Memorial Hospital of South Bend
Memorial Hospital of South Bend in South Bend, IN publishes cash prices for 358 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Indiana median for 219 of 357 procedures and below it for 133. By typical cash price it ranks #54 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
615 N MICHIGAN ST, SOUTH BEND, IN 46601 Collected Sep 28, 2026 Source price file Check a bill from this hospital (574) 647-1000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 2 of 5 CCN 150058 · CMS hospital register NPI 1295772093
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Memorial Hospital of South Bend 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.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 7 actions for a hospital named Memorial Hospital of South Bend in South Bend, IN:
- Aug 25, 2021 Warning notice
- May 4, 2022 Corrective action plan requested
- Jul 21, 2022 Case closed
- Nov 27, 2023 Warning notice
- Mar 15, 2024 Case closed
- Apr 13, 2026 Warning notice
- Jul 24, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W W-O Contrast | $2,141.75 | $3,295.00 | $659.00–$3,295.00 | 58% above | 35% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen W W-O Contrast | $2,141.75 | $3,295.00 | $659.00–$2,701.90 | — | 35% |
| Abdominal X-ray, 2 views CPT 74019 DX ABDOMEN 2 VIEWS | $254.15 | $391.00 | $78.20–$391.00 | 6% below | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 DX ABDOMEN 2 VIEWS | $254.15 | $391.00 | $78.20–$320.62 | — | 35% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 DX Ankle Three Views RT | $190.45 | $293.00 | $58.60–$293.00 | 3% below | 35% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 DX Ankle Three Views LT | $190.45 | $293.00 | $58.60–$293.00 | 3% below | 35% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DX Ankle Three Views LT | $190.45 | $293.00 | $58.60–$240.26 | — | 35% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DX Ankle Three Views RT | $190.45 | $293.00 | $58.60–$240.26 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LTD BILAT PHYS STDY UP/LOW EXTREM | $423.15 | $651.00 | $130.20–$651.00 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 VL Ankle Brachial Index | $423.15 | $651.00 | $130.20–$651.00 | 15% above | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LTD BILAT PHYS STDY UP/LOW EXTREM | $423.15 | $651.00 | $130.20–$533.82 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VL Ankle Brachial Index | $423.15 | $651.00 | $130.20–$533.82 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 50% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity W-O Contrast RT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 50% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ROM Upper Extrem W-O Cont LT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 50% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ROM Upper Extrem W-O Cont RT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 50% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ROM Upper Extrem W-O Cont RT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity W-O Contrast RT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ROM Upper Extrem W-O Cont LT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 DX Esophagus | $310.05 | $477.00 | $95.40–$477.00 | 33% below | 35% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 DX Esophagus | $310.05 | $477.00 | $95.40–$391.14 | — | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Total Body | $1,272.70 | $1,958.00 | $391.60–$1,958.00 | 19% below | 35% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Total Body | $1,272.70 | $1,958.00 | $391.60–$1,605.56 | — | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete LT | $235.95 | $363.00 | $72.60–$363.00 | 46% below | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete RT | $235.95 | $363.00 | $72.60–$363.00 | 46% below | 35% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete LT | $235.95 | $363.00 | $72.60–$297.66 | — | 35% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete RT | $235.95 | $363.00 | $72.60–$297.66 | — | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast (ER or IP ONLY) RT | $156.00 | $240.00 | $48.00–$240.00 | 52% below | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast (ER or IP ONLY) LT | $156.00 | $240.00 | $48.00–$240.00 | 52% below | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited LT | $156.00 | $240.00 | $48.00–$240.00 | 52% below | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited RT | $156.00 | $240.00 | $48.00–$240.00 | 52% below | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited LT | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited RT | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast (ER or IP ONLY) RT | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast (ER or IP ONLY) LT | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen-Pelvis | $2,337.40 | $3,596.00 | $719.20–$3,596.00 | 24% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abdomen Pelvis GI Bleed | $2,337.40 | $3,596.00 | $719.20–$3,596.00 | 24% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Abd/Pelvis for Dissection | $2,337.40 | $3,596.00 | $719.20–$3,596.00 | 24% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen Pelvis GI Bleed | $2,337.40 | $3,596.00 | $719.20–$2,948.72 | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abdomen-Pelvis | $2,337.40 | $3,596.00 | $719.20–$2,948.72 | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Abd/Pelvis for Dissection | $2,337.40 | $3,596.00 | $719.20–$2,948.72 | — | 35% |
| CT angiography (CTA) of the head CPT 70496 CTA Brain Perfusion Scan | $1,780.35 | $2,739.00 | $547.80–$2,739.00 | 40% above | 35% |
| CT angiography (CTA) of the head CPT 70496 CTA Head | $1,780.35 | $2,739.00 | $547.80–$2,739.00 | 40% above | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Head | $1,780.35 | $2,739.00 | $547.80–$2,245.98 | — | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA Brain Perfusion Scan | $1,780.35 | $2,739.00 | $547.80–$2,245.98 | — | 35% |
| CT angiography (CTA) of the neck CPT 70498 CTA Neck | $1,132.30 | $1,742.00 | $348.40–$1,742.00 | 7% below | 35% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck | $1,132.30 | $1,742.00 | $348.40–$1,428.44 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ROM Ang Chest W and W-O Contrast | $1,695.85 | $2,609.00 | $521.80–$2,609.00 | 33% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest Dissection | $1,695.85 | $2,609.00 | $521.80–$2,609.00 | 33% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest | $1,695.85 | $2,609.00 | $521.80–$2,609.00 | 33% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest Trauma | $1,695.85 | $2,609.00 | $521.80–$2,609.00 | 33% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Chest-PE | $1,695.85 | $2,609.00 | $521.80–$2,609.00 | 33% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ROM Ang Chest W and W-O Contrast | $1,695.85 | $2,609.00 | $521.80–$2,139.38 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest-PE | $1,695.85 | $2,609.00 | $521.80–$2,139.38 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest Trauma | $1,695.85 | $2,609.00 | $521.80–$2,139.38 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest | $1,695.85 | $2,609.00 | $521.80–$2,139.38 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Chest Dissection | $1,695.85 | $2,609.00 | $521.80–$2,139.38 | — | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Coronary (with FFR if indicated) | $787.80 | $1,212.00 | $242.40–$1,212.00 | 6% below | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA Coronary (with FFR if indicated) | $787.80 | $1,212.00 | $242.40–$993.84 | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Scoring | $72.15 | $111.00 | $22.20–$111.00 | 61% below | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Cardiac Scoring | $72.15 | $111.00 | $22.20–$91.02 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis W-O Contrast | $2,224.30 | $3,422.00 | $684.40–$3,422.00 | 86% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Enterography W-O Contrast | $2,224.30 | $3,422.00 | $684.40–$3,422.00 | 86% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ROM Abdomen and Pelvis W-O Contr | $2,224.30 | $3,422.00 | $684.40–$3,422.00 | 86% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ROM Cystogram Abdomen and Pelvis | $2,224.30 | $3,422.00 | $684.40–$3,422.00 | 86% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Cystogram Abdomen and Pelvis | $2,224.30 | $3,422.00 | $684.40–$3,422.00 | 86% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ROM Abdomen and Pelvis W-O Contr | $2,224.30 | $3,422.00 | $684.40–$2,806.04 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis W-O Contrast | $2,224.30 | $3,422.00 | $684.40–$2,806.04 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Cystogram Abdomen and Pelvis | $2,224.30 | $3,422.00 | $684.40–$2,806.04 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ROM Cystogram Abdomen and Pelvis | $2,224.30 | $3,422.00 | $684.40–$2,806.04 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Enterography W-O Contrast | $2,224.30 | $3,422.00 | $684.40–$2,806.04 | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis W-Contrast | $3,235.70 | $4,978.00 | $995.60–$4,978.00 | 88% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography W-Contrast | $3,235.70 | $4,978.00 | $995.60–$4,978.00 | 88% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ROM Abdomen and Pelvis W-Contr | $3,235.70 | $4,978.00 | $995.60–$4,978.00 | 88% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ROM Abdomen and Pelvis W-Contr | $3,235.70 | $4,978.00 | $995.60–$4,081.96 | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography W-Contrast | $3,235.70 | $4,978.00 | $995.60–$4,081.96 | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis W-Contrast | $3,235.70 | $4,978.00 | $995.60–$4,081.96 | — | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis W W-O Contrast | $3,665.35 | $5,639.00 | $1,127.80–$5,639.00 | 114% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ROM Abdomen Pelvis W W-O Contr | $3,665.35 | $5,639.00 | $1,127.80–$5,639.00 | 114% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ROM Abdomen Pelvis W W-O Contr | $3,665.35 | $5,639.00 | $1,127.80–$4,623.98 | — | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis W W-O Contrast | $3,665.35 | $5,639.00 | $1,127.80–$4,623.98 | — | 35% |
| CT scan of the abdomen with contrast CPT 74160 CT ROM Abdomen W-Infusion Contrast | $1,883.70 | $2,898.00 | $579.60–$2,898.00 | 77% above | 35% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen W-Contrast | $1,883.70 | $2,898.00 | $579.60–$2,898.00 | 77% above | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W-Contrast | $1,883.70 | $2,898.00 | $579.60–$2,376.36 | — | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ROM Abdomen W-Infusion Contrast | $1,883.70 | $2,898.00 | $579.60–$2,376.36 | — | 35% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen W-O Contrast | $1,140.75 | $1,755.00 | $351.00–$1,755.00 | 35% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 IR 74150 CT Abdomen | $1,140.75 | $1,755.00 | $351.00–$1,755.00 | 35% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 CT ROM Abdomen W-O Infusion Contr | $1,140.75 | $1,755.00 | $351.00–$1,755.00 | 35% above | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 IR 74150 CT Abdomen | $1,140.75 | $1,755.00 | $351.00–$1,439.10 | — | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W-O Contrast | $1,140.75 | $1,755.00 | $351.00–$1,439.10 | — | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ROM Abdomen W-O Infusion Contr | $1,140.75 | $1,755.00 | $351.00–$1,439.10 | — | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial Area W-O Contrast | $966.55 | $1,487.00 | $297.40–$1,487.00 | 16% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT ROM Maxillofacial Area W-O | $966.55 | $1,487.00 | $297.40–$1,487.00 | 16% above | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial Area W-O Contrast | $966.55 | $1,487.00 | $297.40–$1,219.34 | — | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT ROM Maxillofacial Area W-O | $966.55 | $1,487.00 | $297.40–$1,219.34 | — | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain W-O Contrast | $892.45 | $1,373.00 | $274.60–$1,373.00 | 17% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 IR 70450 CT Head | $892.45 | $1,373.00 | $274.60–$1,373.00 | 17% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT ROM Brain W-O Contrast | $892.45 | $1,373.00 | $274.60–$1,373.00 | 17% above | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 IR 70450 CT Head | $892.45 | $1,373.00 | $274.60–$1,125.86 | — | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT ROM Brain W-O Contrast | $892.45 | $1,373.00 | $274.60–$1,125.86 | — | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain W-O Contrast | $892.45 | $1,373.00 | $274.60–$1,125.86 | — | 35% |
| CT scan of the head with contrast CPT 70460 CT Brain W-Contrast | $1,220.05 | $1,877.00 | $375.40–$1,877.00 | 43% above | 35% |
| CT scan of the head with contrast CPT 70460 CT ROM Brain W Contrast | $1,220.05 | $1,877.00 | $375.40–$1,877.00 | 43% above | 35% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain W-Contrast | $1,220.05 | $1,877.00 | $375.40–$1,539.14 | — | 35% |
| CT scan of the head with contrast inpatient CPT 70460 CT ROM Brain W Contrast | $1,220.05 | $1,877.00 | $375.40–$1,539.14 | — | 35% |
| CT scan of the head without and with contrast CPT 70470 CT Brain W W-O Contrast | $1,584.05 | $2,437.00 | $487.40–$2,437.00 | 52% above | 35% |
| CT scan of the head without and with contrast CPT 70470 CT ROM Brain W and W-O Contrast | $1,584.05 | $2,437.00 | $487.40–$2,437.00 | 52% above | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT ROM Brain W and W-O Contrast | $1,584.05 | $2,437.00 | $487.40–$1,998.34 | — | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain W W-O Contrast | $1,584.05 | $2,437.00 | $487.40–$1,998.34 | — | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W-O Contrast | $1,083.55 | $1,667.00 | $333.40–$1,667.00 | 22% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT ROM Lumbar Spine W-O Contrast | $1,083.55 | $1,667.00 | $333.40–$1,667.00 | 22% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W-O Contrast | $1,083.55 | $1,667.00 | $333.40–$1,366.94 | — | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT ROM Lumbar Spine W-O Contrast | $1,083.55 | $1,667.00 | $333.40–$1,366.94 | — | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT ROM Cervical Spine W-O Contrast | $1,611.35 | $2,479.00 | $495.80–$2,479.00 | 93% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine W-O Contrast | $1,611.35 | $2,479.00 | $495.80–$2,479.00 | 93% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT ROM Cervical Spine W-O Contrast | $1,611.35 | $2,479.00 | $495.80–$2,032.78 | — | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cervical Spine W-O Contrast | $1,611.35 | $2,479.00 | $495.80–$2,032.78 | — | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT ROM Pelvis W-O Contrast | $1,764.10 | $2,714.00 | $542.80–$2,714.00 | 91% above | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W-Contrast | $1,764.10 | $2,714.00 | $542.80–$2,714.00 | 91% above | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W-Contrast | $1,764.10 | $2,714.00 | $542.80–$2,225.48 | — | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT ROM Pelvis W-O Contrast | $1,764.10 | $2,714.00 | $542.80–$2,225.48 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Complete Bilateral | $622.70 | $958.00 | $191.60–$958.00 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 VL Carotid Doppler | $635.05 | $977.00 | $195.40–$977.00 | 34% below | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Doppler Complete Bilateral | $622.70 | $958.00 | $191.60–$785.56 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 VL Carotid Doppler | $635.05 | $977.00 | $195.40–$801.14 | — | 35% |
| Chest CT scan without and with contrast CPT 71270 CT ROM Chest W and W-O Contrast SD | $1,847.30 | $2,842.00 | $568.40–$2,842.00 | 70% above | 35% |
| Chest CT scan without and with contrast CPT 71270 CT Chest W W-O Contrast | $1,847.30 | $2,842.00 | $568.40–$2,842.00 | 70% above | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest W W-O Contrast | $1,847.30 | $2,842.00 | $568.40–$2,330.44 | — | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT ROM Chest W and W-O Contrast SD | $1,847.30 | $2,842.00 | $568.40–$2,330.44 | — | 35% |
| Chest X-ray, 2 views both sides CPT 71046 DX CHEST BILAT LATERAL DECUBITUS | $196.30 | $302.00 | $60.40–$302.00 | — | 35% |
| Chest X-ray, 2 views CPT 71046 DX CHEST INSPIRATION & EXPIRATION ONLY | $196.30 | $302.00 | $60.40–$302.00 | 5% below | 35% |
| Chest X-ray, 2 views CPT 71046 DX Chest PA Lateral | $196.30 | $302.00 | $60.40–$302.00 | 5% below | 35% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 DX CHEST BILAT LATERAL DECUBITUS | $196.30 | $302.00 | $60.40–$247.64 | — | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 DX CHEST INSPIRATION & EXPIRATION ONLY | $196.30 | $302.00 | $60.40–$247.64 | — | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 DX Chest PA Lateral | $196.30 | $302.00 | $60.40–$247.64 | — | 35% |
| Chest X-ray, single view CPT 71045 DX Chest X-Ray Portable | $220.35 | $339.00 | $67.80–$339.00 | 36% above | 35% |
| Chest X-ray, single view CPT 71045 DX Chest-KUB Neonate Portable | $220.35 | $339.00 | $67.80–$339.00 | 36% above | 35% |
