University Medical Center El Paso
University Medical Center El Paso in El Paso, TX publishes cash prices for 54 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
4815 Alameda Avenue El Paso, TX 79905 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 NE ABDOMEN PELVIS W CONTR | $261.40 | $1,307.01 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 WS ABDOMEN PELVIS W CONTR | $261.40 | $1,307.01 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ES ABDOMEN PELVIS W CONTR | $306.47 | $1,532.35 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 REN ABDOMEN PELVIS W CONTR | $306.47 | $1,532.35 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ES RAD CT ABD & PELVIS W/ ENTEROGRAPHY | $1,025.03 | $5,125.13 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 NE CT ABD & PELVIS W/ ENTEROGRAPHY | $1,065.69 | $5,328.44 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS WITH CONTRAST | $1,148.56 | $5,742.78 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/ CONT | $1,231.28 | $6,156.41 | 80% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W ENTEROGRAPHY | $1,415.97 | $7,079.87 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 WS ABDOMEN PELVIS W CONTR | $261.40 | $1,307.01 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 NE ABDOMEN PELVIS W CONTR | $261.40 | $1,307.01 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 REN ABDOMEN PELVIS W CONTR | $306.47 | $1,532.35 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ES ABDOMEN PELVIS W CONTR | $306.47 | $1,532.35 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ES RAD CT ABD & PELVIS W/ ENTEROGRAPHY | $1,025.03 | $5,125.13 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 NE CT ABD & PELVIS W/ ENTEROGRAPHY | $1,065.69 | $5,328.44 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS WITH CONTRAST | $1,148.56 | $5,742.78 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/ CONT | $1,231.28 | $6,156.41 | 80% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W ENTEROGRAPHY | $1,415.97 | $7,079.87 | 80% |
| CT scan of the head or brain, no contrast dye CPT 70450 MSU CT HEAD/BRAIN W/O CONTRAST | $459.92 | $2,299.60 | 80% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WITHOUTCONTRAST | $629.74 | $3,148.71 | 80% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 MSU CT HEAD/BRAIN W/O CONTRAST | $459.92 | $2,299.60 | 80% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WITHOUTCONTRAST | $629.74 | $3,148.71 | 80% |
| CT scan of the pelvis, with contrast dye CPT 72193 ES PELVIS W/IV CONT (ROUTINE) | $153.49 | $767.47 | 80% |
| CT scan of the pelvis, with contrast dye CPT 72193 REN PELVIS W/IV CONT (ROUTINE) | $153.49 | $767.47 | 80% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $512.80 | $2,564.02 | 80% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 REN PELVIS W/IV CONT (ROUTINE) | $153.49 | $767.47 | 80% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 ES PELVIS W/IV CONT (ROUTINE) | $153.49 | $767.47 | 80% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST | $512.80 | $2,564.02 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BI | $56.14 | $280.70 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT DIG IMAGE | $116.31 | $581.53 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMO DX BI | $116.31 | $581.53 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 NE MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 ES MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts both sides CPT 77066 WS MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BI | $56.14 | $280.70 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG MAMMO DX BI | $116.31 | $581.53 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT DIG IMAGE | $116.31 | $581.53 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 ES MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 WS MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 NE MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MA DIAG MG DIG BILAT | $119.02 | $595.12 | 80% |
| Diagnostic mammogram, one breast CPT 77065 MG MAMMO DX UNI | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO DX UNI | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT DIG IMAGE RT | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNILAT DIG IMAGE LT | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 NE MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 NE MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 WS MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 WS MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 ES MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 ES MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast one side CPT 77065 MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MG MAMMO DX UNI | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO DX UNI | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT DIG IMAGE LT | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO UNILAT DIG IMAGE RT | $51.37 | $256.85 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 ES MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 NE MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 WS MA DIAG MG DIG RT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 WS MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 ES MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 NE MA DIAG MG DIG LT | $90.79 | $453.94 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 NE MRI KNEE UNI W/O CONT | $189.93 | $949.64 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 NE MRI EXT LOWER JT W/O CONT | $189.93 | $949.64 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LWR EXT JT W/O | $518.83 | $2,594.13 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LWR EXT JT WITHOUT | $518.83 | $2,594.13 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 REN MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 REN MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 ES MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 WS MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 WS MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 ES MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 NE MRI KNEE UNI W/O CONT | $189.93 | $949.64 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 NE MRI EXT LOWER JT W/O CONT | $189.93 | $949.64 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT JT WITHOUT | $518.83 | $2,594.13 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LWR EXT JT W/O | $518.83 | $2,594.13 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 WS MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 ES MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 ES MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 WS MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 