Hospital Joplin, MO-KS

Freeman Health System - Freeman West

Freeman Health System - Freeman West in Joplin, MO publishes cash prices for 361 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 178 of 359 procedures and above it for 157. By typical cash price it ranks #30 of 67 Missouri hospitals and #2 of 7 hospitals in the Joplin, MO area, cheapest first. Select a procedure to compare it with other hospitals nearby.

1102 West 32Nd Street, Joplin, MO 64804,932 East 34th Street, Joplin, MO 64804,932 East 34th Street, Joplin, MO 64804,932 East 34th Street, Joplin, MO 64804,932 East 34th Street, Joplin, MO 64084,1102 W 32nd Street, Joplin, MO 64804 Collected Nov 2, 2026 Source price file Check a bill from this hospital (417) 347-1111

Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 260137 · CMS hospital register NPI 1265546048

Financial assistance

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

Freeman Health System - Freeman West 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 Missouri	Off list
Abdominal CT scan without and with contrast CPT 74170 CT UPPER ABDOMEN W&WO CONTRAST	$2,022.40	$5,056.01	—	4% above	60%
Abdominal CT scan without and with contrast CPT 74170 CT HEMANGIOMA WORKUP W/WO	$2,022.40	$5,056.01	—	4% above	60%
Abdominal CT scan without and with contrast CPT 74170 CT UPPER ABDOMEN W&WO CONTRAST	$2,022.40	$5,056.01	—	4% above	60%
Abdominal CT scan without and with contrast CPT 74170 CT HEMANGIOMA WORKUP W/WO	$2,022.40	$5,056.01	—	4% above	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT HEMANGIOMA WORKUP W/WO	$2,022.40	$5,056.01	—	—	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT HEMANGIOMA WORKUP W/WO	$2,022.40	$5,056.01	—	—	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT UPPER ABDOMEN W&WO CONTRAST	$2,022.40	$5,056.01	—	—	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT UPPER ABDOMEN W&WO CONTRAST	$2,022.40	$5,056.01	—	—	60%
Abdominal X-ray, 2 views CPT 74019 CLINIC ABDOMEN MULTIPLE VIEWS	$249.90	$624.75	—	16% below	60%
Abdominal X-ray, 2 views CPT 74019 CLINIC ABDOMEN MULTIPLE VIEWS	$249.90	$624.75	—	16% below	60%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEW	$322.98	$807.45	—	9% above	60%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$322.98	$807.45	—	9% above	60%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$322.98	$807.45	—	9% above	60%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEW	$322.98	$807.45	—	9% above	60%
Abdominal X-ray, 2 views inpatient CPT 74019 CLINIC ABDOMEN MULTIPLE VIEWS	$249.90	$624.75	—	—	60%
Abdominal X-ray, 2 views inpatient CPT 74019 CLINIC ABDOMEN MULTIPLE VIEWS	$249.90	$624.75	—	—	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$322.98	$807.45	—	—	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEW	$322.98	$807.45	—	—	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$322.98	$807.45	—	—	60%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEW	$322.98	$807.45	—	—	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 CLINIC ANKLE LT	$147.10	$367.76	—	49% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 CLINIC ANKLE RT	$147.10	$367.76	—	49% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 CLINIC ANKLE LT	$147.10	$367.76	—	49% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 CLINIC ANKLE RT	$147.10	$367.76	—	49% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 OR MORE VIEWS RT	$260.82	$652.05	—	10% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 OR MORE VIEWS RT	$260.82	$652.05	—	10% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 OR MORE VIEWS LT	$260.82	$652.05	—	10% below	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 3 OR MORE VIEWS LT	$260.82	$652.05	—	10% below	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 CLINIC ANKLE RT	$147.10	$367.76	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 CLINIC ANKLE LT	$147.10	$367.76	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 CLINIC ANKLE LT	$147.10	$367.76	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 CLINIC ANKLE RT	$147.10	$367.76	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 OR MORE VIEWS RT	$260.82	$652.05	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 OR MORE VIEWS LT	$260.82	$652.05	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 OR MORE VIEWS RT	$260.82	$652.05	—	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE 3 OR MORE VIEWS LT	$260.82	$652.05	—	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX W/PVR	$312.16	$780.41	—	at median	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX W/PVR	$312.16	$780.41	—	at median	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE BRACHIAL INDEX W/PVR	$312.16	$780.41	—	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE BRACHIAL INDEX W/PVR	$312.16	$780.41	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM W/O CONTRAS RT	$1,435.35	$3,588.38	—	20% above	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM W/O CONTRAS RT	$1,435.35	$3,588.38	—	20% above	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM W/O CONTRAS LT	$1,435.35	$3,588.38	—	20% above	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREM W/O CONTRAS LT	$1,435.35	$3,588.38	—	20% above	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM W/O CONTRAS RT	$1,435.35	$3,588.38	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM W/O CONTRAS LT	$1,435.35	$3,588.38	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM W/O CONTRAS LT	$1,435.35	$3,588.38	—	—	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREM W/O CONTRAS RT	$1,435.35	$3,588.38	—	—	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS W/O AIR	$339.36	$848.40	—	22% below	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS W/O AIR	$339.36	$848.40	—	22% below	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS W/O AIR	$339.36	$848.40	—	—	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS W/O AIR	$339.36	$848.40	—	—	60%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$1,220.10	$3,050.25	—	14% below	60%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$1,220.10	$3,050.25	—	14% below	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$1,220.10	$3,050.25	—	—	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$1,220.10	$3,050.25	—	—	60%
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE	$430.92	$1,077.30	—	2% above	60%
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE	$430.92	$1,077.30	—	2% above	60%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE	$430.92	$1,077.30	—	—	60%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMPLETE	$430.92	$1,077.30	—	—	60%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST BILATERAL	$861.42	$2,153.55	—	—	60%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST BILATERAL	$861.42	$2,153.55	—	—	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT	$430.92	$1,077.30	—	24% above	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT	$430.92	$1,077.30	—	24% above	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT	$430.92	$1,077.30	—	24% above	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT	$430.92	$1,077.30	—	24% above	60%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST BILATERAL	$861.42	$2,153.55	—	—	60%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST BILATERAL	$861.42	$2,153.55	—	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT	$430.92	$1,077.30	—	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT	$430.92	$1,077.30	—	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT	$430.92	$1,077.30	—	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT	$430.92	$1,077.30	—	—	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS	$3,866.73	$9,666.83	—	56% above	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS	$3,866.73	$9,666.83	—	56% above	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS	$3,866.73	$9,666.83	—	—	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS	$3,866.73	$9,666.83	—	—	60%
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$2,002.77	$5,006.93	—	2% above	60%
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$2,002.77	$5,006.93	—	2% above	60%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD	$2,002.77	$5,006.93	—	—	60%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD	$2,002.77	$5,006.93	—	—	60%
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$2,240.80	$5,602.01	—	12% above	60%
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$2,240.80	$5,602.01	—	12% above	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK	$2,240.80	$5,602.01	—	—	60%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK	$2,240.80	$5,602.01	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC AORTA	$1,960.77	$4,901.93	—	1% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA PULMONARY W/WO	$1,960.77	$4,901.93	—	1% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC AORTA	$1,960.77	$4,901.93	—	1% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA PULMONARY W/WO	$1,960.77	$4,901.93	—	1% above	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA PULMONARY W/WO	$1,960.77	$4,901.93	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORACIC AORTA	$1,960.77	$4,901.93	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORACIC AORTA	$1,960.77	$4,901.93	—	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA PULMONARY W/WO	$1,960.77	$4,901.93	—	—	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO STRXR QUAN CALCIUM	$1,190.60	$2,976.49	—	6% below	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA W/WO STRXR QUAN CALCIUM	$1,190.60	$2,976.49	—	6% below	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO STRXR QUAN CALCIUM	$1,190.60	$2,976.49	—	—	60%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA W/WO STRXR QUAN CALCIUM	$1,190.60	$2,976.49	—	—	60%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CARDIAC SCORING	$39.60	$99.00	—	49% below	60%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CARDIAC SCORING	$39.60	$99.00	—	49% below	60%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CARDIAC SCORING	$39.60	$99.00	—	—	60%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CARDIAC SCORING	$39.60	$99.00	—	—	60%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN WO PELVIS WO	$2,648.52	$6,621.30	—	23% above	60%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN WO PELVIS WO	$2,648.52	$6,621.30	—	23% above	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN WO PELVIS WO	$2,648.52	$6,621.30	—	—	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN WO PELVIS WO	$2,648.52	$6,621.30	—	—	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN W PELVIS W	$3,285.14	$8,212.84	—	24% above	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN W PELVIS W	$3,285.14	$8,212.84	—	24% above	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN W PELVIS W	$3,285.14	$8,212.84	—	—	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN W PELVIS W	$3,285.14	$8,212.84	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS W	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W PELVIS WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN WO PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN WO PELVIS W	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS W	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W&WO PELVIS WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN W PELVIS WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN WO PELVIS W&WO	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN WO PELVIS W	$3,876.18	$9,690.45	—	21% above	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W PELVIS WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W PELVIS WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS W	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN WO PELVIS W	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN WO PELVIS W	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN WO PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN W&WO PELVIS W	$3,876.18	$9,690.45	—	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN WO PELVIS W&WO	$3,876.18	$9,690.45	—	—	60%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,908.90	$4,772.25	—	13% above	60%
CT scan of the abdomen with contrast CPT 74160 CT HEMANGIOMA WORKUP W CNTRAST	$1,908.90	$4,772.25	—	13% above	60%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,908.90	$4,772.25	—	13% above	60%
CT scan of the abdomen with contrast CPT 74160 CT HEMANGIOMA WORKUP W CNTRAST	$1,908.90	$4,772.25	—	13% above	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$1,908.90	$4,772.25	—	—	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT HEMANGIOMA WORKUP W CNTRAST	$1,908.90	$4,772.25	—	—	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$1,908.90	$4,772.25	—	—	60%
CT scan of the abdomen with contrast inpatient CPT 74160 CT HEMANGIOMA WORKUP W CNTRAST	$1,908.90	$4,772.25	—	—	60%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,502.44	$3,756.11	—	28% above	60%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,502.44	$3,756.11	—	28% above	60%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,502.44	$3,756.11	—	—	60%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,502.44	$3,756.11	—	—	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT LTD PARANASAL SINUSES	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT LTD PARANASAL SINUSES	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONTRAST	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONTRAST	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIL/MANDIBLE LTD WO CONTR	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIL/MANDIBLE LTD WO CONTR	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST	$1,367.10	$3,417.75	—	21% above	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT LTD PARANASAL SINUSES	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXIL/MANDIBLE LTD WO CONTR	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXIL/MANDIBLE LTD WO CONTR	$1,367.10	$3,417.75	—	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT LTD PARANASAL SINUSES	$1,367.10	$3,417.75	—	—	60%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN WITHOUT CONTRAST	$1,372.24	$3,430.61	—	9% above	60%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN WITHOUT CONTRAST	$1,372.24	$3,430.61	—	9% above	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN WITHOUT CONTRAST	$1,372.24	$3,430.61	—	—	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN WITHOUT CONTRAST	$1,372.24	$3,430.61	—	—	60%
CT scan of the head with contrast CPT 70460 CT BRAIN WITH CONTRAST	$1,433.78	$3,584.44	—	at median	60%
CT scan of the head with contrast CPT 70460 CT BRAIN WITH CONTRAST	$1,433.78	$3,584.44	—	at median	60%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN WITH CONTRAST	$1,433.78	$3,584.44	—	—	60%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN WITH CONTRAST	$1,433.78	$3,584.44	—	—	60%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W & W/O CONTRAST	$1,766.00	$4,414.99	—	at median	60%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W & W/O CONTRAST	$1,766.00	$4,414.99	—	at median	60%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W & W/O CONTRAST	$1,766.00	$4,414.99	—	—	60%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W & W/O CONTRAST	$1,766.00	$4,414.99	—	—	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,552.74	$3,881.85	—	9% above	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,552.74	$3,881.85	—	9% above	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,552.74	$3,881.85	—	—	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,552.74	$3,881.85	—	—	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,647.34	$4,118.36	—	5% above	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,647.34	$4,118.36	—	5% above	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,647.34	$4,118.36	—	—	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$1,647.34	$4,118.36	—	—	60%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,892.20	$4,730.51	—	16% above	60%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,892.20	$4,730.51	—	16% above	60%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,892.20	$4,730.51	—	—	60%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,892.20	$4,730.51	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL	$694.26	$1,735.65	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX BILATERAL	$694.26	$1,735.65	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL	$694.26	$1,735.65	—	—	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX BILATERAL	$694.26	$1,735.65	—	—	60%
Chest CT scan without and with contrast CPT 71270 CT CHEST W&W/O CONTRAST	$1,863.12	$4,657.80	—	at median	60%
Chest CT scan without and with contrast CPT 71270 CT CHEST W&W/O CONTRAST	$1,863.12	$4,657.80	—	at median	60%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W&W/O CONTRAST	$1,863.12	$4,657.80	—	—	60%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W&W/O CONTRAST	$1,863.12	$4,657.80	—	—	60%
Chest X-ray, 2 views CPT 71046 CLINIC CHEST PHYSICAL	$72.45	$181.13	—	71% below	60%
Chest X-ray, 2 views CPT 71046 CLINIC CHEST PHYSICAL	$72.45	$181.13	—	71% below	60%
Chest X-ray, 2 views CPT 71046 CLINIC DECUBE CHEST 2 VIEW	$130.30	$325.76	—	47% below	60%
Chest X-ray, 2 views CPT 71046 CLINIC DECUBE CHEST 2 VIEW	$130.30	$325.76	—	47% below	60%
Chest X-ray, 2 views CPT 71046 CLINIC CHEST TWO VIEWS	$169.68	$424.20	—	31% below	60%
Chest X-ray, 2 views CPT 71046 CLINIC CHEST TWO VIEWS	$169.68	$424.20	—	31% below	60%
Chest X-ray, 2 views CPT 71046 DECUBE CHEST 2 VIEW	$205.80	$514.50	—	17% below	60%
Chest X-ray, 2 views CPT 71046 DECUBE CHEST 2 VIEW	$205.80	$514.50	—	17% below	60%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW	$262.08	$655.20	—	6% above	60%
Chest X-ray, 2 views CPT 71046 CHEST TWO VIEWS OR STEREO	$262.08	$655.20	—	6% above	60%
Chest X-ray, 2 views CPT 71046 CHEST TWO VIEWS OR STEREO	$262.08	$655.20	—	6% above	60%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW	$262.08	$655.20	—	6% above	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC CHEST PHYSICAL	$72.45	$181.13	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC CHEST PHYSICAL	$72.45	$181.13	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC DECUBE CHEST 2 VIEW	$130.30	$325.76	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC DECUBE CHEST 2 VIEW	$130.30	$325.76	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC CHEST TWO VIEWS	$169.68	$424.20	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CLINIC CHEST TWO VIEWS	$169.68	$424.20	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 DECUBE CHEST 2 VIEW	$205.80	$514.50	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 DECUBE CHEST 2 VIEW	$205.80	$514.50	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW	$262.08	$655.20	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CHEST TWO VIEWS OR STEREO	$262.08	$655.20	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW	$262.08	$655.20	—	—	60%
Chest X-ray, 2 views inpatient CPT 71046 CHEST TWO VIEWS OR STEREO	$262.08	$655.20	—	—	60%
Chest X-ray, single view CPT 71045 CLINIC CHEST SINGLE VIEW	$117.92	$294.79	—	38% below	60%
Chest X-ray, single view CPT 71045 CLINIC CHEST SINGLE VIEW	$117.92	$294.79	—	38% below	60%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$267.54	$668.85	—	40% above	60%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$267.54	$668.85	—	40% above	60%
Chest X-ray, single view CPT 71045 CHEST SINGLE VIEW	$267.54	$668.85	—	40% above	60%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$267.54	$668.85	—	40% above	60%
Chest X-ray, single view inpatient CPT 71045 CLINIC CHEST SINGLE VIEW	$117.92	$294.79	—	—	60%
Chest X-ray, single view inpatient CPT 71045 CLINIC CHEST SINGLE VIEW	$117.92	$294.79	—	—	60%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$267.54	$668.85	—	—	60%
Chest X-ray, single view inpatient CPT 71045 CHEST SINGLE VIEW	$267.54	$668.85	—	—	60%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$267.54	$668.85	—	—	60%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$267.54	$668.85	—	—	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLINIC CLAVICLE RT	$125.48	$313.69	—	48% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLINIC CLAVICLE LT	$125.48	$313.69	—	48% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLINIC CLAVICLE LT	$125.48	$313.69	—	48% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLINIC CLAVICLE RT	$125.48	$313.69	—	48% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RT	$250.95	$627.38	—	4% above	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LT	$250.95	$627.38	—	4% above	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RT	$250.95	$627.38	—	4% above	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LT	$250.95	$627.38	—	4% above	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLINIC CLAVICLE LT	$125.48	$313.69	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLINIC CLAVICLE RT	$125.48	$313.69	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLINIC CLAVICLE LT	$125.48	$313.69	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLINIC CLAVICLE RT	$125.48	$313.69	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LT	$250.95	$627.38	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RT	$250.95	$627.38	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RT	$250.95	$627.38	—	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LT	$250.95	$627.38	—	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERIT COMPLETE	$582.12	$1,455.30	—	6% below	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERIT COMPLETE	$582.12	$1,455.30	—	6% below	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERIT COMPLETE	$582.12	$1,455.30	—	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERIT COMPLETE	$582.12	$1,455.30	—	—	60%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY	$307.86	$769.65	—	4% below	60%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY	$307.86	$769.65	—	4% below	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY	$307.86	$769.65	—	—	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY	$307.86	$769.65	—	—	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY PERIPHERAL ONLY	$307.86	$769.65	—	65% above	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY PERIPHERAL ONLY	$307.86	$769.65	—	65% above	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY PERIPHERAL ONLY	$307.86	$769.65	—	—	60%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY PERIPHERAL ONLY	$307.86	$769.65	—	—	60%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OBUS LEVEL II	$663.18	$1,657.95	—	at median	60%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OBUS LEVEL II	$663.18	$1,657.95	—	at median	60%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OBUS LEVEL II	$663.18	$1,657.95	—	—	60%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OBUS LEVEL II	$663.18	$1,657.95	—	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$1,367.10	$3,417.75	—	6% above	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$1,367.10	$3,417.75	—	6% above	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$1,367.10	$3,417.75	—	—	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST	$1,855.35	$4,638.38	—	13% above	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST	$1,855.35	$4,638.38	—	13% above	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH CONTRAST	$1,855.35	$4,638.38	—	—	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH CONTRAST	$1,855.35	$4,638.38	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILAT IMPLANT VIEW	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO BILAT DIAG FROM SCREEN	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILATERAL	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILATERAL	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILAT IMPLANT VIEW	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILATERAL	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILAT IMPLANT VIEW	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILAT IMPLANT VIEW	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO BILAT DIAG FROM SCREEN	$241.50	$603.75	—	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMOGRAPHY BILATERAL	$241.50	$603.75	—	—	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL LT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT RT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAM UNI DIAG FROM SCREEN-LT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAM UNI DIAG FROM SCREEN-RT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL LT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL RT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT LT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT LT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILATERAL RT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT RT	$181.86	$454.65	—	22% below	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL RT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT LT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL RT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT RT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT LT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL LT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILAT IMPLANT RT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM UNI DIAG FROM SCREEN-RT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAM UNI DIAG FROM SCREEN-LT	$181.86	$454.65	—	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMOGRAPHY UNILATERAL LT	$181.86	$454.65	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LWR EXT ART GFT DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LWR EXT ART DUPLEX BILATERAL	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 GROIN DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 GROIN DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LWR EXT ART DUPLEX BILATERAL	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LWR EXT ART GFT DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs CPT 93925 BIL LOWER EXTREMITY ART DUPLEX	$698.04	$1,745.10	—	at median	60%
Duplex ultrasound of the leg arteries, both legs CPT 93925 BIL LOWER EXTREMITY ART DUPLEX	$698.04	$1,745.10	—	at median	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 GROIN DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 GROIN DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LWR EXT ART GFT DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LWR EXT ART DUPLEX BILATERAL	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LWR EXT ART DUPLEX BILATERAL	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LWR EXT ART GFT DUPLEX BILAT	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 BIL LOWER EXTREMITY ART DUPLEX	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 BIL LOWER EXTREMITY ART DUPLEX	$698.04	$1,745.10	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VEN DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UP EXT VENOUS DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UP EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VEN DUP W/STD REFLX/BI	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UP EXT VENOUS DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VEN DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 LWR EXT VEN DUP W/STD REFLX/BI	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 UP EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs CPT 93970 BIL EXTREMITY VENOUS DUPLX-LWR	$769.86	$1,924.65	—	1% above	60%
Duplex ultrasound of the leg veins, both legs CPT 93970 BIL EXTREMITY VENOUS DUPLX-LWR	$769.86	$1,924.65	—	1% above	60%
Duplex ultrasound of the leg veins, both legs CPT 93970 BIL EXTREMITY VENOUS DUPLEX-UP	$769.86	$1,924.65	—	1% above	60%
