | at median | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine 0.5 ml | $219.79 | $366.32 | $124.55–$267.41 | at median | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine 0.5 ml | $219.79 | $366.32 | $124.55–$267.41 | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine 0.5 ml | $219.79 | $366.32 | $124.55–$267.41 | — | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus Vaccine Inactivated 0.5 ml | $91.64 | $152.74 | $51.93–$111.50 | 64% above | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus Vaccine Inactivated 0.5 ml | $91.64 | $152.74 | $51.93–$111.50 | 64% above | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus Vaccine Inactivated 0.5 ml | $91.64 | $152.74 | $51.93–$111.50 | — | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovirus Vaccine Inactivated 0.5 ml | $91.64 | $152.74 | $51.93–$111.50 | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | 70% above | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | 70% above | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 nirsevimab (cvx 307) alip preservative-free 100 mg/mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | 32% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | 32% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL So | $997.44 | $1,662.40 | $565.22–$1,213.55 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg | $555.82 | $926.37 | $314.97–$676.25 | 76% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg | $555.82 | $926.37 | $314.97–$676.25 | 76% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg | $555.82 | $926.37 | $314.97–$676.25 | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV vaccine, preF A-preF B, recombinant preservative-free 60 mcg | $555.82 | $926.37 | $314.97–$676.25 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine preF3, recombinant preservative-free 120 mcg In | $555.02 | $925.04 | $314.51–$675.28 | 121% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine preF3, recombinant preservative-free 120 mcg In | $555.02 | $925.04 | $314.51–$675.28 | 121% above | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine preF3, recombinant preservative-free 120 mcg In | $555.02 | $925.04 | $314.51–$675.28 | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine preF3, recombinant preservative-free 120 mcg In | $555.02 | $925.04 | $314.51–$675.28 | — | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine 2.5 Units Inj | $316.85 | $528.08 | $179.55–$385.50 | 57% below | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine 2.5 Units Inj | $316.85 | $528.08 | $179.55–$385.50 | 57% below | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine, Human 2.5 Units/ml | $675.14 | $1,125.24 | $382.58–$821.43 | 8% below | 40% |
| Rabies vaccine, one dose CPT 90675 Rabies Vaccine, Human 2.5 Units/ml | $675.14 | $1,125.24 | $382.58–$821.43 | 8% below | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine 2.5 Units Inj | $316.85 | $528.08 | $179.55–$385.50 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine 2.5 Units Inj | $316.85 | $528.08 | $179.55–$385.50 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, Human 2.5 Units/ml | $675.14 | $1,125.24 | $382.58–$821.43 | — | 40% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, Human 2.5 Units/ml | $675.14 | $1,125.24 | $382.58–$821.43 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Vaccine Monovalent 1 ml Susp | $247.05 | $411.75 | $140.00–$300.58 | 36% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Vaccine Monovalent 1 ml Susp | $247.05 | $411.75 | $140.00–$300.58 | 36% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent 1.5 mL Susp | $263.04 | $438.40 | $149.06–$320.03 | 44% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent 1.5 mL Susp | $263.04 | $438.40 | $149.06–$320.03 | 44% above | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus Vaccine Monovalent 1 ml Susp | $247.05 | $411.75 | $140.00–$300.58 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Rotavirus Vaccine Monovalent 1 ml Susp | $247.05 | $411.75 | $140.00–$300.58 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine monovalent 1.5 mL Susp | $263.04 | $438.40 | $149.06–$320.03 | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine monovalent 1.5 mL Susp | $263.04 | $438.40 | $149.06–$320.03 | — | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus Vaccine Pentavalent 2 ml Susp | $90.16 | $150.26 | $51.09–$109.69 | 17% below | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Rotavirus Vaccine Pentavalent 2 ml Susp | $90.16 | $150.26 | $51.09–$109.69 | 17% below | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus Vaccine Pentavalent 2 ml Susp | $90.16 | $150.26 | $51.09–$109.69 | — | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Rotavirus Vaccine Pentavalent 2 ml Susp | $90.16 | $150.26 | $51.09–$109.69 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Vaccine, inactivated 0.5 ml Inj | $394.13 | $656.89 | $223.34–$479.53 | 82% above | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Vaccine, inactivated 0.5 ml Inj | $394.13 | $656.89 | $223.34–$479.53 | 82% above | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster Vaccine, inactivated 0.5 ml Inj | $394.13 | $656.89 | $223.34–$479.53 | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster Vaccine, inactivated 0.5 ml Inj | $394.13 | $656.89 | $223.34–$479.53 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphth toxoids (Td) adult/adol 2 units-2 units/0.5 mL In | $61.99 | $103.31 | $35.13–$75.42 | 4% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphth toxoids (Td) adult/adol 2 units-2 units/0.5 mL In | $61.99 | $103.31 | $35.13–$75.42 | 4% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphth Toxoids (Td)-Adult/Adol 0.5ml Inj | $83.36 | $138.94 | $47.24–$101.43 | 39% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphth Toxoids (Td)-Adult/Adol 0.5ml Inj | $83.36 | $138.94 | $47.24–$101.43 | 39% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphth toxoids (Td) adult/adol 2 units-2 units/0.5 mL In | $61.99 | $103.31 | $35.13–$75.42 