REN MRI KNEE UNI W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 REN MRI EXT LOWER JT W/O CONT | $563.46 | $2,817.31 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LWR EXT JT W&W/O BI | $745.81 | $3,729.06 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LWR EXT JT W&W/O | $611.28 | $3,056.42 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI MRA LWR EXT JT W&W/O | $611.28 | $3,056.42 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 REN MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 REN MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 REN MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 ES MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 ES MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 ES MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 WS MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 WS MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 WS MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 NE MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI LWR EXT JT W&W/O BI | $745.81 | $3,729.06 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI MRA LWR EXT JT W&W/O | $611.28 | $3,056.42 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LWR EXT JT W&W/O | $611.28 | $3,056.42 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 WS MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 ES MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 ES MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 ES MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 REN MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 REN MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 NE MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 REN MRI KNEE UNI W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 WS MRI EXT LOWER JT W/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 WS MRI KNEE BILATW/WO CONT | $663.83 | $3,319.14 | 80% |
| MRI of the brain, no contrast dye CPT 70551 REN MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye CPT 70551 ES MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye CPT 70551 WS MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye CPT 70551 MRI LIMITED BRAIN W/O PORTABLE | $684.73 | $3,423.65 | 80% |
| MRI of the brain, no contrast dye inpatient CPT 70551 ES MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye inpatient CPT 70551 REN MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye inpatient CPT 70551 WS MRI BRAIN WO CONT | $338.98 | $1,694.88 | 80% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI LIMITED BRAIN W/O PORTABLE | $684.73 | $3,423.65 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 WS MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 ES MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 REN MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&W/O | $1,202.00 | $6,009.98 | 80% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 REN MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 WS MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 ES MRI BRAIN W/WO CONT | $825.61 | $4,128.06 | 80% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W&W/O | $1,202.00 | $6,009.98 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 REN MRI LUMBAR SPIW/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 WS MRI LUMBAR SPINE W/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 ES MRI LUMBAR SPINE W/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O | $461.08 | $2,305.40 | 80% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 REN MRI LUMBAR SPIW/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 ES MRI LUMBAR SPINE W/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 WS MRI LUMBAR SPINE W/O CONT | $435.49 | $2,177.45 | 80% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O | $461.08 | $2,305.40 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ZAT OB US >= 14 WK SNGL FTS | $55.58 | $277.92 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ZAR US >= 14 WK SNG FTS#PF# | $74.14 | $370.70 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 USD PREG >14W SINGLE | $75.22 | $376.12 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WK SNGL FTS | $79.33 | $396.65 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 FAB US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 WSP US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ESP US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 FAB OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 EST OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 WST OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ZAT OB US >= 14 WK SNGL FTS | $55.58 | $277.92 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ZAR US >= 14 WK SNG FTS#PF# | $74.14 | $370.70 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 USD PREG >14W SINGLE | $75.22 | $376.12 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >= 14 WK SNGL FTS | $79.33 | $396.65 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 FAB US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ESP US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 WSP US >= 14 WK SNG FTS#PF# | $83.30 | $416.49 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 FAB OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 WST OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 EST OB US >= 14 WK SNGL FTS | $89.13 | $445.64 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 WS MAMMO SCREEN BILAT W/CAD | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 ES MAMMO SCREEN BILAT W/CAD | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCRN BI | $35.10 | $175.51 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT DIG IMAGE | $50.16 | $250.78 | 80% |
| Screening mammogram, both breasts both sides CPT 77067 MG MAMMO SCRN BI | $72.55 | $362.73 | 80% |
| Screening mammogram, both breasts CPT 77067 ES MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts CPT 77067 REN MAMMOGRAPHY SCREENING | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts CPT 77067 WS MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts CPT 77067 REN MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts CPT 77067 WS MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts CPT 77067 ES MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts CPT 77067 NE MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts CPT 77067 NE MAMMOGRAPHY SCRNING/PREPAY | $50.16 | $250.78 | 80% |
| Screening mammogram, both breasts CPT 77067 MA SCRN MG DIG | $60.35 | $301.73 | 80% |