| Chest X-ray, single view CPT 71045 DX Chest Single View | $220.35 | $339.00 | $67.80–$339.00 | 36% above | 35% |
| Chest X-ray, single view one side CPT 71045 DX CHEST LEFT LATERAL DECUB | $220.35 | $339.00 | $67.80–$339.00 | 36% above | 35% |
| Chest X-ray, single view one side CPT 71045 DX CHEST RIGHT LATERAL DECUB | $220.35 | $339.00 | $67.80–$339.00 | 36% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 DX Chest Single View | $220.35 | $339.00 | $67.80–$277.98 | — | 35% |
| Chest X-ray, single view inpatient CPT 71045 DX Chest-KUB Neonate Portable | $220.35 | $339.00 | $67.80–$277.98 | — | 35% |
| Chest X-ray, single view inpatient CPT 71045 DX Chest X-Ray Portable | $220.35 | $339.00 | $67.80–$277.98 | — | 35% |
| Chest X-ray, single view inpatient one side CPT 71045 DX CHEST LEFT LATERAL DECUB | $220.35 | $339.00 | $67.80–$277.98 | — | 35% |
| Chest X-ray, single view inpatient one side CPT 71045 DX CHEST RIGHT LATERAL DECUB | $220.35 | $339.00 | $67.80–$277.98 | — | 35% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 DX Clavicle LT | $187.85 | $289.00 | $57.80–$289.00 | 2% below | 35% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 DX Clavicle RT | $187.85 | $289.00 | $57.80–$289.00 | 2% below | 35% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 DX Clavicle RT | $187.85 | $289.00 | $57.80–$236.98 | — | 35% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 DX Clavicle LT | $187.85 | $289.00 | $57.80–$236.98 | — | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 VL Retroperitoneal Complete | $585.65 | $901.00 | $180.20–$901.00 | 17% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $585.65 | $901.00 | $180.20–$901.00 | 17% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $585.65 | $901.00 | $180.20–$738.82 | — | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 VL Retroperitoneal Complete | $585.65 | $901.00 | $180.20–$738.82 | — | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Densitometry Axial | $217.10 | $334.00 | $66.80–$334.00 | 25% below | 35% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Densitometry Axial | $217.10 | $334.00 | $66.80–$273.88 | — | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DXA Appendicular | $84.50 | $130.00 | $26.00–$130.00 | 42% below | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DXA Appendicular | $84.50 | $130.00 | $26.00–$106.60 | — | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Anatomic Eval | $435.50 | $670.00 | $134.00–$670.00 | 23% below | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Anatomic Eval | $435.50 | $670.00 | $134.00–$549.40 | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT ROM Chest W-O Infusion Contrast | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 45% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest W-O Contrast | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 45% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Esophagus W-O Contrast 71250 | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 45% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest W-O Contrast | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Esophagus W-O Contrast 71250 | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT ROM Chest W-O Infusion Contrast | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT ROM Chest W-Infusion Contrast | $1,659.45 | $2,553.00 | $510.60–$2,553.00 | 77% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W-Contrast | $1,659.45 | $2,553.00 | $510.60–$2,553.00 | 77% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W-Contrast | $1,659.45 | $2,553.00 | $510.60–$2,093.46 | — | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT ROM Chest W-Infusion Contrast | $1,659.45 | $2,553.00 | $510.60–$2,093.46 | — | 35% |
| Diagnostic mammogram, both breasts CPT 77066 MA Digital Diagnostic Mammo | $473.85 | $729.00 | $145.80–$729.00 | 9% above | 35% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MA Digital Diagnostic Mammo | $473.85 | $729.00 | $145.80–$597.78 | — | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Digital Diagnostic Mammo RT | $364.00 | $560.00 | $112.00–$560.00 | 64% above | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Digital Diagnostic Mammo LT | $364.00 | $560.00 | $112.00–$560.00 | 64% above | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Digital Diagnostic Mammo RT | $364.00 | $560.00 | $112.00–$459.20 | — | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Digital Diagnostic Mammo LT | $364.00 | $560.00 | $112.00–$459.20 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 VL Arterial Doppler Low Ext Bilat | $618.15 | $951.00 | $190.20–$951.00 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 US Lower Extremity Arteries Comp Bil | $618.15 | $951.00 | $190.20–$951.00 | 34% below | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 VL Arterial Doppler Low Ext Bilat | $618.15 | $951.00 | $190.20–$779.82 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Lower Extremity Arteries Comp Bil | $618.15 | $951.00 | $190.20–$779.82 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Doppler Lower Ext Bilat | $698.75 | $1,075.00 | $215.00–$1,075.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VL Venous Doppler Up Ext Bilat | $712.40 | $1,096.00 | $219.20–$1,096.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Doppler Upper Ext Bilat | $712.40 | $1,096.00 | $219.20–$1,096.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Doppler Lower Ext Bilat | $698.75 | $1,075.00 | $215.00–$881.50 | — | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VL Venous Doppler Up Ext Bilat | $712.40 | $1,096.00 | $219.20–$898.72 | — | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Doppler Upper Ext Bilat | $712.40 | $1,096.00 | $219.20–$898.72 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 COMPLETE ECHO W/COLOR FLOW DOPPLR CHG ONLY | $1,372.80 | $2,112.00 | $422.40–$2,112.00 | 17% below | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 COMPLETE ECHO W/COLR FLOW-PEDIATR CHG ONLY | $1,399.45 | $2,153.00 | $430.60–$2,153.00 | 15% below | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 COMPLETE ECHO W/COLOR FLOW DOPPLR CHG ONLY | $1,372.80 | $2,112.00 | $422.40–$1,731.84 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 COMPLETE ECHO W/COLR FLOW-PEDIATR CHG ONLY | $1,399.45 | $2,153.00 | $430.60–$1,765.46 | — | 35% |
| Elbow X-ray, 2 views one side CPT 73070 DX Elbow 2 Views LT | $176.80 | $272.00 | $54.40–$272.00 | 7% above | 35% |
| Elbow X-ray, 2 views one side CPT 73070 DX Elbow 2 Views RT | $176.80 | $272.00 | $54.40–$272.00 | 7% above | 35% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 DX Elbow 2 Views RT | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 DX Elbow 2 Views LT | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 DX Elbow Complete LT | $209.95 | $323.00 | $64.60–$323.00 | 18% below | 35% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 DX Elbow Complete RT | $209.95 | $323.00 | $64.60–$323.00 | 18% below | 35% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 DX Elbow Complete RT | $209.95 | $323.00 | $64.60–$264.86 | — | 35% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 DX Elbow Complete LT | $209.95 | $323.00 | $64.60–$264.86 | — | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Post Fossa-Orbit-Sella W-O Contrast | $989.95 | $1,523.00 | $304.60–$1,523.00 | 16% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ROM Post Fossa (Orbit Sella W-O) | $989.95 | $1,523.00 | $304.60–$1,523.00 | 16% above | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ROM Post Fossa (Orbit Sella W-O) | $989.95 | $1,523.00 | $304.60–$1,248.86 | — | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Post Fossa-Orbit-Sella W-O Contrast | $989.95 | $1,523.00 | $304.60–$1,248.86 | — | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 DX Facial Bones Complete | $273.00 | $420.00 | $84.00–$420.00 | at median | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 DX Facial Bones Complete | $273.00 | $420.00 | $84.00–$344.40 | — | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 DX Forearm LT | $188.50 | $290.00 | $58.00–$290.00 | 2% above | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 DX Forearm RT | $188.50 | $290.00 | $58.00–$290.00 | 2% above | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 DX Forearm LT | $188.50 | $290.00 | $58.00–$237.80 | — | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 DX Forearm RT | $188.50 | $290.00 | $58.00–$237.80 | — | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Scan W-O Pharmaceutical | $843.05 | $1,297.00 | $259.40–$1,297.00 | 36% below | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Scan W-O Pharmaceutical | $843.05 | $1,297.00 | $259.40–$1,063.54 | — | 35% |
| Hand X-ray, 2 views one side CPT 73120 DX Hand 2 Views RT | $184.60 | $284.00 | $56.80–$284.00 | 8% above | 35% |
| Hand X-ray, 2 views one side CPT 73120 DX Hand 2 Views LT | $184.60 | $284.00 | $56.80–$284.00 | 8% above | 35% |
| Hand X-ray, 2 views inpatient one side CPT 73120 DX Hand 2 Views LT | $184.60 | $284.00 | $56.80–$232.88 | — | 35% |
| Hand X-ray, 2 views inpatient one side CPT 73120 DX Hand 2 Views RT | $184.60 | $284.00 | $56.80–$232.88 | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 DX OS Calcis Heel LT | $180.70 | $278.00 | $55.60–$278.00 | 15% below | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 DX OS Calcis Heel RT | $180.70 | $278.00 | $55.60–$278.00 | 15% below | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 DX OS Calcis Heel LT | $180.70 | $278.00 | $55.60–$227.96 | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 DX OS Calcis Heel RT | $180.70 | $278.00 | $55.60–$227.96 | — | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RC Sleep Study Unatt & Resp | $439.40 | $676.00 | $135.20–$676.00 | 7% above | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 RC Sleep Study Unatt & Resp | $439.40 | $676.00 | $135.20–$554.32 | — | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RC CPAP Titration-Sleep Lab | $3,248.05 | $4,997.00 | $999.40–$4,997.00 | at median | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RC CPAP Titration-Sleep Lab | $3,248.05 | $4,997.00 | $999.40–$4,097.54 | — | 35% |
| Knee X-ray, 3 views one side CPT 73562 DX Knee Minimum Three Views RT | $210.60 | $324.00 | $64.80–$324.00 | 8% below | 35% |
| Knee X-ray, 3 views one side CPT 73562 DX Knee Minimum Three Views LT | $210.60 | $324.00 | $64.80–$324.00 | 8% below | 35% |
| Knee X-ray, 3 views inpatient one side CPT 73562 DX Knee Minimum Three Views RT | $210.60 | $324.00 | $64.80–$265.68 | — | 35% |
| Knee X-ray, 3 views inpatient one side CPT 73562 DX Knee Minimum Three Views LT | $210.60 | $324.00 | $64.80–$265.68 | — | 35% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 DX Knee Complete- 4 or More Views RT | $243.10 | $374.00 | $74.80–$374.00 | 7% below | 35% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 DX Knee Complete- 4 or More Views LT | $243.10 | $374.00 | $74.80–$374.00 | 7% below | 35% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 DX Knee Complete- 4 or More Views RT | $243.10 | $374.00 | $74.80–$306.68 | — | 35% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 DX Knee Complete- 4 or More Views LT | $243.10 | $374.00 | $74.80–$306.68 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W-O Contrast RT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 54% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 54% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ROM Lower Extr W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 54% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W-O Contrast RT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ROM Lower Extr W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W-O Contrast LT | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 IR 76705 US Abd Limited | $417.30 | $642.00 | $128.40–$642.00 | 9% below | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 VL Abdomen Ltd | $417.30 | $642.00 | $128.40–$642.00 | 9% below | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen LTD | $417.30 | $642.00 | $128.40–$642.00 | 9% below | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 VL Abdomen Ltd | $417.30 | $642.00 | $128.40–$526.44 | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen LTD | $417.30 | $642.00 | $128.40–$526.44 | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 IR 76705 US Abd Limited | $417.30 | $642.00 | $128.40–$526.44 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 IR 76882 Extremity Non Vasc | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non-Vascular LT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Limited LT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Limited RT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Non-Vascular RT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 VL Ext Nonvascular RT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 VL Ext Nonvascular LT | $388.05 | $597.00 | $119.40–$597.00 | 28% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 IR 76882 Extremity Non Vasc | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non-Vascular LT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Limited RT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 VL Ext Nonvascular RT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Non-Vascular RT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 VL Ext Nonvascular LT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Limited LT | $388.05 | $597.00 | $119.40–$489.54 | — | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Chest Lung Screen | $141.70 | $218.00 | $43.60–$218.00 | 26% below | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Chest Lung Screen | $141.70 | $218.00 | $43.60–$178.76 | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 DX Tibia - Fibula RT | $193.05 | $297.00 | $59.40–$297.00 | 3% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 DX Tibia - Fibula LT | $193.05 | $297.00 | $59.40–$297.00 | 3% below | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 DX Tibia - Fibula RT | $193.05 | $297.00 | $59.40–$243.54 | — | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 DX Tibia - Fibula LT | $193.05 | $297.00 | $59.40–$243.54 | — | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV Brain W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 18% above | 35% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Brain W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MR Breast W W-O Contrast BL CAD | $1,746.55 | $2,687.00 | $537.40–$2,687.00 | 324% above | 35% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MR Breast W W-O Contrast BL CAD | $1,746.55 | $2,687.00 | $537.40–$2,203.34 | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Lower Ext Joint W-O Contrast LT | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 28% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR Lower Ext Joint W-O Contrast RT | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 28% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR Lower Ext Joint W-O Contrast LT | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR Lower Ext Joint W-O Contrast RT | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Lower Ext Joint W W-O Contrast RT | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 14% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR Lower Ext Joint W W-O Contrast LT | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 14% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR Lower Ext Joint W W-O Contrast LT | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR Lower Ext Joint W W-O Contrast RT | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the abdomen without contrast CPT 74181 MR Abdomen W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 24% above | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 MR Abdomen W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR Abdomen W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 5% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR MRCP | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 5% above | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR MRCP | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Abdomen W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the brain, no contrast dye CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 30% above | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 26% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MR Brain Perfusion W W/O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 26% above | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain Perfusion W W/O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 30% above | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR Lumbar Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR Lumbar Spine W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 13% above | 35% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR Lumbar Spine W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR Thoracic Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 31% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR Thoracic Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR Cervical Spine W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 13% above | 35% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR Cervical Spine W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR Cervical Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 27% above | 35% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR Cervical Spine W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MR Pelvis W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,541.00 | 13% above | 35% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR Pelvis W W-O Contrast | $1,651.65 | $2,541.00 | $508.20–$2,083.62 | — | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MR Pelvis W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 26% above | 35% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Pelvis W-O Contrast | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Upper Ext Joint W-O Contrast RT | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 24% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR Upper Ext Joint W-O Contrast LT | $1,320.80 | $2,032.00 | $406.40–$2,032.00 | 24% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR Upper Ext Joint W-O Contrast LT | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR Upper Ext Joint W-O Contrast RT | $1,320.80 | $2,032.00 | $406.40–$1,666.24 | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 DX Spine Cervical 4 Views | $325.65 | $501.00 | $100.20–$501.00 | 6% below | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 DX EOS C-spine AP/Lat/Flex/Ext 72050 | $325.65 | $501.00 | $100.20–$501.00 | 6% below | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 DX EOS C-spine AP/Lat/Flex/Ext 72050 | $325.65 | $501.00 | $100.20–$410.82 | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 DX Spine Cervical 4 Views | $325.65 | $501.00 | $100.20–$410.82 | — | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CT ROM Neck Soft Tissue W-Contrast | $1,591.85 | $2,449.00 | $489.80–$2,449.00 | 63% above | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue W-Contrast | $1,591.85 | $2,449.00 | $489.80–$2,449.00 | 63% above | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT ROM Neck Soft Tissue W-Contrast | $1,591.85 | $2,449.00 | $489.80–$2,008.18 | — | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue W-Contrast | $1,591.85 | $2,449.00 | $489.80–$2,008.18 | — | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CT ROM Neck Soft Tissue W-O Cont | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 45% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue W-O Contrast | $1,207.05 | $1,857.00 | $371.40–$1,857.00 | 45% above | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue W-O Contrast | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT ROM Neck Soft Tissue W-O Cont | $1,207.05 | $1,857.00 | $371.40–$1,522.74 | — | 35% |