Duplex ultrasound of the leg veins, both legs CPT 93970 BIL EXTREMITY VENOUS DUPLEX-UP	$769.86	$1,924.65	—	1% above	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VEN DUP W/STD REFLX/BI	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 UP EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VEN DUP W/STD REFLX/BI	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 UP EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VENOUS MAPPING BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 UP EXT VENOUS DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 UP EXT VENOUS DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VEN DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 LWR EXT VEN DUPLEX BILAT	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BIL EXTREMITY VENOUS DUPLX-LWR	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BIL EXTREMITY VENOUS DUPLEX-UP	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BIL EXTREMITY VENOUS DUPLX-LWR	$769.86	$1,924.65	—	—	60%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 BIL EXTREMITY VENOUS DUPLEX-UP	$769.86	$1,924.65	—	—	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 2-D ECHO W/ DOPPLER	$1,511.16	$3,777.90	—	10% below	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 2-D ECHO W/ DOPPLER	$1,511.16	$3,777.90	—	10% below	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 2-D ECHO W/ DOPPLER	$1,511.16	$3,777.90	—	—	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 2-D ECHO W/ DOPPLER	$1,511.16	$3,777.90	—	—	60%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP/LAT RT	$209.16	$522.90	—	at median	60%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP/LAT LT	$209.16	$522.90	—	at median	60%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP/LAT RT	$209.16	$522.90	—	at median	60%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP/LAT LT	$209.16	$522.90	—	at median	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP/LAT LT	$209.16	$522.90	—	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP/LAT RT	$209.16	$522.90	—	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP/LAT LT	$209.16	$522.90	—	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP/LAT RT	$209.16	$522.90	—	—	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 CLINIC ELBOW LT	$117.92	$294.79	—	58% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 CLINIC ELBOW RT	$117.92	$294.79	—	58% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 CLINIC ELBOW RT	$117.92	$294.79	—	58% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 CLINIC ELBOW LT	$117.92	$294.79	—	58% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW MINIMUM LT	$251.37	$628.43	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW MINIMUM LT	$251.37	$628.43	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW MINIMUM RT	$251.37	$628.43	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW 3 VIEW MINIMUM RT	$251.37	$628.43	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW - 3 VIEWS MINIMUM LT	$251.58	$628.95	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW - 3 VIEWS MINIMUM RT	$251.58	$628.95	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW - 3 VIEWS MINIMUM LT	$251.58	$628.95	—	10% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW - 3 VIEWS MINIMUM RT	$251.58	$628.95	—	10% below	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 CLINIC ELBOW RT	$117.92	$294.79	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 CLINIC ELBOW LT	$117.92	$294.79	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 CLINIC ELBOW RT	$117.92	$294.79	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 CLINIC ELBOW LT	$117.92	$294.79	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW MINIMUM RT	$251.37	$628.43	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW MINIMUM RT	$251.37	$628.43	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW MINIMUM LT	$251.37	$628.43	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW 3 VIEW MINIMUM LT	$251.37	$628.43	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW - 3 VIEWS MINIMUM LT	$251.58	$628.95	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW - 3 VIEWS MINIMUM RT	$251.58	$628.95	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW - 3 VIEWS MINIMUM LT	$251.58	$628.95	—	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW - 3 VIEWS MINIMUM RT	$251.58	$628.95	—	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA TURCICA W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC'S W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SELLA TURCICA W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC'S W/O CONTRAST	$1,577.84	$3,944.59	—	23% above	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA TURCICA W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC'S W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC'S W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SELLA TURCICA W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST	$1,577.84	$3,944.59	—	—	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VIEWS	$77.70	$194.25	—	74% below	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VIEWS	$77.70	$194.25	—	74% below	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 CLINIC FACIAL BONES	$243.60	$609.00	—	18% below	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 CLINIC FACIAL BONES	$243.60	$609.00	—	18% below	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VIEW	$384.30	$960.75	—	29% above	60%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3 VIEW	$384.30	$960.75	—	29% above	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VIEWS	$77.70	$194.25	—	—	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VIEWS	$77.70	$194.25	—	—	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 CLINIC FACIAL BONES	$243.60	$609.00	—	—	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 CLINIC FACIAL BONES	$243.60	$609.00	—	—	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VIEW	$384.30	$960.75	—	—	60%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3 VIEW	$384.30	$960.75	—	—	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CLINIC FOREARM RT	$104.16	$260.40	—	50% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CLINIC FOREARM LT	$104.16	$260.40	—	50% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CLINIC FOREARM RT	$104.16	$260.40	—	50% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 CLINIC FOREARM LT	$104.16	$260.40	—	50% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT	$222.18	$555.45	—	6% above	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT	$222.18	$555.45	—	6% above	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RT	$222.18	$555.45	—	6% above	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LT	$222.18	$555.45	—	6% above	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CLINIC FOREARM LT	$104.16	$260.40	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CLINIC FOREARM RT	$104.16	$260.40	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CLINIC FOREARM LT	$104.16	$260.40	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 CLINIC FOREARM RT	$104.16	$260.40	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LT	$222.18	$555.45	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RT	$222.18	$555.45	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LT	$222.18	$555.45	—	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RT	$222.18	$555.45	—	—	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY NO CCK	$1,220.10	$3,050.25	—	2% below	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY NO CCK	$1,220.10	$3,050.25	—	2% below	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY NO CCK	$1,220.10	$3,050.25	—	—	60%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY NO CCK	$1,220.10	$3,050.25	—	—	60%
Hand X-ray, 2 views one side CPT 73120 CLINIC HAND 2 VIEWS LT	$102.27	$255.68	—	46% below	60%
Hand X-ray, 2 views one side CPT 73120 CLINIC HAND 2 VIEWS RT	$102.27	$255.68	—	46% below	60%
Hand X-ray, 2 views one side CPT 73120 CLINIC HAND 2 VIEWS RT	$102.27	$255.68	—	46% below	60%
Hand X-ray, 2 views one side CPT 73120 CLINIC HAND 2 VIEWS LT	$102.27	$255.68	—	46% below	60%
Hand X-ray, 2 views one side CPT 73120 HAND - 2 VIEWS LT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND 1 VIEW RT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND 1 VIEW RT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND 1 VIEW LT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND 1 VIEW LT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND - 2 VIEWS RT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND - 2 VIEWS RT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views one side CPT 73120 HAND - 2 VIEWS LT	$243.18	$607.95	—	28% above	60%
Hand X-ray, 2 views inpatient one side CPT 73120 CLINIC HAND 2 VIEWS LT	$102.27	$255.68	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 CLINIC HAND 2 VIEWS RT	$102.27	$255.68	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 CLINIC HAND 2 VIEWS LT	$102.27	$255.68	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 CLINIC HAND 2 VIEWS RT	$102.27	$255.68	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 1 VIEW LT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 1 VIEW RT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND - 2 VIEWS RT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND - 2 VIEWS LT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 1 VIEW LT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 1 VIEW RT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND - 2 VIEWS RT	$243.18	$607.95	—	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND - 2 VIEWS LT	$243.18	$607.95	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS LT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS RT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS RT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS LT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS RT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS LT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS LT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS RT	$63.84	$159.60	—	68% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CLINIC OSCALCIS(HEEL) RT	$109.30	$273.26	—	44% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CLINIC OSCALCIS(HEEL) LT	$109.30	$273.26	—	44% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CLINIC OSCALCIS(HEEL) RT	$109.30	$273.26	—	44% below	60%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CLINIC OSCALCIS(HEEL) LT	$109.30	$273.26	—	44% below	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS LT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS RT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS LT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS RT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS RT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS LT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS LT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OSCALCIS HEEL MIN 2 VIEWS RT	$63.84	$159.60	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CLINIC OSCALCIS(HEEL) RT	$109.30	$273.26	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CLINIC OSCALCIS(HEEL) LT	$109.30	$273.26	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CLINIC OSCALCIS(HEEL) RT	$109.30	$273.26	—	—	60%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CLINIC OSCALCIS(HEEL) LT	$109.30	$273.26	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRATION <6	$2,515.70	$6,289.24	—	4% below	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRATION	$2,515.70	$6,289.24	—	4% below	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRATION	$2,515.70	$6,289.24	—	4% below	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRAT W/ EXT EEG <6	$2,893.28	$7,233.19	—	10% above	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRAT W/ EXT EEG	$2,893.28	$7,233.19	—	10% above	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP TITRAT W/ EXT EEG	$2,893.28	$7,233.19	—	10% above	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRATION	$2,515.70	$6,289.24	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRATION	$2,515.70	$6,289.24	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRATION <6	$2,515.70	$6,289.24	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRAT W/ EXT EEG	$2,893.28	$7,233.19	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRAT W/ EXT EEG	$2,893.28	$7,233.19	—	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP TITRAT W/ EXT EEG <6	$2,893.28	$7,233.19	—	—	60%
Knee X-ray, 3 views one side CPT 73562 CLINIC KNEE RT	$148.78	$371.96	—	45% below	60%
Knee X-ray, 3 views one side CPT 73562 CLINIC KNEE LT	$148.78	$371.96	—	45% below	60%
Knee X-ray, 3 views one side CPT 73562 CLINIC KNEE LT	$148.78	$371.96	—	45% below	60%
Knee X-ray, 3 views one side CPT 73562 CLINIC KNEE RT	$148.78	$371.96	—	45% below	60%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS LT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS RT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS LT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS LT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS RT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS RT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS LT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views one side CPT 73562 KNEE MIN 3 VIEWS RT	$268.80	$672.00	—	at median	60%
Knee X-ray, 3 views inpatient one side CPT 73562 CLINIC KNEE RT	$148.78	$371.96	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 CLINIC KNEE LT	$148.78	$371.96	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 CLINIC KNEE LT	$148.78	$371.96	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 CLINIC KNEE RT	$148.78	$371.96	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS RT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS LT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS LT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS RT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS RT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS RT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE COMP STUDY MIN 3 VIEWS LT	$268.80	$672.00	—	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE MIN 3 VIEWS LT	$268.80	$672.00	—	—	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 CLINIC KNEE W/PATELLA LT	$134.82	$337.05	—	59% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 CLINIC KNEE W/PATELLA LT	$134.82	$337.05	—	59% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 CLINIC KNEE W/PATELLA RT	$134.82	$337.05	—	59% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 CLINIC KNEE W/PATELLA RT	$134.82	$337.05	—	59% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW LT	$329.70	$824.25	—	at median	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW RT	$329.70	$824.25	—	at median	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW LT	$329.70	$824.25	—	at median	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW RT	$329.70	$824.25	—	at median	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CLINIC KNEE W/PATELLA LT	$134.82	$337.05	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CLINIC KNEE W/PATELLA LT	$134.82	$337.05	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CLINIC KNEE W/PATELLA RT	$134.82	$337.05	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 CLINIC KNEE W/PATELLA RT	$134.82	$337.05	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW LT	$329.70	$824.25	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW LT	$329.70	$824.25	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW RT	$329.70	$824.25	—	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA OR TUNN VIEW RT	$329.70	$824.25	—	—	60%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LOWER EXTREM W/O CONT BILAT	$1,423.59	$3,558.98	—	—	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM W/O CONTRAS RT	$1,423.59	$3,558.98	—	13% above	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM W/O CONTRAS LT	$1,423.59	$3,558.98	—	13% above	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM W/O CONTRAS LT	$1,423.59	$3,558.98	—	13% above	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTREM W/O CONTRAS RT	$1,423.59	$3,558.98	—	13% above	60%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT LOWER EXTREM W/O CONT BILAT	$1,423.59	$3,558.98	—	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM W/O CONTRAS RT	$1,423.59	$3,558.98	—	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM W/O CONTRAS RT	$1,423.59	$3,558.98	—	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM W/O CONTRAS LT	$1,423.59	$3,558.98	—	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXTREM W/O CONTRAS LT	$1,423.59	$3,558.98	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 FAST ABD US LIMITED	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 FAST ABD US LIMITED	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD	$414.12	$1,035.30	—	16% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 FAST ABD US LIMITED	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 FAST ABD US LIMITED	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS	$414.12	$1,035.30	—	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD	$414.12	$1,035.30	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY-NON VASC LMTD LT	$304.50	$761.25	—	14% below	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY-NON VASC LMTD RT	$304.50	$761.25	—	14% below	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY-NON VASC LMTD LT	$304.50	$761.25	—	14% below	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXTREMITY-NON VASC LMTD RT	$304.50	$761.25	—	14% below	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY-NON VASC LMTD LT	$304.50	$761.25	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY-NON VASC LMTD RT	$304.50	$761.25	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY-NON VASC LMTD RT	$304.50	$761.25	—	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXTREMITY-NON VASC LMTD LT	$304.50	$761.25	—	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST SCREENING	$1,367.10	$3,417.75	—	202% above	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST SCREENING	$1,367.10	$3,417.75	—	202% above	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST SCREENING	$1,367.10	$3,417.75	—	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST SCREENING	$1,367.10	$3,417.75	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CLINIC TIBIA & FIBIA RT	$123.16	$307.91	—	49% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CLINIC TIBIA & FIBIA RT	$123.16	$307.91	—	49% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CLINIC TIBIA & FIBIA LT	$123.16	$307.91	—	49% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 CLINIC TIBIA & FIBIA LT	$123.16	$307.91	—	49% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB LT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB RT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB RT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB LT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEG RT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEG LT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEG LT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEG RT	$227.64	$569.10	—	6% below	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CLINIC TIBIA & FIBIA LT	$123.16	$307.91	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CLINIC TIBIA & FIBIA RT	$123.16	$307.91	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CLINIC TIBIA & FIBIA LT	$123.16	$307.91	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 CLINIC TIBIA & FIBIA RT	$123.16	$307.91	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB LT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB RT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEG LT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB RT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEG RT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEG LT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB LT	$227.64	$569.10	—	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEG RT	$227.64	$569.10	—	—	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRI ANGIOGRAPHY HEAD W/O CNTRS	$1,368.57	$3,421.43	—	11% below	60%
MR angiography (MRA) of the head without contrast CPT 70544 MR-VENOGRAM BRAIN	$1,368.57	$3,421.43	—	11% below	60%
MR angiography (MRA) of the head without contrast CPT 70544 MRI ANGIOGRAPHY HEAD W/O CNTRS	$1,368.57	$3,421.43	—	11% below	60%
MR angiography (MRA) of the head without contrast CPT 70544 MR-VENOGRAM BRAIN	$1,368.57	$3,421.43	—	11% below	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI ANGIOGRAPHY HEAD W/O CNTRS	$1,368.57	$3,421.43	—	—	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR-VENOGRAM BRAIN	$1,368.57	$3,421.43	—	—	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI ANGIOGRAPHY HEAD W/O CNTRS	$1,368.57	$3,421.43	—	—	60%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR-VENOGRAM BRAIN	$1,368.57	$3,421.43	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE WO CONTRAST RT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE WO CONTRAST LT	$1,869.21	$4,673.03	—	6% above	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE WO CONTRAST LT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE WO CONTRAST RT	$1,869.21	$4,673.03	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP WWO CONTRAST RT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE WWO CONTRAST LT	$2,276.92	$5,692.31	—	at median	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE WWO CONTRAST RT	$2,276.92	$5,692.31	—	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE WWO CONTRAST LT	$2,276.92	$5,692.31	—	—	60%
MRI of the abdomen without contrast CPT 74181 MRCP W/O CONTRAST	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast CPT 74181 MR - ABDOMEN LIVER W/O CONTRA	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast CPT 74181 MR - ABDOMEN LIVER W/O CONTRA	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast CPT 74181 MRCP W/O CONTRAST	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast CPT 74181 MR - KIDNEY WITHOUT CONTRAST	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast CPT 74181 MR - KIDNEY WITHOUT CONTRAST	$1,884.86	$4,712.14	—	13% above	60%
MRI of the abdomen without contrast inpatient CPT 74181 MR - ABDOMEN LIVER W/O CONTRA	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP W/O CONTRAST	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen without contrast inpatient CPT 74181 MR - KIDNEY WITHOUT CONTRAST	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen without contrast inpatient CPT 74181 MR - ABDOMEN LIVER W/O CONTRA	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP W/O CONTRAST	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen without contrast inpatient CPT 74181 MR - KIDNEY WITHOUT CONTRAST	$1,884.86	$4,712.14	—	—	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR KIDNEY W/WO CONTRAST	$2,511.50	$6,278.74	—	4% above	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD LIVER W/WO CONTRAST	$2,511.50	$6,278.74	—	4% above	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD LIVER W/WO CONTRAST	$2,511.50	$6,278.74	—	4% above	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR KIDNEY W/WO CONTRAST	$2,511.50	$6,278.74	—	4% above	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR KIDNEY W/WO CONTRAST	$2,511.50	$6,278.74	—	—	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR KIDNEY W/WO CONTRAST	$2,511.50	$6,278.74	—	—	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD LIVER W/WO CONTRAST	$2,511.50	$6,278.74	—	—	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD LIVER W/WO CONTRAST	$2,511.50	$6,278.74	—	—	60%
MRI of the brain, no contrast dye CPT 70551 MR IAC'S WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye CPT 70551 MR IAC'S WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye CPT 70551 MR - SELLA WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye CPT 70551 MR - BRAIN WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye CPT 70551 MR - SELLA WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye CPT 70551 MR - BRAIN WITHOUT CONTRAST	$1,990.48	$4,976.21	—	29% above	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR IAC'S WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR IAC'S WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR - SELLA WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR - BRAIN WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR - BRAIN WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 MR - SELLA WITHOUT CONTRAST	$1,990.48	$4,976.21	—	—	60%
MRI of the brain, with and without contrast dye CPT 70553 MR IAC'S W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye CPT 70553 MR - BRAIN W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye CPT 70553 MR IAC'S W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye CPT 70553 MR - SELLA W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye CPT 70553 MR - SELLA W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye CPT 70553 MR - BRAIN W/WO CONTRAST	$2,489.24	$6,223.09	—	at median	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR - BRAIN W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR IAC'S W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR - SELLA W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR - BRAIN W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR IAC'S W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR - SELLA W/WO CONTRAST	$2,489.24	$6,223.09	—	—	60%
MRI of the lower back, no contrast dye CPT 72148 MR - LUMBAR SPINE W/O CONTRAS	$2,078.79	$5,196.98	—	12% above	60%
MRI of the lower back, no contrast dye CPT 72148 MR - LUMBAR SPINE W/O CONTRAS	$2,078.79	$5,196.98	—	12% above	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR - LUMBAR SPINE W/O CONTRAS	$2,078.79	$5,196.98	—	—	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR - LUMBAR SPINE W/O CONTRAS	$2,078.79	$5,196.98	—	—	60%
MRI of the lower back, without and then with contrast dye CPT 72158 MR - LSP W/WO CONTRAST	$2,473.17	$6,182.93	—	at median	60%
MRI of the lower back, without and then with contrast dye CPT 72158 MR - LSP W/WO CONTRAST	$2,473.17	$6,182.93	—	at median	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR - LSP W/WO CONTRAST	$2,473.17	$6,182.93	—	—	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR - LSP W/WO CONTRAST	$2,473.17	$6,182.93	—	—	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR - THORACIC SPINE W/O CONTR	$2,010.86	$5,027.14	—	15% above	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR - THORACIC SPINE W/O CONTR	$2,010.86	$5,027.14	—	15% above	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR - THORACIC SPINE W/O CONTR	$2,010.86	$5,027.14	—	—	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR - THORACIC SPINE W/O CONTR	$2,010.86	$5,027.14	—	—	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR - CSP W/WO CONTRAST	$2,437.78	$6,094.46	—	1% below	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR - CSP W/WO CONTRAST	$2,437.78	$6,094.46	—	1% below	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR - CSP W/WO CONTRAST	$2,437.78	$6,094.46	—	—	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR - CSP W/WO CONTRAST	$2,437.78	$6,094.46	—	—	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR - CSP WITHOUT CONTRAST	$2,074.17	$5,185.43	—	6% above	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR - CSP WITHOUT CONTRAST	$2,074.17	$5,185.43	—	6% above	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR - CSP WITHOUT CONTRAST	$2,074.17	$5,185.43	—	—	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR - CSP WITHOUT CONTRAST	$2,074.17	$5,185.43	—	—	60%
MRI of the pelvis without and with contrast CPT 72197 MR - PELVIS W/WO CONTRAST	$2,475.90	$6,189.75	—	at median	60%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE W/WO CONTRAST	$2,475.90	$6,189.75	—	at median	60%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE W/WO CONTRAST	$2,475.90	$6,189.75	—	at median	60%
MRI of the pelvis without and with contrast CPT 72197 MR - PELVIS W/WO CONTRAST	$2,475.90	$6,189.75	—	at median	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE W/WO CONTRAST	$2,475.90	$6,189.75	—	—	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE W/WO CONTRAST	$2,475.90	$6,189.75	—	—	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR - PELVIS W/WO CONTRAST	$2,475.90	$6,189.75	—	—	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR - PELVIS W/WO CONTRAST	$2,475.90	$6,189.75	—	—	60%
MRI of the pelvis, no contrast dye CPT 72195 MR - PELVIS WITHOUT CONTRAST	$1,841.60	$4,603.99	—	at median	60%
MRI of the pelvis, no contrast dye CPT 72195 MR - PELVIS WITHOUT CONTRAST	$1,841.60	$4,603.99	—	at median	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR - PELVIS WITHOUT CONTRAST	$1,841.60	$4,603.99	—	—	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR - PELVIS WITHOUT CONTRAST	$1,841.60	$4,603.99	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW WO CONTRAST LT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER WO CONTRAST RT	$1,885.48	$4,713.71	—	2% above	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST WO CONTRAST LT	$1,885.48	$4,713.71	—	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST WO CONTRAST RT	$1,885.48	$4,713.71	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CLINIC CERVICAL SPINE 5 VIEWS	$199.92	$499.80	—	52% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CLINIC CERVICAL SPINE 5 VIEWS	$199.92	$499.80	—	52% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE 4+ VIEWS	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERV 2V PLUS FLEX-EXT	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL 5 VIEWS	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE 4+ VIEWS	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERV 2V PLUS FLEX-EXT	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL 5 VIEWS	$383.88	$959.70	—	7% below	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CLINIC CERVICAL SPINE 5 VIEWS	$199.92	$499.80	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CLINIC CERVICAL SPINE 5 VIEWS	$199.92	$499.80	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE 4+ VIEWS	$383.88	$959.70	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL 5 VIEWS	$383.88	$959.70	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERV 2V PLUS FLEX-EXT	$383.88	$959.70	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE 4+ VIEWS	$383.88	$959.70	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL 5 VIEWS	$383.88	$959.70	—	—	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERV 2V PLUS FLEX-EXT	$383.88	$959.70	—	—	60%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$1,679.90	$4,199.74	—	16% above	60%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$1,679.90	$4,199.74	—	16% above	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$1,679.90	$4,199.74	—	—	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$1,679.90	$4,199.74	—	—	60%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CNTRST	$1,650.70	$4,126.76	—	42% above	60%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O CNTRST	$1,650.70	$4,126.76	—	42% above	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CNTRST	$1,650.70	$4,126.76	—	—	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CNTRST	$1,650.70	$4,126.76	—	—	60%
Neck soft tissue X-ray CPT 70360 CLINIC NECK SOFT TISSUE	$130.30	$325.76	—	43% below	60%
Neck soft tissue X-ray CPT 70360 CLINIC NECK SOFT TISSUE	$130.30	$325.76	—	43% below	60%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK	$184.80	$462.00	—	19% below	60%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE EXAM	$184.80	$462.00	—	19% below	60%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE EXAM	$184.80	$462.00	—	19% below	60%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK	$184.80	$462.00	—	19% below	60%
Neck soft tissue X-ray inpatient CPT 70360 CLINIC NECK SOFT TISSUE	$130.30	$325.76	—	—	60%
Neck soft tissue X-ray inpatient CPT 70360 CLINIC NECK SOFT TISSUE	$130.30	$325.76	—	—	60%
Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK	$184.80	$462.00	—	—	60%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE EXAM	$184.80	$462.00	—	—	60%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE EXAM	$184.80	$462.00	—	—	60%
Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK	$184.80	$462.00	—	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL PERFUSION	$2,756.88	$6,892.20	—	23% below	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL PERFUSION	$2,756.88	$6,892.20	—	23% below	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL PERFUSION	$2,756.88	$6,892.20	—	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL PERFUSION	$2,756.88	$6,892.20	—	—	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS BREAST	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS THYROID	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT PANCREATIC CA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS PANCREATIC CA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS OVARIAN CA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS CERVICAL CA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET SUBS SKULL-THIGH SCAN	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS PULM SOLIT NODULE	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT PULM SOLIT NODULE	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT SMALL CELL LUNG	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT SOFT TISSUE SARC	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT THYROID	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS NEUROENDOCRINE	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT LYMPHOMA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS LYMPHOMA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT HEADNECK	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS HEADNECK	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT ESOPHAL	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS ESOPHA	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT LUNG	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS LUNG	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT COLOREC	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG SUBS COLOREC	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET INIT SKULL-THIGH SCAN	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMG INIT BREAST	$4,270.46	$10,676.14	—	at median	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT LUNG	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS LYMPHOMA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT LYMPHOMA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS NEUROENDOCRINE	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT BREAST	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS PANCREATIC CA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT ESOPHAL	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS HEADNECK	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT PANCREATIC CA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS THYROID	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT HEADNECK	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS LUNG	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET INIT SKULL-THIGH SCAN	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT COLOREC	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS BREAST	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS COLOREC	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT THYROID	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT SOFT TISSUE SARC	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT SMALL CELL LUNG	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG INIT PULM SOLIT NODULE	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET SUBS SKULL-THIGH SCAN	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS ESOPHA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS PULM SOLIT NODULE	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS CERVICAL CA	$4,270.46	$10,676.14	—	—	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMG SUBS OVARIAN CA	$4,270.46	$10,676.14	—	—	60%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,400.60	$3,501.49	—	at median	60%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$1,400.60	$3,501.49	—	at median	60%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,400.60	$3,501.49	—	—	60%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$1,400.60	$3,501.49	—	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC SURVEY NONPREG/LIMITED	$77.28	$193.20	—	79% below	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC SURVEY NONPREG/LIMITED	$77.28	$193.20	—	79% below	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC SURVEY NONPREG/LIMITED	$77.28	$193.20	—	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC SURVEY NONPREG/LIMITED	$77.28	$193.20	—	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC TRANSABDOMINAL ONLY	$503.58	$1,258.95	—	20% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC TRANSABDOMINAL ONLY	$503.58	$1,258.95	—	20% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC TRANSABDOMINAL ONLY	$503.58	$1,258.95	—	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC TRANSABDOMINAL ONLY	$503.58	$1,258.95	—	—	60%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OBUS LEVEL I	$520.38	$1,300.95	—	2% below	60%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OBUS LEVEL I	$520.38	$1,300.95	—	2% below	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OBUS LEVEL I	$520.38	$1,300.95	—	—	60%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OBUS LEVEL I	$520.38	$1,300.95	—	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS 1ST TRIMESTER	$414.12	$1,035.30	—	19% below	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OBUS 1ST TRIMESTER	$414.12	$1,035.30	—	19% below	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS 1ST TRIMESTER	$414.12	$1,035.30	—	—	60%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OBUS 1ST TRIMESTER	$414.12	$1,035.30	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OBUS LIMITED SURVEY	$309.96	$774.90	—	14% below	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OBUS LIMITED SURVEY	$309.96	$774.90	—	14% below	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OBUS LIMITED SURVEY	$309.96	$774.90	—	—	60%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OBUS LIMITED SURVEY	$309.96	$774.90	—	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW LT	$111.62	$279.04	—	53% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW RT	$111.62	$279.04	—	53% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW LT	$111.62	$279.04	—	53% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW RT	$111.62	$279.04	—	53% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2 VIEW LT	$219.24	$548.10	—	7% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2 VIEW LT	$219.24	$548.10	—	7% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2 VIEW RT	$219.24	$548.10	—	7% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNIL 2 VIEW RT	$219.24	$548.10	—	7% below	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW LT	$111.62	$279.04	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW LT	$111.62	$279.04	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW RT	$111.62	$279.04	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CLINIC RIBS UNILAT 2 VIEW RT	$111.62	$279.04	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2 VIEW LT	$219.24	$548.10	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2 VIEW RT	$219.24	$548.10	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2 VIEW LT	$219.24	$548.10	—	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNIL 2 VIEW RT	$219.24	$548.10	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CLINIC RIBS UNILATERAL LT	$184.17	$460.43	—	33% below	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CLINIC RIBS UNILATERAL RT	$184.17	$460.43	—	33% below	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CLINIC RIBS UNILATERAL LT	$184.17	$460.43	—	33% below	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CLINIC RIBS UNILATERAL RT	$184.17	$460.43	—	33% below	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC RT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC LT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC LT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNIL W/PA CXR RT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNIL W/PA CXR LT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNIL W/PA CXR RT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNIL W/PA CXR LT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC RT	$320.46	$801.15	—	17% above	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CLINIC RIBS UNILATERAL LT	$184.17	$460.43	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CLINIC RIBS UNILATERAL RT	$184.17	$460.43	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CLINIC RIBS UNILATERAL RT	$184.17	$460.43	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CLINIC RIBS UNILATERAL LT	$184.17	$460.43	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC RT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC LT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNIL W/PA CXR LT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNIL W/PA CXR RT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC RT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNILAT 3 VIEWS W/PAC LT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNIL W/PA CXR LT	$320.46	$801.15	—	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS UNIL W/PA CXR RT	$320.46	$801.15	—	—	60%
Screening mammogram, both breasts both sides CPT 77067 MAMMOG IMPLANT SCREEN-BILAT	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts both sides CPT 77067 MAMMOG IMPLANT SCREEN-BILAT	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts CPT 77067 MAMMOGRAPHY SCREEN 2 VIEWS	$254.00	$634.99	—	44% above	60%
Screening mammogram, both breasts CPT 77067 MAMMOGRAPHY SCREEN 2 VIEWS	$254.00	$634.99	—	44% above	60%
Screening mammogram, both breasts one side CPT 77067 MAMMOG IMPLANT SCREEN-UNILAT	$127.05	$317.63	—	28% below	60%
Screening mammogram, both breasts one side CPT 77067 UNILAT SCREENING MAMMOGRAM	$127.05	$317.63	—	28% below	60%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMOG IMPLANT SCREEN-BILAT	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMOG IMPLANT SCREEN-BILAT	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAPHY SCREEN 2 VIEWS	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts inpatient CPT 77067 MAMMOGRAPHY SCREEN 2 VIEWS	$254.00	$634.99	—	—	60%
Screening mammogram, both breasts inpatient one side CPT 77067 UNILAT SCREENING MAMMOGRAM	$127.05	$317.63	—	—	60%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMOG IMPLANT SCREEN-UNILAT	$127.05	$317.63	—	—	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 CLINIC SHOULDER LT	$154.24	$385.61	—	42% below	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 CLINIC SHOULDER RT	$154.24	$385.61	—	42% below	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 CLINIC SHOULDER RT	$154.24	$385.61	—	42% below	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 CLINIC SHOULDER LT	$154.24	$385.61	—	42% below	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEW LT	$271.42	$678.56	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEW RT	$271.42	$678.56	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEW RT	$271.42	$678.56	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEW LT	$271.42	$678.56	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 4 VIEW RT	$271.74	$679.35	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 4 VIEW LT	$271.74	$679.35	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 4 VIEW RT	$271.74	$679.35	—	3% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 4 VIEW LT	$271.74	$679.35	—	3% above	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 CLINIC SHOULDER RT	$154.24	$385.61	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 CLINIC SHOULDER LT	$154.24	$385.61	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 CLINIC SHOULDER RT	$154.24	$385.61	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 CLINIC SHOULDER LT	$154.24	$385.61	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEW LT	$271.42	$678.56	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEW LT	$271.42	$678.56	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEW RT	$271.42	$678.56	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEW RT	$271.42	$678.56	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 4 VIEW RT	$271.74	$679.35	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 4 VIEW LT	$271.74	$679.35	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 4 VIEW RT	$271.74	$679.35	—	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 4 VIEW LT	$271.74	$679.35	—	—	60%
Sinus X-ray, complete, 3 or more views CPT 70220 CLINIC SINUSES	$244.02	$610.05	—	18% below	60%
Sinus X-ray, complete, 3 or more views CPT 70220 CLINIC SINUSES	$244.02	$610.05	—	18% below	60%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$282.98	$707.44	—	5% below	60%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$282.98	$707.44	—	5% below	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 CLINIC SINUSES	$244.02	$610.05	—	—	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 CLINIC SINUSES	$244.02	$610.05	—	—	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VIEWS	$282.98	$707.44	—	—	60%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VIEWS	$282.98	$707.44	—	—	60%
Skull X-ray, fewer than 4 views CPT 70250 CLINIC SKULL AP AND LATERAL	$154.24	$385.61	—	40% below	60%
Skull X-ray, fewer than 4 views CPT 70250 CLINIC SKULL AP AND LATERAL	$154.24	$385.61	—	40% below	60%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 2 VIEWS	$226.80	$567.00	—	12% below	60%
Skull X-ray, fewer than 4 views CPT 70250 SKULL 2 VIEWS	$226.80	$567.00	—	12% below	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 CLINIC SKULL AP AND LATERAL	$154.24	$385.61	—	—	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 CLINIC SKULL AP AND LATERAL	$154.24	$385.61	—	—	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 2 VIEWS	$226.80	$567.00	—	—	60%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 2 VIEWS	$226.80	$567.00	—	—	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG W/EXT EEG <6 HRS	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG W/EXTENDED EEG	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG W/EXTENDED EEG	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) CPT 95810 PSG <6 HRS	$2,842.66	$7,106.66	—	21% above	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG	$2,842.66	$7,106.66	—	—	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG <6 HRS	$2,842.66	$7,106.66	—	—	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG W/EXTENDED EEG	$2,842.66	$7,106.66	—	—	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG	$2,842.66	$7,106.66	—	—	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG W/EXT EEG <6 HRS	$2,842.66	$7,106.66	—	—	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG W/EXTENDED EEG	$2,842.66	$7,106.66	—	—	60%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W/O CONTRAST	$1,170.96	$2,927.40	—	32% below	60%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W/O CONTRAST	$1,170.96	$2,927.40	—	32% below	60%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO STRESS W/O CONTRAST	$1,170.96	$2,927.40	—	—	60%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO STRESS W/O CONTRAST	$1,170.96	$2,927.40	—	—	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W/VIDEO	$559.86	$1,399.65	—	25% above	60%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W/VIDEO	$559.86	$1,399.65	—	25% above	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION W/VIDEO	$559.86	$1,399.65	—	—	60%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION W/VIDEO	$559.86	$1,399.65	—	—	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 CLINIC FEMUR 2 VIEW RT	$166.74	$416.85	—	35% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 CLINIC FEMUR2 VIEW LT	$166.74	$416.85	—	35% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 CLINIC FEMUR2 VIEW LT	$166.74	$416.85	—	35% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 CLINIC FEMUR 2 VIEW RT	$166.74	$416.85	—	35% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VIEWS RT	$319.20	$798.00	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VIEWS LT	$319.20	$798.00	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VIEWS RT	$319.20	$798.00	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2 VIEWS LT	$319.20	$798.00	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR THIGH TWO VIEWS LT	$320.04	$800.10	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR THIGH TWO VIEWS LT	$320.04	$800.10	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR THIGH TWO VIEWS RT	$320.04	$800.10	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR THIGH TWO VIEWS RT	$320.04	$800.10	—	24% above	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 CLINIC FEMUR2 VIEW LT	$166.74	$416.85	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 CLINIC FEMUR 2 VIEW RT	$166.74	$416.85	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 CLINIC FEMUR2 VIEW LT	$166.74	$416.85	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 CLINIC FEMUR 2 VIEW RT	$166.74	$416.85	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VIEWS LT	$319.20	$798.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VIEWS RT	$319.20	$798.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VIEWS RT	$319.20	$798.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2 VIEWS LT	$319.20	$798.00	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR THIGH TWO VIEWS RT	$320.04	$800.10	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR THIGH TWO VIEWS LT	$320.04	$800.10	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR THIGH TWO VIEWS RT	$320.04	$800.10	—	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR THIGH TWO VIEWS LT	$320.04	$800.10	—	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,652.60	$4,131.49	—	24% above	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,652.60	$4,131.49	—	24% above	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,652.60	$4,131.49	—	—	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$1,652.60	$4,131.49	—	—	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) MIN 2 VIEWS RT	$109.30	$273.26	—	45% below	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) MIN 2 VIEWS RT	$109.30	$273.26	—	45% below	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) MIN 2 VIEWS LT	$109.30	$273.26	—	45% below	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE (S) MIN 2 VIEWS LT	$109.30	$273.26	—	45% below	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) MIN 2 VIEWS LT	$210.00	$525.00	—	6% above	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) MIN 2 VIEWS LT	$210.00	$525.00	—	6% above	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) MIN 2 VIEWS RT	$210.00	$525.00	—	6% above	60%
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) MIN 2 VIEWS RT	$210.00	$525.00	—	6% above	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) MIN 2 VIEWS LT	$109.30	$273.26	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) MIN 2 VIEWS RT	$109.30	$273.26	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) MIN 2 VIEWS RT	$109.30	$273.26	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE (S) MIN 2 VIEWS LT	$109.30	$273.26	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) MIN 2 VIEWS RT	$210.00	$525.00	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) MIN 2 VIEWS LT	$210.00	$525.00	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) MIN 2 VIEWS RT	$210.00	$525.00	—	—	60%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) MIN 2 VIEWS LT	$210.00	$525.00	—	—	60%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL STUDY NONPREGNANT	$116.76	$291.90	—	77% below	60%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL STUDY NONPREGNANT	$116.76	$291.90	—	77% below	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL STUDY NONPREGNANT	$116.76	$291.90	—	—	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL STUDY NONPREGNANT	$116.76	$291.90	—	—	60%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL STUDY PREGNANT	$355.32	$888.30	—	17% below	60%
Transvaginal ultrasound during pregnancy CPT 76817 TV CERVIX LENGTH	$355.32	$888.30	—	17% below	60%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL STUDY PREGNANT	$355.32	$888.30	—	17% below	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL STUDY PREGNANT	$355.32	$888.30	—	—	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL STUDY PREGNANT	$355.32	$888.30	—	—	60%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TV CERVIX LENGTH	$355.32	$888.30	—	—	60%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL SURVEY	$757.68	$1,894.20	—	5% below	60%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL SURVEY	$757.68	$1,894.20	—	5% below	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL SURVEY	$757.68	$1,894.20	—	—	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL SURVEY	$757.68	$1,894.20	—	—	60%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$550.62	$1,376.55	—	3% below	60%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$550.62	$1,376.55	—	3% below	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$550.62	$1,376.55	—	—	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$550.62	$1,376.55	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$536.76	$1,341.90	—	7% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK	$536.76	$1,341.90	—	7% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$536.76	$1,341.90	—	7% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK	$536.76	$1,341.90	—	7% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK	$536.76	$1,341.90	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$536.76	$1,341.90	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$536.76	$1,341.90	—	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK	$536.76	$1,341.90	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O AIR CONTRAST	$525.00	$1,312.50	—	9% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O AIR W/SBFT	$525.00	$1,312.50	—	9% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O AIR CONTRAST	$525.00	$1,312.50	—	9% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O AIR W/SBFT	$525.00	$1,312.50	—	9% below	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O AIR CONTRAST	$525.00	$1,312.50	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O AIR W/SBFT	$525.00	$1,312.50	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O AIR CONTRAST	$525.00	$1,312.50	—	—	60%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O AIR W/SBFT	$525.00	$1,312.50	—	—	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 CLINIC HUMERUS LT	$125.48	$313.69	—	48% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 CLINIC HUMERUS RT	$125.48	$313.69	—	48% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 CLINIC HUMERUS LT	$125.48	$313.69	—	48% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 CLINIC HUMERUS RT	$125.48	$313.69	—	48% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS RT	$232.05	$580.13	—	4% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS LT	$232.05	$580.13	—	4% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS RT	$232.05	$580.13	—	4% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS LT	$232.05	$580.13	—	4% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS TWO VIEWS RT	$232.26	$580.65	—	3% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS TWO VIEWS RT	$232.26	$580.65	—	3% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS TWO VIEWS LT	$232.26	$580.65	—	3% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS TWO VIEWS LT	$232.26	$580.65	—	3% below	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 CLINIC HUMERUS RT	$125.48	$313.69	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 CLINIC HUMERUS LT	$125.48	$313.69	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 CLINIC HUMERUS LT	$125.48	$313.69	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 CLINIC HUMERUS RT	$125.48	$313.69	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS LT	$232.05	$580.13	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS RT	$232.05	$580.13	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS RT	$232.05	$580.13	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS LT	$232.05	$580.13	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS TWO VIEWS RT	$232.26	$580.65	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS TWO VIEWS LT	$232.26	$580.65	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS TWO VIEWS RT	$232.26	$580.65	—	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS TWO VIEWS LT	$232.26	$580.65	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS MAPPING	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UPPER EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UPPER EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UPPER EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UPPER EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 UP EXT VENOUS DUPLEX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX/LT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 LWR EXT VEN DUPLEX/RT	$589.26	$1,473.15	—	4% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS MAPPING	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UPPER EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UPPER EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUP W/STD REFLX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX/LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX/RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UP EXT VENOUS DUPLEX LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 LWR EXT VEN DUPLEX RT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UPPER EXT VENOUS MAPPING LT	$589.26	$1,473.15	—	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 UPPER EXT VENOUS MAPPING RT	$589.26	$1,473.15	—	—	60%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT LT	$226.38	$565.95	—	10% above	60%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT LT	$226.38	$565.95	—	10% above	60%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT RT	$226.38	$565.95	—	10% above	60%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT RT	$226.38	$565.95	—	10% above	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT RT	$226.38	$565.95	—	—	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT LT	$226.38	$565.95	—	—	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT LT	$226.38	$565.95	—	—	60%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT RT	$226.38	$565.95	—	—	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CLINIC WRIST LT	$125.48	$313.69	—	52% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CLINIC WRIST LT	$125.48	$313.69	—	52% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CLINIC WRIST RT	$125.48	$313.69	—	52% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 CLINIC WRIST RT	$125.48	$313.69	—	52% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS MIN LT	$254.00	$634.99	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS MIN RT	$254.00	$634.99	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS MIN LT	$254.00	$634.99	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS MIN RT	$254.00	$634.99	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS MINIMUM LT	$254.10	$635.25	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS MINIMUM LT	$254.10	$635.25	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS MINIMUM RT	$254.10	$635.25	—	3% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 4 VIEWS MINIMUM RT	$254.10	$635.25	—	3% below	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CLINIC WRIST LT	$125.48	$313.69	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CLINIC WRIST RT	$125.48	$313.69	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CLINIC WRIST LT	$125.48	$313.69	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 CLINIC WRIST RT	$125.48	$313.69	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS MIN RT	$254.00	$634.99	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS MIN RT	$254.00	$634.99	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS MIN LT	$254.00	$634.99	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS MIN LT	$254.00	$634.99	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS MINIMUM RT	$254.10	$635.25	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS MINIMUM RT	$254.10	$635.25	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS MINIMUM LT	$254.10	$635.25	—	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 4 VIEWS MINIMUM LT	$254.10	$635.25	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP UNILATERAL LT	$174.51	$436.28	—	27% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP UNILATERAL RT	$174.51	$436.28	—	27% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP UNILATERAL LT	$174.51	$436.28	—	27% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP UNILATERAL RT	$174.51	$436.28	—	27% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW LT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW LT + PELVIS	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW LT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW RT + PELVIS	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMP STUDY UNILAT 2V LT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW RT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMP STUDY UNILAT 2V RT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMP STUDY UNILAT 2V LT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW RT + PELVIS	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP COMP STUDY UNILAT 2V RT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW RT	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP 2 VIEW LT + PELVIS	$218.40	$546.00	—	8% below	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP 2 VIEW LT + PELVIS	$328.12	$820.31	—	38% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP 2 VIEW LT + PELVIS	$328.12	$820.31	—	38% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP 2 VIEW RT + PELVIS	$328.12	$820.31	—	38% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 CLINIC HIP 2 VIEW RT + PELVIS	$328.12	$820.31	—	38% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP UNILATERAL LT	$174.51	$436.28	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP UNILATERAL LT	$174.51	$436.28	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP UNILATERAL RT	$174.51	$436.28	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP UNILATERAL RT	$174.51	$436.28	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMP STUDY UNILAT 2V RT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW RT + PELVIS	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW LT + PELVIS	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW LT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW RT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMP STUDY UNILAT 2V LT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMP STUDY UNILAT 2V RT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW RT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW LT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW LT + PELVIS	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP 2 VIEW RT + PELVIS	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP COMP STUDY UNILAT 2V LT	$218.40	$546.00	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP 2 VIEW LT + PELVIS	$328.12	$820.31	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP 2 VIEW RT + PELVIS	$328.12	$820.31	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP 2 VIEW LT + PELVIS	$328.12	$820.31	—	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 CLINIC HIP 2 VIEW RT + PELVIS	$328.12	$820.31	—	—	60%
X-ray of the abdomen, 1 view CPT 74018 CLINIC KUB	$154.24	$385.61	—	25% below	60%
X-ray of the abdomen, 1 view CPT 74018 CLINIC KUB	$154.24	$385.61	—	25% below	60%
X-ray of the abdomen, 1 view CPT 74018 KUB/ABDOMEN	$237.72	$594.30	—	15% above	60%