| Screening mammogram, both breasts CPT 77067 NE MA SCREENING DIG TOMO BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts CPT 77067 WS MA SCREENNG DIGITAL BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts CPT 77067 ES MA SCREENING DIG TOMO BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts CPT 77067 WS MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts CPT 77067 NE MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts CPT 77067 ES MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts CPT 77067 RAD MA SCREENING DIG TOMO BIL PROMO | $98.74 | $493.71 | 80% |
| Screening mammogram, both breasts one side CPT 77067 ES MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts one side CPT 77067 NE MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts one side CPT 77067 NE MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts one side CPT 77067 WS MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts one side CPT 77067 WS MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts one side CPT 77067 ES MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 ES MAMMO SCREEN BILAT W/CAD | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 WS MAMMO SCREEN BILAT W/CAD | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCRN BI | $35.10 | $175.51 | 80% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT DIG IMAGE | $50.16 | $250.78 | 80% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG MAMMO SCRN BI | $72.55 | $362.73 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 ES MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 REN MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 WS MAMMOGRAPHY SCRNING/PREPAY | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 REN MAMMOGRAPHY SCREENING | $31.24 | $156.22 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 WS MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 ES MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 NE MAMMOGRAPHY SCREENING | $32.67 | $163.35 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 NE MAMMOGRAPHY SCRNING/PREPAY | $50.16 | $250.78 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 MA SCRN MG DIG | $60.35 | $301.73 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 NE MA SCREENING DIG TOMO BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 ES MA SCREENING DIG TOMO BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 WS MA SCREENNG DIGITAL BIL PROMO | $87.89 | $439.44 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 ES MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 WS MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 NE MA SCRN MG DIG | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient CPT 77067 RAD MA SCREENING DIG TOMO BIL PROMO | $98.74 | $493.71 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 ES MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 WS MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 ES MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 NE MA SCRN MG DIG RT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 NE MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Screening mammogram, both breasts inpatient one side CPT 77067 WS MA SCRN MG DIG LT | $89.60 | $448.00 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 ERD US TRANSVAGINAL | $48.33 | $241.63 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 NE PELVIC NON-OB TRANSVAGINAL | $49.40 | $247.02 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 WST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 ZAT US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 EST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 EST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 NE US TRANSVAGINAL #PF# | $83.89 | $419.44 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 ZAR US TRANSVAGINAL #PF# | $90.00 | $450.00 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 WSP US TRANSVAGINAL #PF# | $90.00 | $450.00 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $98.56 | $492.78 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 FAB US TRANSVAGINAL #PF# | $101.12 | $505.58 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 ESP US TRANSVAGINAL #PF# | $101.12 | $505.58 | 80% |
| Transvaginal pelvic ultrasound CPT 76830 FAB US TRANSVAGINAL | $108.19 | $540.97 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ERD US TRANSVAGINAL | $48.33 | $241.63 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 NE PELVIC NON-OB TRANSVAGINAL | $49.40 | $247.02 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 EST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 WST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ZAT US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 EST US TRANSVAGINAL | $65.56 | $327.81 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 NE US TRANSVAGINAL #PF# | $83.89 | $419.44 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ZAR US TRANSVAGINAL #PF# | $90.00 | $450.00 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 WSP US TRANSVAGINAL #PF# | $90.00 | $450.00 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $98.56 | $492.78 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 FAB US TRANSVAGINAL #PF# | $101.12 | $505.58 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ESP US TRANSVAGINAL #PF# | $101.12 | $505.58 | 80% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 FAB US TRANSVAGINAL | $108.19 | $540.97 | 80% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPL | $148.54 | $742.71 | 80% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN CMPL | $148.54 | $742.71 | 80% |
| X-ray of the lower back, 4 or more views CPT 72110 ED XR L-SPINE 4+V | $107.93 | $539.67 | 80% |
| X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4+VIEWS | $107.93 | $539.67 | 80% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 ED XR L-SPINE 4+V | $107.93 | $539.67 | 80% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE 4+VIEWS | $107.93 | $539.67 | 80% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 NE BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) CPT 80048 LES BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) CPT 80048 CHEM BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) CPT 80048 LEN BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) CPT 80048 LWS BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) CPT 80048 LEN CHM8 POC | $31.81 | $159.04 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHEM BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 NE BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LWS BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LES BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LEN BASIC METABOLIC PANEL | $27.09 | $135.45 | 80% |