| Neck soft tissue X-ray CPT 70360 DX Neck Soft Tissue Examination | $147.55 | $227.00 | $45.40–$227.00 | 15% below | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 DX Neck Soft Tissue Examination | $147.55 | $227.00 | $45.40–$186.14 | — | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MAC Myocard Perfus Spect (Strs) | $2,490.80 | $3,832.00 | $766.40–$3,832.00 | 35% below | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocard Perfusion Spect (Stress) | $2,490.80 | $3,832.00 | $766.40–$3,832.00 | 35% below | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocard Perfusion Spect (Stress) | $2,490.80 | $3,832.00 | $766.40–$3,142.24 | — | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MAC Myocard Perfus Spect (Strs) | $2,490.80 | $3,832.00 | $766.40–$3,142.24 | — | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET-CT Dotatate | $4,245.15 | $6,531.00 | $1,306.20–$6,531.00 | 5% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET-CT Pylarify (Prostate CA) | $4,245.15 | $6,531.00 | $1,306.20–$6,531.00 | 5% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM PET-CT Dotatate | $4,245.15 | $6,531.00 | $1,306.20–$5,355.42 | — | 35% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM PET-CT Pylarify (Prostate CA) | $4,245.15 | $6,531.00 | $1,306.20–$5,355.42 | — | 35% |
| Pelvic CT scan without contrast CPT 72192 CT Cystogram Pelvis Only | $1,080.95 | $1,663.00 | $332.60–$1,663.00 | 30% above | 35% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis W-O Contrast | $1,080.95 | $1,663.00 | $332.60–$1,663.00 | 30% above | 35% |
| Pelvic CT scan without contrast CPT 72192 CT Drain Pneumonstomy-Abscess-Perc | $1,080.95 | $1,663.00 | $332.60–$1,663.00 | 30% above | 35% |
| Pelvic CT scan without contrast CPT 72192 CT ROM Cystogram Pelvis Only | $1,080.95 | $1,663.00 | $332.60–$1,663.00 | 30% above | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Cystogram Pelvis Only | $1,080.95 | $1,663.00 | $332.60–$1,363.66 | — | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Drain Pneumonstomy-Abscess-Perc | $1,080.95 | $1,663.00 | $332.60–$1,363.66 | — | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis W-O Contrast | $1,080.95 | $1,663.00 | $332.60–$1,363.66 | — | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT ROM Cystogram Pelvis Only | $1,080.95 | $1,663.00 | $332.60–$1,363.66 | — | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic LTD | $235.95 | $363.00 | $72.60–$363.00 | 34% below | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic LTD | $235.95 | $363.00 | $72.60–$297.66 | — | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $464.10 | $714.00 | $142.80–$714.00 | at median | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Complete | $464.10 | $714.00 | $142.80–$585.48 | — | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | $123.40–$617.00 | 28% below | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Wks | $401.05 | $617.00 | $123.40–$505.94 | — | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Wks Gest | $458.25 | $705.00 | $141.00–$705.00 | 11% below | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 Wks Gest | $458.25 | $705.00 | $141.00–$578.10 | — | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 RC Ultrasound Scan | $303.55 | $467.00 | $93.40–$467.00 | 20% below | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $303.55 | $467.00 | $93.40–$467.00 | 20% below | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited | $303.55 | $467.00 | $93.40–$382.94 | — | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 RC Ultrasound Scan | $303.55 | $467.00 | $93.40–$382.94 | — | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 DX Ribs RT | $199.55 | $307.00 | $61.40–$307.00 | 2% below | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 DX Ribs LT | $199.55 | $307.00 | $61.40–$307.00 | 2% below | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 DX Ribs RT | $199.55 | $307.00 | $61.40–$251.74 | — | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 DX Ribs LT | $199.55 | $307.00 | $61.40–$251.74 | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 DX Ribs RT and PA Chest | $260.00 | $400.00 | $80.00–$400.00 | 7% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 DX Ribs LT and PA Chest | $260.00 | $400.00 | $80.00–$400.00 | 7% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 DX Ribs RT and PA Chest | $260.00 | $400.00 | $80.00–$328.00 | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 DX Ribs LT and PA Chest | $260.00 | $400.00 | $80.00–$328.00 | — | 35% |
| Screening mammogram, both breasts CPT 77067 MA Digital Screening Mammo | $322.40 | $496.00 | $99.20–$496.00 | 29% above | 35% |
| Screening mammogram, both breasts inpatient CPT 77067 MA Digital Screening Mammo | $322.40 | $496.00 | $99.20–$406.72 | — | 35% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 DX Shoulder Complete LT | $197.60 | $304.00 | $60.80–$304.00 | 5% below | 35% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 DX Shoulder Complete RT | $197.60 | $304.00 | $60.80–$304.00 | 5% below | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DX Shoulder Complete LT | $197.60 | $304.00 | $60.80–$249.28 | — | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DX Shoulder Complete RT | $197.60 | $304.00 | $60.80–$249.28 | — | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 DX Sinuses Paranasal Complete | $247.00 | $380.00 | $76.00–$380.00 | 13% below | 35% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 DX Sinuses Paranasal Complete | $247.00 | $380.00 | $76.00–$311.60 | — | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 DX Skull Partial | $182.00 | $280.00 | $56.00–$280.00 | 22% below | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 DX Skull Partial | $182.00 | $280.00 | $56.00–$229.60 | — | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,987.40 | $4,596.00 | $919.20–$4,596.00 | 13% above | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 DIAGNOSTIC SLEEP STUDY | $2,987.40 | $4,596.00 | $919.20–$3,768.72 | — | 35% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO CHG ONLY | $1,259.05 | $1,937.00 | $387.40–$1,937.00 | 30% below | 35% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO CHG ONLY | $1,259.05 | $1,937.00 | $387.40–$1,588.34 | — | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 DX Swallowing Function Study | $283.40 | $436.00 | $87.20–$436.00 | 22% below | 35% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 DX Swallowing Function Study | $283.40 | $436.00 | $87.20–$357.52 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 DX Femur LT 2 View | $204.10 | $314.00 | $62.80–$314.00 | 2% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 DX Femur RT 2 View | $204.10 | $314.00 | $62.80–$314.00 | 2% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 DX Femur LT 2 View | $204.10 | $314.00 | $62.80–$257.48 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 DX Femur RT 2 View | $204.10 | $314.00 | $62.80–$257.48 | — | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Thoracic Spine W-O Contrast | $1,574.95 | $2,423.00 | $484.60–$2,423.00 | 85% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT ROM Thoracic Spine W-O Contrast | $1,574.95 | $2,423.00 | $484.60–$2,423.00 | 85% above | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Thoracic Spine W-O Contrast | $1,574.95 | $2,423.00 | $484.60–$1,986.86 | — | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT ROM Thoracic Spine W-O Contrast | $1,574.95 | $2,423.00 | $484.60–$1,986.86 | — | 35% |
| Toe X-ray, 2 or more views one side CPT 73660 DX Toes RT | $160.55 | $247.00 | $49.40–$247.00 | 5% above | 35% |
| Toe X-ray, 2 or more views one side CPT 73660 DX Toes LT | $160.55 | $247.00 | $49.40–$247.00 | 5% above | 35% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 DX Toes LT | $160.55 | $247.00 | $49.40–$202.54 | — | 35% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 DX Toes RT | $160.55 | $247.00 | $49.40–$202.54 | — | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $406.90 | $626.00 | $125.20–$626.00 | at median | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $406.90 | $626.00 | $125.20–$513.32 | — | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $458.25 | $705.00 | $141.00–$705.00 | 24% above | 35% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $458.25 | $705.00 | $141.00–$578.10 | — | 35% |
| Ultrasound of the abdomen, complete CPT 76700 VL Abdomen Complete | $666.90 | $1,026.00 | $205.20–$1,026.00 | 27% above | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | $205.20–$1,026.00 | 27% above | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $666.90 | $1,026.00 | $205.20–$841.32 | — | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 VL Abdomen Complete | $666.90 | $1,026.00 | $205.20–$841.32 | — | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 VL Testicular Complete | $568.10 | $874.00 | $174.80–$874.00 | 34% above | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 US Testicular | $568.10 | $874.00 | $174.80–$874.00 | 34% above | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular | $568.10 | $874.00 | $174.80–$716.68 | — | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 VL Testicular Complete | $568.10 | $874.00 | $174.80–$716.68 | — | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid Head Neck | $352.95 | $543.00 | $108.60–$543.00 | 17% below | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid Head Neck | $352.95 | $543.00 | $108.60–$445.26 | — | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DX Upper GI W/O Air Contrast | $435.50 | $670.00 | $134.00–$670.00 | 17% below | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DX Upper GI W/O Air Contrast | $435.50 | $670.00 | $134.00–$549.40 | — | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 DX Humerus LT | $186.55 | $287.00 | $57.40–$287.00 | 3% below | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 DX Humerus RT | $186.55 | $287.00 | $57.40–$287.00 | 3% below | 35% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 DX Humerus LT | $186.55 | $287.00 | $57.40–$235.34 | — | 35% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 DX Humerus RT | $186.55 | $287.00 | $57.40–$235.34 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 zzUS Venous Doppler-Extremity Limited | $389.35 | $599.00 | $119.80–$599.00 | 39% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL Venous Doppler Extremity Limited | $389.35 | $599.00 | $119.80–$599.00 | 39% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Lower Ext RT | $381.55 | $587.00 | $117.40–$587.00 | 40% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Doppler Lower Ext LT | $381.55 | $587.00 | $117.40–$587.00 | 40% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Venous Doppler Up Ext RT | $389.35 | $599.00 | $119.80–$599.00 | 39% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VL Venous Doppler Up Ext LT | $389.35 | $599.00 | $119.80–$599.00 | 39% below | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 zzUS Venous Doppler-Extremity Limited | $389.35 | $599.00 | $119.80–$491.18 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL Venous Doppler Extremity Limited | $389.35 | $599.00 | $119.80–$491.18 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Lower Ext LT | $381.55 | $587.00 | $117.40–$481.34 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Doppler Lower Ext RT | $381.55 | $587.00 | $117.40–$481.34 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Venous Doppler Up Ext RT | $389.35 | $599.00 | $119.80–$491.18 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VL Venous Doppler Up Ext LT | $389.35 | $599.00 | $119.80–$491.18 | — | 35% |
| Wrist X-ray, 2 views one side CPT 73100 DX Wrist 2 Views RT | $172.25 | $265.00 | $53.00–$265.00 | 10% above | 35% |
| Wrist X-ray, 2 views one side CPT 73100 DX Wrist 2 Views LT | $172.25 | $265.00 | $53.00–$265.00 | 10% above | 35% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 DX Wrist 2 Views RT | $172.25 | $265.00 | $53.00–$217.30 | — | 35% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 DX Wrist 2 Views LT | $172.25 | $265.00 | $53.00–$217.30 | — | 35% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 DX Wrist Complete RT | $203.45 | $313.00 | $62.60–$313.00 | 20% below | 35% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 DX Wrist Complete LT | $203.45 | $313.00 | $62.60–$313.00 | 20% below | 35% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DX Wrist Complete RT | $203.45 | $313.00 | $62.60–$256.66 | — | 35% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DX Wrist Complete LT | $203.45 | $313.00 | $62.60–$256.66 | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DX Hip Unilateral Complete RT | $187.85 | $289.00 | $57.80–$289.00 | 29% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DX Hip Unilateral Complete LT | $187.85 | $289.00 | $57.80–$289.00 | 29% below | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DX Hip Unilateral Complete LT | $187.85 | $289.00 | $57.80–$236.98 | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DX Hip Unilateral Complete RT | $187.85 | $289.00 | $57.80–$236.98 | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 DX Abdomen AP (KUB) | $179.40 | $276.00 | $55.20–$276.00 | 17% below | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 DX Abdomen AP (KUB) | $179.40 | $276.00 | $55.20–$226.32 | — | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 DX Ankle 2 Views RT | $159.90 | $246.00 | $49.20–$246.00 | at median | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 DX Ankle 2 Views LT | $159.90 | $246.00 | $49.20–$246.00 | at median | 35% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 DX Ankle 2 Views RT | $159.90 | $246.00 | $49.20–$201.72 | — | 35% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 DX Ankle 2 Views LT | $159.90 | $246.00 | $49.20–$201.72 | — | 35% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 DX Fingers LT | $160.55 | $247.00 | $49.40–$247.00 | 1% above | 35% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 DX Fingers RT | $160.55 | $247.00 | $49.40–$247.00 | 1% above | 35% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DX Fingers LT | $160.55 | $247.00 | $49.40–$202.54 | — | 35% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DX Fingers RT | $160.55 | $247.00 | $49.40–$202.54 | — | 35% |
| X-ray of the foot, 2 views one side CPT 73620 DX Foot Two Views RT | $141.70 | $218.00 | $43.60–$218.00 | 13% below | 35% |
| X-ray of the foot, 2 views one side CPT 73620 DX Foot Two Views LT | $141.70 | $218.00 | $43.60–$218.00 | 13% below | 35% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 DX Foot Two Views RT | $141.70 | $218.00 | $43.60–$178.76 | — | 35% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 DX Foot Two Views LT | $141.70 | $218.00 | $43.60–$178.76 | — | 35% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 DX Foot Complete RT | $190.45 | $293.00 | $58.60–$293.00 | 5% below | 35% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 DX Foot Complete LT | $190.45 | $293.00 | $58.60–$293.00 | 5% below | 35% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DX Foot Complete LT | $190.45 | $293.00 | $58.60–$240.26 | — | 35% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DX Foot Complete RT | $190.45 | $293.00 | $58.60–$240.26 | — | 35% |