X-ray of the abdomen, 1 view CPT 74018 KUB/ABDOMEN	$237.72	$594.30	—	15% above	60%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$237.72	$594.30	—	15% above	60%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$237.72	$594.30	—	15% above	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 CLINIC KUB	$154.24	$385.61	—	—	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 CLINIC KUB	$154.24	$385.61	—	—	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$237.72	$594.30	—	—	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$237.72	$594.30	—	—	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 KUB/ABDOMEN	$237.72	$594.30	—	—	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 KUB/ABDOMEN	$237.72	$594.30	—	—	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS LT	$46.94	$117.34	—	76% below	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS RT	$46.94	$117.34	—	76% below	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS LT	$46.94	$117.34	—	76% below	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS RT	$46.94	$117.34	—	76% below	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE - 2 VIEWS RT	$231.84	$579.60	—	18% above	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE - 2 VIEWS RT	$231.84	$579.60	—	18% above	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE - 2 VIEWS LT	$231.84	$579.60	—	18% above	60%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE - 2 VIEWS LT	$231.84	$579.60	—	18% above	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS RT	$46.94	$117.34	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS RT	$46.94	$117.34	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS LT	$46.94	$117.34	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS LT	$46.94	$117.34	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE - 2 VIEWS RT	$231.84	$579.60	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE - 2 VIEWS RT	$231.84	$579.60	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE - 2 VIEWS LT	$231.84	$579.60	—	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE - 2 VIEWS LT	$231.84	$579.60	—	—	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-RT	$123.16	$307.91	—	40% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-RT	$123.16	$307.91	—	40% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-LT	$123.16	$307.91	—	40% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-LT	$123.16	$307.91	—	40% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEW LT	$204.33	$510.83	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEW RT	$204.33	$510.83	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEW RT	$204.33	$510.83	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEW LT	$204.33	$510.83	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEWS-RT	$204.54	$511.35	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEWS-RT	$204.54	$511.35	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEWS-LT	$204.54	$511.35	—	1% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEWS-LT	$204.54	$511.35	—	1% below	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-LT	$123.16	$307.91	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-RT	$123.16	$307.91	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-LT	$123.16	$307.91	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 CLINIC FINGER(S) MIN 2 VW-RT	$123.16	$307.91	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEW LT	$204.33	$510.83	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEW RT	$204.33	$510.83	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEW RT	$204.33	$510.83	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEW LT	$204.33	$510.83	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEWS-LT	$204.54	$511.35	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEWS-RT	$204.54	$511.35	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEWS-RT	$204.54	$511.35	—	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEWS-LT	$204.54	$511.35	—	—	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT 1 VIEW RT	$137.76	$344.40	—	34% below	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT 1 VIEW RT	$137.76	$344.40	—	34% below	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT 1 VIEW LT	$137.76	$344.40	—	34% below	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT 1 VIEW LT	$137.76	$344.40	—	34% below	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT - 2 VIEWS LT	$211.26	$528.15	—	1% above	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT - 2 VIEWS RT	$211.26	$528.15	—	1% above	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT - 2 VIEWS RT	$211.26	$528.15	—	1% above	60%
X-ray of the foot, 2 views one side CPT 73620 FOOT - 2 VIEWS LT	$211.26	$528.15	—	1% above	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 1 VIEW LT	$137.76	$344.40	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 1 VIEW LT	$137.76	$344.40	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 1 VIEW RT	$137.76	$344.40	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 1 VIEW RT	$137.76	$344.40	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT - 2 VIEWS LT	$211.26	$528.15	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT - 2 VIEWS RT	$211.26	$528.15	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT - 2 VIEWS LT	$211.26	$528.15	—	—	60%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT - 2 VIEWS RT	$211.26	$528.15	—	—	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CLINIC FOOT LT	$147.10	$367.76	—	46% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CLINIC FOOT RT	$147.10	$367.76	—	46% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CLINIC FOOT RT	$147.10	$367.76	—	46% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 CLINIC FOOT LT	$147.10	$367.76	—	46% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW RT	$255.36	$638.40	—	5% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW LT	$255.36	$638.40	—	5% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW RT	$255.36	$638.40	—	5% below	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW LT	$255.36	$638.40	—	5% below	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CLINIC FOOT RT	$147.10	$367.76	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CLINIC FOOT RT	$147.10	$367.76	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CLINIC FOOT LT	$147.10	$367.76	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 CLINIC FOOT LT	$147.10	$367.76	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW LT	$255.36	$638.40	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW RT	$255.36	$638.40	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW RT	$255.36	$638.40	—	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT COMP STUDY MIN 3 VIEW LT	$255.36	$638.40	—	—	60%
X-ray of the hand, 3 or more views one side CPT 73130 CLINIC HAND 3 VIEWS RT	$123.16	$307.91	—	53% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 CLINIC HAND 3 VIEWS LT	$123.16	$307.91	—	53% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 CLINIC HAND 3 VIEWS LT	$123.16	$307.91	—	53% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 CLINIC HAND 3 VIEWS RT	$123.16	$307.91	—	53% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW MIN LT	$256.52	$641.29	—	1% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW MIN LT	$256.52	$641.29	—	1% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW MIN RT	$256.62	$641.55	—	1% below	60%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEW MIN RT	$256.62	$641.55	—	1% below	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 CLINIC HAND 3 VIEWS LT	$123.16	$307.91	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 CLINIC HAND 3 VIEWS RT	$123.16	$307.91	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 CLINIC HAND 3 VIEWS LT	$123.16	$307.91	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 CLINIC HAND 3 VIEWS RT	$123.16	$307.91	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW MIN LT	$256.52	$641.29	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW MIN LT	$256.52	$641.29	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW MIN RT	$256.62	$641.55	—	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEW MIN RT	$256.62	$641.55	—	—	60%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE SINGLE VIEW BIL	$244.86	$612.15	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE SINGLE VIEW LT	$89.04	$222.60	—	61% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE SINGLE VIEW RT	$89.04	$222.60	—	61% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE SINGLE VIEW LT	$89.04	$222.60	—	61% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE SINGLE VIEW RT	$89.04	$222.60	—	61% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE 2 VIEWS LT	$102.27	$255.68	—	55% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE 2 VIEWS RT	$102.27	$255.68	—	55% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE 2 VIEWS LT	$102.27	$255.68	—	55% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 CLINIC KNEE 2 VIEWS RT	$102.27	$255.68	—	55% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE SINGLE VIEW UNI RT	$200.34	$500.85	—	12% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE SINGLE VIEW UNI LT	$200.34	$500.85	—	12% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE SINGLE VIEW UNI RT	$200.34	$500.85	—	12% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE SINGLE VIEW UNI LT	$200.34	$500.85	—	12% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS RT	$244.65	$611.63	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS LT	$244.65	$611.63	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS RT	$244.65	$611.63	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2 VIEWS LT	$244.65	$611.63	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE - 2 VIEWS LT	$244.86	$612.15	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE - 2 VIEWS RT	$244.86	$612.15	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE - 2 VIEWS RT	$244.86	$612.15	—	7% above	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE - 2 VIEWS LT	$244.86	$612.15	—	7% above	60%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE SINGLE VIEW BIL	$244.86	$612.15	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE SINGLE VIEW LT	$89.04	$222.60	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE SINGLE VIEW LT	$89.04	$222.60	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE SINGLE VIEW RT	$89.04	$222.60	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE SINGLE VIEW RT	$89.04	$222.60	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE 2 VIEWS LT	$102.27	$255.68	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE 2 VIEWS LT	$102.27	$255.68	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE 2 VIEWS RT	$102.27	$255.68	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 CLINIC KNEE 2 VIEWS RT	$102.27	$255.68	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE SINGLE VIEW UNI LT	$200.34	$500.85	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE SINGLE VIEW UNI LT	$200.34	$500.85	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE SINGLE VIEW UNI RT	$200.34	$500.85	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE SINGLE VIEW UNI RT	$200.34	$500.85	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS LT	$244.65	$611.63	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS LT	$244.65	$611.63	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS RT	$244.65	$611.63	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 2 VIEWS RT	$244.65	$611.63	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE - 2 VIEWS RT	$244.86	$612.15	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE - 2 VIEWS RT	$244.86	$612.15	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE - 2 VIEWS LT	$244.86	$612.15	—	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE - 2 VIEWS LT	$244.86	$612.15	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 CLINIC LUMBAR SPINE AP & LAT	$154.24	$385.61	—	47% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 CLINIC LUMBAR SPINE AP & LAT	$154.24	$385.61	—	47% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2V FLEX AND EXTEN	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2-3 VIEW	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LS SPINE 2-3 VIEW	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL 2-3 VIEWS	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL 2-3 VIEWS	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2V FLEX AND EXTEN	$281.40	$703.50	—	3% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 CLINIC LUMBAR SPINE AP & LAT	$154.24	$385.61	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 CLINIC LUMBAR SPINE AP & LAT	$154.24	$385.61	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL 2-3 VIEWS	$281.40	$703.50	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2V FLEX AND EXTEN	$281.40	$703.50	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2-3 VIEW	$281.40	$703.50	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2V FLEX AND EXTEN	$281.40	$703.50	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LS SPINE 2-3 VIEW	$281.40	$703.50	—	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL 2-3 VIEWS	$281.40	$703.50	—	—	60%
X-ray of the lower back, 4 or more views CPT 72110 CLINIC LUMBAR SPINE PHYSICAL	$89.04	$222.60	—	79% below	60%
X-ray of the lower back, 4 or more views CPT 72110 CLINIC LUMBAR SPINE PHYSICAL	$89.04	$222.60	—	79% below	60%
X-ray of the lower back, 4 or more views CPT 72110 CLINIC LUMBAR SPINE COMPLETE	$272.37	$680.93	—	36% below	60%
X-ray of the lower back, 4 or more views CPT 72110 CLINIC LUMBAR SPINE COMPLETE	$272.37	$680.93	—	36% below	60%
X-ray of the lower back, 4 or more views CPT 72110 LUMBOSACRAL COMP OBLIQ VIEW	$382.20	$955.50	—	10% below	60%
X-ray of the lower back, 4 or more views CPT 72110 LSPINE 2V PLUS FLEX-EXT	$382.20	$955.50	—	10% below	60%
X-ray of the lower back, 4 or more views CPT 72110 LSPINE 2V PLUS FLEX-EXT	$382.20	$955.50	—	10% below	60%
X-ray of the lower back, 4 or more views CPT 72110 LUMBOSACRAL COMP OBLIQ VIEW	$382.20	$955.50	—	10% below	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 CLINIC LUMBAR SPINE PHYSICAL	$89.04	$222.60	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 CLINIC LUMBAR SPINE PHYSICAL	$89.04	$222.60	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 CLINIC LUMBAR SPINE COMPLETE	$272.37	$680.93	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 CLINIC LUMBAR SPINE COMPLETE	$272.37	$680.93	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSACRAL COMP OBLIQ VIEW	$382.20	$955.50	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LSPINE 2V PLUS FLEX-EXT	$382.20	$955.50	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSACRAL COMP OBLIQ VIEW	$382.20	$955.50	—	—	60%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LSPINE 2V PLUS FLEX-EXT	$382.20	$955.50	—	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2-VIEW	$147.00	$367.50	—	42% below	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2-VIEW	$147.00	$367.50	—	42% below	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2-VIEW	$147.00	$367.50	—	—	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2-VIEW	$147.00	$367.50	—	—	60%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$53.86	$134.66	—	78% below	60%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$53.86	$134.66	—	78% below	60%
X-ray of the nasal bones, 3 or more views CPT 70160 CLINIC NASAL BONES	$207.27	$518.18	—	17% below	60%
X-ray of the nasal bones, 3 or more views CPT 70160 CLINIC NASAL BONES	$207.27	$518.18	—	17% below	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$53.86	$134.66	—	—	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$53.86	$134.66	—	—	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 CLINIC NASAL BONES	$207.27	$518.18	—	—	60%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 CLINIC NASAL BONES	$207.27	$518.18	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CLINIC CERVICAL SPINE AP & LAT	$147.10	$367.76	—	50% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CLINIC CERVICAL SPINE AP & LAT	$147.10	$367.76	—	50% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERV SPINAL FLEXION/EXTEN ONLY	$268.80	$672.00	—	8% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP & LAT	$268.80	$672.00	—	8% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP & LAT	$268.80	$672.00	—	8% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERV SPINAL FLEXION/EXTEN ONLY	$268.80	$672.00	—	8% below	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CLINIC CERVICAL SPINE AP & LAT	$147.10	$367.76	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CLINIC CERVICAL SPINE AP & LAT	$147.10	$367.76	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERV SPINAL FLEXION/EXTEN ONLY	$268.80	$672.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE AP & LAT	$268.80	$672.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERV SPINAL FLEXION/EXTEN ONLY	$268.80	$672.00	—	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE AP & LAT	$268.80	$672.00	—	—	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 CLINIC PELVIS	$154.24	$385.61	—	30% below	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 CLINIC PELVIS	$154.24	$385.61	—	30% below	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$225.12	$562.80	—	2% above	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$225.12	$562.80	—	2% above	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 CLINIC PELVIS	$154.24	$385.61	—	—	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 CLINIC PELVIS	$154.24	$385.61	—	—	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$225.12	$562.80	—	—	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$225.12	$562.80	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 CLINIC SACRUM & COCCYX	$154.24	$385.61	—	40% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 CLINIC SACRUM & COCCYX	$154.24	$385.61	—	40% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX	$246.96	$617.40	—	3% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX	$246.96	$617.40	—	3% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX	$246.96	$617.40	—	3% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX	$246.96	$617.40	—	3% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 CLINIC SACRUM & COCCYX	$154.24	$385.61	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 CLINIC SACRUM & COCCYX	$154.24	$385.61	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX	$246.96	$617.40	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX	$246.96	$617.40	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX	$246.96	$617.40	—	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX	$246.96	$617.40	—	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ACTH blood test CPT 82024 ACTH	$242.76	$606.90	—	42% above	60%
ACTH blood test CPT 82024 ACTH	$242.76	$606.90	—	42% above	60%
ACTH blood test inpatient CPT 82024 ACTH	$242.76	$606.90	—	—	60%
ACTH blood test inpatient CPT 82024 ACTH	$242.76	$606.90	—	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$50.61	$126.53	—	4% above	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$50.61	$126.53	—	4% above	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$51.24	$128.10	—	5% above	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$51.24	$128.10	—	5% above	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$50.61	$126.53	—	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$50.61	$126.53	—	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT)	$51.24	$128.10	—	—	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT)	$51.24	$128.10	—	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$55.86	$139.65	—	20% above	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$55.86	$139.65	—	20% above	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$56.70	$141.75	—	22% above	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$56.70	$141.75	—	22% above	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$55.86	$139.65	—	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$55.86	$139.65	—	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST)	$56.70	$141.75	—	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST)	$56.70	$141.75	—	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$283.60	$709.01	—	18% above	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$283.60	$709.01	—	18% above	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$283.60	$709.01	—	—	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$283.60	$709.01	—	—	60%
Albumin blood test CPT 82040 SERUM ALBUMIN	$68.67	$171.68	—	114% above	60%
Albumin blood test CPT 82040 SERUM ALBUMIN	$68.67	$171.68	—	114% above	60%
Albumin blood test CPT 82040 ALBUMIN SERUM PLASMA OR WH BLD	$69.30	$173.25	—	116% above	60%
Albumin blood test CPT 82040 ALBUMIN SERUM PLASMA OR WH BLD	$69.30	$173.25	—	116% above	60%
Albumin blood test inpatient CPT 82040 SERUM ALBUMIN	$68.67	$171.68	—	—	60%
Albumin blood test inpatient CPT 82040 SERUM ALBUMIN	$68.67	$171.68	—	—	60%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM PLASMA OR WH BLD	$69.30	$173.25	—	—	60%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM PLASMA OR WH BLD	$69.30	$173.25	—	—	60%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$261.24	$653.10	—	61% above	60%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$261.24	$653.10	—	61% above	60%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$261.24	$653.10	—	61% above	60%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$261.24	$653.10	—	61% above	60%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$261.24	$653.10	—	—	60%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$261.24	$653.10	—	—	60%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$261.24	$653.10	—	—	60%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$261.24	$653.10	—	—	60%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$52.29	$130.73	—	2% above	60%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$52.29	$130.73	—	2% above	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$52.29	$130.73	—	—	60%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$52.29	$130.73	—	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE	$38.12	$95.29	—	77% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE	$38.12	$95.29	—	77% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGIN SCREEN INDIVIDUAL	$43.68	$109.20	—	103% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGIN SCREEN INDIVIDUAL	$43.68	$109.20	—	103% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE	$89.56	$223.91	—	316% above	60%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE	$89.56	$223.91	—	316% above	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE	$38.12	$95.29	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE	$38.12	$95.29	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGIN SCREEN INDIVIDUAL	$43.68	$109.20	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGIN SCREEN INDIVIDUAL	$43.68	$109.20	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE	$89.56	$223.91	—	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE	$89.56	$223.91	—	—	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN MATERNAL	$181.86	$454.65	—	89% above	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) MARKER	$181.86	$454.65	—	89% above	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN MATERNAL	$181.86	$454.65	—	89% above	60%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) MARKER	$181.86	$454.65	—	89% above	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP) MARKER	$181.86	$454.65	—	—	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP) MARKER	$181.86	$454.65	—	—	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN MATERNAL	$181.86	$454.65	—	—	60%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN MATERNAL	$181.86	$454.65	—	—	60%
Ammonia blood test CPT 82140 AMMONIA BLOOD	$112.56	$281.40	—	47% above	60%
Ammonia blood test CPT 82140 AMMONIA BLOOD	$112.56	$281.40	—	47% above	60%
Ammonia blood test inpatient CPT 82140 AMMONIA BLOOD	$112.56	$281.40	—	—	60%
Ammonia blood test inpatient CPT 82140 AMMONIA BLOOD	$112.56	$281.40	—	—	60%
Amylase blood test CPT 82150 AMYLASE	$100.80	$252.00	—	76% above	60%
Amylase blood test CPT 82150 AMYLASE	$100.80	$252.00	—	76% above	60%
Amylase blood test inpatient CPT 82150 AMYLASE	$100.80	$252.00	—	—	60%
Amylase blood test inpatient CPT 82150 AMYLASE	$100.80	$252.00	—	—	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEPTIDE	$131.04	$327.60	—	63% above	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEPTIDE	$131.04	$327.60	—	63% above	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEPTIDE	$131.04	$327.60	—	—	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEPTIDE	$131.04	$327.60	—	—	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$41.06	$102.64	—	38% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$41.06	$102.64	—	38% below	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES	$145.74	$364.35	—	119% above	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES	$145.74	$364.35	—	119% above	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$41.06	$102.64	—	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$41.06	$102.64	—	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTIBODIES	$145.74	$364.35	—	—	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTIBODIES	$145.74	$364.35	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B-TYPE NATRIURETIC PEPTIDE	$168.84	$422.10	—	36% above	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B-TYPE NATRIURETIC PEPTIDE	$168.84	$422.10	—	36% above	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B-TYPE NATRIURETIC PEPTIDE	$168.84	$422.10	—	—	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B-TYPE NATRIURETIC PEPTIDE	$168.84	$422.10	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTHER EAR/EYE/CSF	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACT OTHER EAR/EYE/CSF	$124.32	$310.80	—	82% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL OTHER	$129.46	$323.66	—	90% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL OTHER	$129.46	$323.66	—	90% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTHER EAR/EYE/CSF	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACT OTHER EAR/EYE/CSF	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP	$124.32	$310.80	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIAL OTHER	$129.46	$323.66	—	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIAL OTHER	$129.46	$323.66	—	—	60%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$104.16	$260.40	—	7% below	60%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$104.16	$260.40	—	7% below	60%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$104.16	$260.40	—	—	60%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$104.16	$260.40	—	—	60%
Bilirubin blood test, total CPT 82247 BILRUBIN TOTAL	$49.35	$123.38	—	at median	60%
Bilirubin blood test, total CPT 82247 BILRUBIN TOTAL	$49.35	$123.38	—	at median	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN NEONATAL	$49.98	$124.95	—	1% above	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$49.98	$124.95	—	1% above	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN NEONATAL	$49.98	$124.95	—	1% above	60%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$49.98	$124.95	—	1% above	60%
Bilirubin blood test, total inpatient CPT 82247 BILRUBIN TOTAL	$49.35	$123.38	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILRUBIN TOTAL	$49.35	$123.38	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$49.98	$124.95	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN NEONATAL	$49.98	$124.95	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$49.98	$124.95	—	—	60%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN NEONATAL	$49.98	$124.95	—	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO 88305	$126.00	$315.00	—	36% below	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS & MICRO 88305	$126.00	$315.00	—	36% below	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO 88305	$126.00	$315.00	—	—	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS & MICRO 88305	$126.00	$315.00	—	—	60%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD	$153.30	$383.25	—	38% above	60%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD	$153.30	$383.25	—	38% above	60%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$153.72	$384.30	—	38% above	60%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$153.72	$384.30	—	38% above	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD	$153.30	$383.25	—	—	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD	$153.30	$383.25	—	—	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$153.72	$384.30	—	—	60%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$153.72	$384.30	—	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FEE	$13.10	$32.75	—	19% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FEE	$13.10	$32.75	—	19% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ON-SITE VENIPUNCTURE	$13.76	$34.39	—	15% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ON-SITE VENIPUNCTURE	$13.76	$34.39	—	15% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$14.70	$36.75	—	10% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$14.70	$36.75	—	10% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW	$15.44	$38.59	—	5% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW	$15.44	$38.59	—	5% below	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FEE	$13.10	$32.75	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FEE	$13.10	$32.75	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ON-SITE VENIPUNCTURE	$13.76	$34.39	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ON-SITE VENIPUNCTURE	$13.76	$34.39	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$14.70	$36.75	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$14.70	$36.75	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW	$15.44	$38.59	—	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW	$15.44	$38.59	—	—	60%
Blood glucose (sugar) test CPT 82947 BEDSIDE GLUCOSE BLOOD	$19.00	$47.51	—	36% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$19.00	$47.51	—	36% below	60%
Blood glucose (sugar) test CPT 82947 BEDSIDE GLUCOSE BLOOD	$19.00	$47.51	—	36% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$19.00	$47.51	—	36% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD BEDSIDE TESTING	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE URINE RANDOM COLLECT	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD BEDSIDE TESTING	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test CPT 82947 GLUCOSE URINE RANDOM COLLECT	$19.74	$49.35	—	34% below	60%
Blood glucose (sugar) test inpatient CPT 82947 BEDSIDE GLUCOSE BLOOD	$19.00	$47.51	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$19.00	$47.51	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 BEDSIDE GLUCOSE BLOOD	$19.00	$47.51	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$19.00	$47.51	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$19.74	$49.35	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE URINE RANDOM COLLECT	$19.74	$49.35	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD BEDSIDE TESTING	$19.74	$49.35	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE URINE RANDOM COLLECT	$19.74	$49.35	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE	$19.74	$49.35	—	—	60%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD BEDSIDE TESTING	$19.74	$49.35	—	—	60%
Blood lead test CPT 83655 LEAD URINE	$99.12	$247.80	—	82% above	60%
Blood lead test CPT 83655 LEAD URINE	$99.12	$247.80	—	82% above	60%
Blood lead test CPT 83655 LEAD BLOOD	$99.12	$247.80	—	82% above	60%
Blood lead test CPT 83655 LEAD BLOOD	$99.12	$247.80	—	82% above	60%
Blood lead test inpatient CPT 83655 LEAD URINE	$99.12	$247.80	—	—	60%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$99.12	$247.80	—	—	60%
Blood lead test inpatient CPT 83655 LEAD URINE	$99.12	$247.80	—	—	60%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$99.12	$247.80	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPN URIN QUA	$76.44	$191.10	—	43% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPN URIN QUA	$76.44	$191.10	—	43% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUALITATIVE	$76.44	$191.10	—	43% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUALITATIVE	$76.44	$191.10	—	43% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPN URIN QUA	$76.44	$191.10	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUALITATIVE	$76.44	$191.10	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPN URIN QUA	$76.44	$191.10	—	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUALITATIVE	$76.44	$191.10	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$49.98	$124.95	—	at median	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$49.98	$124.95	—	at median	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$49.98	$124.95	—	—	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$49.98	$124.95	—	—	60%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN	$42.21	$105.53	—	14% above	60%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN	$42.21	$105.53	—	14% above	60%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANT	$42.84	$107.10	—	16% above	60%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANT	$42.84	$107.10	—	16% above	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN	$42.21	$105.53	—	—	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN	$42.21	$105.53	—	—	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANT	$42.84	$107.10	—	—	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANT	$42.84	$107.10	—	—	60%