| Basic metabolic panel (blood test) inpatient CPT 80048 LEN CHM8 POC | $31.81 | $159.04 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NHC NE THSTEPS POLIOVIRUS,IPV,SC #PF# | $22.40 | $112.00 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 SPC LIPID PANEL | $27.38 | $136.92 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LEN LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LES LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LWS LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 YSL LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NHC NE THSTEPS POLIOVIRUS,IPV,SC #PF# | $22.40 | $112.00 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 SPC LIPID PANEL | $27.38 | $136.92 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 YSL LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LWS LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LES LIPID PANEL | $34.94 | $174.72 | 80% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LEN LIPID PANEL | $34.94 | $174.72 | 80% |
| Complete blood count (CBC) with differential CPT 85025 LES CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 CBC BASELINE | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 CHEM CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 YSL CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 NE CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 LWS CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential CPT 85025 LEN CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHEM CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LEN CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 NE CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC BASELINE | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LWS CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 YSL CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC) with differential inpatient CPT 85025 LES CBC AUTO W/AUTO DIFF | $8.65 | $43.24 | 80% |
| Complete blood count (CBC), no differential CPT 85027 LES CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential CPT 85027 LEN CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential CPT 85027 CHEM HEMOGRAM AUTO | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential CPT 85027 YSL CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential CPT 85027 LWS CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 YSL CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 LES CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 LEN CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CHEM HEMOGRAM AUTO | $6.50 | $32.49 | 80% |
| Complete blood count (CBC), no differential inpatient CPT 85027 LWS CBC AUTO W/O DIFF | $6.50 | $32.49 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL ADJUSTED CALCIUM | $15.52 | $77.60 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 LES CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 LEN CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 LWS CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 NE CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 YSL CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 CHEM CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) CPT 80053 LEN CHM14 POC | $36.29 | $181.44 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL ADJUSTED CALCIUM | $15.52 | $77.60 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LWS CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 YSL CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 NE CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHEM CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LEN CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LES CMPRH METAB PANEL | $34.44 | $172.20 | 80% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 LEN CHM14 POC | $36.29 | $181.44 | 80% |
| Kidney function blood test panel CPT 80069 LAB RENAL FUNCTION PANEL | $20.50 | $102.48 | 80% |
| Kidney function blood test panel CPT 80069 LEN RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel CPT 80069 LES RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel CPT 80069 LWS RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel CPT 80069 LEN RENAL FUNCTION PANEL POC | $27.38 | $136.92 | 80% |
| Kidney function blood test panel inpatient CPT 80069 LAB RENAL FUNCTION PANEL | $20.50 | $102.48 | 80% |
| Kidney function blood test panel inpatient CPT 80069 LEN RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel inpatient CPT 80069 LES RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel inpatient CPT 80069 LWS RENAL FUNCTION PANEL | $27.22 | $136.08 | 80% |
| Kidney function blood test panel inpatient CPT 80069 LEN RENAL FUNCTION PANEL POC | $27.38 | $136.92 | 80% |
| Liver function blood test panel CPT 80076 CHEM HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel CPT 80076 NE HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel CPT 80076 YSL HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel CPT 80076 LWS HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel CPT 80076 LES HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel CPT 80076 LEN HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 NE HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 LEN HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 LES HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 LWS HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 CHEM HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Liver function blood test panel inpatient CPT 80076 YSL HEPATIC FUNCTION PANEL | $9.13 | $45.66 | 80% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $19.49 | $97.44 | 80% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $19.49 | $97.44 | 80% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 CHEM PSA FREE | $45.15 | $225.75 | 80% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 CHEM PSA FREE | $45.15 | $225.75 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHEM PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LES PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 YSL YSL PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LEN PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 SPC PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 LWS PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 SPC PSA TOTAL ULTRASENSITIVE | $19.82 | $99.12 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 SPC PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LWS PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 YSL YSL PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LES PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LEN PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHEM PSA TOTAL | $17.47 | $87.36 | 80% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 SPC PSA TOTAL ULTRASENSITIVE | $19.82 | $99.12 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 SPC PRT THROMBO TM (PTT) | $6.89 | $34.46 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAS TIME | $16.88 | $84.42 