| X-ray of the hand, 3 or more views one side CPT 73130 DX Hand Complete LT | $203.45 | $313.00 | $62.60–$313.00 | 1% above | 35% |
| X-ray of the hand, 3 or more views one side CPT 73130 DX Hand Complete RT | $203.45 | $313.00 | $62.60–$313.00 | 1% above | 35% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 DX Hand Complete LT | $203.45 | $313.00 | $62.60–$256.66 | — | 35% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 DX Hand Complete RT | $203.45 | $313.00 | $62.60–$256.66 | — | 35% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 DX Knee 1 or 2 Views RT | $181.35 | $279.00 | $55.80–$279.00 | 13% below | 35% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 DX Knee 1 or 2 Views LT | $181.35 | $279.00 | $55.80–$279.00 | 13% below | 35% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DX Knee 1 or 2 Views LT | $181.35 | $279.00 | $55.80–$228.78 | — | 35% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DX Knee 1 or 2 Views RT | $181.35 | $279.00 | $55.80–$228.78 | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DX EOS Lumbar Spine Flex/Ext 72100 | $280.80 | $432.00 | $86.40–$432.00 | 12% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DX Spine Lumbar AP-Lat | $280.80 | $432.00 | $86.40–$432.00 | 12% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DX Spine Lumbar AP-Lat | $280.80 | $432.00 | $86.40–$354.24 | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DX EOS Lumbar Spine Flex/Ext 72100 | $280.80 | $432.00 | $86.40–$354.24 | — | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 DX EOS Lumbar Spine AP/Lat/Flx/Ext 72110 | $337.35 | $519.00 | $103.80–$519.00 | 3% below | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | $103.80–$519.00 | 3% below | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 DX EOS Lumbar Spine AP/Lat/Flx/Ext 72110 | $337.35 | $519.00 | $103.80–$425.58 | — | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 DX Spine Lumbar 4 Views | $337.35 | $519.00 | $103.80–$425.58 | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 DX Spine Thoracic AP-LAT NO Swim | $185.90 | $286.00 | $57.20–$286.00 | 20% below | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 DX EOS T-spine AP/Lat 72070 | $185.90 | $286.00 | $57.20–$286.00 | 20% below | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DX EOS T-spine AP/Lat 72070 | $185.90 | $286.00 | $57.20–$234.52 | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DX Spine Thoracic AP-LAT NO Swim | $185.90 | $286.00 | $57.20–$234.52 | — | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 DX Nasal Bones | $189.15 | $291.00 | $58.20–$291.00 | 7% below | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 DX Nasal Bones | $189.15 | $291.00 | $58.20–$238.62 | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DX EOS C-spine Flex/Ext 72040 | $201.50 | $310.00 | $62.00–$310.00 | 19% below | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DX Spine Cervical AP-Lat | $201.50 | $310.00 | $62.00–$310.00 | 19% below | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DX Spine Cervical AP-Lat | $201.50 | $310.00 | $62.00–$254.20 | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DX EOS C-spine Flex/Ext 72040 | $201.50 | $310.00 | $62.00–$254.20 | — | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 DX Pelvis 1 or 2 Views | $163.80 | $252.00 | $50.40–$252.00 | 17% below | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 72170 XRay Exam of Pelvis, 1 or 2 Views | $163.80 | $252.00 | $50.40–$252.00 | 17% below | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 72170 XRay Exam of Pelvis, 1 or 2 Views | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DX Pelvis 1 or 2 Views | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 DX Sacrum and Coccyx | $196.30 | $302.00 | $60.40–$302.00 | 10% below | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 DX Sacrum and Coccyx | $196.30 | $302.00 | $60.40–$247.64 | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Adrenocorticotropic Hormone (ACTH), Plasma | $498.55 | $767.00 | $153.40–$767.00 | 101% above | 35% |
| ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone (ACTH), Plasma | $498.55 | $767.00 | $153.40–$628.94 | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SPGT) | $71.50 | $110.00 | $22.00–$110.00 | 160% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SPGT) | $71.50 | $110.00 | $22.00–$90.20 | — | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT AST Blood | $70.85 | $109.00 | $21.80–$109.00 | 144% above | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT AST Blood | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute (HAV, HBV, HCV) w/ Reflexes | $598.65 | $921.00 | $184.20–$921.00 | 89% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute (HAV, HBV, HCV) w/ Reflexes | $598.65 | $921.00 | $184.20–$755.22 | — | 35% |
| Albumin blood test CPT 82040 Albumin Serum | $54.60 | $84.00 | $16.80–$84.00 | 139% above | 35% |
| Albumin blood test CPT 82040 82040 ASSAY OF SERUM ALBUMIN | $54.60 | $84.00 | $16.80–$84.00 | 139% above | 35% |
| Albumin blood test inpatient CPT 82040 82040 ASSAY OF SERUM ALBUMIN | $54.60 | $84.00 | $16.80–$68.88 | — | 35% |
| Albumin blood test inpatient CPT 82040 Albumin Serum | $54.60 | $84.00 | $16.80–$68.88 | — | 35% |
| Aldosterone blood test CPT 82088 Aldosterone Urine 24-Hour RL | $557.70 | $858.00 | $171.60–$858.00 | 171% above | 35% |
| Aldosterone blood test CPT 82088 Aldosterone Plasma | $557.70 | $858.00 | $171.60–$858.00 | 171% above | 35% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Urine 24-Hour RL | $557.70 | $858.00 | $171.60–$703.56 | — | 35% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone Plasma | $557.70 | $858.00 | $171.60–$703.56 | — | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $70.85 | $109.00 | $21.80–$109.00 | 121% above | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Insect, Cockroach, German I006-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Cows Milk F002-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Egg (Yolk) F075-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Green Pea F012-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree, Cottonwood T014-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold/Microorganism, Alternaria alternata M006-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree, Maple/Box Elder T001-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold/Microorganism, Cladosporium herbarum M002-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed, Ragweed, Giant W003-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Weed, Ragweed, Short W001-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass, Orchard Grass G003-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold/Microorganism, Penicillium chrysogen M001-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Grass, Timothy Grass G006-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree, Elm, American T008-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzALL G2 RL | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree, Common Silver Birch T003-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tree, White Mulberry T070-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Occupational, Latex K082-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Walnut F256-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Pecan Nut F201-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Animal/Epidermal Dog Dander E005-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mold/Microorganism, Aspergillus fumigatus M003-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Peanut F013-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat F004-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Corn F008-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Codfish F003-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Clam F207-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Shrimp F024-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Egg White F001-IgE w/ Component Reflexes | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Hair/Dander E001-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Drug, Penicilloyl V C002-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Almond Nut F020-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dust Mite D farinae D002-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Chicken F083-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzALL F33 RL | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Gluten F079-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Soybean F014-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 zzALL F26 RL | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Food, Sesame Seed F010-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dust Mite D pteronyssinsus D001-IgE | $70.85 | $109.00 | $21.80–$109.00 | 269% above | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Shrimp F024-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Gluten F079-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Soybean F014-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzALL F26 RL | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Egg (Yolk) F075-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Green Pea F012-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mold/Microorganism, Alternaria alternata M006-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Hair/Dander E001-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Drug, Penicilloyl V C002-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Almond Nut F020-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dust Mite D farinae D002-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Chicken F083-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzALL F33 RL | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Sesame Seed F010-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dust Mite D pteronyssinsus D001-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Insect, Cockroach, German I006-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Cows Milk F002-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed, Ragweed, Giant W003-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Weed, Ragweed, Short W001-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass, Orchard Grass G003-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mold/Microorganism, Penicillium chrysogen M001-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Grass, Timothy Grass G006-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree, Elm, American T008-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzALL G2 RL | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree, Common Silver Birch T003-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree, White Mulberry T070-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Walnut F256-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Occupational, Latex K082-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Pecan Nut F201-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Animal/Epidermal Dog Dander E005-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mold/Microorganism, Aspergillus fumigatus M003-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Peanut F013-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat F004-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Corn F008-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Codfish F003-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Clam F207-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Food, Egg White F001-IgE w/ Component Reflexes | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree, Cottonwood T014-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tree, Maple/Box Elder T001-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mold/Microorganism, Cladosporium herbarum M002-IgE | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein (AFP) Tumor Marker CSF | $222.30 | $342.00 | $68.40–$342.00 | 118% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-Fetoprotein (AFP) Tumor Marker Serum | $222.30 | $342.00 | $68.40–$342.00 | 118% above | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein (AFP) Tumor Marker CSF | $222.30 | $342.00 | $68.40–$280.44 | — | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-Fetoprotein (AFP) Tumor Marker Serum | $222.30 | $342.00 | $68.40–$280.44 | — | 35% |
| Ammonia blood test CPT 82140 82140 ASSAY OF AMMONIA | $176.80 | $272.00 | $54.40–$272.00 | 47% above | 35% |
| Ammonia blood test CPT 82140 Ammonia Plasma | $176.80 | $272.00 | $54.40–$272.00 | 47% above | 35% |
| Ammonia blood test inpatient CPT 82140 Ammonia Plasma | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Ammonia blood test inpatient CPT 82140 82140 ASSAY OF AMMONIA | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Amylase blood test CPT 82150 Amylase Pancreatic Serum | $93.60 | $144.00 | $28.80–$144.00 | 81% above | 35% |
| Amylase blood test CPT 82150 Amylase Total Body Fluid | $93.60 | $144.00 | $28.80–$144.00 | 81% above | 35% |
| Amylase blood test CPT 82150 UAMY RL | $93.60 | $144.00 | $28.80–$144.00 | 81% above | 35% |
| Amylase blood test CPT 82150 xAmylase U 24 Hr | $93.60 | $144.00 | $28.80–$144.00 | 81% above | 35% |
| Amylase blood test CPT 82150 Amylase Total Serum | $93.60 | $144.00 | $28.80–$144.00 | 81% above | 35% |
| Amylase blood test inpatient CPT 82150 UAMY RL | $93.60 | $144.00 | $28.80–$118.08 | — | 35% |
| Amylase blood test inpatient CPT 82150 xAmylase U 24 Hr | $93.60 | $144.00 | $28.80–$118.08 | — | 35% |
| Amylase blood test inpatient CPT 82150 Amylase Total Body Fluid | $93.60 | $144.00 | $28.80–$118.08 | — | 35% |
| Amylase blood test inpatient CPT 82150 Amylase Total Serum | $93.60 | $144.00 | $28.80–$118.08 | — | 35% |
| Amylase blood test inpatient CPT 82150 Amylase Pancreatic Serum | $93.60 | $144.00 | $28.80–$118.08 | — | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide (CCP) Abs. IgA IgG ELISA | $105.95 | $163.00 | $32.60–$163.00 | 101% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide (CCP) Abs. IgA IgG ELISA | $105.95 | $163.00 | $32.60–$133.66 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies (ANA) w/ Rflx to Sjogren's Abs A/B | $98.80 | $152.00 | $30.40–$152.00 | 65% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 ANTINUCLEAR ANTIBODIES | $98.80 | $152.00 | $30.40–$152.00 | 65% above | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (ANA) Qualitative by Multiplex Immunoassay | $98.80 | $152.00 | $30.40–$152.00 | 65% above | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 ANTINUCLEAR ANTIBODIES | $98.80 | $152.00 | $30.40–$124.64 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies (ANA) w/ Rflx to Sjogren's Abs A/B | $98.80 | $152.00 | $30.40–$124.64 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (ANA) Qualitative by Multiplex Immunoassay | $98.80 | $152.00 | $30.40–$124.64 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT pro BNP | $361.40 | $556.00 | $111.20–$556.00 | 112% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP B Type Natriuretic Polypeptide | $361.40 | $556.00 | $111.20–$556.00 | 112% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP B Type Natriuretic Polypeptide | $361.40 | $556.00 | $111.20–$455.92 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT pro BNP | $361.40 | $556.00 | $111.20–$455.92 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Respiratory Lower (Non-Sputum) | $128.70 | $198.00 | $39.60–$198.00 | 38% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Genital, Routine | $128.70 | $198.00 | $39.60–$198.00 | 38% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Dialysis Fluid | $128.70 | $198.00 | $39.60–$198.00 | 38% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Respiratory Lower (Non-Sputum) | $128.70 | $198.00 | $39.60–$162.36 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Genital, Routine | $128.70 | $198.00 | $39.60–$162.36 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Dialysis Fluid | $128.70 | $198.00 | $39.60–$162.36 | — | 35% |
| Basic metabolic panel (blood test) CPT 80048 BMP Basic Metabolic Panel | $79.30 | $122.00 | $24.40–$122.00 | 1% above | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP Basic Metabolic Panel | $79.30 | $122.00 | $24.40–$100.04 | — | 35% |
| Bilirubin blood test, total CPT 82247 Bilirubin Body Fluid | $69.55 | $107.00 | $21.40–$107.00 | 101% above | 35% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $69.55 | $107.00 | $21.40–$107.00 | 101% above | 35% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Body Fluid | $69.55 | $107.00 | $21.40–$87.74 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $69.55 | $107.00 | $21.40–$87.74 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only 88305-Tc Bm Bx Interp Only | $219.70 | $338.00 | $67.60–$338.00 | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only 88305-Tc L4 Complicated | $219.70 | $338.00 | $67.60–$338.00 | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only 88305TC Cytology Cell Block | $219.70 | $338.00 | $67.60–$338.00 | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 TISSUE EXAM BY PATHOLOGIST | $219.70 | $338.00 | $67.60–$338.00 | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill Only 88305-Tc Clot Interp | $219.70 | $338.00 | $67.60–$338.00 | 15% below | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only 88305TC Cytology Cell Block | $219.70 | $338.00 | $67.60–$277.16 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 TISSUE EXAM BY PATHOLOGIST | $219.70 | $338.00 | $67.60–$277.16 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only 88305-Tc Bm Bx Interp Only | $219.70 | $338.00 | $67.60–$277.16 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only 88305-Tc Clot Interp | $219.70 | $338.00 | $67.60–$277.16 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bill Only 88305-Tc L4 Complicated | $219.70 | $338.00 | $67.60–$277.16 | — | 35% |