C-peptide blood test CPT 84681 C-PEPTIDE	$126.84	$317.10	—	21% above	60%
C-peptide blood test CPT 84681 C-PEPTIDE	$126.84	$317.10	—	21% above	60%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$126.84	$317.10	—	—	60%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$126.84	$317.10	—	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$82.32	$205.80	—	38% above	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$82.32	$205.80	—	38% above	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$82.32	$205.80	—	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$82.32	$205.80	—	—	60%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGNT BY NUCLEIC ACID C DIF	$155.82	$389.55	—	3% above	60%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGNT BY NUCLEIC ACID C DIF	$155.82	$389.55	—	3% above	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGNT BY NUCLEIC ACID C DIF	$155.82	$389.55	—	—	60%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGNT BY NUCLEIC ACID C DIF	$155.82	$389.55	—	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9	$173.88	$434.70	—	65% above	60%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9	$173.88	$434.70	—	65% above	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9	$173.88	$434.70	—	—	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19-9	$173.88	$434.70	—	—	60%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$162.54	$406.35	—	49% above	60%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$162.54	$406.35	—	49% above	60%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$162.54	$406.35	—	—	60%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$162.54	$406.35	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 AMP PRB	$66.57	$166.43	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 AMP PRB	$66.57	$166.43	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 SARS COV2 AMP PRB	$67.20	$168.00	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 SARS COV2 AMP PRB	$67.20	$168.00	—	31% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 AMP PRB	$66.57	$166.43	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 AMP PRB	$66.57	$166.43	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 SARS COV2 AMP PRB	$67.20	$168.00	—	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 SARS COV2 AMP PRB	$67.20	$168.00	—	—	60%
Calcium blood test, total CPT 82310 CALCIUM	$66.57	$166.43	—	44% above	60%
Calcium blood test, total CPT 82310 CALCIUM	$66.57	$166.43	—	44% above	60%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$66.57	$166.43	—	—	60%
Calcium blood test, total inpatient CPT 82310 CALCIUM	$66.57	$166.43	—	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$137.34	$343.35	—	35% above	60%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$137.34	$343.35	—	35% above	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$137.34	$343.35	—	—	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$137.34	$343.35	—	—	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$27.20	$68.00	—	63% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$27.20	$68.00	—	63% below	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER ANTIBODY	$123.06	$307.65	—	67% above	60%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER ANTIBODY	$123.06	$307.65	—	67% above	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$27.20	$68.00	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGG ANTIBODY	$27.20	$68.00	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY	$123.06	$307.65	—	—	60%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY	$123.06	$307.65	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR	$168.84	$422.10	—	91% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR	$168.84	$422.10	—	91% above	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR	$168.84	$422.10	—	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS BY PCR	$168.84	$422.10	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$15.64	$39.11	—	85% below	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$15.64	$39.11	—	85% below	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$15.64	$39.11	—	—	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$15.64	$39.11	—	—	60%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTODIFF	$13.86	$34.65	—	73% below	60%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTODIFF	$13.86	$34.65	—	73% below	60%
Complete blood count (CBC) with differential CPT 85025 CBC	$77.91	$194.78	—	54% above	60%
Complete blood count (CBC) with differential CPT 85025 CBC	$77.91	$194.78	—	54% above	60%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTODIFF	$13.86	$34.65	—	—	60%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTODIFF	$13.86	$34.65	—	—	60%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC	$77.91	$194.78	—	—	60%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC	$77.91	$194.78	—	—	60%
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$69.72	$174.30	—	31% above	60%
Complete blood count (CBC), no differential CPT 85027 H/H HEMOGRAM AND PLT COUNT	$69.72	$174.30	—	31% above	60%
Complete blood count (CBC), no differential CPT 85027 H/H HEMOGRAM AND PLT COUNT	$69.72	$174.30	—	31% above	60%
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$69.72	$174.30	—	31% above	60%
Complete blood count (CBC), no differential inpatient CPT 85027 H/H HEMOGRAM AND PLT COUNT	$69.72	$174.30	—	—	60%
Complete blood count (CBC), no differential inpatient CPT 85027 H/H HEMOGRAM AND PLT COUNT	$69.72	$174.30	—	—	60%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTOMATED	$69.72	$174.30	—	—	60%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTOMATED	$69.72	$174.30	—	—	60%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$15.75	$39.38	—	87% below	60%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$15.75	$39.38	—	87% below	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$15.75	$39.38	—	—	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$15.75	$39.38	—	—	60%
Cortisol blood test, total CPT 82533 SERUM CORTISOL TOTAL	$155.82	$389.55	—	79% above	60%
Cortisol blood test, total CPT 82533 SERUM CORTISOL TOTAL	$155.82	$389.55	—	79% above	60%
Cortisol blood test, total inpatient CPT 82533 SERUM CORTISOL TOTAL	$155.82	$389.55	—	—	60%
Cortisol blood test, total inpatient CPT 82533 SERUM CORTISOL TOTAL	$155.82	$389.55	—	—	60%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$71.82	$179.55	—	14% above	60%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$71.82	$179.55	—	14% above	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$71.82	$179.55	—	—	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$71.82	$179.55	—	—	60%
Creatinine blood test CPT 82565 CREATININE SERUM	$15.44	$38.59	—	52% below	60%
Creatinine blood test CPT 82565 CREATININE SERUM	$15.44	$38.59	—	52% below	60%
Creatinine blood test CPT 82565 CREATININE	$48.09	$120.23	—	50% above	60%
Creatinine blood test CPT 82565 CREATININE	$48.09	$120.23	—	50% above	60%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$15.44	$38.59	—	—	60%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM	$15.44	$38.59	—	—	60%
Creatinine blood test inpatient CPT 82565 CREATININE	$48.09	$120.23	—	—	60%
Creatinine blood test inpatient CPT 82565 CREATININE	$48.09	$120.23	—	—	60%
Cytomegalovirus (CMV) antibody test CPT 86644 DONOR PROCESSING FEE CMV	$69.72	$174.30	—	at median	60%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$69.72	$174.30	—	at median	60%
Cytomegalovirus (CMV) antibody test CPT 86644 DONOR PROCESSING FEE CMV	$69.72	$174.30	—	at median	60%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$69.72	$174.30	—	at median	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$69.72	$174.30	—	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$69.72	$174.30	—	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 DONOR PROCESSING FEE CMV	$69.72	$174.30	—	—	60%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 DONOR PROCESSING FEE CMV	$69.72	$174.30	—	—	60%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$125.16	$312.90	—	at median	60%
D-dimer blood test (blood clot marker) CPT 85379 DIMER TEST QUANTITATIVE	$125.16	$312.90	—	at median	60%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$125.16	$312.90	—	at median	60%
D-dimer blood test (blood clot marker) CPT 85379 DIMER TEST QUANTITATIVE	$125.16	$312.90	—	at median	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$125.16	$312.90	—	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$125.16	$312.90	—	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DIMER TEST QUANTITATIVE	$125.16	$312.90	—	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DIMER TEST QUANTITATIVE	$125.16	$312.90	—	—	60%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$147.00	$367.50	—	4% above	60%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$147.00	$367.50	—	4% above	60%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$147.00	$367.50	—	—	60%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$147.00	$367.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS DOWNSTREAM	$13.90	$34.75	—	82% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS DOWNSTREAM	$13.90	$34.75	—	82% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WITHOUT COLLECTION	$14.70	$36.75	—	81% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WITHOUT COLLECTION	$14.70	$36.75	—	81% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT WITHOUT COLLECTION	$16.30	$40.75	—	79% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT WITHOUT COLLECTION	$16.30	$40.75	—	79% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS CONFIRMATION	$16.80	$42.00	—	78% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS CONFIRMATION	$16.80	$42.00	—	78% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS K2	$21.30	$53.25	—	72% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS K2	$21.30	$53.25	—	72% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS LAB BASED	$22.70	$56.75	—	71% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS LAB BASED	$22.70	$56.75	—	71% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ON-SITE DS LAB BASED	$22.70	$56.75	—	71% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ON-SITE DS LAB BASED	$22.70	$56.75	—	71% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT LAB BASED	$24.30	$60.75	—	69% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT LAB BASED	$24.30	$60.75	—	69% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 5 PANEL	$26.80	$67.00	—	65% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 5 PANEL	$26.80	$67.00	—	65% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS W170 (ORAL 4 PNL W/O THC)	$26.80	$67.00	—	65% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS W170 (ORAL 4 PNL W/O THC)	$26.80	$67.00	—	65% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 7 PANEL	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WG77 (ORAL 7 PNL W/O THC)	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WW30 (ORAL 9 PNL W/O THC)	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 7 PANEL	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 9 PANEL	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WG77 (ORAL 7 PNL W/O THC)	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS WW30 (ORAL 9 PNL W/O THC)	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS ORAL 9 PANEL	$28.00	$70.00	—	64% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9+NARCOTICS W/O COLLECTION	$37.50	$93.75	—	51% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9+NARCOTICS W/O COLLECTION	$37.50	$93.75	—	51% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL + NARCOTICS	$40.90	$102.25	—	47% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL + NARCOTICS	$40.90	$102.25	—	47% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 8 PNL/OF/BUP/FEN/ECS/SYN	$42.00	$105.00	—	46% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 8 PNL/OF/BUP/FEN/ECS/SYN	$42.00	$105.00	—	46% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT NONFED 9 PANEL+NARCOTICS	$42.60	$106.50	—	45% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT NONFED 9 PANEL+NARCOTICS	$42.60	$106.50	—	45% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL+K2	$43.20	$108.00	—	44% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL+K2	$43.20	$108.00	—	44% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT 8 PNL/OF/BUP/FEN/ECS/SYN	$45.00	$112.50	—	42% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OT 8 PNL/OF/BUP/FEN/ECS/SYN	$45.00	$112.50	—	42% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 5 PANEL+K2	$45.40	$113.50	—	41% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 5 PANEL+K2	$45.40	$113.50	—	41% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL+NARCOTICS+K2	$57.90	$144.75	—	25% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS 9 PANEL+NARCOTICS+K2	$57.90	$144.75	—	25% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS HAIR 5	$58.80	$147.00	—	24% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS HAIR 5	$58.80	$147.00	—	24% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OR 8PNL+NARC+ALC AFTER HRS	$59.10	$147.75	—	23% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS OR 8PNL+NARC+ALC AFTER HRS	$59.10	$147.75	—	23% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS HAIR 5 + OPIATES	$68.80	$172.00	—	11% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS HAIR 5 + OPIATES	$68.80	$172.00	—	11% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS SPLIT LAB CONFIRMATION	$186.50	$466.25	—	141% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS SPLIT LAB CONFIRMATION	$186.50	$466.25	—	141% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS PRESUMPTIVE SNGLE DRUG CLAS	$200.76	$501.90	—	160% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS PRESUMPTIVE SNGLE DRUG CLAS	$200.76	$501.90	—	160% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN FOR MECONIUM	$210.42	$526.05	—	172% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN FOR MECONIUM	$210.42	$526.05	—	172% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$242.34	$605.85	—	214% above	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$242.34	$605.85	—	214% above	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS DOWNSTREAM	$13.90	$34.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS DOWNSTREAM	$13.90	$34.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WITHOUT COLLECTION	$14.70	$36.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WITHOUT COLLECTION	$14.70	$36.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT WITHOUT COLLECTION	$16.30	$40.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT WITHOUT COLLECTION	$16.30	$40.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS CONFIRMATION	$16.80	$42.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS CONFIRMATION	$16.80	$42.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS K2	$21.30	$53.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS K2	$21.30	$53.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS LAB BASED	$22.70	$56.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ON-SITE DS LAB BASED	$22.70	$56.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ON-SITE DS LAB BASED	$22.70	$56.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS LAB BASED	$22.70	$56.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT LAB BASED	$24.30	$60.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT LAB BASED	$24.30	$60.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 5 PANEL	$26.80	$67.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS W170 (ORAL 4 PNL W/O THC)	$26.80	$67.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 5 PANEL	$26.80	$67.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS W170 (ORAL 4 PNL W/O THC)	$26.80	$67.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 7 PANEL	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WW30 (ORAL 9 PNL W/O THC)	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WG77 (ORAL 7 PNL W/O THC)	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 9 PANEL	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WG77 (ORAL 7 PNL W/O THC)	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS WW30 (ORAL 9 PNL W/O THC)	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 7 PANEL	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ORAL 9 PANEL	$28.00	$70.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9+NARCOTICS W/O COLLECTION	$37.50	$93.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9+NARCOTICS W/O COLLECTION	$37.50	$93.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL + NARCOTICS	$40.90	$102.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL + NARCOTICS	$40.90	$102.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 8 PNL/OF/BUP/FEN/ECS/SYN	$42.00	$105.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 8 PNL/OF/BUP/FEN/ECS/SYN	$42.00	$105.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT NONFED 9 PANEL+NARCOTICS	$42.60	$106.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT NONFED 9 PANEL+NARCOTICS	$42.60	$106.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL+K2	$43.20	$108.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL+K2	$43.20	$108.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT 8 PNL/OF/BUP/FEN/ECS/SYN	$45.00	$112.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OT 8 PNL/OF/BUP/FEN/ECS/SYN	$45.00	$112.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 5 PANEL+K2	$45.40	$113.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 5 PANEL+K2	$45.40	$113.50	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL+NARCOTICS+K2	$57.90	$144.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS 9 PANEL+NARCOTICS+K2	$57.90	$144.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS HAIR 5	$58.80	$147.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS HAIR 5	$58.80	$147.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OR 8PNL+NARC+ALC AFTER HRS	$59.10	$147.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS OR 8PNL+NARC+ALC AFTER HRS	$59.10	$147.75	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS HAIR 5 + OPIATES	$68.80	$172.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS HAIR 5 + OPIATES	$68.80	$172.00	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS SPLIT LAB CONFIRMATION	$186.50	$466.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS SPLIT LAB CONFIRMATION	$186.50	$466.25	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS PRESUMPTIVE SNGLE DRUG CLAS	$200.76	$501.90	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS PRESUMPTIVE SNGLE DRUG CLAS	$200.76	$501.90	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN FOR MECONIUM	$210.42	$526.05	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN FOR MECONIUM	$210.42	$526.05	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$242.34	$605.85	—	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$242.34	$605.85	—	—	60%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES SERUM	$107.52	$268.80	—	28% above	60%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES SERUM	$107.52	$268.80	—	28% above	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES SERUM	$107.52	$268.80	—	—	60%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES SERUM	$107.52	$268.80	—	—	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IGG	$87.36	$218.40	—	10% above	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IGM	$87.36	$218.40	—	10% above	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IGG	$87.36	$218.40	—	10% above	60%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-VCA IGM	$87.36	$218.40	—	10% above	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IGG	$87.36	$218.40	—	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IGG	$87.36	$218.40	—	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IGM	$87.36	$218.40	—	—	60%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-VCA IGM	$87.36	$218.40	—	—	60%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$162.54	$406.35	—	14% above	60%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$162.54	$406.35	—	14% above	60%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL	$162.54	$406.35	—	—	60%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL	$162.54	$406.35	—	—	60%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$152.46	$381.15	—	48% above	60%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$152.46	$381.15	—	48% above	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$152.46	$381.15	—	—	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$152.46	$381.15	—	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$312.90	$782.25	—	66% above	60%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$312.90	$782.25	—	66% above	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$312.90	$782.25	—	—	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$312.90	$782.25	—	—	60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$114.56	$286.39	—	20% above	60%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$114.56	$286.39	—	20% above	60%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$114.56	$286.39	—	—	60%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$114.56	$286.39	—	—	60%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$110.88	$277.20	—	21% above	60%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$110.88	$277.20	—	21% above	60%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$110.88	$277.20	—	—	60%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$110.88	$277.20	—	—	60%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$126.32	$315.79	—	54% above	60%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$126.32	$315.79	—	54% above	60%
Folate (folic acid) blood test CPT 82746 FOLATE	$126.84	$317.10	—	54% above	60%
Folate (folic acid) blood test CPT 82746 FOLATE	$126.84	$317.10	—	54% above	60%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$126.32	$315.79	—	—	60%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$126.32	$315.79	—	—	60%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$126.84	$317.10	—	—	60%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$126.84	$317.10	—	—	60%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$135.24	$338.10	—	36% above	60%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$135.24	$338.10	—	36% above	60%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$135.24	$338.10	—	—	60%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$135.24	$338.10	—	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE BY DIRECT DIALYSIS	$112.56	$281.40	—	46% above	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$112.56	$281.40	—	46% above	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE BY DIRECT DIALYSIS	$112.56	$281.40	—	46% above	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$112.56	$281.40	—	46% above	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$112.56	$281.40	—	—	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$112.56	$281.40	—	—	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE BY DIRECT DIALYSIS	$112.56	$281.40	—	—	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE BY DIRECT DIALYSIS	$112.56	$281.40	—	—	60%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$189.84	$474.60	—	55% above	60%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$189.84	$474.60	—	55% above	60%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$189.84	$474.60	—	—	60%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$189.84	$474.60	—	—	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$82.32	$205.80	—	43% above	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$82.32	$205.80	—	43% above	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$82.32	$205.80	—	—	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$82.32	$205.80	—	—	60%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$451.92	$1,129.80	—	57% above	60%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$451.92	$1,129.80	—	57% above	60%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$451.92	$1,129.80	—	—	60%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$451.92	$1,129.80	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POST PRANDIAL	$61.74	$154.35	—	45% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POST PRANDIAL	$61.74	$154.35	—	45% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 RAPID DIABETIC SCREEN	$61.74	$154.35	—	45% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 RAPID DIABETIC SCREEN	$61.74	$154.35	—	45% above	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POST PRANDIAL	$61.74	$154.35	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 RAPID DIABETIC SCREEN	$61.74	$154.35	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POST PRANDIAL	$61.74	$154.35	—	—	60%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 RAPID DIABETIC SCREEN	$61.74	$154.35	—	—	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2 HR	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3HR - OB	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPECIMENS INCL GLUCOSE	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPECIMENS INCL GLUCOSE	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3HR - OB	$114.66	$286.65	—	26% above	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPECIMENS INCL GLUCOSE	$114.66	$286.65	—	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3HR - OB	$114.66	$286.65	—	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2 HR	$114.66	$286.65	—	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3HR - OB	$114.66	$286.65	—	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2 HR	$114.66	$286.65	—	—	60%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPECIMENS INCL GLUCOSE	$114.66	$286.65	—	—	60%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG	$136.08	$340.20	—	15% above	60%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG	$136.08	$340.20	—	15% above	60%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG	$136.08	$340.20	—	—	60%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG	$136.08	$340.20	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 PCR NA QUANTIFICATION	$406.98	$1,017.45	—	17% above	60%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 PCR NA QUANTIFICATION	$406.98	$1,017.45	—	17% above	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 PCR NA QUANTIFICATION	$406.98	$1,017.45	—	—	60%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 PCR NA QUANTIFICATION	$406.98	$1,017.45	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG W/ HIV 1/2 ABS ONE RES	$115.92	$289.80	—	31% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG W/ HIV 1/2 ABS ONE RES	$115.92	$289.80	—	31% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG W/ HIV 1/2 ABS ONE RES	$115.92	$289.80	—	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG W/ HIV 1/2 ABS ONE RES	$115.92	$289.80	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$12.81	$32.03	—	79% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$12.81	$32.03	—	79% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN	$101.64	$254.10	—	69% above	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN	$101.64	$254.10	—	69% above	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$12.81	$32.03	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$12.81	$32.03	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN	$101.64	$254.10	—	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN	$101.64	$254.10	—	—	60%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$27.72	$69.30	—	at median	60%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$27.72	$69.30	—	at median	60%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$27.72	$69.30	—	—	60%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$27.72	$69.30	—	—	60%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$93.66	$234.15	—	40% above	60%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$93.66	$234.15	—	40% above	60%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$94.50	$236.25	—	41% above	60%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$94.50	$236.25	—	41% above	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$93.66	$234.15	—	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$93.66	$234.15	—	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$94.50	$236.25	—	—	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$94.50	$236.25	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$91.14	$227.85	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$91.14	$227.85	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB-IMMUNIT	$91.56	$228.90	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$91.56	$228.90	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$91.56	$228.90	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB-IMMUNIT	$91.56	$228.90	—	36% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$91.14	$227.85	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$91.14	$227.85	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$91.56	$228.90	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$91.56	$228.90	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB-IMMUNIT	$91.56	$228.90	—	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB-IMMUNIT	$91.56	$228.90	—	—	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$19.11	$47.78	—	69% below	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$19.11	$47.78	—	69% below	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AB IMMUNIT	$24.88	$62.21	—	60% below	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AB IMMUNIT	$24.88	$62.21	—	60% below	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$116.76	$291.90	—	87% above	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$116.76	$291.90	—	87% above	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$19.11	$47.78	—	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$19.11	$47.78	—	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AB IMMUNIT	$24.88	$62.21	—	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AB IMMUNIT	$24.88	$62.21	—	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$116.76	$291.90	—	—	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$116.76	$291.90	—	—	60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$26.14	$65.36	—	66% below	60%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$26.14	$65.36	—	66% below	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$26.14	$65.36	—	—	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$26.14	$65.36	—	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANTIFICATION	$385.14	$962.85	—	29% above	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANTIFICATION	$385.14	$962.85	—	29% above	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANTIFICATION	$385.14	$962.85	—	—	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANTIFICATION	$385.14	$962.85	—	—	60%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB	$63.84	$159.60	—	at median	60%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB	$63.84	$159.60	—	at median	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 AB	$63.84	$159.60	—	—	60%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 AB	$63.84	$159.60	—	—	60%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$93.66	$234.15	—	47% above	60%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$93.66	$234.15	—	47% above	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$93.66	$234.15	—	—	60%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$93.66	$234.15	—	—	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$117.18	$292.95	—	62% above	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$117.18	$292.95	—	62% above	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$117.18	$292.95	—	—	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$117.18	$292.95	—	—	60%
Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL	$304.08	$760.20	—	150% above	60%
Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL	$304.08	$760.20	—	150% above	60%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LEVEL	$304.08	$760.20	—	—	60%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LEVEL	$304.08	$760.20	—	—	60%
Insulin blood test CPT 83525 INSULIN LEVEL	$123.06	$307.65	—	104% above	60%
Insulin blood test CPT 83525 INSULIN LEVEL	$123.06	$307.65	—	104% above	60%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL	$123.06	$307.65	—	—	60%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL	$123.06	$307.65	—	—	60%
Iron blood test (serum iron) CPT 83540 IRON	$24.15	$60.38	—	47% below	60%
Iron blood test (serum iron) CPT 83540 IRON	$24.15	$60.38	—	47% below	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$24.15	$60.38	—	—	60%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$24.15	$60.38	—	—	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$78.12	$195.30	—	17% above	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$78.12	$195.30	—	17% above	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY (TIBC)	$81.80	$204.49	—	22% above	60%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY (TIBC)	$81.80	$204.49	—	22% above	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$78.12	$195.30	—	—	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$78.12	$195.30	—	—	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY (TIBC)	$81.80	$204.49	—	—	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY (TIBC)	$81.80	$204.49	—	—	60%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$138.18	$345.45	—	26% above	60%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$138.18	$345.45	—	26% above	60%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$138.18	$345.45	—	—	60%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$138.18	$345.45	—	—	60%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$155.82	$389.55	—	53% above	60%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$155.82	$389.55	—	53% above	60%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$155.82	$389.55	—	—	60%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$155.82	$389.55	—	—	60%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$145.74	$364.35	—	67% above	60%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$145.74	$364.35	—	67% above	60%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID CSF	$145.74	$364.35	—	67% above	60%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID CSF	$145.74	$364.35	—	67% above	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$145.74	$364.35	—	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID CSF	$145.74	$364.35	—	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$145.74	$364.35	—	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID CSF	$145.74	$364.35	—	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$55.86	$139.65	—	9% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$55.86	$139.65	—	9% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$56.70	$141.75	—	10% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$56.70	$141.75	—	10% above	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$55.86	$139.65	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$55.86	$139.65	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID	$56.70	$141.75	—	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID	$56.70	$141.75	—	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$111.30	$278.25	—	48% above	60%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$111.30	$278.25	—	48% above	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$111.30	$278.25	—	—	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$111.30	$278.25	—	—	60%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$19.42	$48.56	—	83% below	60%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$19.42	$48.56	—	83% below	60%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$19.42	$48.56	—	—	60%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$19.42	$48.56	—	—	60%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$104.58	$261.45	—	14% above	60%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$104.58	$261.45	—	14% above	60%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$104.58	$261.45	—	—	60%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$104.58	$261.45	—	—	60%
Magnesium blood test CPT 83735 MAGNESIUM	$92.61	$231.53	—	95% above	60%
Magnesium blood test CPT 83735 MAGNESIUM	$92.61	$231.53	—	95% above	60%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$93.66	$234.15	—	97% above	60%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$93.66	$234.15	—	97% above	60%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$92.61	$231.53	—	—	60%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$92.61	$231.53	—	—	60%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$93.66	$234.15	—	—	60%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$93.66	$234.15	—	—	60%
Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER (IGG AB)	$23.84	$59.59	—	53% below	60%
Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER (IGG AB)	$23.84	$59.59	—	53% below	60%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$103.74	$259.35	—	103% above	60%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$103.74	$259.35	—	103% above	60%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA TITER (IGG AB)	$23.84	$59.59	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA TITER (IGG AB)	$23.84	$59.59	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$103.74	$259.35	—	—	60%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$103.74	$259.35	—	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST	$73.29	$183.23	—	77% above	60%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST	$73.29	$183.23	—	77% above	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST	$73.29	$183.23	—	—	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST	$73.29	$183.23	—	—	60%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGG	$32.44	$81.11	—	45% below	60%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGG	$32.44	$81.11	—	45% below	60%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$141.96	$354.90	—	140% above	60%
Mumps immunity blood test CPT 86735 MUMPS IgG ANTIBODY	$141.96	$354.90	—	140% above	60%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$141.96	$354.90	—	140% above	60%
Mumps immunity blood test CPT 86735 MUMPS IgG ANTIBODY	$141.96	$354.90	—	140% above	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGG	$32.44	$81.11	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGG	$32.44	$81.11	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$141.96	$354.90	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgG ANTIBODY	$141.96	$354.90	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgG ANTIBODY	$141.96	$354.90	—	—	60%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$141.96	$354.90	—	—	60%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$294.84	$737.10	—	at median	60%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$294.84	$737.10	—	at median	60%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$294.84	$737.10	—	—	60%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$294.84	$737.10	—	—	60%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$181.02	$452.55	—	125% above	60%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$181.02	$452.55	—	125% above	60%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$181.02	$452.55	—	—	60%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$181.02	$452.55	—	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$116.34	$290.85	—	48% above	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$116.34	$290.85	—	48% above	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN	$116.34	$290.85	—	—	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN	$116.34	$290.85	—	—	60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP MANUAL SCREEN	$73.08	$182.70	—	at median	60%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP MANUAL SCREEN	$73.08	$182.70	—	at median	60%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP MANUAL SCREEN	$73.08	$182.70	—	—	60%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP MANUAL SCREEN	$73.08	$182.70	—	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$238.77	$596.93	—	35% above	60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$238.77	$596.93	—	35% above	60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$239.40	$598.50	—	36% above	60%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$239.40	$598.50	—	36% above	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$238.77	$596.93	—	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$238.77	$596.93	—	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$239.40	$598.50	—	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$239.40	$598.50	—	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$71.40	$178.50	—	32% above	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$71.40	$178.50	—	32% above	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$71.40	$178.50	—	—	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$71.40	$178.50	—	—	60%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$80.32	$200.81	—	114% above	60%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS	$80.32	$200.81	—	114% above	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$80.32	$200.81	—	—	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS	$80.32	$200.81	—	—	60%
Potassium blood test CPT 84132 POTASSIUM SERUM	$42.63	$106.58	—	8% above	60%
Potassium blood test CPT 84132 POTASSIUM SERUM	$42.63	$106.58	—	8% above	60%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$42.63	$106.58	—	—	60%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$42.63	$106.58	—	—	60%
Progesterone blood test CPT 84144 PROGESTERONE	$109.20	$273.00	—	at median	60%
Progesterone blood test CPT 84144 PROGESTERONE	$109.20	$273.00	—	at median	60%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$109.20	$273.00	—	—	60%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$109.20	$273.00	—	—	60%
Prolactin blood test CPT 84146 PROLACTIN	$201.60	$504.00	—	73% above	60%
Prolactin blood test CPT 84146 PROLACTIN	$201.60	$504.00	—	73% above	60%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$201.60	$504.00	—	—	60%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$201.60	$504.00	—	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$63.84	$159.60	—	124% above	60%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$63.84	$159.60	—	124% above	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$63.84	$159.60	—	—	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$63.84	$159.60	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 4 PNL W/O THC	$14.00	$35.00	—	79% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 4 PNL W/O THC	$14.00	$35.00	—	79% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 9 PNL W/O THC	$18.40	$46.00	—	73% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 9 PNL W/O THC	$18.40	$46.00	—	73% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 6 PANEL	$19.50	$48.75	—	71% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 6 PANEL	$19.50	$48.75	—	71% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 9 PANEL	$21.80	$54.50	—	68% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 9 PANEL	$21.80	$54.50	—	68% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS OT EXPRESS 6 PANEL	$21.84	$54.60	—	68% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS OT EXPRESS 6 PANEL	$21.84	$54.60	—	68% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 10 PANEL	$22.50	$56.25	—	67% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 10 PANEL	$22.50	$56.25	—	67% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS OT EXPRESS 9 PANEL	$23.30	$58.25	—	66% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS OT EXPRESS 9 PANEL	$23.30	$58.25	—	66% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 12 PANEL	$24.36	$60.90	—	64% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DS EXPRESS 12 PANEL	$24.36	$60.90	—	64% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 4 PNL W/O THC	$14.00	$35.00	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 4 PNL W/O THC	$14.00	$35.00	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 9 PNL W/O THC	$18.40	$46.00	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 9 PNL W/O THC	$18.40	$46.00	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 6 PANEL	$19.50	$48.75	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 6 PANEL	$19.50	$48.75	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 9 PANEL	$21.80	$54.50	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 9 PANEL	$21.80	$54.50	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS OT EXPRESS 6 PANEL	$21.84	$54.60	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS OT EXPRESS 6 PANEL	$21.84	$54.60	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 10 PANEL	$22.50	$56.25	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 10 PANEL	$22.50	$56.25	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS OT EXPRESS 9 PANEL	$23.30	$58.25	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS OT EXPRESS 9 PANEL	$23.30	$58.25	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 12 PANEL	$24.36	$60.90	—	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DS EXPRESS 12 PANEL	$24.36	$60.90	—	—	60%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A ANTIGEN	$33.92	$84.79	—	43% below	60%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ANTIGEN	$33.92	$84.79	—	43% below	60%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A ANTIGEN	$33.92	$84.79	—	43% below	60%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ANTIGEN	$33.92	$84.79	—	43% below	60%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B ANTIGEN	$33.92	$84.79	—	—	60%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A ANTIGEN	$33.92	$84.79	—	—	60%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A ANTIGEN	$33.92	$84.79	—	—	60%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B ANTIGEN	$33.92	$84.79	—	—	60%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 GROUP A STREP SCREEN	$95.34	$238.35	—	112% above	60%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 GROUP A STREP SCREEN	$95.34	$238.35	—	112% above	60%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 GROUP A STREP SCREEN	$95.34	$238.35	—	—	60%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 GROUP A STREP SCREEN	$95.34	$238.35	—	—	60%
Renin blood test CPT 84244 RENIN	$135.24	$338.10	—	7% above	60%
Renin blood test CPT 84244 RENIN	$135.24	$338.10	—	7% above	60%
Renin blood test inpatient CPT 84244 RENIN	$135.24	$338.10	—	—	60%
Renin blood test inpatient CPT 84244 RENIN	$135.24	$338.10	—	—	60%
Rh blood typing CPT 86901 BLOOD TYPING RH (D)	$49.98	$124.95	—	11% above	60%
Rh blood typing CPT 86901 BLOOD TYPING RH (D)	$49.98	$124.95	—	11% above	60%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH (D)	$49.98	$124.95	—	—	60%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH (D)	$49.98	$124.95	—	—	60%
Rheumatoid factor (RF) test CPT 86431 RA TEST (JOPLIN)	$71.82	$179.55	—	47% above	60%
Rheumatoid factor (RF) test CPT 86431 RA TEST (JOPLIN)	$71.82	$179.55	—	47% above	60%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TEST (JOPLIN)	$71.82	$179.55	—	—	60%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TEST (JOPLIN)	$71.82	$179.55	—	—	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG	$27.82	$69.56	—	46% below	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY IGG	$27.82	$69.56	—	46% below	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY (IGM/IGG)	$87.36	$218.40	—	70% above	60%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY (IGM/IGG)	$87.36	$218.40	—	70% above	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG	$27.82	$69.56	—	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY IGG	$27.82	$69.56	—	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY (IGM/IGG)	$87.36	$218.40	—	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY (IGM/IGG)	$87.36	$218.40	—	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED	$54.18	$135.45	—	58% above	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED	$54.18	$135.45	—	58% above	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED	$54.18	$135.45	—	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED	$54.18	$135.45	—	—	60%
Sodium blood test CPT 84295 SODIUM SERUM	$45.57	$113.93	—	16% above	60%
Sodium blood test CPT 84295 SODIUM SERUM	$45.57	$113.93	—	16% above	60%
Sodium blood test CPT 84295 SODIUM	$46.20	$115.50	—	17% above	60%
Sodium blood test CPT 84295 SODIUM	$46.20	$115.50	—	17% above	60%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$45.57	$113.93	—	—	60%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$45.57	$113.93	—	—	60%
Sodium blood test inpatient CPT 84295 SODIUM	$46.20	$115.50	—	—	60%
Sodium blood test inpatient CPT 84295 SODIUM	$46.20	$115.50	—	—	60%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$80.22	$200.55	—	36% above	60%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$80.22	$200.55	—	36% above	60%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$80.22	$200.55	—	—	60%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$80.22	$200.55	—	—	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$66.78	$166.95	—	31% above	60%
Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$66.78	$166.95	—	31% above	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$66.78	$166.95	—	—	60%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 ANTIBODY TREPONEMA PALLIDUM	$66.78	$166.95	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL (CSF)	$42.84	$107.10	—	53% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$42.84	$107.10	—	53% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$42.84	$107.10	—	53% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL (CSF)	$42.84	$107.10	—	53% above	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$42.84	$107.10	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL (CSF)	$42.84	$107.10	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$42.84	$107.10	—	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL (CSF)	$42.84	$107.10	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB TEST	$38.12	$95.29	—	79% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB TEST	$38.12	$95.29	—	79% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB CELL MEDIATED IMMUNE RESPON	$304.92	$762.30	—	71% above	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB CELL MEDIATED IMMUNE RESPON	$304.92	$762.30	—	71% above	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB TEST	$38.12	$95.29	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB TEST	$38.12	$95.29	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MEDIATED IMMUNE RESPON	$304.92	$762.30	—	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MEDIATED IMMUNE RESPON	$304.92	$762.30	—	—	60%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$162.54	$406.35	—	36% above	60%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$162.54	$406.35	—	36% above	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$162.54	$406.35	—	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$162.54	$406.35	—	—	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$138.18	$345.45	—	77% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 L K MICROSOMAL ANTIBODIES	$138.18	$345.45	—	77% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 L K MICROSOMAL ANTIBODIES	$138.18	$345.45	—	77% above	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$138.18	$345.45	—	77% above	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 L K MICROSOMAL ANTIBODIES	$138.18	$345.45	—	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$138.18	$345.45	—	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 L K MICROSOMAL ANTIBODIES	$138.18	$345.45	—	—	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$138.18	$345.45	—	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$9.20	$23.00	—	77% below	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$9.20	$23.00	—	77% below	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$9.20	$23.00	—	—	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$9.20	$23.00	—	—	60%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E (IGE)	$140.28	$350.70	—	94% above	60%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E (IGE)	$140.28	$350.70	—	94% above	60%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E (IGE)	$140.28	$350.70	—	—	60%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E (IGE)	$140.28	$350.70	—	—	60%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$18.90	$47.25	—	43% below	60%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$18.90	$47.25	—	43% below	60%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$18.90	$47.25	—	—	60%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$18.90	$47.25	—	—	60%
Total thyroxine (T4) blood test CPT 84436 T4	$85.26	$213.15	—	44% above	60%
Total thyroxine (T4) blood test CPT 84436 T4	$85.26	$213.15	—	44% above	60%
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$85.26	$213.15	—	—	60%
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$85.26	$213.15	—	—	60%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$133.14	$332.85	—	77% above	60%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$133.14	$332.85	—	77% above	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$133.14	$332.85	—	—	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$133.14	$332.85	—	—	60%
Transferrin blood test CPT 84466 TRANSFERRIN	$130.94	$327.34	—	55% above	60%
Transferrin blood test CPT 84466 TRANSFERRIN	$130.94	$327.34	—	55% above	60%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$130.94	$327.34	—	—	60%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$130.94	$327.34	—	—	60%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMP PROBE	$168.84	$422.10	—	23% above	60%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS AMP PROBE	$168.84	$422.10	—	23% above	60%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS AMP PROBE	$168.84	$422.10	—	—	60%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS AMP PROBE	$168.84	$422.10	—	—	60%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$52.29	$130.73	—	16% above	60%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$52.29	$130.73	—	16% above	60%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$52.29	$130.73	—	—	60%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$52.29	$130.73	—	—	60%
Troponin test, quantitative CPT 84484 TROPONIN I	$122.22	$305.55	—	11% above	60%
Troponin test, quantitative CPT 84484 TROPONIN I	$122.22	$305.55	—	11% above	60%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$122.22	$305.55	—	—	60%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$122.22	$305.55	—	—	60%
Uric acid blood test CPT 84550 URIC ACID	$20.58	$51.45	—	51% below	60%
Uric acid blood test CPT 84550 URIC ACID	$20.58	$51.45	—	51% below	60%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$93.24	$233.10	—	124% above	60%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$93.24	$233.10	—	124% above	60%
Uric acid blood test inpatient CPT 84550 URIC ACID	$20.58	$51.45	—	—	60%
Uric acid blood test inpatient CPT 84550 URIC ACID	$20.58	$51.45	—	—	60%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$93.24	$233.10	—	—	60%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$93.24	$233.10	—	—	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPY	$19.20	$48.00	—	45% below	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPY	$19.20	$48.00	—	45% below	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO DIP W/MICRO	$63.42	$158.55	—	81% above	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO DIP W/MICRO	$63.42	$158.55	—	81% above	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO	$63.42	$158.55	—	81% above	60%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICRO	$63.42	$158.55	—	81% above	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPY	$19.20	$48.00	—	—	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPY	$19.20	$48.00	—	—	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO DIP W/MICRO	$63.42	$158.55	—	—	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO	$63.42	$158.55	—	—	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO DIP W/MICRO	$63.42	$158.55	—	—	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICRO	$63.42	$158.55	—	—	60%
Urinalysis with microscope exam, manual CPT 81000 DIPSTICK URINALYSIS	$11.40	$28.50	—	57% below	60%
Urinalysis with microscope exam, manual CPT 81000 DIPSTICK URINALYSIS	$11.40	$28.50	—	57% below	60%
Urinalysis with microscope exam, manual CPT 81000 ON-SITE DIPSTICK URINALYSIS	$11.97	$29.93	—	55% below	60%
Urinalysis with microscope exam, manual CPT 81000 ON-SITE DIPSTICK URINALYSIS	$11.97	$29.93	—	55% below	60%
Urinalysis with microscope exam, manual CPT 81000 PH-DIPSTICK	$39.48	$98.70	—	48% above	60%
Urinalysis with microscope exam, manual CPT 81000 PH-DIPSTICK	$39.48	$98.70	—	48% above	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 DIPSTICK URINALYSIS	$11.40	$28.50	—	—	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 DIPSTICK URINALYSIS	$11.40	$28.50	—	—	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 ON-SITE DIPSTICK URINALYSIS	$11.97	$29.93	—	—	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 ON-SITE DIPSTICK URINALYSIS	$11.97	$29.93	—	—	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 PH-DIPSTICK	$39.48	$98.70	—	—	60%
Urinalysis with microscope exam, manual inpatient CPT 81000 PH-DIPSTICK	$39.48	$98.70	—	—	60%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO DIP W/O MICRO	$51.24	$128.10	—	128% above	60%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO DIP W/O MICRO	$51.24	$128.10	—	128% above	60%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$51.24	$128.10	—	128% above	60%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$51.24	$128.10	—	128% above	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO DIP W/O MICRO	$51.24	$128.10	—	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO DIP W/O MICRO	$51.24	$128.10	—	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$51.24	$128.10	—	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$51.24	$128.10	—	—	60%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS MAN DIP W/O MICRO	$26.25	$65.63	—	90% above	60%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS MAN DIP W/O MICRO	$26.25	$65.63	—	90% above	60%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS MAN DIP W/O MICRO	$26.25	$65.63	—	—	60%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS MAN DIP W/O MICRO	$26.25	$65.63	—	—	60%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$89.46	$223.65	—	34% above	60%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$89.46	$223.65	—	34% above	60%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL URINE	$92.61	$231.53	—	38% above	60%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL URINE	$92.61	$231.53	—	38% above	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$89.46	$223.65	—	—	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$89.46	$223.65	—	—	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL URINE	$92.61	$231.53	—	—	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL URINE	$92.61	$231.53	—	—	60%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE MICROALBUMIN QT	$141.12	$352.80	—	309% above	60%
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE MICROALBUMIN QT	$141.12	$352.80	—	309% above	60%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE MICROALBUMIN QT	$141.12	$352.80	—	—	60%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE MICROALBUMIN QT	$141.12	$352.80	—	—	60%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$42.63	$106.58	—	12% below	60%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$42.63	$106.58	—	12% below	60%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST BY COLOR	$43.26	$108.15	—	11% below	60%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST BY COLOR	$43.26	$108.15	—	11% below	60%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$42.63	$106.58	—	—	60%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$42.63	$106.58	—	—	60%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST BY COLOR	$43.26	$108.15	—	—	60%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST BY COLOR	$43.26	$108.15	—	—	60%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$116.13	$290.33	—	49% above	60%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$116.13	$290.33	—	49% above	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$116.13	$290.33	—	—	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$116.13	$290.33	—	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$211.05	$527.63	—	56% above	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$211.05	$527.63	—	56% above	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$211.05	$527.63	—	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$211.05	$527.63	—	—	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1 25	$211.68	$529.20	—	22% above	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D 1 25	$211.68	$529.20	—	22% above	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1 25	$211.68	$529.20	—	—	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXYVITAMIN D 1 25	$211.68	$529.20	—	—	60%
Zinc blood test CPT 84630 ZINC-BLOOD	$46.83	$117.08	—	21% below	60%
Zinc blood test CPT 84630 ZINC-BLOOD	$46.83	$117.08	—	21% below	60%
Zinc blood test CPT 84630 ZINC SERUM	$86.10	$215.25	—	45% above	60%
Zinc blood test CPT 84630 ZINC SERUM	$86.10	$215.25	—	45% above	60%
Zinc blood test inpatient CPT 84630 ZINC-BLOOD	$46.83	$117.08	—	—	60%