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAS TIME (PTT) | $18.82 | $94.08 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 CHEM PRT THROMBO TM (PTT) | $18.98 | $94.92 | 80% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 CLIN CHEM PRT THROMBO TM (PTT) | $20.66 | $103.32 | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 SPC PRT THROMBO TM (PTT) | $6.89 | $34.46 | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAS TIME | $16.88 | $84.42 | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAS TIME (PTT) | $18.82 | $94.08 | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHEM PRT THROMBO TM (PTT) | $18.98 | $94.92 | 80% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CLIN CHEM PRT THROMBO TM (PTT) | $20.66 | $103.32 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) | $3.35 | $16.76 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LES PROTHROMBIN TIME POC | $9.92 | $49.60 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LEN PROTHROMBIN TIME (PT) POC | $10.75 | $53.76 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LAB PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LEN PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 YSL PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHEM PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 SPEC_CHEM PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LWS PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LES PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT) | $3.35 | $16.76 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LES PROTHROMBIN TIME POC | $9.92 | $49.60 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LEN PROTHROMBIN TIME (PT) POC | $10.75 | $53.76 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LEN PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LES PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LAB PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 YSL PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHEM PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 SPEC_CHEM PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LWS PROTHROMBIN TIME (PT) | $14.45 | $72.24 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LEN THYROID STIMULATING HORMON | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LES THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 LWS THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 YSL THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CLIN_CHEM TSH | $22.68 | $113.40 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 SPC THYROID STIMULATING HORMONE | $26.80 | $133.98 | 80% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHEM TSH | $37.63 | $188.16 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LWS THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LEN THYROID STIMULATING HORMON | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 YSL THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LES THYROID STIMULATING HORMONE | $15.12 | $75.60 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CLIN_CHEM TSH | $22.68 | $113.40 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 SPC THYROID STIMULATING HORMONE | $26.80 | $133.98 | 80% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHEM TSH | $37.63 | $188.16 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 LES UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 LEN UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 LWS UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 NE UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 YSL UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 CHEM UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated CPT 81001 FAB ORDER COMMUNICATION ONLY | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LWS UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LEN UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 YSL UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 LES UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHEM UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 FAB ORDER COMMUNICATION ONLY | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 NE UA AUTO W/MICRO | $6.72 | $33.60 | 80% |
| Urinalysis with microscope exam, manual CPT 81000 CET UA DIPSTICKNONAUTO W/MICRO | $4.75 | $23.76 | 80% |
| Urinalysis with microscope exam, manual CPT 81000 EST DIPSTICK NONAUTO W/MICRO | $7.39 | $36.96 | 80% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CET UA DIPSTICKNONAUTO W/MICRO | $4.75 | $23.76 | 80% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 EST DIPSTICK NONAUTO W/MICRO | $7.39 | $36.96 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 CLIN_CHEM UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 NE UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 CHEM UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 CHEM UA AUTO GLUCOSE | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 UCC ESLK URINALYSIS DIPSTICK | $2.67 | $13.37 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 DPT UADIPSTICK NON-AUTO W/O M | $2.67 | $13.37 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 LES UA BIOCHEM SCREEN | $3.36 | $16.80 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 LEN UA BIOCHEM SCREEN | $3.36 | $16.80 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 UCC ESLK URINALYSIS AUTO W/O MCRO | $6.22 | $31.08 | 80% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O MCRO | $6.22 | $31.08 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHEM UA AUTO GLUCOSE | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CLIN_CHEM UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHEM UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 NE UA AUTO W/O MICRO | $2.51 | $12.55 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 DPT UADIPSTICK NON-AUTO W/O M | $2.67 | $13.37 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UCC ESLK URINALYSIS DIPSTICK | $2.67 | $13.37 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LES UA BIOCHEM SCREEN | $3.36 | $16.80 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 LEN UA BIOCHEM SCREEN | $3.36 | $16.80 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UCC ESLK URINALYSIS AUTO W/O MCRO | $6.22 | $31.08 | 80% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O MCRO | $6.22 | $31.08 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 LWS UA BIOCHEM SCREEN NONAUTO | $3.86 | $19.32 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 LES UA BIOCHEM SCREEN | $3.86 | $19.32 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 CEC UA DIP NONAUTO W/O MICRO | $4.70 | $23.52 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 EST UA DIP NON AUTO W/O MICRO | $4.70 | $23.52 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 DPT UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 FAB UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 ZAT UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 CHEM UA RED SUBS | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 CHEM UA NONAUTO SP GRAV | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 CHEM UA NONAUTO PROTEIN | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 UA DIP NONAUTO W/O MICRO | $7.56 | $37.81 | 80% |