| Blood culture for bacteria CPT 87040 Culture Blood Routine w/ Rapid ID | $148.85 | $229.00 | $45.80–$229.00 | 14% above | 35% |
| Blood culture for bacteria inpatient CPT 87040 Culture Blood Routine w/ Rapid ID | $148.85 | $229.00 | $45.80–$187.78 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $18.85 | $29.00 | $5.80–$29.00 | 14% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Per RN/Assistant #Venous | $18.85 | $29.00 | $5.80–$29.00 | 14% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw | $18.85 | $29.00 | $5.80–$29.00 | 14% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only 36415 Venipuncture | $18.85 | $29.00 | $5.80–$29.00 | 14% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw ROC | $20.15 | $31.00 | $6.20–$31.00 | 21% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw- IVT | $20.15 | $31.00 | $6.20–$31.00 | 21% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Phlebotomy Draw | $20.15 | $31.00 | $6.20–$31.00 | 21% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Per RN/Assistant #Venous | $18.85 | $29.00 | $5.80–$23.78 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $18.85 | $29.00 | $5.80–$23.78 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only 36415 Venipuncture | $18.85 | $29.00 | $5.80–$23.78 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw | $18.85 | $29.00 | $5.80–$23.78 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw- IVT | $20.15 | $31.00 | $6.20–$25.42 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw ROC | $20.15 | $31.00 | $6.20–$25.42 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Phlebotomy Draw | $20.15 | $31.00 | $6.20–$25.42 | — | 35% |
| Blood glucose (sugar) test CPT 82947 Glucose Blood | $64.35 | $99.00 | $19.80–$99.00 | 142% above | 35% |
| Blood glucose (sugar) test CPT 82947 82947 ASSAY GLUCOSE BLOOD QUANT | $64.35 | $99.00 | $19.80–$99.00 | 142% above | 35% |
| Blood glucose (sugar) test CPT 82947 82947 I-STAT GLUCOSE | $64.35 | $99.00 | $19.80–$99.00 | 142% above | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 I-STAT GLUCOSE | $64.35 | $99.00 | $19.80–$81.18 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 ASSAY GLUCOSE BLOOD QUANT | $64.35 | $99.00 | $19.80–$81.18 | — | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood | $64.35 | $99.00 | $19.80–$81.18 | — | 35% |
| Blood lead test CPT 83655 83655 ASSAY OF LEAD | $165.10 | $254.00 | $50.80–$254.00 | 132% above | 35% |
| Blood lead test CPT 83655 Lead Whole Blood (Adult) | $165.10 | $254.00 | $50.80–$254.00 | 132% above | 35% |
| Blood lead test inpatient CPT 83655 83655 ASSAY OF LEAD | $165.10 | $254.00 | $50.80–$208.28 | — | 35% |
| Blood lead test inpatient CPT 83655 Lead Whole Blood (Adult) | $165.10 | $254.00 | $50.80–$208.28 | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qualitative Pregnancy Serum | $67.60 | $104.00 | $20.80–$104.00 | 7% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qualitative with Quantitative if Indicated | $67.60 | $104.00 | $20.80–$104.00 | 7% below | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qualitative Pregnancy Serum | $67.60 | $104.00 | $20.80–$85.28 | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 hCG Qualitative with Quantitative if Indicated | $67.60 | $104.00 | $20.80–$85.28 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 86900 BLOOD TYPING SEROLOGIC ABO | $87.75 | $135.00 | $27.00–$135.00 | 79% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO and Rh Type Neonate Less than 4 Months | $87.75 | $135.00 | $27.00–$135.00 | 79% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO and Rh Type Neonate Less than 4 Months | $87.75 | $135.00 | $27.00–$110.70 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 86900 BLOOD TYPING SEROLOGIC ABO | $87.75 | $135.00 | $27.00–$110.70 | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 84520 ASSAY OF UREA NITROGEN | $57.85 | $89.00 | $17.80–$89.00 | 145% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Body Fluid | $57.85 | $89.00 | $17.80–$89.00 | 145% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Blood | $57.85 | $89.00 | $17.80–$89.00 | 145% above | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Blood | $57.85 | $89.00 | $17.80–$72.98 | — | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 84520 ASSAY OF UREA NITROGEN | $57.85 | $89.00 | $17.80–$72.98 | — | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Body Fluid | $57.85 | $89.00 | $17.80–$72.98 | — | 35% |
| C-peptide blood test CPT 84681 C Peptide Serum | $284.70 | $438.00 | $87.60–$438.00 | 107% above | 35% |
| C-peptide blood test inpatient CPT 84681 C Peptide Serum | $284.70 | $438.00 | $87.60–$359.16 | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein Quantitative | $70.85 | $109.00 | $21.80–$109.00 | 3% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein Quantitative | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| C. difficile toxin gene test (stool PCR) CPT 87493 zzClostridium difficile Toxin Gene Feces by NAA | $497.90 | $766.00 | $153.20–$766.00 | 274% above | 35% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 zzClostridium difficile Toxin Gene Feces by NAA | $497.90 | $766.00 | $153.20–$628.12 | — | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen (CA) 19-9 | $284.70 | $438.00 | $87.60–$438.00 | 96% above | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Antigen (CA) 19-9 | $284.70 | $438.00 | $87.60–$359.16 | — | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 | $256.75 | $395.00 | $79.00–$395.00 | 57% above | 35% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 | $256.75 | $395.00 | $79.00–$323.90 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 Coronavirus COVID-19 2019 Novel by RT-PCR LabCorp | $76.70 | $118.00 | $23.60–$118.00 | 27% below | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 Coronavirus COVID-19 2019 Novel by RT-PCR LabCorp | $76.70 | $118.00 | $23.60–$96.76 | — | 35% |
| Calcium blood test, total CPT 82310 Calcium Blood | $70.85 | $109.00 | $21.80–$109.00 | 168% above | 35% |
| Calcium blood test, total inpatient CPT 82310 Calcium Blood | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Serum | $192.40 | $296.00 | $59.20–$296.00 | 60% above | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen Serum | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VZV Varicella zoster Virus Antibody IgM, CSF | $139.10 | $214.00 | $42.80–$214.00 | 43% above | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VZV Varicella Zoster Virus Antibodies Quantitative IgM | $139.10 | $214.00 | $42.80–$214.00 | 43% above | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Virus (VZV) Antibodies IgG | $139.10 | $214.00 | $42.80–$214.00 | 43% above | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV Varicella zoster Virus Antibody IgM, CSF | $139.10 | $214.00 | $42.80–$175.48 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VZV Varicella Zoster Virus Antibodies Quantitative IgM | $139.10 | $214.00 | $42.80–$175.48 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Virus (VZV) Antibodies IgG | $139.10 | $214.00 | $42.80–$175.48 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia plus GC by DNA Amplification Urine | $230.75 | $355.00 | $71.00–$355.00 | 137% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 CHYLMD TRACH DNA AMP PROBE | $230.75 | $355.00 | $71.00–$355.00 | 137% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia plus GC by DNA Amplification Swab | $230.75 | $355.00 | $71.00–$355.00 | 137% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by DNA Amplification Swab | $230.75 | $355.00 | $71.00–$355.00 | 137% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia plus GC by DNA Amplification Urine | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 CHYLMD TRACH DNA AMP PROBE | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia plus GC by DNA Amplification Swab | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia by DNA Amplification Swab | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $192.40 | $296.00 | $59.20–$296.00 | 83% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 LIPID PANEL | $192.40 | $296.00 | $59.20–$296.00 | 83% above | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 LIPID PANEL | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC wDiff | $64.35 | $99.00 | $19.80–$99.00 | 55% above | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC wDiff | $64.35 | $99.00 | $19.80–$81.18 | — | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC | $91.65 | $141.00 | $28.20–$141.00 | 211% above | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC | $91.65 | $141.00 | $28.20–$115.62 | — | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 Metabolic PanelComprehensive | $67.60 | $104.00 | $20.80–$104.00 | 24% below | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Metabolic PanelComprehensive | $67.60 | $104.00 | $20.80–$85.28 | — | 35% |
| Cortisol blood test, total CPT 82533 Cortisol (Total) Serum | $195.65 | $301.00 | $60.20–$301.00 | 107% above | 35% |
| Cortisol blood test, total CPT 82533 Cortisol Saliva by LC-MS/MS | $195.65 | $301.00 | $60.20–$301.00 | 107% above | 35% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol (Total) Serum | $195.65 | $301.00 | $60.20–$246.82 | — | 35% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Saliva by LC-MS/MS | $195.65 | $301.00 | $60.20–$246.82 | — | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase with MB if Indicated | $92.95 | $143.00 | $28.60–$143.00 | 140% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 CK Total Blood | $92.95 | $143.00 | $28.60–$143.00 | 140% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 82550 ASSAY OF CK (CPK) | $92.95 | $143.00 | $28.60–$143.00 | 140% above | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK Total Blood | $92.95 | $143.00 | $28.60–$117.26 | — | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 ASSAY OF CK (CPK) | $92.95 | $143.00 | $28.60–$117.26 | — | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase with MB if Indicated | $92.95 | $143.00 | $28.60–$117.26 | — | 35% |
| Creatinine blood test CPT 82565 iStat Creatinine | $63.70 | $98.00 | $19.60–$98.00 | 121% above | 35% |
| Creatinine blood test CPT 82565 Creatinine Serum | $63.70 | $98.00 | $19.60–$98.00 | 121% above | 35% |
| Creatinine blood test inpatient CPT 82565 iStat Creatinine | $63.70 | $98.00 | $19.60–$80.36 | — | 35% |
| Creatinine blood test inpatient CPT 82565 Creatinine Serum | $63.70 | $98.00 | $19.60–$80.36 | — | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 86644 CMV ANTIBODY | $196.95 | $303.00 | $60.60–$303.00 | 147% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Antibodies IgG | $196.95 | $303.00 | $60.60–$303.00 | 147% above | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Antibodies IgG | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 CMV ANTIBODY | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 D Dimer Quantitative Plasma | $128.70 | $198.00 | $39.60–$198.00 | 5% above | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer Quantitative Plasma | $128.70 | $198.00 | $39.60–$162.36 | — | 35% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone (DHEA) Sulfate | $304.20 | $468.00 | $93.60–$468.00 | 107% above | 35% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate, LC/MS-MS | $304.20 | $468.00 | $93.60–$468.00 | 107% above | 35% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate, LC/MS-MS | $304.20 | $468.00 | $93.60–$383.76 | — | 35% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone (DHEA) Sulfate | $304.20 | $468.00 | $93.60–$383.76 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Screen, Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Screen 10 Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Drug Screen Forensic Fluids Lab | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 zzU DAS Comp RL | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Tetrahydrocannabinol (THC), Screen w/ Rflx to Confirmation, Serum | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Gamma-Hydroxybutyric Acid (GHB) Screen and Confirmation, Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Scrn 9-Urine (W/Etoh) | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 LSD Screen, Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 U DAS 8 | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Caffeine Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Comprehensive Umbilical Cord Drug Screen (USDTL) | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethyl Glucuronide / Ethyl Sulfate (EtG / EtS), Screen and Conf, Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 With Reflex Confirmation (AMP,BAR,BZO,COC,PCP,THC,OPI,OXY,MD,PPX), Serum | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Cannabinoid (THC) Screen Only, Urine | $192.40 | $296.00 | $59.20–$296.00 | 68% above | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 zzU DAS Comp RL | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Scrn 9-Urine (W/Etoh) | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LSD Screen, Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethyl Glucuronide / Ethyl Sulfate (EtG / EtS), Screen and Conf, Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Caffeine Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 U DAS 8 | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Screen 10 Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 With Reflex Confirmation (AMP,BAR,BZO,COC,PCP,THC,OPI,OXY,MD,PPX), Serum | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Comprehensive Umbilical Cord Drug Screen (USDTL) | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Gamma-Hydroxybutyric Acid (GHB) Screen and Confirmation, Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabolite Screen, Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tetrahydrocannabinol (THC), Screen w/ Rflx to Confirmation, Serum | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Meconium Drug Screen Forensic Fluids Lab | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Cannabinoid (THC) Screen Only, Urine | $192.40 | $296.00 | $59.20–$242.72 | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel Venous | $86.45 | $133.00 | $26.60–$133.00 | 34% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 zzzElectrolyte Panel, Stat | $86.45 | $133.00 | $26.60–$133.00 | 34% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel Venous | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 zzzElectrolyte Panel, Stat | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EPSTEIN-BARR CAPSID VCA | $245.70 | $378.00 | $75.60–$378.00 | 201% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein-Barr Virus (EBV) Antibodies to Viral Capsid Antigen (VCA) IgM | $245.70 | $378.00 | $75.60–$378.00 | 201% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein-Barr Virus (EBV) Antibodies to Viral Capsid Antigen (VCA) IgG | $245.70 | $378.00 | $75.60–$378.00 | 201% above | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 EPSTEIN-BARR CAPSID VCA | $245.70 | $378.00 | $75.60–$309.96 | — | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein-Barr Virus (EBV) Antibodies to Viral Capsid Antigen (VCA) IgM | $245.70 | $378.00 | $75.60–$309.96 | — | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein-Barr Virus (EBV) Antibodies to Viral Capsid Antigen (VCA) IgG | $245.70 | $378.00 | $75.60–$309.96 | — | 35% |
| Estradiol blood test CPT 82670 Estradiol Serum | $359.45 | $553.00 | $110.60–$553.00 | 180% above | 35% |
| Estradiol blood test inpatient CPT 82670 Estradiol Serum | $359.45 | $553.00 | $110.60–$453.46 | — | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Serum | $253.50 | $390.00 | $78.00–$390.00 | 98% above | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Serum | $253.50 | $390.00 | $78.00–$319.80 | — | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Feces | $178.10 | $274.00 | $54.80–$274.00 | 2% below | 35% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Feces | $178.10 | $274.00 | $54.80–$224.68 | — | 35% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $160.55 | $247.00 | $49.40–$247.00 | 101% above | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $160.55 | $247.00 | $49.40–$202.54 | — | 35% |
| Fibrinogen blood test CPT 85384 85384 Fibrinogen Activity (7038) | $111.15 | $171.00 | $34.20–$171.00 | 86% above | 35% |
| Fibrinogen blood test CPT 85384 85384 Fibrinogen Activity | $111.15 | $171.00 | $34.20–$171.00 | 86% above | 35% |
| Fibrinogen blood test inpatient CPT 85384 85384 Fibrinogen Activity (7038) | $111.15 | $171.00 | $34.20–$140.22 | — | 35% |
| Fibrinogen blood test inpatient CPT 85384 85384 Fibrinogen Activity | $111.15 | $171.00 | $34.20–$140.22 | — | 35% |
| Folate (folic acid) blood test CPT 82746 82746 ASSAY OF FOLIC ACID SERUM | $202.15 | $311.00 | $62.20–$311.00 | 164% above | 35% |