Zinc blood test inpatient CPT 84630 ZINC-BLOOD	$46.83	$117.08	—	—	60%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$86.10	$215.25	—	—	60%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$86.10	$215.25	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG T/BETA SERUM QUANTITATIVE	$142.38	$355.95	—	70% above	60%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG T/BETA SERUM QUANTITATIVE	$142.38	$355.95	—	70% above	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG T/BETA SERUM QUANTITATIVE	$142.38	$355.95	—	—	60%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG T/BETA SERUM QUANTITATIVE	$142.38	$355.95	—	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREO BRST BIO 1ST LESION LT	$2,772.94	$6,932.36	—	20% above	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREO BRST BIO 1ST LESION RT	$2,772.94	$6,932.36	—	20% above	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREO BRST BIO 1ST LESION RT	$2,772.94	$6,932.36	—	20% above	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 STEREO BRST BIO 1ST LESION LT	$2,772.94	$6,932.36	—	20% above	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREO BRST BIO 1ST LESION RT	$2,772.94	$6,932.36	—	—	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREO BRST BIO 1ST LESION RT	$2,772.94	$6,932.36	—	—	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREO BRST BIO 1ST LESION LT	$2,772.94	$6,932.36	—	—	60%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 STEREO BRST BIO 1ST LESION LT	$2,772.94	$6,932.36	—	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIBULA CLSD NO REDUC	$512.40	$1,281.00	—	17% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 FX DISTAL FIBULA CLSD NO REDUC	$512.40	$1,281.00	—	17% above	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX DISTAL FIBULA CLSD NO REDUC	$512.40	$1,281.00	—	—	60%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 FX DISTAL FIBULA CLSD NO REDUC	$512.40	$1,281.00	—	—	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX METATARSAL NO REDUCTION	$492.14	$1,230.34	—	27% above	60%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 FX METATARSAL NO REDUCTION	$492.14	$1,230.34	—	27% above	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX METATARSAL NO REDUCTION	$492.14	$1,230.34	—	—	60%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 FX METATARSAL NO REDUCTION	$492.14	$1,230.34	—	—	60%
Cardiac catheterization with coronary angiogram CPT 93458 LT HEART ART/VENT ANGIO	$7,497.00	$18,742.50	—	19% below	60%
Cardiac catheterization with coronary angiogram CPT 93458 LT HEART ART/VENT ANGIO	$7,497.00	$18,742.50	—	19% below	60%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LT HEART ART/VENT ANGIO	$7,497.00	$18,742.50	—	—	60%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LT HEART ART/VENT ANGIO	$7,497.00	$18,742.50	—	—	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,088.64	$2,721.60	—	3% above	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ELECTIVE CARDIOVERSION	$1,088.64	$2,721.60	—	3% above	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ELECTIVE CARDIOVERSION	$1,088.64	$2,721.60	—	3% above	60%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,088.64	$2,721.60	—	3% above	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,088.64	$2,721.60	—	—	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ELECTIVE CARDIOVERSION	$1,088.64	$2,721.60	—	—	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ELECTIVE CARDIOVERSION	$1,088.64	$2,721.60	—	—	60%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,088.64	$2,721.60	—	—	60%
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$22,871.84	$57,179.59	—	5% below	60%
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$22,871.84	$57,179.59	—	5% below	60%
Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$22,871.84	$57,179.59	—	—	60%
Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$22,871.84	$57,179.59	—	—	60%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$516.60	$1,291.50	—	at median	60%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$516.60	$1,291.50	—	at median	60%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE	$516.60	$1,291.50	—	—	60%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE	$516.60	$1,291.50	—	—	60%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX DISTAL RADIUS NO REDUCTION	$589.16	$1,472.89	—	42% above	60%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FX DISTAL RADIUS NO REDUCTION	$589.16	$1,472.89	—	42% above	60%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 FX DISTAL RADIUS NO REDUCTION	$589.16	$1,472.89	—	—	60%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 FX DISTAL RADIUS NO REDUCTION	$589.16	$1,472.89	—	—	60%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1	$10,625.58	$26,563.95	—	24% below	60%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1	$10,625.58	$26,563.95	—	24% below	60%
Coronary stent placement, one artery inpatient CPT 92928 PRQ CARD STENT W/ANGIO 1	$10,625.58	$26,563.95	—	—	60%
Coronary stent placement, one artery inpatient CPT 92928 PRQ CARD STENT W/ANGIO 1	$10,625.58	$26,563.95	—	—	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 CRUMEN REMOVAL IMPACT IRR/LAV	$69.72	$174.30	—	37% below	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 CRUMEN REMOVAL IMPACT IRR/LAV	$69.72	$174.30	—	37% below	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN REMOVAL IMPACT IRR/LAV	$241.71	$604.28	—	119% above	60%
Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN REMOVAL IMPACT IRR/LAV	$241.71	$604.28	—	119% above	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CRUMEN REMOVAL IMPACT IRR/LAV	$69.72	$174.30	—	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CRUMEN REMOVAL IMPACT IRR/LAV	$69.72	$174.30	—	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CERUMEN REMOVAL IMPACT IRR/LAV	$241.71	$604.28	—	—	60%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 CERUMEN REMOVAL IMPACT IRR/LAV	$241.71	$604.28	—	—	60%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMIN	$67.10	$167.74	—	35% below	60%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN	$67.10	$167.74	—	35% below	60%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN	$67.10	$167.74	—	35% below	60%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMIN	$67.10	$167.74	—	35% below	60%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN	$67.10	$167.74	—	—	60%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN	$67.10	$167.74	—	—	60%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMIN	$67.10	$167.74	—	—	60%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMIN	$67.10	$167.74	—	—	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CONTR INJ HYSTEROSALPINGOGRAPH	$193.20	$483.00	—	17% below	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CONTR INJ HYSTEROSALPINGOGRAPH	$193.20	$483.00	—	17% below	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CONTR INJ HYSTEROSALPINGOGRAPH	$193.20	$483.00	—	—	60%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CONTR INJ HYSTEROSALPINGOGRAPH	$193.20	$483.00	—	—	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D PARONYCHIA	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D CARBUNKLE SKIN	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D PARONYCHIA	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SEBACEOUS CYST	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D FURUNCLE	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D FURUNCLE	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SEBACEOUS CYST	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D CARBUNKLE SKIN	$77.18	$192.94	—	73% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS-SIMPLE	$155.50	$388.76	—	45% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS-SIMPLE	$155.50	$388.76	—	45% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISE DRAINAGE	$175.04	$437.59	—	38% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISE DRAINAGE	$175.04	$437.59	—	38% below	60%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISE SOFT TISSUE ABSCESS	$469.88	$1,174.69	—	66% above	60%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISE SOFT TISSUE ABSCESS	$469.88	$1,174.69	—	66% above	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D CARBUNKLE SKIN	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D FURUNCLE	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SEBACEOUS CYST	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D PARONYCHIA	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D FURUNCLE	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SEBACEOUS CYST	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D PARONYCHIA	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D CARBUNKLE SKIN	$77.18	$192.94	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS-SIMPLE	$155.50	$388.76	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS-SIMPLE	$155.50	$388.76	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE DRAINAGE	$175.04	$437.59	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE DRAINAGE	$175.04	$437.59	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE SOFT TISSUE ABSCESS	$469.88	$1,174.69	—	—	60%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISE SOFT TISSUE ABSCESS	$469.88	$1,174.69	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH	$89.25	$223.13	—	72% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH	$89.25	$223.13	—	72% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT-TND/LIG/CYST	$103.11	$257.78	—	68% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT-TND/LIG/CYST	$103.11	$257.78	—	68% below	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON SHEATH	$89.25	$223.13	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON SHEATH	$89.25	$223.13	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT-TND/LIG/CYST	$103.11	$257.78	—	—	60%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT-TND/LIG/CYST	$103.11	$257.78	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR	$64.16	$160.39	—	78% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR	$64.16	$160.39	—	78% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS LG JOINT W/O US	$100.70	$251.74	—	65% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS LG JOINT W/O US	$100.70	$251.74	—	65% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JNT INJ/ARTH LEG/SHLDR/KNEE	$111.51	$278.78	—	62% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JNT INJ/ARTH LEG/SHLDR/KNEE	$111.51	$278.78	—	62% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROC/INJ LG JOINT	$267.12	$667.80	—	8% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROC/INJ LG JOINT	$267.12	$667.80	—	8% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR	$64.16	$160.39	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR	$64.16	$160.39	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS LG JOINT W/O US	$100.70	$251.74	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS LG JOINT W/O US	$100.70	$251.74	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JNT INJ/ARTH LEG/SHLDR/KNEE	$111.51	$278.78	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JNT INJ/ARTH LEG/SHLDR/KNEE	$111.51	$278.78	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROC/INJ LG JOINT	$267.12	$667.80	—	—	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROC/INJ LG JOINT	$267.12	$667.80	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMEDIATE	$64.16	$160.39	—	81% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMEDIATE	$64.16	$160.39	—	81% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMED W/O US	$88.52	$221.29	—	74% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMED W/O US	$88.52	$221.29	—	74% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JNT INJ/ARTH MED WRST/ELB/ANK	$107.73	$269.33	—	68% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JNT INJ/ARTH MED WRST/ELB/ANK	$107.73	$269.33	—	68% below	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMEDIATE	$64.16	$160.39	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMEDIATE	$64.16	$160.39	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMED W/O US	$88.52	$221.29	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTERMED W/O US	$88.52	$221.29	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JNT INJ/ARTH MED WRST/ELB/ANK	$107.73	$269.33	—	—	60%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JNT INJ/ARTH MED WRST/ELB/ANK	$107.73	$269.33	—	—	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL	$64.16	$160.39	—	77% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL	$64.16	$160.39	—	77% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 JOINT INJ/ARTH SM FINGERS	$102.48	$256.20	—	63% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 JOINT INJ/ARTH SM FINGERS	$102.48	$256.20	—	63% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL W/O US	$217.66	$544.16	—	20% below	60%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL W/O US	$217.66	$544.16	—	20% below	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL	$64.16	$160.39	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL	$64.16	$160.39	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 JOINT INJ/ARTH SM FINGERS	$102.48	$256.20	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 JOINT INJ/ARTH SM FINGERS	$102.48	$256.20	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL W/O US	$217.66	$544.16	—	—	60%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL W/O US	$217.66	$544.16	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYR STE (NO H&F) <2.5 CM	$383.88	$959.70	—	12% below	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYR STE (NO H&F) <2.5 CM	$383.88	$959.70	—	12% below	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYER STR <2.5 CM	$505.58	$1,263.94	—	16% above	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYER S T E < 2.5 CM	$505.58	$1,263.94	—	16% above	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYER STR <2.5 CM	$505.58	$1,263.94	—	16% above	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC LAYER S T E < 2.5 CM	$505.58	$1,263.94	—	16% above	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYR STE (NO H&F) <2.5 CM	$383.88	$959.70	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYR STE (NO H&F) <2.5 CM	$383.88	$959.70	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYER STR <2.5 CM	$505.58	$1,263.94	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYER S T E < 2.5 CM	$505.58	$1,263.94	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYER S T E < 2.5 CM	$505.58	$1,263.94	—	—	60%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC LAYER STR <2.5 CM	$505.58	$1,263.94	—	—	60%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH	$8,539.76	$21,349.39	—	29% above	60%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH	$8,539.76	$21,349.39	—	29% above	60%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH	$8,539.76	$21,349.39	—	—	60%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH	$8,539.76	$21,349.39	—	—	60%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$1,514.73	$3,786.83	—	68% below	60%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$1,514.73	$3,786.83	—	68% below	60%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$1,514.73	$3,786.83	—	—	60%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$1,514.73	$3,786.83	—	—	60%
Nail removal (partial or complete), one nail CPT 11730 EVUL NAIL PLATE PART/COMPLETE	$190.58	$476.44	—	23% below	60%
Nail removal (partial or complete), one nail CPT 11730 EVUL NAIL PLATE PART/COMPLETE	$190.58	$476.44	—	23% below	60%
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE AVULSION	$203.60	$508.99	—	18% below	60%
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE AVULSION	$203.60	$508.99	—	18% below	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 EVUL NAIL PLATE PART/COMPLETE	$190.58	$476.44	—	—	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 EVUL NAIL PLATE PART/COMPLETE	$190.58	$476.44	—	—	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE AVULSION	$203.60	$508.99	—	—	60%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE AVULSION	$203.60	$508.99	—	—	60%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK	$371.18	$927.94	—	2% below	60%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOCK	$371.18	$927.94	—	2% below	60%
Occipital nerve block (injection for headaches) inpatient CPT 64405 GREATER OCCIPITAL NERVE BLOCK	$371.18	$927.94	—	—	60%
Occipital nerve block (injection for headaches) inpatient CPT 64405 GREATER OCCIPITAL NERVE BLOCK	$371.18	$927.94	—	—	60%
Pacemaker implant (dual chamber) CPT 33208 PACEMAKER PERMANENT A-V	$16,526.06	$41,315.14	—	at median	60%
Pacemaker implant (dual chamber) CPT 33208 PACEMAKER PERMANENT A-V	$16,526.06	$41,315.14	—	at median	60%
Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER PERMANENT A-V	$16,526.06	$41,315.14	—	—	60%
Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER PERMANENT A-V	$16,526.06	$41,315.14	—	—	60%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/ IMG	$641.55	$1,603.88	—	36% below	60%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS W/ IMG	$641.55	$1,603.88	—	36% below	60%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS	$643.86	$1,609.65	—	36% below	60%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS	$643.86	$1,609.65	—	36% below	60%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/ IMG	$641.55	$1,603.88	—	—	60%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS W/ IMG	$641.55	$1,603.88	—	—	60%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS	$643.86	$1,609.65	—	—	60%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS	$643.86	$1,609.65	—	—	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION/COMPLETE OR PART	$726.81	$1,817.03	—	24% above	60%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION/COMPLETE OR PART	$726.81	$1,817.03	—	24% above	60%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION/COMPLETE OR PART	$726.81	$1,817.03	—	—	60%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION/COMPLETE OR PART	$726.81	$1,817.03	—	—	60%
Removal of a foreign object under the skin, simple CPT 10120 FB REMOVAL-SUBQ SIMPLE	$164.85	$412.13	—	66% below	60%
Removal of a foreign object under the skin, simple CPT 10120 FB REMOVAL-SUBQ SIMPLE	$164.85	$412.13	—	66% below	60%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB SUBQ/SIMP	$235.52	$588.79	—	52% below	60%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB SUBQ/SIMP	$235.52	$588.79	—	52% below	60%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SUBQ - SI	$235.52	$588.79	—	52% below	60%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SUBQ - SI	$235.52	$588.79	—	52% below	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REMOVAL-SUBQ SIMPLE	$164.85	$412.13	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REMOVAL-SUBQ SIMPLE	$164.85	$412.13	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY SUBQ - SI	$235.52	$588.79	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB SUBQ/SIMP	$235.52	$588.79	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY SUBQ - SI	$235.52	$588.79	—	—	60%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB SUBQ/SIMP	$235.52	$588.79	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) both sides CPT 50590 LITHOTRIPSY BILATERAL	$16,328.02	$40,820.06	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY REVISIT	$10,885.35	$27,213.38	—	36% above	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$10,885.35	$27,213.38	—	36% above	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY REVISIT	$10,885.35	$27,213.38	—	36% above	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$10,885.35	$27,213.38	—	36% above	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient both sides CPT 50590 LITHOTRIPSY BILATERAL	$16,328.02	$40,820.06	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY REVISIT	$10,885.35	$27,213.38	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$10,885.35	$27,213.38	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY REVISIT	$10,885.35	$27,213.38	—	—	60%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$10,885.35	$27,213.38	—	—	60%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM (ELBOW TO FING)	$129.68	$324.19	—	52% below	60%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM (ELBOW TO FING)	$129.68	$324.19	—	52% below	60%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM (ELBOW TO FING)	$129.68	$324.19	—	—	60%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM (ELBOW TO FING)	$129.68	$324.19	—	—	60%
Short arm splint (forearm and hand) CPT 29125 SPLINT - SHORT ARM	$92.30	$230.74	—	50% below	60%
Short arm splint (forearm and hand) CPT 29125 SPLINT - SHORT ARM	$92.30	$230.74	—	50% below	60%
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM	$156.34	$390.86	—	16% below	60%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT/ SHORT ARM	$156.34	$390.86	—	16% below	60%
Short arm splint (forearm and hand) CPT 29125 SPLINT SHORT ARM	$156.34	$390.86	—	16% below	60%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SPLINT/ SHORT ARM	$156.34	$390.86	—	16% below	60%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT - SHORT ARM	$92.30	$230.74	—	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT - SHORT ARM	$92.30	$230.74	—	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM	$156.34	$390.86	—	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT/ SHORT ARM	$156.34	$390.86	—	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SPLINT/ SHORT ARM	$156.34	$390.86	—	—	60%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT SHORT ARM	$156.34	$390.86	—	—	60%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG	$161.49	$403.73	—	43% below	60%
Short leg cast (below the knee) CPT 29405 CAST SHORT LEG	$161.49	$403.73	—	43% below	60%
Short leg cast (below the knee) CPT 29405 CAST - SHORT LEG	$175.04	$437.59	—	38% below	60%
Short leg cast (below the knee) CPT 29405 CAST - SHORT LEG	$175.04	$437.59	—	38% below	60%
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG	$161.49	$403.73	—	—	60%
Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG	$161.49	$403.73	—	—	60%
Short leg cast (below the knee) inpatient CPT 29405 CAST - SHORT LEG	$175.04	$437.59	—	—	60%
Short leg cast (below the knee) inpatient CPT 29405 CAST - SHORT LEG	$175.04	$437.59	—	—	60%
Short leg splint (calf to foot) CPT 29515 SPLINT - SHORT LEG	$113.50	$283.76	—	43% below	60%
Short leg splint (calf to foot) CPT 29515 SPLINT - SHORT LEG	$113.50	$283.76	—	43% below	60%
Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG	$181.44	$453.60	—	9% below	60%
Short leg splint (calf to foot) CPT 29515 SPLINT SHORT LEG	$181.44	$453.60	—	9% below	60%
Short leg splint (calf to foot) CPT 29515 APPLICATION SPLINT/ SHORT LEG	$181.44	$453.60	—	9% below	60%
Short leg splint (calf to foot) CPT 29515 APPLICATION SPLINT/ SHORT LEG	$181.44	$453.60	—	9% below	60%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT - SHORT LEG	$113.50	$283.76	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT - SHORT LEG	$113.50	$283.76	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SPLINT/ SHORT LEG	$181.44	$453.60	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG	$181.44	$453.60	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT SHORT LEG	$181.44	$453.60	—	—	60%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SPLINT/ SHORT LEG	$181.44	$453.60	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SMP STE (HAND&FT) <2.5CM	$283.50	$708.75	—	10% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SMP STE (HAND&FT) <2.5CM	$283.50	$708.75	—	10% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SMP STE (HAND&FT) <2.5 CM	$283.50	$708.75	—	10% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SMP STE (HAND&FT) <2.5 CM	$283.50	$708.75	—	10% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE S T E < 2.5CM	$325.60	$814.01	—	26% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE S T E < 2.5CM	$325.60	$814.01	—	26% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE STE <2.5 CM	$325.60	$814.01	—	26% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE STE <2.5 CM	$325.60	$814.01	—	26% above	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SMP STE (HAND&FT) <2.5CM	$283.50	$708.75	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SMP STE (HAND&FT) <2.5 CM	$283.50	$708.75	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SMP STE (HAND&FT) <2.5 CM	$283.50	$708.75	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SMP STE (HAND&FT) <2.5CM	$283.50	$708.75	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE S T E < 2.5CM	$325.60	$814.01	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE STE <2.5 CM	$325.60	$814.01	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE STE <2.5 CM	$325.60	$814.01	—	—	60%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE S T E < 2.5CM	$325.60	$814.01	—	—	60%
Skin biopsy, punch, one lesion CPT 11104 SKIN BIOPSY SGL LESION PUNCH	$102.48	$256.20	—	69% below	60%
Skin biopsy, punch, one lesion CPT 11104 SKIN BIOPSY SGL LESION PUNCH	$102.48	$256.20	—	69% below	60%
Skin biopsy, punch, one lesion inpatient CPT 11104 SKIN BIOPSY SGL LESION PUNCH	$102.48	$256.20	—	—	60%
Skin biopsy, punch, one lesion inpatient CPT 11104 SKIN BIOPSY SGL LESION PUNCH	$102.48	$256.20	—	—	60%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS 1-15	$115.40	$288.49	—	31% below	60%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS 1-15	$115.40	$288.49	—	31% below	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15	$115.40	$288.49	—	—	60%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15	$115.40	$288.49	—	—	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$367.18	$917.96	—	45% below	60%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$367.18	$917.96	—	45% below	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$367.18	$917.96	—	—	60%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$367.18	$917.96	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE S T E 2.6 TO 7.5C	$333.69	$834.23	—	4% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE STE 2.6 - 7.5 CM	$333.69	$834.23	—	4% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE S T E 2.6 TO 7.5C	$333.69	$834.23	—	4% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE STE 2.6 - 7.5 CM	$333.69	$834.23	—	4% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SMP STE (HAND&FT)2.6-7.5CM	$386.30	$965.74	—	20% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SMP STE (HAND&FT)2.6-7.5CM	$386.30	$965.74	—	20% above	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE S T E 2.6 TO 7.5C	$333.69	$834.23	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE S T E 2.6 TO 7.5C	$333.69	$834.23	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE STE 2.6 - 7.5 CM	$333.69	$834.23	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE STE 2.6 - 7.5 CM	$333.69	$834.23	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SMP STE (HAND&FT)2.6-7.5CM	$386.30	$965.74	—	—	60%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SMP STE (HAND&FT)2.6-7.5CM	$386.30	$965.74	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SMP FACE <2.5 CM	$276.46	$691.16	—	8% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SMP FACE <2.5 CM	$276.46	$691.16	—	8% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC WOUND SIMPLE FACE <2.5 CM	$334.22	$835.54	—	31% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC WOUND SIMPLE FACE < 2.5CM	$334.22	$835.54	—	31% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC WOUND SIMPLE FACE <2.5 CM	$334.22	$835.54	—	31% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC WOUND SIMPLE FACE < 2.5CM	$334.22	$835.54	—	31% above	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SMP FACE <2.5 CM	$276.46	$691.16	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SMP FACE <2.5 CM	$276.46	$691.16	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC WOUND SIMPLE FACE <2.5 CM	$334.22	$835.54	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC WOUND SIMPLE FACE < 2.5CM	$334.22	$835.54	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC WOUND SIMPLE FACE < 2.5CM	$334.22	$835.54	—	—	60%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC WOUND SIMPLE FACE <2.5 CM	$334.22	$835.54	—	—	60%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS	$1,057.56	$2,643.90	—	3% above	60%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS	$1,057.56	$2,643.90	—	3% above	60%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS	$1,057.56	$2,643.90	—	—	60%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS	$1,057.56	$2,643.90	—	—	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLE	$77.70	$194.25	—	75% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLE	$77.70	$194.25	—	75% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG POINT 1 OR 2 MUSCLES	$115.82	$289.54	—	62% below	60%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG POINT 1 OR 2 MUSCLES	$115.82	$289.54	—	62% below	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLE	$77.70	$194.25	—	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1 OR 2 MUSCLE	$77.70	$194.25	—	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG POINT 1 OR 2 MUSCLES	$115.82	$289.54	—	—	60%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG POINT 1 OR 2 MUSCLES	$115.82	$289.54	—	—	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST 1ST LESION	$1,727.04	$4,317.60	—	2% below	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY BREAST 1ST LESION	$1,727.04	$4,317.60	—	2% below	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST 1ST LESION	$1,727.04	$4,317.60	—	—	60%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY BREAST 1ST LESION	$1,727.04	$4,317.60	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/SUBC 1ST 20 SQ CM	$388.08	$970.20	—	31% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/SUBC 1ST 20 SQ CM	$388.08	$970.20	—	31% below	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/SUBC 1ST 20 SQ CM	$388.08	$970.20	—	—	60%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/SUBC 1ST 20 SQ CM	$388.08	$970.20	—	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$220.40	$550.99	—	66% below	60%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$220.40	$550.99	—	66% below	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$220.40	$550.99	—	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$220.40	$550.99	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$44.94	$112.35	—	68% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$44.94	$112.35	—	68% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEBULIZER TX SUBSEQUENT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE TX INIT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ-PAP THERAPY - INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEBULIZER TX - INITAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEB TX SUBSEQUENT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEB TX INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PEP THERAPY INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEB TX INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ-PAP THERAPY - SUBSEQUENT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZ-PAP THERAPY - INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE TX SUBSEQUENT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE TX INIT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOL NEBULIZER TX - INITAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PEP THERAPY SUBSEQUENT	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PEP THERAPY INITIAL	$82.95	$207.38	—	41% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$44.94	$112.35	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$44.94	$112.35	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PEP THERAPY INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE TX INIT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE TX INIT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEBULIZER TX - INITAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEBULIZER TX SUBSEQUENT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METERED DOSE TX SUBSEQUENT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ-PAP THERAPY - INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ-PAP THERAPY - SUBSEQUENT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEB TX SUBSEQUENT	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEB TX INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PEP THERAPY INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEB TX INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOL NEBULIZER TX - INITAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZ-PAP THERAPY - INITIAL	$82.95	$207.38	—	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PEP THERAPY SUBSEQUENT	$82.95	$207.38	—	—	60%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INF 1ST HR	$274.78	$686.96	—	37% below	60%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INF 1ST HR	$274.78	$686.96	—	37% below	60%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INF 1ST HR	$274.78	$686.96	—	—	60%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INF 1ST HR	$274.78	$686.96	—	—	60%