| Urinalysis without microscope exam, manual CPT 81002 WST UA DIP NONAUTO W/O MICRO | $7.94 | $39.71 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 LES UA BIOCHEM SCREEN | $3.86 | $19.32 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 LWS UA BIOCHEM SCREEN NONAUTO | $3.86 | $19.32 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 EST UA DIP NON AUTO W/O MICRO | $4.70 | $23.52 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CEC UA DIP NONAUTO W/O MICRO | $4.70 | $23.52 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 ZAT UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DPT UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 FAB UA DIP NON-AUTO W/O MICRO | $5.54 | $27.72 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHEM UA NONAUTO PROTEIN | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHEM UA NONAUTO SP GRAV | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHEM UA RED SUBS | $7.35 | $36.75 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA DIP NONAUTO W/O MICRO | $7.56 | $37.81 | 80% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 WST UA DIP NONAUTO W/O MICRO | $7.94 | $39.71 | 80% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care CPT 59510 DPT DEL C-SECT W/ANTE/POST CARE | $514.61 | $2,573.05 | 80% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 DEL C-SECT W/ANTE/POST CARE | $578.22 | $2,891.08 | 80% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 WST DEL C-SECT W/ANTE/POST CARE | $607.13 | $3,035.63 | 80% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 FAB DEL C-SECT W/ANTE/POST CARE | $607.13 | $3,035.63 | 80% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 EST DEL C-SECT W/ANTE/POST CARE | $607.13 | $3,035.63 | 80% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 ZAT DEL C-SECT W/ANTE/POST CARE | $607.13 | $3,035.63 | 80% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 ZAT DEL C-SECT W/ANTE/POST CARE | $607.13 | $3,035.63 | 80% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY FLEX W/US | $334.64 | $1,673.20 | 80% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY FLEX W/US | $334.64 | $1,673.20 | 80% |
| Colonoscopy with polyp removal CPT 45385 ERD COLONOSCPY FLEX W/REM SNAR | $931.25 | $4,656.26 | 80% |
| Colonoscopy with polyp removal inpatient CPT 45385 ERD COLONOSCPY FLEX W/REM SNAR | $931.25 | $4,656.26 | 80% |
| Colonoscopy with tissue sample CPT 45380 ERD COLONOSCPY FLEX W/BIOPSY | $677.07 | $3,385.37 | 80% |
| Colonoscopy with tissue sample inpatient CPT 45380 ERD COLONOSCPY FLEX W/BIOPSY | $677.07 | $3,385.37 | 80% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH LEFT HEART W/ VENTRCLGRPH | $1,332.18 | $6,660.91 | 80% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH LEFT HEART W/ VENTRCLGRPH | $1,332.18 | $6,660.91 | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPIDRL SUBARAC L/S W/IMG | $131.83 | $659.17 | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 ERD INJ EPIDRL SUBARAC L/S W/IM | $283.56 | $1,417.79 | 80% |
| Lower-back epidural injection, with imaging guidance CPT 62323 RAD INJ EPIDRL SUBARAC L/S W/IMG | $322.44 | $1,612.22 | 80% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ EPIDRL SUBARAC L/S W/IMG | $131.83 | $659.17 | 80% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ERD INJ EPIDRL SUBARAC L/S W/IM | $283.56 | $1,417.79 | 80% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 RAD INJ EPIDRL SUBARAC L/S W/IMG | $322.44 | $1,612.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NSICU INJ EPI SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 EMU INJ EPI SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 OBSU INJ EPIDURAL SUBARACH L/S | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NM INJ SUBARC EPID L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 MED INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 TR INJ EPIDURAL SUBARACH SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 ICU INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 MSICU INJ EPID SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 TRA INJ EPID SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 TEL INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 XR INJ EPIDURAL SUBARACH L/S SGL | $233.77 | $1,168.87 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 RAD ARTHRO ASP/INJ JT MAJOR | $233.77 | $1,168.87 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 ZAR INJ EPIDURAL SUB L/S SGL #PF# | $246.22 | $1,231.08 | 80% |
| Lower-back epidural injection, without imaging guidance CPT 62322 ER INJ EPIDL SUBAR L/S W/O IMG | $608.00 | $3,040.00 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ICU INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 MED INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 TEL INJ EPIDURAL SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NSICU INJ EPI SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 TRA INJ EPID SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 MSICU INJ EPID SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 TR INJ EPIDURAL SUBARACH SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NM INJ SUBARC EPID L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 OBSU INJ EPIDURAL SUBARACH L/S | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EMU INJ EPI SUBARACH L/S SGL | $200.84 | $1,004.22 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 XR INJ EPIDURAL SUBARACH L/S SGL | $233.77 | $1,168.87 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 RAD ARTHRO ASP/INJ JT MAJOR | $233.77 | $1,168.87 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ZAR INJ EPIDURAL SUB L/S SGL #PF# | $246.22 | $1,231.08 | 80% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 ER INJ EPIDL SUBAR L/S W/O IMG | $608.00 | $3,040.00 | 80% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ EPIDURAL LUMBAR/SACRAL SGL | $338.41 | $1,692.06 | 80% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 RAD INJ EPIDURAL LUMBAR/SACRAL SGL | $348.52 | $1,742.59 | 80% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ EPIDURAL LUMBAR/SACRAL SGL | $338.41 | $1,692.06 | 80% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 RAD INJ EPIDURAL LUMBAR/SACRAL SGL | $348.52 | $1,742.59 | 80% |
| Prostate biopsy CPT 55700 BX PROSTATE NDL/PUNCH | $210.91 | $1,054.55 | 80% |