| Folate (folic acid) blood test CPT 82746 Folate Serum | $202.15 | $311.00 | $62.20–$311.00 | 164% above | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Serum | $202.15 | $311.00 | $62.20–$255.02 | — | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 82746 ASSAY OF FOLIC ACID SERUM | $202.15 | $311.00 | $62.20–$255.02 | — | 35% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $224.90 | $346.00 | $69.20–$346.00 | 70% above | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free | $224.90 | $346.00 | $69.20–$283.72 | — | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free T4 | $117.65 | $181.00 | $36.20–$181.00 | 45% above | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Free T4 | $117.65 | $181.00 | $36.20–$148.42 | — | 35% |
| Free testosterone test CPT 84402 84402 ASSAY OF FREE TESTOSTERONE | $350.35 | $539.00 | $107.80–$539.00 | 319% above | 35% |
| Free testosterone test inpatient CPT 84402 84402 ASSAY OF FREE TESTOSTERONE | $350.35 | $539.00 | $107.80–$441.98 | — | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT Gamma Glutamyl Transferase Blood | $105.95 | $163.00 | $32.60–$163.00 | 225% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT Gamma Glutamyl Transferase Blood | $105.95 | $163.00 | $32.60–$133.66 | — | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hr Challenge 50 G Gestational | $65.00 | $100.00 | $20.00–$100.00 | 59% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 82950 GLUCOSE TEST | $65.00 | $100.00 | $20.00–$100.00 | 59% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 82950 GLUCOSE TEST | $65.00 | $100.00 | $20.00–$82.00 | — | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hr Challenge 50 G Gestational | $65.00 | $100.00 | $20.00–$82.00 | — | 35% |
| Glucose tolerance test, 3 samples CPT 82951 Lactose Tolerance Test | $176.80 | $272.00 | $54.40–$272.00 | 139% above | 35% |
| Glucose tolerance test, 3 samples CPT 82951 82951 GLUCOSE TOLERANCE TEST (GTT) | $176.80 | $272.00 | $54.40–$272.00 | 139% above | 35% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2 Hr Gestational (24-28 wks) Glucose Tolerance Test 75gm | $176.80 | $272.00 | $54.40–$272.00 | 139% above | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 82951 GLUCOSE TOLERANCE TEST (GTT) | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Lactose Tolerance Test | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 Hr Gestational (24-28 wks) Glucose Tolerance Test 75gm | $176.80 | $272.00 | $54.40–$223.04 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 zzGC NAAT U RL | $289.25 | $445.00 | $89.00–$445.00 | 197% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC by DNA Amplification Swab | $289.25 | $445.00 | $89.00–$445.00 | 197% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N.GONORRHOEAE DNA AMP PROB | $289.25 | $445.00 | $89.00–$445.00 | 197% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N.GONORRHOEAE DNA AMP PROB | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 zzGC NAAT U RL | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC by DNA Amplification Swab | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| H. pylori antibody blood test CPT 86677 86677 ANTIBODY HELICOBACTER PYLORI | $138.45 | $213.00 | $42.60–$213.00 | 44% above | 35% |
| H. pylori antibody blood test inpatient CPT 86677 86677 ANTIBODY HELICOBACTER PYLORI | $138.45 | $213.00 | $42.60–$174.66 | — | 35% |
| H. pylori stool antigen test CPT 87338 Fec H pyl RL | $196.95 | $303.00 | $60.60–$303.00 | 50% above | 35% |
| H. pylori stool antigen test inpatient CPT 87338 Fec H pyl RL | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Human Immunodeficiency Virus 1 (HIV-1) Quant rtPCR Nongraphical CSF | $1,165.45 | $1,793.00 | $358.60–$1,793.00 | 229% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Human Immunodeficiency Virus 1 (HIV-1) Quant rtPCR Nongraphical CSF | $1,165.45 | $1,793.00 | $358.60–$1,470.26 | — | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV p24 Ag/Ab Combo w/ Rflx to Confirmation | $321.10 | $494.00 | $98.80–$494.00 | 438% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV p24 Ag/Ab Combo w/ Rflx to Confirmation | $321.10 | $494.00 | $98.80–$405.08 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 REFLEX: HPV, Low Volume | $338.65 | $521.00 | $104.20–$521.00 | 224% above | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 REFLEX: HPV, Low Volume | $338.65 | $521.00 | $104.20–$427.22 | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C (w/ Est Avg Glucose) | $131.95 | $203.00 | $40.60–$203.00 | 102% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C (w/ Est Avg Glucose) | $131.95 | $203.00 | $40.60–$166.46 | — | 35% |
| Hemoglobin blood test CPT 85018 Hgb Hemoglobin | $80.60 | $124.00 | $24.80–$124.00 | 339% above | 35% |
| Hemoglobin blood test CPT 85018 Hemocue | $80.60 | $124.00 | $24.80–$124.00 | 339% above | 35% |
| Hemoglobin blood test CPT 85018 85018 IH HEMOGLOBIN | $80.60 | $124.00 | $24.80–$124.00 | 339% above | 35% |
| Hemoglobin blood test CPT 85018 RC Hemocue Cord Blood | $80.60 | $124.00 | $24.80–$124.00 | 339% above | 35% |
| Hemoglobin blood test inpatient CPT 85018 Hemocue | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 RC Hemocue Cord Blood | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 Hgb Hemoglobin | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Hemoglobin blood test inpatient CPT 85018 85018 IH HEMOGLOBIN | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Virus (HBV) Core Antibody, Total with Reflex to IgM | $163.80 | $252.00 | $50.40–$252.00 | 145% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 86704 HEPATITIS B CORE ANTIBODY (HBcAb); Total | $163.80 | $252.00 | $50.40–$252.00 | 145% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Virus (HBV) Core Total Antibodies | $163.80 | $252.00 | $50.40–$252.00 | 145% above | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 86704 HEPATITIS B CORE ANTIBODY (HBcAb); Total | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Virus (HBV) Core Antibody, Total with Reflex to IgM | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Virus (HBV) Core Total Antibodies | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Virus (HBV) Surface Antibody Quantitative | $147.55 | $227.00 | $45.40–$227.00 | 126% above | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Virus (HBV) Surface Antibody Quantitative | $147.55 | $227.00 | $45.40–$186.14 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Virus (HBV) Surface Antigen w Reflex to HBs Ag Neutralization | $89.05 | $137.00 | $27.40–$137.00 | 46% above | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Virus (HBV) Surface Antigen w Reflex to HBs Ag Neutralization | $89.05 | $137.00 | $27.40–$112.34 | — | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody | $194.35 | $299.00 | $59.80–$299.00 | 95% above | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody | $194.35 | $299.00 | $59.80–$245.18 | — | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (HCV) GT1a NS5A Profile | $553.15 | $851.00 | $170.20–$851.00 | 147% above | 35% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus (HCV) GT1a NS5A Profile | $553.15 | $851.00 | $170.20–$697.82 | — | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 86695 HERPES SIMPLEX TYPE 1 TEST | $170.30 | $262.00 | $52.40–$262.00 | 236% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 REFLEX: Herpes Simplex Virus Type 1 Antibody IgG CSF | $170.30 | $262.00 | $52.40–$262.00 | 236% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus (HSV) Type 1-Specific Antibodies IgG | $170.30 | $262.00 | $52.40–$262.00 | 236% above | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 HERPES SIMPLEX TYPE 1 TEST | $170.30 | $262.00 | $52.40–$214.84 | — | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus (HSV) Type 1-Specific Antibodies IgG | $170.30 | $262.00 | $52.40–$214.84 | — | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 REFLEX: Herpes Simplex Virus Type 1 Antibody IgG CSF | $170.30 | $262.00 | $52.40–$214.84 | — | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 REFLEX: Herpes Simplex Virus Type 2 Antibody IgG CSF | $265.85 | $409.00 | $81.80–$409.00 | 266% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus (HSV) Type 2-Specific Abs, IgG | $265.85 | $409.00 | $81.80–$409.00 | 266% above | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus (HSV) Type 2-Specific Abs, IgG | $265.85 | $409.00 | $81.80–$335.38 | — | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 REFLEX: Herpes Simplex Virus Type 2 Antibody IgG CSF | $265.85 | $409.00 | $81.80–$335.38 | — | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein High Sensitivity Cardiac | $178.10 | $274.00 | $54.80–$274.00 | 141% above | 35% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein High Sensitivity Cardiac | $178.10 | $274.00 | $54.80–$224.68 | — | 35% |
| Homocysteine blood test CPT 83090 Homocysteine | $228.80 | $352.00 | $70.40–$352.00 | 76% above | 35% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine | $228.80 | $352.00 | $70.40–$288.64 | — | 35% |
| Insulin blood test CPT 83525 83525 ASSAY OF INSULIN | $156.00 | $240.00 | $48.00–$240.00 | 118% above | 35% |
| Insulin blood test CPT 83525 Insulin Total RL | $156.00 | $240.00 | $48.00–$240.00 | 118% above | 35% |
| Insulin blood test inpatient CPT 83525 Insulin Total RL | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| Insulin blood test inpatient CPT 83525 83525 ASSAY OF INSULIN | $156.00 | $240.00 | $48.00–$196.80 | — | 35% |
| Iron blood test (serum iron) CPT 83540 Iron Liver Tissue | $89.05 | $137.00 | $27.40–$137.00 | 86% above | 35% |
| Iron blood test (serum iron) CPT 83540 83540 IRON BINDING CAPACITY | $89.05 | $137.00 | $27.40–$137.00 | 86% above | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 83540 IRON BINDING CAPACITY | $89.05 | $137.00 | $27.40–$112.34 | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Liver Tissue | $89.05 | $137.00 | $27.40–$112.34 | — | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING TEST | $118.95 | $183.00 | $36.60–$183.00 | 169% above | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING TEST | $118.95 | $183.00 | $36.60–$150.06 | — | 35% |
| Kidney function blood test panel CPT 80069 Renal | $128.70 | $198.00 | $39.60–$198.00 | 27% above | 35% |
| Kidney function blood test panel inpatient CPT 80069 Renal | $128.70 | $198.00 | $39.60–$162.36 | — | 35% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (Lh) Serum | $253.50 | $390.00 | $78.00–$390.00 | 79% above | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone (Lh) Serum | $253.50 | $390.00 | $78.00–$319.80 | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid Blood | $154.70 | $238.00 | $47.60–$238.00 | 72% above | 35% |
| Lactate (lactic acid) blood test CPT 83605 REFLEX: Lactic Acid 3hr | $154.70 | $238.00 | $47.60–$238.00 | 72% above | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Blood | $154.70 | $238.00 | $47.60–$195.16 | — | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 REFLEX: Lactic Acid 3hr | $154.70 | $238.00 | $47.60–$195.16 | — | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LD Total Body Fluid | $81.25 | $125.00 | $25.00–$125.00 | 90% above | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ld Total Serum | $81.25 | $125.00 | $25.00–$125.00 | 90% above | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD Total Body Fluid | $81.25 | $125.00 | $25.00–$102.50 | — | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ld Total Serum | $81.25 | $125.00 | $25.00–$102.50 | — | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Serum | $33.80 | $52.00 | $10.40–$52.00 | 62% below | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Serum | $33.80 | $52.00 | $10.40–$42.64 | — | 35% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $86.45 | $133.00 | $26.60–$133.00 | 9% below | 35% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Lyme disease antibody test CPT 86618 86618 LYME DISEASE TOTAL ANTIBODIES-CSF | $215.15 | $331.00 | $66.20–$331.00 | 75% above | 35% |
| Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody w/ Rflx to Immunoassay | $215.15 | $331.00 | $66.20–$331.00 | 75% above | 35% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Antibody w/ Rflx to Immunoassay | $215.15 | $331.00 | $66.20–$271.42 | — | 35% |
| Lyme disease antibody test inpatient CPT 86618 86618 LYME DISEASE TOTAL ANTIBODIES-CSF | $215.15 | $331.00 | $66.20–$271.42 | — | 35% |
| Magnesium blood test CPT 83735 Magnesium Urine Random | $96.20 | $148.00 | $29.60–$148.00 | 102% above | 35% |
| Magnesium blood test CPT 83735 U Mag 24 RL | $96.20 | $148.00 | $29.60–$148.00 | 102% above | 35% |
| Magnesium blood test CPT 83735 Magnesium-Serum (Ob Pt) | $96.20 | $148.00 | $29.60–$148.00 | 102% above | 35% |
| Magnesium blood test CPT 83735 Mg Magnesium Blood | $96.20 | $148.00 | $29.60–$148.00 | 102% above | 35% |
| Magnesium blood test CPT 83735 Magnesium Feces | $96.20 | $148.00 | $29.60–$148.00 | 102% above | 35% |
| Magnesium blood test inpatient CPT 83735 U Mag 24 RL | $96.20 | $148.00 | $29.60–$121.36 | — | 35% |
| Magnesium blood test inpatient CPT 83735 Magnesium-Serum (Ob Pt) | $96.20 | $148.00 | $29.60–$121.36 | — | 35% |
| Magnesium blood test inpatient CPT 83735 Mg Magnesium Blood | $96.20 | $148.00 | $29.60–$121.36 | — | 35% |
| Magnesium blood test inpatient CPT 83735 Magnesium Feces | $96.20 | $148.00 | $29.60–$121.36 | — | 35% |
| Magnesium blood test inpatient CPT 83735 Magnesium Urine Random | $96.20 | $148.00 | $29.60–$121.36 | — | 35% |
| Measles (rubeola) antibody test CPT 86765 zzRubeola IgM Antibody | $183.95 | $283.00 | $56.60–$283.00 | 134% above | 35% |
| Measles (rubeola) antibody test CPT 86765 86765 RUBEOLA ANTIBODY | $183.95 | $283.00 | $56.60–$283.00 | 134% above | 35% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibodies IgG | $183.95 | $283.00 | $56.60–$283.00 | 134% above | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 zzRubeola IgM Antibody | $183.95 | $283.00 | $56.60–$232.06 | — | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibodies IgG | $183.95 | $283.00 | $56.60–$232.06 | — | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 86765 RUBEOLA ANTIBODY | $183.95 | $283.00 | $56.60–$232.06 | — | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Infectious Mononucleosis Screen | $70.85 | $109.00 | $21.80–$109.00 | 9% below | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Infectious Mononucleosis Screen | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Mumps immunity blood test CPT 86735 Mumps Antibodies, IgG | $146.25 | $225.00 | $45.00–$225.00 | 92% above | 35% |
| Mumps immunity blood test CPT 86735 Mumps Antibodies, IgM | $146.25 | $225.00 | $45.00–$225.00 | 92% above | 35% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgG | $146.25 | $225.00 | $45.00–$184.50 | — | 35% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgM | $146.25 | $225.00 | $45.00–$184.50 | — | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 ASSAY OF PSA FREE | $251.55 | $387.00 | $77.40–$387.00 | 261% above | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 ASSAY OF PSA FREE | $251.55 | $387.00 | $77.40–$317.34 | — | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $230.75 | $355.00 | $71.00–$355.00 | 190% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $230.75 | $355.00 | $71.00–$355.00 | 190% above | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Prostate Specific Antigen Total Screening | $230.75 | $355.00 | $71.00–$355.00 | 190% above | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Prostate Specific Antigen Total Diagnostic | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Prostate Specific Antigen Total Screening | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Pap Test (Image-guided) Liquid-based Prep (LC 193000) | $332.15 | $511.00 | $102.20–$511.00 | 300% above | 35% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap Test (Image-guided) Liquid-based Prep (LC 193000) | $332.15 | $511.00 | $102.20–$419.02 | — | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact Parathyroid Hormone, Blood, No Calcium | $481.65 | $741.00 | $148.20–$741.00 | 150% above | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact Parathyroid Hormone, Blood, No Calcium | $481.65 | $741.00 | $148.20–$607.62 | — | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT with Mixing Studies if Indicated | $74.10 | $114.00 | $22.80–$114.00 | 48% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $74.10 | $114.00 | $22.80–$114.00 | 48% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $74.10 | $114.00 | $22.80–$114.00 | 48% above | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLASTIN TIME PARTIAL | $74.10 | $114.00 | $22.80–$93.48 | — | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT with Mixing Studies if Indicated | $74.10 | $114.00 | $22.80–$93.48 | — | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $74.10 | $114.00 | $22.80–$93.48 | — | 35% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Serum | $83.20 | $128.00 | $25.60–$128.00 | 190% above | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Serum | $83.20 | $128.00 | $25.60–$104.96 | — | 35% |
| Potassium blood test CPT 84132 Potassium Blood | $70.85 | $109.00 | $21.80–$109.00 | 148% above | 35% |
| Potassium blood test CPT 84132 iStat Potassium | $70.85 | $109.00 | $21.80–$109.00 | 148% above | 35% |