Critical care, first 30 to 74 minutes CPT 99291 FACILITY CRITICAL CARE	$277.62	$694.05	—	87% below	60%
Critical care, first 30 to 74 minutes CPT 99291 FACILITY CRITICAL CARE	$277.62	$694.05	—	87% below	60%
Critical care, first 30 to 74 minutes CPT 99291 FACILITY CRIT CARE 1ST HOUR	$1,856.61	$4,641.53	—	10% below	60%
Critical care, first 30 to 74 minutes CPT 99291 FACILITY CRIT CARE 1ST HOUR	$1,856.61	$4,641.53	—	10% below	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FACILITY CRITICAL CARE	$277.62	$694.05	—	—	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FACILITY CRITICAL CARE	$277.62	$694.05	—	—	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FACILITY CRIT CARE 1ST HOUR	$1,856.61	$4,641.53	—	—	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 FACILITY CRIT CARE 1ST HOUR	$1,856.61	$4,641.53	—	—	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG WITH INTERP	$42.00	$105.00	—	24% below	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG WITH INTERP	$42.00	$105.00	—	24% below	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG & INTERPRETATION*	$215.46	$538.65	—	292% above	60%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG & INTERPRETATION*	$215.46	$538.65	—	292% above	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG WITH INTERP	$42.00	$105.00	—	—	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG WITH INTERP	$42.00	$105.00	—	—	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG & INTERPRETATION*	$215.46	$538.65	—	—	60%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG & INTERPRETATION*	$215.46	$538.65	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM	$180.60	$451.50	—	2% below	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$180.60	$451.50	—	2% below	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$180.60	$451.50	—	2% below	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM	$180.60	$451.50	—	2% below	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM	$180.60	$451.50	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$180.60	$451.50	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$180.60	$451.50	—	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM	$180.60	$451.50	—	—	60%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT	$866.36	$2,165.89	—	33% below	60%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT	$866.36	$2,165.89	—	33% below	60%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT	$866.36	$2,165.89	—	—	60%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT	$866.36	$2,165.89	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FACILITY FEE - LEVEL I	$128.84	$322.09	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SANE LEVEL 1	$128.84	$322.09	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FACILITY FEE - LEVEL I	$128.84	$322.09	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SANE LEVEL 1	$128.84	$322.09	—	46% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FACILITY FEE - LEVEL I	$128.84	$322.09	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SANE LEVEL 1	$128.84	$322.09	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SANE LEVEL 1	$128.84	$322.09	—	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FACILITY FEE - LEVEL I	$128.84	$322.09	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 FACILITY FEE - LEVEL II	$312.69	$781.73	—	15% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 SANE LEVEL 2	$312.69	$781.73	—	15% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 FACILITY FEE - LEVEL II	$312.69	$781.73	—	15% below	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 SANE LEVEL 2	$312.69	$781.73	—	15% below	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 SANE LEVEL 2	$312.69	$781.73	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 FACILITY FEE - LEVEL II	$312.69	$781.73	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 SANE LEVEL 2	$312.69	$781.73	—	—	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 FACILITY FEE - LEVEL II	$312.69	$781.73	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 SANE LEVEL 3	$536.76	$1,341.90	—	37% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 FACILITY FEE - LEVEL III	$536.76	$1,341.90	—	37% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 FACILITY FEE - LEVEL III	$536.76	$1,341.90	—	37% below	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 SANE LEVEL 3	$536.76	$1,341.90	—	37% below	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 SANE LEVEL 3	$536.76	$1,341.90	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 FACILITY FEE - LEVEL III	$536.76	$1,341.90	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 SANE LEVEL 3	$536.76	$1,341.90	—	—	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 FACILITY FEE - LEVEL III	$536.76	$1,341.90	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FACILITY FEE - LEVEL IV	$741.82	$1,854.56	—	19% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 SANE LEVEL 4	$741.82	$1,854.56	—	19% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 SANE LEVEL 4	$741.82	$1,854.56	—	19% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FACILITY FEE - LEVEL IV	$741.82	$1,854.56	—	19% below	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 SANE LEVEL 4	$741.82	$1,854.56	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FACILITY FEE - LEVEL IV	$741.82	$1,854.56	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 SANE LEVEL 4	$741.82	$1,854.56	—	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FACILITY FEE - LEVEL IV	$741.82	$1,854.56	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FACILITY FEE - LEVEL V	$1,155.00	$2,887.50	—	26% below	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 SANE LEVEL 5	$1,155.00	$2,887.50	—	26% below	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 SANE LEVEL 5	$1,155.00	$2,887.50	—	26% below	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FACILITY FEE - LEVEL V	$1,155.00	$2,887.50	—	26% below	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FACILITY FEE - LEVEL V	$1,155.00	$2,887.50	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FACILITY FEE - LEVEL V	$1,155.00	$2,887.50	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 SANE LEVEL 5	$1,155.00	$2,887.50	—	—	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 SANE LEVEL 5	$1,155.00	$2,887.50	—	—	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST	$583.38	$1,458.45	—	24% below	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 THALIUM STRESS TEST	$583.38	$1,458.45	—	24% below	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST	$583.38	$1,458.45	—	24% below	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 THALIUM STRESS TEST	$583.38	$1,458.45	—	24% below	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST	$583.38	$1,458.45	—	—	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 THALIUM STRESS TEST	$583.38	$1,458.45	—	—	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 THALIUM STRESS TEST	$583.38	$1,458.45	—	—	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST	$583.38	$1,458.45	—	—	60%
Eye exam, returning patient, intermediate CPT 92012 EXAM INTERMED ESTABLISHED PT	$113.19	$282.98	—	at median	60%
Eye exam, returning patient, intermediate CPT 92012 EXAM INTERMED ESTABLISHED PT	$113.19	$282.98	—	at median	60%
Eye exam, returning patient, intermediate inpatient CPT 92012 EXAM INTERMED ESTABLISHED PT	$113.19	$282.98	—	—	60%
Eye exam, returning patient, intermediate inpatient CPT 92012 EXAM INTERMED ESTABLISHED PT	$113.19	$282.98	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1STHR(16-90)	$243.81	$609.53	—	2% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1STHR	$243.81	$609.53	—	2% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1STHR(16-90)	$243.81	$609.53	—	2% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRATION 1STHR	$243.81	$609.53	—	2% above	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1STHR	$243.81	$609.53	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1STHR(16-90)	$243.81	$609.53	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1STHR	$243.81	$609.53	—	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRATION 1STHR(16-90)	$243.81	$609.53	—	—	60%
IV infusion of a medicine, first hour CPT 96365 IV INFUS TX/DX 1STHR(16-90MIN)	$259.56	$648.90	—	10% below	60%
IV infusion of a medicine, first hour CPT 96365 IV INFUS TX/DX 1STHR(16-90MIN)	$259.56	$648.90	—	10% below	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS TX/DX 1STHR(16-90MIN)	$259.56	$648.90	—	—	60%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS TX/DX 1STHR(16-90MIN)	$259.56	$648.90	—	—	60%
IV push of a medicine, first drug CPT 96374 IVP/IVPB<16MIN SINGLE/INIT RX	$147.21	$368.03	—	18% below	60%
IV push of a medicine, first drug CPT 96374 IVP/IVPB<16MIN SINGLE/INIT RX	$147.21	$368.03	—	18% below	60%
IV push of a medicine, first drug inpatient CPT 96374 IVP/IVPB<16MIN SINGLE/INIT RX	$147.21	$368.03	—	—	60%
IV push of a medicine, first drug inpatient CPT 96374 IVP/IVPB<16MIN SINGLE/INIT RX	$147.21	$368.03	—	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NURSE SPECIAL INJECTION FEE	$12.08	$30.19	—	87% below	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NURSE SPECIAL INJECTION FEE	$12.08	$30.19	—	87% below	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM TX/DX/ANTIBIOTIC	$37.48	$93.71	—	60% below	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM TX/DX/ANTIBIOTIC	$37.48	$93.71	—	60% below	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 NURSE SPECIAL INJECTION FEE	$12.08	$30.19	—	—	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 NURSE SPECIAL INJECTION FEE	$12.08	$30.19	—	—	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM TX/DX/ANTIBIOTIC	$37.48	$93.71	—	—	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM TX/DX/ANTIBIOTIC	$37.48	$93.71	—	—	60%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$90.30	$225.75	—	at median	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$90.30	$225.75	—	—	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-LEAD	$104.00	$260.00	—	52% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-LEAD	$104.00	$260.00	—	52% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-HAZWHOPER	$129.00	$322.50	—	40% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-HAZWHOPER	$129.00	$322.50	—	40% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-ASBESTOS	$148.68	$371.70	—	31% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL-ASBESTOS	$148.68	$371.70	—	31% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL ASBESTOS	$148.68	$371.70	—	31% below	60%
New patient office visit, about 45 minutes CPT 99204 PHYSICAL ASBESTOS	$148.68	$371.70	—	31% below	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-LEAD	$104.00	$260.00	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-LEAD	$104.00	$260.00	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-HAZWHOPER	$129.00	$322.50	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-HAZWHOPER	$129.00	$322.50	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-ASBESTOS	$148.68	$371.70	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL ASBESTOS	$148.68	$371.70	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL-ASBESTOS	$148.68	$371.70	—	—	60%
New patient office visit, about 45 minutes inpatient CPT 99204 PHYSICAL ASBESTOS	$148.68	$371.70	—	—	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-BUS DRIVER	$30.00	$75.00	—	76% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-BUS DRIVER	$30.00	$75.00	—	76% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-FORKLIFT	$36.00	$90.00	—	71% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-FORKLIFT	$36.00	$90.00	—	71% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-GENERAL	$38.10	$95.25	—	69% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-GENERAL	$38.10	$95.25	—	69% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-DOT	$40.00	$100.00	—	68% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-DOT	$40.00	$100.00	—	68% below	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-FIREFIGHTER	$212.00	$530.00	—	71% above	60%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PHYSICAL-FIREFIGHTER	$212.00	$530.00	—	71% above	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-BUS DRIVER	$30.00	$75.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-BUS DRIVER	$30.00	$75.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-FORKLIFT	$36.00	$90.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-FORKLIFT	$36.00	$90.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-GENERAL	$38.10	$95.25	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-GENERAL	$38.10	$95.25	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-DOT	$40.00	$100.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-DOT	$40.00	$100.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-FIREFIGHTER	$212.00	$530.00	—	—	60%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PHYSICAL-FIREFIGHTER	$212.00	$530.00	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL ASSESSMENT(15MINS)	$28.98	$72.45	—	28% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL ASSESSMENT(15MINS)	$28.98	$72.45	—	28% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL ASSESSMENT(15MINS)	$28.98	$72.45	—	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL ASSESSMENT(15MINS)	$28.98	$72.45	—	—	60%
Occupational therapy evaluation, low complexity CPT 97165 EVAL LOW COMPLEXITY	$107.52	$268.80	—	19% below	60%
Occupational therapy evaluation, low complexity inpatient CPT 97165 EVAL LOW COMPLEXITY	$107.52	$268.80	—	—	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 EVAL HIGH COMPLEXITY	$155.40	$388.50	—	13% below	60%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 EVAL HIGH COMPLEXITY	$155.40	$388.50	—	—	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 EVAL LOW COMPLEXITY	$107.52	$268.80	—	16% below	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 EVAL LOW COMPLEXITY	$107.52	$268.80	—	—	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVAL MODERATE COMPLEXITY	$143.22	$358.05	—	8% below	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 EVAL MODERATE COMPLEXITY	$143.22	$358.05	—	—	60%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN	$80.64	$201.60	—	1% below	60%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN	$80.64	$201.60	—	—	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXCERISE (15 MIN)	$78.33	$195.83	—	at median	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE (15 MIN)	$78.54	$196.35	—	at median	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXCERISE (15 MIN)	$78.33	$195.83	—	—	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE (15 MIN)	$78.54	$196.35	—	—	60%
Preventive checkup, new patient aged 18–39 CPT 99385 H/P 18-39	$124.53	$311.33	—	18% below	60%
Preventive checkup, new patient aged 18–39 CPT 99385 H/P 18-39	$124.53	$311.33	—	18% below	60%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 H/P 18-39	$124.53	$311.33	—	—	60%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 H/P 18-39	$124.53	$311.33	—	—	60%
Preventive checkup, new patient aged 40–64 CPT 99386 H/P 40-64	$124.53	$311.33	—	27% below	60%
Preventive checkup, new patient aged 40–64 CPT 99386 H/P 40-64	$124.53	$311.33	—	27% below	60%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 H/P 40-64	$124.53	$311.33	—	—	60%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 H/P 40-64	$124.53	$311.33	—	—	60%
Preventive checkup, new patient aged 65 or older CPT 99387 H/P 65 +	$127.26	$318.15	—	23% below	60%
Preventive checkup, new patient aged 65 or older CPT 99387 H/P 65 +	$127.26	$318.15	—	23% below	60%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 H/P 65 +	$127.26	$318.15	—	—	60%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 H/P 65 +	$127.26	$318.15	—	—	60%
Preventive checkup, returning patient aged 18–39 CPT 99395 H/P EST 18-39	$124.53	$311.33	—	1% below	60%
Preventive checkup, returning patient aged 18–39 CPT 99395 H/P EST 18-39	$124.53	$311.33	—	1% below	60%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 H/P EST 18-39	$124.53	$311.33	—	—	60%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 H/P EST 18-39	$124.53	$311.33	—	—	60%
Preventive checkup, returning patient aged 40–64 CPT 99396 H/P EST 40-64	$124.53	$311.33	—	5% below	60%
Preventive checkup, returning patient aged 40–64 CPT 99396 H/P EST 40-64	$124.53	$311.33	—	5% below	60%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 H/P EST 40-64	$124.53	$311.33	—	—	60%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 H/P EST 40-64	$124.53	$311.33	—	—	60%
Preventive checkup, returning patient aged 65 or older CPT 99397 H/P EST 65 +	$127.26	$318.15	—	19% below	60%
Preventive checkup, returning patient aged 65 or older CPT 99397 H/P EST 65 +	$127.26	$318.15	—	19% below	60%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 H/P EST 65 +	$127.26	$318.15	—	—	60%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 H/P EST 65 +	$127.26	$318.15	—	—	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MIN	$31.08	$77.70	—	16% above	60%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MIN	$31.08	$77.70	—	16% above	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10 MIN	$31.08	$77.70	—	—	60%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10 MIN	$31.08	$77.70	—	—	60%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG EVALUATION	$246.96	$617.40	—	4% below	60%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG EVALUATION	$246.96	$617.40	—	—	60%
Speech therapy session, individual CPT 92507 SPEECH THERAPY COMPLEX	$178.08	$445.20	—	5% above	60%
Speech therapy session, individual CPT 92507 SPEECH THERAPY SIMPLE	$178.08	$445.20	—	5% above	60%
Speech therapy session, individual CPT 92507 SPEECH THERAPY INTERMEDIATE	$178.08	$445.20	—	5% above	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY INTERMEDIATE	$178.08	$445.20	—	—	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY COMPLEX	$178.08	$445.20	—	—	60%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY SIMPLE	$178.08	$445.20	—	—	60%
Spirometry (breathing test) CPT 94010 PFT INCLUDES OSHA QUESTION	$34.00	$85.00	—	85% below	60%
Spirometry (breathing test) CPT 94010 ON-SITE PFT	$34.00	$85.00	—	85% below	60%
Spirometry (breathing test) CPT 94010 PFT INCLUDES OSHA QUESTION	$34.00	$85.00	—	85% below	60%
Spirometry (breathing test) CPT 94010 ON-SITE PFT	$34.00	$85.00	—	85% below	60%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$130.94	$327.34	—	43% below	60%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$130.94	$327.34	—	43% below	60%
Spirometry (breathing test) inpatient CPT 94010 PFT INCLUDES OSHA QUESTION	$34.00	$85.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 ON-SITE PFT	$34.00	$85.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 PFT INCLUDES OSHA QUESTION	$34.00	$85.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 ON-SITE PFT	$34.00	$85.00	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$130.94	$327.34	—	—	60%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$130.94	$327.34	—	—	60%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL PRE & POST	$329.28	$823.20	—	25% below	60%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL PRE & POST	$329.28	$823.20	—	25% below	60%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL PRE & POST	$329.28	$823.20	—	—	60%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL PRE & POST	$329.28	$823.20	—	—	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 INDUSTRIAL BACK SCREEN	$32.24	$80.59	—	60% below	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 PULMONARY REHAB THER ACTIVITY	$86.00	$214.99	—	7% above	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY (15 MIN)	$86.10	$215.25	—	7% above	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 POSITIONING 15 MIN	$86.10	$215.25	—	7% above	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 POSITIONING - 15 MIN	$86.10	$215.25	—	7% above	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 INDUSTRIAL BACK SCREEN	$32.24	$80.59	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PULMONARY REHAB THER ACTIVITY	$86.00	$214.99	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 POSITIONING 15 MIN	$86.10	$215.25	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY (15 MIN)	$86.10	$215.25	—	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 POSITIONING - 15 MIN	$86.10	$215.25	—	—	60%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$129.78	$324.45	—	25% below	60%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$129.78	$324.45	—	25% below	60%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$129.78	$324.45	—	—	60%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$129.78	$324.45	—	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 VACCINATION FLU 65 YRS+	$26.90	$67.25	—	29% below	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 VACCINATION FLU 65 YRS+	$26.90	$67.25	—	29% below	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 VACCINATION FLU 65 YRS+	$26.90	$67.25	—	—	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 VACCINATION FLU 65 YRS+	$26.90	$67.25	—	—	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VACCINATION VARICELLA	$126.20	$315.50	—	24% below	60%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VACCINATION VARICELLA	$126.20	$315.50	—	24% below	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VACCINATION VARICELLA	$126.20	$315.50	—	—	60%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VACCINATION VARICELLA	$126.20	$315.50	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL HD TRI PF 0.5 ML	$24.78	$61.95	—	47% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL HD TRI PF 0.5 ML	$24.78	$61.95	—	47% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL HD TRI PF 0.5 ML	$24.78	$61.95	—	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL HD TRI PF 0.5 ML	$24.78	$61.95	—	—	60%
Hepatitis A vaccine, adult dose CPT 90632 VACCINATION HEPATITIS A 1 D	$65.40	$163.50	—	15% below	60%
Hepatitis A vaccine, adult dose CPT 90632 VACCINATION HEPATITIS A 1 D	$65.40	$163.50	—	15% below	60%
Hepatitis A vaccine, adult dose CPT 90632 ON-SITE HEP A INJECTION	$68.67	$171.68	—	11% below	60%
Hepatitis A vaccine, adult dose CPT 90632 ON-SITE HEP A INJECTION	$68.67	$171.68	—	11% below	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 VACCINATION HEPATITIS A 1 D	$65.40	$163.50	—	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 VACCINATION HEPATITIS A 1 D	$65.40	$163.50	—	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 ON-SITE HEP A INJECTION	$68.67	$171.68	—	—	60%
Hepatitis A vaccine, adult dose inpatient CPT 90632 ON-SITE HEP A INJECTION	$68.67	$171.68	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VACCINATION HEPATITIS B 1 D	$45.40	$113.50	—	42% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VACCINATION HEPATITIS B 1 D	$45.40	$113.50	—	42% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ON-SITE HEP B INJECTION	$47.67	$119.18	—	39% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ON-SITE HEP B INJECTION	$47.67	$119.18	—	39% below	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VACCINATION HEPATITIS B 1 D	$45.40	$113.50	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VACCINATION HEPATITIS B 1 D	$45.40	$113.50	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ON-SITE HEP B INJECTION	$47.67	$119.18	—	—	60%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ON-SITE HEP B INJECTION	$47.67	$119.18	—	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX 5 MCG/0.5 ML	$24.78	$61.95	—	67% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX 5 MCG/0.5 ML	$24.78	$61.95	—	67% below	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX 5 MCG/0.5 ML	$24.78	$61.95	—	—	60%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 RECOMBIVAX 5 MCG/0.5 ML	$24.78	$61.95	—	—	60%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC HD TRI PF 0.5 ML	$84.42	$211.05	—	7% below	60%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC HD TRI PF 0.5 ML	$84.42	$211.05	—	7% below	60%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC HD TRI PF 0.5 ML	$84.42	$211.05	—	—	60%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC HD TRI PF 0.5 ML	$84.42	$211.05	—	—	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINATION MMR	$71.40	$178.50	—	55% below	60%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VACCINATION MMR	$71.40	$178.50	—	55% below	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINATION MMR	$71.40	$178.50	—	—	60%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VACCINATION MMR	$71.40	$178.50	—	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 0.5 ML INJ	$322.56	$806.40	—	31% above	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 0.5 ML INJ	$322.56	$806.40	—	31% above	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 0.5 ML INJ	$322.56	$806.40	—	—	60%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 0.5 ML INJ	$322.56	$806.40	—	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE 0.5 ML	$364.56	$911.40	—	27% below	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 VACCINE 0.5 ML	$364.56	$911.40	—	27% below	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 VACCINE 0.5 ML	$364.56	$911.40	—	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 VACCINE 0.5 ML	$364.56	$911.40	—	—	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 0.5 ML VIAL	$174.72	$436.80	—	at median	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 0.5 ML VIAL	$174.72	$436.80	—	at median	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 0.5 ML VIAL	$174.72	$436.80	—	—	60%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 0.5 ML VIAL	$174.72	$436.80	—	—	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100MG/ML PFS	$147.84	$369.60	—	87% below	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 BEYFORTUS 100MG/ML PFS	$147.84	$369.60	—	87% below	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100MG/ML PFS	$147.84	$369.60	—	—	60%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 BEYFORTUS 100MG/ML PFS	$147.84	$369.60	—	—	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50MG/0.5ML PFS	$147.84	$369.60	—	87% below	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50MG/0.5ML PFS	$147.84	$369.60	—	87% below	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50MG/0.5ML PFS	$147.84	$369.60	—	—	60%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50MG/0.5ML PFS	$147.84	$369.60	—	—	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE 0.5 ML BIVALENT	$435.96	$1,089.90	—	7% below	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE 0.5 ML BIVALENT	$435.96	$1,089.90	—	7% below	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE 0.5 ML BIVALENT	$435.96	$1,089.90	—	—	60%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE 0.5 ML BIVALENT	$435.96	$1,089.90	—	—	60%
Rabies vaccine, one dose CPT 90675 VACCIN RABAVERT RABIES 1ML	$197.30	$493.25	—	77% below	60%
Rabies vaccine, one dose CPT 90675 VACCIN RABAVERT RABIES 1ML	$197.30	$493.25	—	77% below	60%
Rabies vaccine, one dose inpatient CPT 90675 VACCIN RABAVERT RABIES 1ML	$197.30	$493.25	—	—	60%
Rabies vaccine, one dose inpatient CPT 90675 VACCIN RABAVERT RABIES 1ML	$197.30	$493.25	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 VACCINATION DIP/TETANUS	$34.00	$85.00	—	66% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 VACCINATION DIP/TETANUS	$34.00	$85.00	—	66% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ON-SITE DIPTHERIA/TETNUS INJ	$35.60	$88.99	—	64% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ON-SITE DIPTHERIA/TETNUS INJ	$35.60	$88.99	—	64% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP-TETANUS DIPTHERIA PERTUSS	$40.80	$102.00	—	59% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP-TETANUS DIPTHERIA PERTUSS	$40.80	$102.00	—	59% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 VACCINATION DIP/TETANUS	$34.00	$85.00	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 VACCINATION DIP/TETANUS	$34.00	$85.00	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ON-SITE DIPTHERIA/TETNUS INJ	$35.60	$88.99	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ON-SITE DIPTHERIA/TETNUS INJ	$35.60	$88.99	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP-TETANUS DIPTHERIA PERTUSS	$40.80	$102.00	—	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP-TETANUS DIPTHERIA PERTUSS	$40.80	$102.00	—	—	60%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 VACCINATION TYPHOID	$106.20	$265.50	—	1% below	60%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 VACCINATION TYPHOID	$106.20	$265.50	—	1% below	60%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 VACCINATION TYPHOID	$106.20	$265.50	—	—	60%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 VACCINATION TYPHOID	$106.20	$265.50	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION OF VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION OF VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION VACCINE	$31.92	$79.80	—	44% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION OF VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION OF VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION VACCINE	$31.92	$79.80	—	—	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJECTION VACCINE EA ADDITIONA	$17.64	$44.10	—	61% below	60%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INJECTION VACCINE EA ADDITIONA	$17.64	$44.10	—	61% below	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJECTION VACCINE EA ADDITIONA	$17.64	$44.10	—	—	60%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INJECTION VACCINE EA ADDITIONA	$17.64	$44.10	—	—	60%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.freemanhealth.com/sites/default/files/media-library/431704371_freeman-health-system---freeman-west_standardcharges.csv