| Prostate biopsy inpatient CPT 55700 BX PROSTATE NDL/PUNCH | $210.91 | $1,054.55 | 80% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ERD DX W/BRUSHING/WASHING | $242.33 | $1,211.64 | 80% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ERD DX W/BRUSHING/WASHING | $242.33 | $1,211.64 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 DEL VAG W/ANTE/POST S/P C-SECT | $1,293.65 | $6,468.26 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ZAT DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 FAB DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 DPT DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 EST DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 WST DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ZAT DEL VAG W/ANTE/POST S/P C-SECT | $1,358.33 | $6,791.67 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 DEL VAGINAL W/ANTE/POST CARE | $512.76 | $2,563.81 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 DPT DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 FAB DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 ZAT DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 WST DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 EST DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ZAT DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 WST DEL VAGINAL W/ANTE/POST CARE | $538.40 | $2,692.00 | 80% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 FAB PF EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 WSP EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 DPP EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 UTP EKG ROUTINE #PF# | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ESP EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 UCC ESLK EKG ROUTINE PRO | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 NE EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 CEP EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 HPC EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ZAR EKG ROUTINE | $9.41 | $47.04 | 80% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 UTP EKG ROUTINE #PF# | $9.41 | $47.04 | 80% |
| Family therapy without the patient, 50 minutes CPT 90846 ZAR PSYCH THRPY FAMILY W/O PT #PF# | $42.75 | $213.74 | 80% |
| New patient office visit, about 30 minutes CPT 99203 RWC OFFICE VST NEW 99203 #PF# | $38.43 | $192.15 | 80% |
| New patient office visit, about 30 minutes CPT 99203 OV INTERMEDIATE, NEW | $38.48 | $192.40 | 80% |
| New patient office visit, about 30 minutes CPT 99203 EST OV INTERMEDIATE, NEW | $38.79 | $193.94 | 80% |
| New patient office visit, about 30 minutes CPT 99203 WST OV INTERMEDIATE, NEW | $40.40 | $202.02 | 80% |
| New patient office visit, about 30 minutes CPT 99203 YSL INITIAL EXAM PRE-NATAL | $40.40 | $202.02 | 80% |
| New patient office visit, about 30 minutes CPT 99203 NEW COMP CLINIC VISIT L3 | $40.40 | $202.02 | 80% |
| New patient office visit, about 30 minutes CPT 99203 CET OV INTERMEDIATE NEW | $40.40 | $202.02 | 80% |
| New patient office visit, about 30 minutes CPT 99203 CEP O/V INTERMEDIATE NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 CEP NON DOT PHYSICAL #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 ESP OV INTERMEDIATE NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 YSL OV INTERMEDIATE NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 SISD OV INTERMEDIATE, NEW | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 O/V INTERMEDIATE NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 FAB OV INTERMEDIATE NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 WSP OV INTERMEDIATE, NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 NHC NE OV INTERMEDIATE, NEW #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 CEP DOT PHYSICAL #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 OV INTERMEDIATE NEW DPP #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 UCC ESLK E&M NEW 30-44 | $74.06 | $370.30 | 80% |
| New patient office visit, about 30 minutes CPT 99203 UTP VISIT NEW LEVEL III #PF# | $74.06 | $370.30 | 80% |
| New patient office visit, about 45 minutes CPT 99204 RWC OFFICE VST NEW 99204 #PF# | $45.78 | $228.90 | 80% |
| New patient office visit, about 45 minutes CPT 99204 EST OV EXTENDED, NEW | $48.10 | $240.51 | 80% |
| New patient office visit, about 45 minutes CPT 99204 CET OV EXTENDED NEW | $48.72 | $243.60 | 80% |
| New patient office visit, about 45 minutes CPT 99204 WST OV EXTENDED, NEW | $48.72 | $243.60 | 80% |
| New patient office visit, about 45 minutes CPT 99204 YSL O/V EXTENDED NEW | $48.72 | $243.60 | 80% |
| New patient office visit, about 45 minutes CPT 99204 OV EXTENDED, NEW | $69.60 | $348.00 | 80% |
| New patient office visit, about 45 minutes CPT 99204 WSP OV EXTENDED, NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 OV EXTENDED NEW DPP #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 SISD OV EXTENDED, NEW | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 FAB OV NEW MODERATE #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 UCC ESLK E&M NEW 45-59 | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 NHC NE OV EXTENDED, NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 UTP VISIT NEW LEVEL IV #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 CEP O/V EXTENDED NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 EMP O/V EXTENDED NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 YSL OV EXTENDED NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 45 minutes CPT 99204 ESP OV EXTENDED NEW #PF# | $111.24 | $556.19 | 80% |
| New patient office visit, about 60 minutes CPT 99205 EST OV COMPREHENSIVE NEW | $27.59 | $137.95 | 80% |
| New patient office visit, about 60 minutes CPT 99205 FAB OV COMPREHENSIVE NEW | $27.59 | $137.95 | 80% |
| New patient office visit, about 60 minutes CPT 99205 WST OV COMPREHENSIVE NEW | $27.59 | $137.95 | 80% |
| New patient office visit, about 60 minutes CPT 99205 OV COMPREHENSIVE NEW DPT | $32.24 | $161.18 | 80% |
| New patient office visit, about 60 minutes CPT 99205 CET OV COMPREHENSIVE NEW | $35.33 | $176.65 | 80% |
| New patient office visit, about 60 minutes CPT 99205 OV COMPREHENSIVE NEW | $41.06 | $205.28 | 80% |
| New patient office visit, about 60 minutes CPT 99205 YSL O/V COMPREHENSIVE NEW | $43.11 | $215.54 | 80% |
| New patient office visit, about 60 minutes CPT 99205 RWC OFFICE VST NEW 99205 #PF# | $75.60 | $378.00 | 80% |
| New patient office visit, about 60 minutes CPT 99205 NHC NE VISIT NEW LEVEL V #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 DPP VISIT NEW LEVEL V #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 WSP VISIT NEW LEVEL V #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 ESP VISIT NEW LEVEL V #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 YSL OV COMPREHENSIVE NEW #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 EMP O/V COMPREHENSIVE NEW #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 CEP O/V COMPREHENSIVE NEW #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 UTP VISIT NEW LEVEL V #PF# | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 UCC ESLK E&M NEW 60-74 | $146.99 | $734.97 | 80% |