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphth toxoids (Td) adult/adol 2 units-2 units/0.5 mL In | $61.99 | $103.31 | $35.13–$75.42 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphth Toxoids (Td)-Adult/Adol 0.5ml Inj | $83.36 | $138.94 | $47.24–$101.43 | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphth Toxoids (Td)-Adult/Adol 0.5ml Inj | $83.36 | $138.94 | $47.24–$101.43 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphth-Pertussis, Acel-Tetanus (Adacel) Inj 0.5 ml | $96.47 | $160.79 | $54.67–$117.38 | 12% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphth-Pertussis, Acel-Tetanus (Adacel) Inj 0.5 ml | $96.47 | $160.79 | $54.67–$117.38 | 12% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphth-Tetanus-Pertuss (Tdap Reduced) Inj 0.5 ml | $98.76 | $164.60 | $55.96–$120.16 | 15% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphth-Tetanus-Pertuss (Tdap Reduced) Inj 0.5 ml | $98.76 | $164.60 | $55.96–$120.16 | 15% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diphth-Pertussis, Acel-Tetanus (Adacel) Inj 0.5 ml | $96.47 | $160.79 | $54.67–$117.38 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diphth-Pertussis, Acel-Tetanus (Adacel) Inj 0.5 ml | $96.47 | $160.79 | $54.67–$117.38 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diphth-Tetanus-Pertuss (Tdap Reduced) Inj 0.5 ml | $98.76 | $164.60 | $55.96–$120.16 | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diphth-Tetanus-Pertuss (Tdap Reduced) Inj 0.5 ml | $98.76 | $164.60 | $55.96–$120.16 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS CC INFLUENZA VACCINE ADMIN | $49.80 | $83.00 | $28.22–$60.59 | 45% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS PNEUMOCOCCAL VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS HEP B VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS Hepatitis B Admin Subsequent | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS H1N1 VACCINE ADMINISTRATION | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS Immunization-Other Admin Initial | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS IMMUNIZATION ADMINISTRATION | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS Pneumococcal Admin Initial | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS Hepatitis B Admin Initial | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS Influenza Admin Initial | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS INFLUENZA VIRUS VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 GHS IMMUNIZATION ADMIN - INITIAL | $52.80 | $88.00 | $29.92–$64.24 | 54% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Immunization Initial VFC NON-Medicaid IA No Counseling | $12.60 | $21.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Pneumococcal Admin Initial | $33.00 | $55.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Influenza Admin Initial | $33.00 | $55.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Hepatitis B Admin Initial | $33.00 | $55.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Immunization Initial VFC Medicaid No Counseling IA | $39.00 | $65.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization admin/1 vaccine 90471 | $39.00 | $65.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Immunization Initial No Counseling | $39.00 | $65.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS CC INFLUENZA VACCINE ADMIN | $49.80 | $83.00 | $28.22–$60.59 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Hepatitis B Admin Subsequent | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS Immunization-Other Admin Initial | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS H1N1 VACCINE ADMINISTRATION | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS HEP B VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS IMMUNIZATION ADMINISTRATION | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS PNEUMOCOCCAL VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS IMMUNIZATION ADMIN - INITIAL | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 GHS INFLUENZA VIRUS VACCINE ADMIN | $52.80 | $88.00 | $29.92–$64.24 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS Immunization-Other Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS Subsequent Pneumococcal virus vaccine admin | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS Influenza Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS Pneumococcal Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS Subsequent Influenza virus vaccine admin | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS IMMUNIZATION ADMIN - EACH ADDITIONAL | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 GHS SUBSEQUENT VACCINE ADMINISTRATION | $30.60 | $51.00 | $17.34–$37.23 | 8% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization Subsequent-VFC NON-Medicaid IL | $4.20 | $7.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization Subsequent-VFC NON-Medicaid IA No Counselin | $12.60 | $21.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization Subsequent-VFC NON-Medicaid IA Counseling | $12.60 | $21.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization admin/ea add vaccine 90472 | $21.00 | $35.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization Subsequent No Counseling | $21.00 | $35.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization Subsequent VFC Medicaid No Counseling IA | $21.00 | $35.00 | $928.00–$2,679.00 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Influenza Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS IMMUNIZATION ADMIN - EACH ADDITIONAL | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS SUBSEQUENT VACCINE ADMINISTRATION | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Immunization-Other Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Subsequent Pneumococcal virus vaccine admin | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Pneumococcal Admin Subsequent | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 GHS Subsequent Influenza virus vaccine admin | $30.60 | $51.00 | $17.34–$37.23 | — | 40% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/genesishealth-cah