| New patient office visit, about 60 minutes CPT 99205 SISD OV COMPREHENSIVE NEW | $146.99 | $734.97 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 RWC THER EXER EA 15 MIN OT | $31.06 | $155.30 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 IP THERAPEUTIC EXER EA 15 MIN OT | $41.24 | $206.18 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OP THERAPEUTIC EXER EA 15 MIN OT | $41.24 | $206.18 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 RWC THER EXER EA 15 MIN OT | $31.06 | $155.30 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OP THERAPEUTIC EXER EA 15 MIN OT | $41.24 | $206.18 | 80% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 IP THERAPEUTIC EXER EA 15 MIN OT | $41.24 | $206.18 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE VIST NEW 18-39 #PF# | $15.29 | $76.44 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 CEP PREVENTIVE VIST NEW 18-39 #PF# | $15.29 | $76.44 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 FAB THSTEPS NEW 18-20 YRS #PF# | $15.34 | $76.70 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 UTP PREVENT MED NEW 18-39 YRS #PF# | $16.60 | $83.00 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NHC NE PREV VISIT, NEW AGE 18-39 #PF# | $16.60 | $83.00 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NHC NE THSTEPS NEW, 18-20 YRS #PF# | $17.26 | $86.32 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39 DPP #PF# | $17.43 | $87.15 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 WSP PREV VISIT, NEW AGE 18-39 #PF# | $17.43 | $87.15 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 WSP THSTEPS NEW, 18-20 YRS #PF# | $17.43 | $87.15 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV MED NEW 18-39 YRS | $17.92 | $89.60 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39 #PF# | $22.30 | $111.50 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW 18-39 #PF# | $22.30 | $111.50 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 ZAT PREV MED NEW 18-39 YRS | $24.46 | $122.30 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 CET PREV MED NEW 18-39 YRS | $24.46 | $122.30 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 EST PREV MED NEW 18-39 YRS | $24.46 | $122.30 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 WST PREV MED NEW 18-39 YRS | $24.46 | $122.30 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 DPT PREV MED NEW 18-39 YRS | $29.12 | $145.60 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 ESP NEW PREV VISIT AGE 18-39 #PF# | $39.68 | $198.42 | 80% |
| Preventive checkup, new patient aged 18–39 CPT 99385 SISD PREV MED NEW 18-39 YRS | $43.48 | $217.39 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64 DPP #PF# | $32.00 | $160.00 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 NHC NE PREV VISIT, NEW AGE 40-64 #PF# | $32.00 | $160.00 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 UTP PREVENT MED NEW 40-64 YRS #PF# | $32.00 | $160.00 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 WSP PREV VISIT, NEW AGE 40-64 #PF# | $33.60 | $168.00 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 ESP PREV VISIT, NEW AGE 40-64 #PF# | $33.60 | $168.00 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 CEP PREVENTIVE VISIT NEW 40-64 #PF# | $44.35 | $221.76 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 EMP PREVENTIVE VISIT NEW 40-64 #PF# | $44.35 | $221.76 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 YSL PREVENTIVE VISIT NEW 40-64 #PF# | $44.35 | $221.76 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREV MED NEW 40-64 YRS | $50.69 | $253.43 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 SISD PREV MED NEW 40-64 YRS | $52.76 | $263.80 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 WST PREV MED NEW 40-64 YRS | $53.22 | $266.10 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 DPT PREV MED NEW 40-64 YRS | $53.22 | $266.10 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 CET PREV MED NEW 40-64 YRS | $53.22 | $266.10 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 EST PREV MED NEW 40-64 YRS | $53.22 | $266.10 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 ZAT PREV MED NEW 40-64 YRS | $58.38 | $291.88 | 80% |
| Preventive checkup, new patient aged 40–64 CPT 99386 FAB PREVENT NEW 40-64 #PF# | $69.50 | $347.48 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 NHC NE OV CONSULT INTER & PX #PF# | $36.48 | $182.40 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 YSL OV CONSULT INTERMEDIATE #PF# | $38.30 | $191.52 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OV CONSULT INTER & PX DPP #PF# | $38.30 | $191.52 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 ESP OV CONSULT INTER & PX #PF# | $38.30 | $191.52 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OV CONSULT INERMEDIATE #PF# | $38.30 | $191.52 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 SISD OV CONSULT INTER & PX | $40.75 | $203.77 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CEP OV CONSULT INERMEDIATE #PF# | $45.60 | $228.00 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 CET OV CONSULT INTER W PX | $45.99 | $229.95 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 FAB OV CONSULT INTERMEDIATE | $45.99 | $229.95 | 80% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 WSP OV CONSULT INTER & PX #PF# | $47.88 | $239.40 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 NHC NE OV CONSULT EXTENDED & PX #PF# | $37.28 | $186.40 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CET OV CONSULT EXTENDED & PX | $37.60 | $187.99 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 FAB OV CONSULT EXTENDED | $37.60 | $187.99 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OV CONULT EXTENDED #PF# | $39.14 | $195.72 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OV CONSULT EXTENDED & PX DPP #PF# | $39.14 | $195.72 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 ESP OV CONSULT EXTENDED & PX #PF# | $39.14 | $195.72 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 YSL OV CONSULT EXTENDED #PF# | $39.14 | $195.72 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 WSP OV CONSULT EXTENDED & PX #PF# | $46.60 | $233.00 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CEP OV CONULT EXTENDED #PF# | $46.60 | $233.00 | 80% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 SISD OV CONSULT EXTENDED & PX | $60.91 | $304.54 | 80% |
Source file: https://umcelpaso.org/files/74-6000756_University-Medical-Center-of-El-Paso_standardcharges-3-23-2026.csv