| Potassium blood test inpatient CPT 84132 iStat Potassium | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Potassium blood test inpatient CPT 84132 Potassium Blood | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 MaterniT21 PLUS Core | $6,527.30 | $10,042.00 | $2,008.40–$10,042.00 | 667% above | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 MaterniT21 PLUS Core | $6,527.30 | $10,042.00 | $2,008.40–$8,234.44 | — | 35% |
| Progesterone blood test CPT 84144 Progesterone | $284.70 | $438.00 | $87.60–$438.00 | 107% above | 35% |
| Progesterone blood test inpatient CPT 84144 Progesterone | $284.70 | $438.00 | $87.60–$359.16 | — | 35% |
| Prolactin blood test CPT 84146 Prolactin | $265.85 | $409.00 | $81.80–$409.00 | 164% above | 35% |
| Prolactin blood test inpatient CPT 84146 Prolactin | $265.85 | $409.00 | $81.80–$335.38 | — | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $50.05 | $77.00 | $15.40–$77.00 | 89% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin Time POC PT | $50.05 | $77.00 | $15.40–$77.00 | 89% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $50.05 | $77.00 | $15.40–$77.00 | 89% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME | $50.05 | $77.00 | $15.40–$77.00 | 89% above | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME | $50.05 | $77.00 | $15.40–$63.14 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT Prothrombin Time with Mixing Studies if Indicated | $50.05 | $77.00 | $15.40–$63.14 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $50.05 | $77.00 | $15.40–$63.14 | — | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Prothrombin Time POC PT | $50.05 | $77.00 | $15.40–$63.14 | — | 35% |
| Rapid flu test (influenza antigen) CPT 87804 87804 INFLUENZA ASSAY W/OPTIC | $163.80 | $252.00 | $50.40–$252.00 | 212% above | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 87804 INFLUENZA ASSAY W/OPTIC | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep Screen with Reflex to Culture if Indicated Group A RL | $163.80 | $252.00 | $50.40–$252.00 | 111% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep Screen with Reflex to Culture if Indicated Group A RL | $163.80 | $252.00 | $50.40–$206.64 | — | 35% |
| Renin blood test CPT 84244 Renin Activity, Plasma | $300.30 | $462.00 | $92.40–$462.00 | 171% above | 35% |
| Renin blood test CPT 84244 84244 ASSAY OF RENIN | $300.30 | $462.00 | $92.40–$462.00 | 171% above | 35% |
| Renin blood test inpatient CPT 84244 Renin Activity, Plasma | $300.30 | $462.00 | $92.40–$378.84 | — | 35% |
| Renin blood test inpatient CPT 84244 84244 ASSAY OF RENIN | $300.30 | $462.00 | $92.40–$378.84 | — | 35% |
| Rh blood typing CPT 86901 86901 Blood Typng Serologic RH(D) | $61.10 | $94.00 | $18.80–$94.00 | 58% above | 35% |
| Rh blood typing CPT 86901 86901 BLOOD TYPING SEROLOGIC RH(D) | $61.10 | $94.00 | $18.80–$94.00 | 58% above | 35% |
| Rh blood typing inpatient CPT 86901 86901 BLOOD TYPING SEROLOGIC RH(D) | $61.10 | $94.00 | $18.80–$77.08 | — | 35% |
| Rh blood typing inpatient CPT 86901 86901 Blood Typng Serologic RH(D) | $61.10 | $94.00 | $18.80–$77.08 | — | 35% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor by Turbidimetry, Synovial Fluid (RDL) | $75.40 | $116.00 | $23.20–$116.00 | 55% above | 35% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Blood | $77.35 | $119.00 | $23.80–$119.00 | 59% above | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor by Turbidimetry, Synovial Fluid (RDL) | $75.40 | $116.00 | $23.20–$95.12 | — | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Blood | $77.35 | $119.00 | $23.80–$97.58 | — | 35% |
| Rubella antibody test (immunity check) CPT 86762 86762 RUBELLA ANTIBODY | $196.95 | $303.00 | $60.60–$303.00 | 196% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgM | $196.95 | $303.00 | $60.60–$303.00 | 196% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgG | $196.95 | $303.00 | $60.60–$303.00 | 196% above | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgM | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 86762 RUBELLA ANTIBODY | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies IgG | $196.95 | $303.00 | $60.60–$248.46 | — | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $44.85 | $69.00 | $13.80–$69.00 | 15% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate | $44.85 | $69.00 | $13.80–$56.58 | — | 35% |
| Sodium blood test CPT 84295 Sodium Blood | $68.25 | $105.00 | $21.00–$105.00 | 87% above | 35% |
| Sodium blood test inpatient CPT 84295 Sodium Blood | $68.25 | $105.00 | $21.00–$86.10 | — | 35% |
| Stool ova and parasites exam CPT 87177 87177 OVA AND PARASITES SMEARS | $72.80 | $112.00 | $22.40–$112.00 | 50% above | 35% |
| Stool ova and parasites exam inpatient CPT 87177 87177 OVA AND PARASITES SMEARS | $72.80 | $112.00 | $22.40–$91.84 | — | 35% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool for Occult Blood | $12.35 | $19.00 | $3.80–$19.00 | 66% below | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool for Occult Blood | $12.35 | $19.00 | $3.80–$15.58 | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood Immunoassay Screen Feces | $217.10 | $334.00 | $66.80–$334.00 | 318% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood Immunoassay Screen Feces | $217.10 | $334.00 | $66.80–$273.88 | — | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 REFLEX: Treponemal Antibodies, T. pallidum Particle Agglutination (TPPA) | $183.30 | $282.00 | $56.40–$282.00 | 171% above | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 REFLEX: Treponemal Antibodies, T. pallidum Particle Agglutination (TPPA) | $183.30 | $282.00 | $56.40–$231.24 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Cerebrospinal Fluid | $59.80 | $92.00 | $18.40–$92.00 | 47% above | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin (RPR) Qualitative Test | $59.80 | $92.00 | $18.40–$92.00 | 47% above | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin (RPR) Qualitative Test | $59.80 | $92.00 | $18.40–$75.44 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Cerebrospinal Fluid | $59.80 | $92.00 | $18.40–$75.44 | — | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 84403 ASSAY OF TOTAL TESTOSTERONE | $333.45 | $513.00 | $102.60–$513.00 | 181% above | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $333.45 | $513.00 | $102.60–$513.00 | 181% above | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total | $333.45 | $513.00 | $102.60–$420.66 | — | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 ASSAY OF TOTAL TESTOSTERONE | $333.45 | $513.00 | $102.60–$420.66 | — | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LC-1 (Liver Cytosol Protein-1) | $118.95 | $183.00 | $36.60–$183.00 | 28% above | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 86376 MICROSOMAL ANTIBODY EACH | $118.95 | $183.00 | $36.60–$183.00 | 28% above | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Thyroid Peroxidase Antibodies | $118.95 | $183.00 | $36.60–$183.00 | 28% above | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal (LKM) Antibodies | $118.95 | $183.00 | $36.60–$183.00 | 28% above | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 MICROSOMAL ANTIBODY EACH | $118.95 | $183.00 | $36.60–$150.06 | — | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal (LKM) Antibodies | $118.95 | $183.00 | $36.60–$150.06 | — | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LC-1 (Liver Cytosol Protein-1) | $118.95 | $183.00 | $36.60–$150.06 | — | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Thyroid Peroxidase Antibodies | $118.95 | $183.00 | $36.60–$150.06 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $230.75 | $355.00 | $71.00–$355.00 | 183% above | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone Sensitive | $230.75 | $355.00 | $71.00–$355.00 | 183% above | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone Sensitive | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Thyroid Stimulating Hormone) Sensitive w/Rflx to Free T4 | $230.75 | $355.00 | $71.00–$291.10 | — | 35% |
| Total IgE blood test CPT 82785 Immunoglobulin E (IgE) Quantitative, Serum | $225.55 | $347.00 | $69.40–$347.00 | 200% above | 35% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E (IgE) Quantitative, Serum | $225.55 | $347.00 | $69.40–$284.54 | — | 35% |
| Total cholesterol blood test CPT 82465 Cholesterol Total Blood | $57.85 | $89.00 | $17.80–$89.00 | 89% above | 35% |
| Total cholesterol blood test CPT 82465 82465 ASSAY BLD/SERUM CHOLESTEROL | $57.85 | $89.00 | $17.80–$89.00 | 89% above | 35% |
| Total cholesterol blood test inpatient CPT 82465 82465 ASSAY BLD/SERUM CHOLESTEROL | $57.85 | $89.00 | $17.80–$72.98 | — | 35% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total Blood | $57.85 | $89.00 | $17.80–$72.98 | — | 35% |
| Total thyroxine (T4) blood test CPT 84436 T4 Total | $98.80 | $152.00 | $30.40–$152.00 | 109% above | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 Total | $98.80 | $152.00 | $30.40–$124.64 | — | 35% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 Total By Immunoassay | $141.70 | $218.00 | $43.60–$218.00 | 17% above | 35% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total By Immunoassay | $141.70 | $218.00 | $43.60–$178.76 | — | 35% |
| Transferrin blood test CPT 84466 Transferrin Serum | $179.40 | $276.00 | $55.20–$276.00 | 111% above | 35% |
| Transferrin blood test inpatient CPT 84466 Transferrin Serum | $179.40 | $276.00 | $55.20–$226.32 | — | 35% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA (Aptima or ThinPrep) | $428.35 | $659.00 | $131.80–$659.00 | 351% above | 35% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis by PCR, Swab or Urine (Xpert Kit, Beacon Labs) | $428.35 | $659.00 | $131.80–$659.00 | 351% above | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis by PCR, Swab or Urine (Xpert Kit, Beacon Labs) | $428.35 | $659.00 | $131.80–$540.38 | — | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA (Aptima or ThinPrep) | $428.35 | $659.00 | $131.80–$540.38 | — | 35% |
| Triglycerides blood test CPT 84478 Triglycerides Body Fluid | $86.45 | $133.00 | $26.60–$133.00 | 142% above | 35% |
| Triglycerides blood test CPT 84478 84478 ASSAY OF TRIGLYCERIDES | $86.45 | $133.00 | $26.60–$133.00 | 142% above | 35% |
| Triglycerides blood test CPT 84478 Triglycerides | $86.45 | $133.00 | $26.60–$133.00 | 142% above | 35% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides Body Fluid | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Triglycerides blood test inpatient CPT 84478 84478 ASSAY OF TRIGLYCERIDES | $86.45 | $133.00 | $26.60–$109.06 | — | 35% |
| Troponin test, quantitative CPT 84484 Troponin T | $118.30 | $182.00 | $36.40–$182.00 | 2% below | 35% |
| Troponin test, quantitative CPT 84484 iStat Troponin I | $118.30 | $182.00 | $36.40–$182.00 | 2% below | 35% |
| Troponin test, quantitative inpatient CPT 84484 Troponin T | $118.30 | $182.00 | $36.40–$149.24 | — | 35% |
| Troponin test, quantitative inpatient CPT 84484 iStat Troponin I | $118.30 | $182.00 | $36.40–$149.24 | — | 35% |
| Uric acid blood test CPT 84550 Uric Acid Serum | $60.45 | $93.00 | $18.60–$93.00 | 26% above | 35% |
| Uric acid blood test inpatient CPT 84550 Uric Acid Serum | $60.45 | $93.00 | $18.60–$76.26 | — | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA Scrn w/Micro + Cult if Ind | $33.80 | $52.00 | $10.40–$52.00 | 20% below | 35% |
| Urinalysis with microscope exam, automated CPT 81001 UA Urinalysis Complete | $33.80 | $52.00 | $10.40–$52.00 | 20% below | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Urinalysis Complete | $33.80 | $52.00 | $10.40–$42.64 | — | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA Scrn w/Micro + Cult if Ind | $33.80 | $52.00 | $10.40–$42.64 | — | 35% |
| Urinalysis with microscope exam, manual CPT 81000 N-Autom Urine Dip W Micro | $7.15 | $11.00 | $2.20–$11.00 | 73% below | 35% |
| Urinalysis with microscope exam, manual CPT 81000 Done | $7.15 | $11.00 | $2.20–$11.00 | 73% below | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 N-Autom Urine Dip W Micro | $7.15 | $11.00 | $2.20–$9.02 | — | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Done | $7.15 | $11.00 | $2.20–$9.02 | — | 35% |
| Urinalysis without microscope exam, automated CPT 81003 UA Urinalysis Macroscopic Only | $30.55 | $47.00 | $9.40–$47.00 | 25% above | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Urinalysis Macroscopic Only | $30.55 | $47.00 | $9.40–$38.54 | — | 35% |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine Routine includes Colony Count | $100.10 | $154.00 | $30.80–$154.00 | 129% above | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine Routine includes Colony Count | $100.10 | $154.00 | $30.80–$126.28 | — | 35% |
| Urine microalbumin (albumin) test CPT 82043 U Malb 24 RL | $79.30 | $122.00 | $24.40–$122.00 | 129% above | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 U Malb 24 RL | $79.30 | $122.00 | $24.40–$100.04 | — | 35% |
| Urine pregnancy test, read by color change CPT 81025 BEDSIDE PREG TEST-URINE | $45.50 | $70.00 | $14.00–$70.00 | 15% below | 35% |
| Urine pregnancy test, read by color change CPT 81025 Surg Pregnancy Test | $90.35 | $139.00 | $27.80–$139.00 | 68% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 UCG Qualitative Pregnancy Test Urine | $90.35 | $139.00 | $27.80–$139.00 | 68% above | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 BEDSIDE PREG TEST-URINE | $45.50 | $70.00 | $14.00–$57.40 | — | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 UCG Qualitative Pregnancy Test Urine | $90.35 | $139.00 | $27.80–$113.98 | — | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Surg Pregnancy Test | $90.35 | $139.00 | $27.80–$113.98 | — | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 82607 VITAMIN B-12 | $211.90 | $326.00 | $65.20–$326.00 | 187% above | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $211.90 | $326.00 | $65.20–$326.00 | 187% above | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 82607 VITAMIN B-12 | $211.90 | $326.00 | $65.20–$267.32 | — | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $211.90 | $326.00 | $65.20–$267.32 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy | $414.05 | $637.00 | $127.40–$637.00 | 207% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxy Vitamin D (D2+D3 Fractionated) LC/MS-MS | $414.05 | $637.00 | $127.40–$637.00 | 207% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxy Vitamin D (D2+D3 Fractionated) LC/MS-MS | $414.05 | $637.00 | $127.40–$522.34 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy | $414.05 | $637.00 | $127.40–$522.34 | — | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25 Dihydroxy (Calcitrol) | $513.50 | $790.00 | $158.00–$790.00 | 188% above | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1 25 Dihydroxy (Calcitrol) | $513.50 | $790.00 | $158.00–$647.80 | — | 35% |
| Zinc blood test CPT 84630 Zinc Serum or Plasma | $65.00 | $100.00 | $20.00–$100.00 | 21% below | 35% |
| Zinc blood test inpatient CPT 84630 Zinc Serum or Plasma | $65.00 | $100.00 | $20.00–$82.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin (hCG) Tumor Marker | $84.50 | $130.00 | $26.00–$130.00 | 6% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 CHORIONIC GONADOTROPIN TEST | $84.50 | $130.00 | $26.00–$130.00 | 6% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Quantitative Serum | $84.50 | $130.00 | $26.00–$130.00 | 6% above | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 CHORIONIC GONADOTROPIN TEST | $84.50 | $130.00 | $26.00–$106.60 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Quantitative Serum | $84.50 | $130.00 | $26.00–$106.60 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin (hCG) Tumor Marker | $84.50 | $130.00 | $26.00–$106.60 | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Bx Brst 1st Lesion Strtctc RT | $4,676.75 | $7,195.00 | $1,439.00–$7,195.00 | 87% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Bx Brst 1st Lesion Strtctc LT | $4,676.75 | $7,195.00 | $1,439.00–$7,195.00 | 87% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA Bx Brst 1st Lesion Strtctc RT | $4,676.75 | $7,195.00 | $1,439.00–$5,899.90 | — | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MA Bx Brst 1st Lesion Strtctc LT | $4,676.75 | $7,195.00 | $1,439.00–$5,899.90 | — | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DSTL FIBULAR FX LAT MALLS | $217.10 | $334.00 | $66.80–$334.00 | 45% below | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DSTL FIBULAR FX LAT MALLS | $217.10 | $334.00 | $66.80–$273.88 | — | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX, WO MANIP | $238.55 | $367.00 | $73.40–$367.00 | 45% below | 35% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX, WO MANIP | $238.55 | $367.00 | $73.40–$300.94 | — | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 L Hrt Artery/Ventricle Angio | $7,330.05 | $11,277.00 | $2,255.40–$11,277.00 | 26% below | 35% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 L Hrt Artery/Ventricle Angio | $7,330.05 | $11,277.00 | $2,255.40–$9,247.14 | — | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ECC | $1,086.15 | $1,671.00 | $334.20–$1,671.00 | 23% below | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Charge | $1,106.95 | $1,703.00 | $340.60–$1,703.00 | 21% below | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Procedure | $1,106.95 | $1,703.00 | $340.60–$1,703.00 | 21% below | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ECC | $1,086.15 | $1,671.00 | $334.20–$1,370.22 | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Procedure | $1,106.95 | $1,703.00 | $340.60–$1,396.46 | — | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Charge | $1,106.95 | $1,703.00 | $340.60–$1,396.46 | — | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 Comp EPS w/Afib and PVI | $41,405.00 | $63,700.00 | $12,740.00–$63,700.00 | 49% above | 35% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 Comp EPS w/Afib and PVI | $41,405.00 | $63,700.00 | $12,740.00–$52,234.00 | — | 35% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $611.00 | $940.00 | $188.00–$940.00 | 55% below | 35% |
| Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX | $611.00 | $940.00 | $188.00–$770.80 | — | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Mogan | $682.50 | $1,050.00 | $210.00–$1,050.00 | 4% below | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Mogan | $682.50 | $1,050.00 | $210.00–$861.00 | — | 35% |
| Circumcision, surgical, older than a newborn CPT 54160 Plastibell | $150.80 | $232.00 | $46.40–$232.00 | 62% below | 35% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 Plastibell | $150.80 | $232.00 | $46.40–$190.24 | — | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $243.75 | $375.00 | $75.00–$375.00 | 44% below | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA | $243.75 | $375.00 | $75.00–$307.50 | — | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 RC CYSTOSCOPY | $536.25 | $825.00 | $165.00–$825.00 | 80% below | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 RC CYSTOSCOPY | $536.25 | $825.00 | $165.00–$676.50 | — | 35% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EARWAX UNI | $70.85 | $109.00 | $21.80–$109.00 | 60% below | 35% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove impacted earwax | $70.85 | $109.00 | $21.80–$109.00 | 60% below | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EARWAX UNI | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove impacted earwax | $70.85 | $109.00 | $21.80–$89.38 | — | 35% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX | $161.85 | $249.00 | $49.80–$249.00 | 1% above | 35% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX | $161.85 | $249.00 | $49.80–$204.18 | — | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY-UTERUS LINING | $169.65 | $261.00 | $52.20–$261.00 | 41% below | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY-UTERUS LINING | $169.65 | $261.00 | $52.20–$214.02 | — | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR 62321 INJ C or T Spine Imag | $1,362.40 | $2,096.00 | $419.20–$2,096.00 | 28% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR 62321 INJ C or T Spine Imag | $1,362.40 | $2,096.00 | $419.20–$1,718.72 | — | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,040.65 | $1,601.00 | $320.20–$1,601.00 | 10% below | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR 64493 Facet Inj Lumbar Ini Level | $2,058.55 | $3,167.00 | $633.40–$3,167.00 | 78% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,040.65 | $1,601.00 | $320.20–$1,312.82 | — | 35% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 IR 64493 Facet Inj Lumbar Ini Level | $2,058.55 | $3,167.00 | $633.40–$2,596.94 | — | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 DX--Hysterosalpingogram | $131.95 | $203.00 | $40.60–$203.00 | 54% below | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 DX--Hysterosalpingogram | $131.95 | $203.00 | $40.60–$166.46 | — | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS | $349.70 | $538.00 | $107.60–$538.00 | 24% below | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE SKIN ABSCESS | $371.15 | $571.00 | $114.20–$571.00 | 20% below | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS | $349.70 | $538.00 | $107.60–$441.16 | — | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE SKIN ABSCESS | $371.15 | $571.00 | $114.20–$468.22 | — | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TEND SHEATH LIGAMENT CYST | $466.70 | $718.00 | $143.60–$718.00 | 13% below | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 IR 20550 Inj Tendon Sheath Ligament | $484.25 | $745.00 | $149.00–$745.00 | 9% below | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TEND SHEATH LIGAMENT CYST | $466.70 | $718.00 | $143.60–$588.76 | — | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 IR 20550 Inj Tendon Sheath Ligament | $484.25 | $745.00 | $149.00–$610.90 | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJ JOINT/BURSA/CYST-MAJOR | $457.60 | $704.00 | $140.80–$704.00 | 11% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR 20610 Asp Inject Major Joint LT | $457.60 | $704.00 | $140.80–$704.00 | 11% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR 20610 Asp Inject Major Joint RT | $457.60 | $704.00 | $140.80–$704.00 | 11% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJ JOINT/BURSA/CYST-MAJOR | $457.60 | $704.00 | $140.80–$577.28 | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR 20610 Asp Inject Major Joint LT | $457.60 | $704.00 | $140.80–$577.28 | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR 20610 Asp Inject Major Joint RT | $457.60 | $704.00 | $140.80–$577.28 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR-INJ JNT-BURSA CYST-INTERMED | $343.85 | $529.00 | $105.80–$529.00 | 20% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Aspiration and/or injection of fluid from medium join | $343.85 | $529.00 | $105.80–$529.00 | 20% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 IR 20605 Asp Inject Medium Joint LT | $343.85 | $529.00 | $105.80–$529.00 | 20% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 IR 20605 Asp Inject Medium Joint RT | $343.85 | $529.00 | $105.80–$529.00 | 20% below | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR-INJ JNT-BURSA CYST-INTERMED | $343.85 | $529.00 | $105.80–$433.78 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Aspiration and/or injection of fluid from medium join | $343.85 | $529.00 | $105.80–$433.78 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 IR 20605 Asp Inject Medium Joint LT | $343.85 | $529.00 | $105.80–$433.78 | — | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 IR 20605 Asp Inject Medium Joint RT | $343.85 | $529.00 | $105.80–$433.78 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRAT INJECT JOINT BURSA CYST | $289.25 | $445.00 | $89.00–$445.00 | 2% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 IR 20600 Asp Inject Small Joint LT | $289.25 | $445.00 | $89.00–$445.00 | 2% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 IR 20600 Asp Inject Small Joint RT | $289.25 | $445.00 | $89.00–$445.00 | 2% below | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRAT INJECT JOINT BURSA CYST | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 IR 20600 Asp Inject Small Joint RT | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 IR 20600 Asp Inject Small Joint LT | $289.25 | $445.00 | $89.00–$364.90 | — | 35% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY , APPENDECTOMY | $4,915.30 | $7,562.00 | $1,512.40–$7,562.00 | 66% below | 35% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY , APPENDECTOMY | $4,915.30 | $7,562.00 | $1,512.40–$6,200.84 | — | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE WOUNDS .1-2.5 CM | $245.70 | $378.00 | $75.60–$378.00 | 66% below | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE WOUNDS .1-2.5 CM | $245.70 | $378.00 | $75.60–$309.96 | — | 35% |
| Left heart catheterization, diagnostic one side CPT 93452 Left Heart Cath w/o Coronaries | $7,794.80 | $11,992.00 | $2,398.40–$11,992.00 | at median | 35% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Heart Cath w/o Coronaries | $7,794.80 | $11,992.00 | $2,398.40–$9,833.44 | — | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR 62323 INJ L Spine Imag | $1,362.40 | $2,096.00 | $419.20–$2,096.00 | 6% above | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR 62323 INJ L Spine Imag | $1,362.40 | $2,096.00 | $419.20–$1,718.72 | — | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 IR 62322 INJ L Spine No Imaging | $1,362.40 | $2,096.00 | $419.20–$2,096.00 | 4% below | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 IR 62322 INJ L Spine No Imaging | $1,362.40 | $2,096.00 | $419.20–$1,718.72 | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Inj Anes Ster-Lumbar | $1,791.40 | $2,756.00 | $551.20–$2,756.00 | 10% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR 64483 Nerve Root Inj Lumbar | $1,791.40 | $2,756.00 | $551.20–$2,756.00 | 10% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR 64483 Nerve Root Inj Lumbar | $1,791.40 | $2,756.00 | $551.20–$2,259.92 | — | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Inj Anes Ster-Lumbar | $1,791.40 | $2,756.00 | $551.20–$2,259.92 | — | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION OF SKIN LESION | $449.15 | $691.00 | $138.20–$691.00 | 80% below | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION OF SKIN LESION | $449.15 | $691.00 | $138.20–$566.62 | — | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION OF SKIN LESION/1 | $520.65 | $801.00 | $160.20–$801.00 | 29% below | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION OF SKIN LESION/1 | $520.65 | $801.00 | $160.20–$656.82 | — | 35% |
| Nail removal (partial or complete), one nail CPT 11730 RC AVULSION OF NAIL PLATE | $224.90 | $346.00 | $69.20–$346.00 | 43% below | 35% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion of Nail Plate | $224.90 | $346.00 | $69.20–$346.00 | 43% below | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of Nail Plate | $224.90 | $346.00 | $69.20–$283.72 | — | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 RC AVULSION OF NAIL PLATE | $224.90 | $346.00 | $69.20–$283.72 | — | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL BLOCK | $231.40 | $356.00 | $71.20–$356.00 | 62% below | 35% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL BLOCK | $231.40 | $356.00 | $71.20–$291.92 | — | 35% |
| Paracentesis with imaging guidance CPT 49083 IR 49083 Paracentesis W-Imaging | $1,595.75 | $2,455.00 | $491.00–$2,455.00 | 15% above | 35% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,595.75 | $2,455.00 | $491.00–$2,455.00 | 15% above | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $1,595.75 | $2,455.00 | $491.00–$2,013.10 | — | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 IR 49083 Paracentesis W-Imaging | $1,595.75 | $2,455.00 | $491.00–$2,013.10 | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PERMANENT NAIL REMOVAL | $644.15 | $991.00 | $198.20–$991.00 | 7% below | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL | $698.10 | $1,074.00 | $214.80–$1,074.00 | at median | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PERMANENT NAIL REMOVAL | $644.15 | $991.00 | $198.20–$812.62 | — | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL | $698.10 | $1,074.00 | $214.80–$880.68 | — | 35% |
| Prostate biopsy CPT 55700 IR 55700 Biopsy Prostate | $2,470.00 | $3,800.00 | $760.00–$3,800.00 | 31% below | 35% |
| Prostate biopsy inpatient CPT 55700 IR 55700 Biopsy Prostate | $2,470.00 | $3,800.00 | $760.00–$3,116.00 | — | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 IR 64635 Rhizotomy Lumbar Single | $2,505.75 | $3,855.00 | $771.00–$3,855.00 | 24% below | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 IR 64635 Rhizotomy Lumbar Single | $2,505.75 | $3,855.00 | $771.00–$3,161.10 | — | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 INCIS REMOVE FOREIGN BODY-SUBCUT | $486.20 | $748.00 | $149.60–$748.00 | 21% below | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS REMOVE FOREIGN BODY-SUBCUT | $486.20 | $748.00 | $149.60–$613.36 | — | 35% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $218.40 | $336.00 | $67.20–$336.00 | 39% below | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CAST | $218.40 | $336.00 | $67.20–$275.52 | — | 35% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION-FOREARM SPLINT | $152.10 | $234.00 | $46.80–$234.00 | 16% below | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION-FOREARM SPLINT | $152.10 | $234.00 | $46.80–$191.88 | — | 35% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST | $235.95 | $363.00 | $72.60–$363.00 | 38% below | 35% |
| Short leg cast (below the knee) CPT 29405 PT 29405 Short Leg Cast | $235.95 | $363.00 | $72.60–$363.00 | 38% below | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 PT 29405 Short Leg Cast | $235.95 | $363.00 | $72.60–$297.66 | — | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST | $235.95 | $363.00 | $72.60–$297.66 | — | 35% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION-SHORT LEG SPLINT | $150.15 | $231.00 | $46.20–$231.00 | 38% below | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION-SHORT LEG SPLINT | $150.15 | $231.00 | $46.20–$189.42 | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFIC WOUNDS -1 2-5 CM | $223.60 | $344.00 | $68.80–$344.00 | 49% below | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR S/N/AX/GEN/TRNK 2.5CM/< | $358.15 | $551.00 | $110.20–$551.00 | 18% below | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR SUPERFIC WOUNDS -1 2-5 CM | $223.60 | $344.00 | $68.80–$282.08 | — | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR S/N/AX/GEN/TRNK 2.5CM/< | $358.15 | $551.00 | $110.20–$451.82 | — | 35% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $390.65 | $601.00 | $120.20–$601.00 | 13% below | 35% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $390.65 | $601.00 | $120.20–$492.82 | — | 35% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS | $147.55 | $227.00 | $45.40–$227.00 | 48% below | 35% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS | $147.55 | $227.00 | $45.40–$186.14 | — | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE-LUMBAR/DIAGNOSTIC | $691.60 | $1,064.00 | $212.80–$1,064.00 | 33% below | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 IR 62270 Lumbar Puncture-Diagnostic | $752.70 | $1,158.00 | $231.60–$1,158.00 | 27% below | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture - Diagnostic | $771.55 | $1,187.00 | $237.40–$1,187.00 | 25% below | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE-LUMBAR/DIAGNOSTIC | $691.60 | $1,064.00 | $212.80–$872.48 | — | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR 62270 Lumbar Puncture-Diagnostic | $752.70 | $1,158.00 | $231.60–$949.56 | — | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture - Diagnostic | $771.55 | $1,187.00 | $237.40–$973.34 | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SUPERFIC WOUNDS 2.6-7.5 CM | $309.40 | $476.00 | $95.20–$476.00 | 22% below | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR S/N/AX/GEN/TRNK 2.6-7.5CM | $358.15 | $551.00 | $110.20–$551.00 | 10% below | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR SUPERFIC WOUNDS 2.6-7.5 CM | $309.40 | $476.00 | $95.20–$390.32 | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR S/N/AX/GEN/TRNK 2.6-7.5CM | $358.15 | $551.00 | $110.20–$451.82 | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFIC WOUNDS -1 2-5 C/1 | $213.85 | $329.00 | $65.80–$329.00 | 50% below | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR SUPERFIC WOUNDS -1 2-5 C/1 | $213.85 | $329.00 | $65.80–$269.78 | — | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIA BX SKIN SINGL LESION | $358.15 | $551.00 | $110.20–$551.00 | 12% below | 35% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIA BX SKIN SINGL LESION | $358.15 | $551.00 | $110.20–$451.82 | — | 35% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING GUIDANCE | $1,600.95 | $2,463.00 | $492.60–$2,463.00 | 46% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis Aspir w/ Image | $1,600.95 | $2,463.00 | $492.60–$2,463.00 | 46% above | 35% |
| Thoracentesis with imaging guidance one side CPT 32555 IR 32555 Thoracentesis RT W-Image | $1,600.95 | $2,463.00 | $492.60–$2,463.00 | 46% above | 35% |
| Thoracentesis with imaging guidance one side CPT 32555 IR 32555 Thoracentesis LT W-Image | $1,600.95 | $2,463.00 | $492.60–$2,463.00 | 46% above | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING GUIDANCE | $1,600.95 | $2,463.00 | $492.60–$2,019.66 | — | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Aspir w/ Image | $1,600.95 | $2,463.00 | $492.60–$2,019.66 | — | 35% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 IR 32555 Thoracentesis RT W-Image | $1,600.95 | $2,463.00 | $492.60–$2,019.66 | — | 35% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 IR 32555 Thoracentesis LT W-Image | $1,600.95 | $2,463.00 | $492.60–$2,019.66 | — | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT | $238.55 | $367.00 | $73.40–$367.00 | 58% below | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 IR 20552 Trigger Point Inj 1-2 | $238.55 | $367.00 | $73.40–$367.00 | 58% below | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 IR 20552 Trigger Point Inj 1-2 | $238.55 | $367.00 | $73.40–$300.94 | — | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT | $238.55 | $367.00 | $73.40–$300.94 | — | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 MA Bx Brst 1st Lesion US Imag RT | $4,065.75 | $6,255.00 | $1,251.00–$6,255.00 | 75% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 MA Bx Brst 1st Lesion US Imag LT | $4,065.75 | $6,255.00 | $1,251.00–$6,255.00 | 75% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 MA Bx Brst 1st Lesion US Imag LT | $4,065.75 | $6,255.00 | $1,251.00–$5,129.10 | — | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 MA Bx Brst 1st Lesion US Imag RT | $4,065.75 | $6,255.00 | $1,251.00–$5,129.10 | — | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHGASTRODSCPY DIAG BRUSH WASH | $871.00 | $1,340.00 | $268.00–$1,340.00 | 63% below | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHGASTRODSCPY DIAG BRUSH WASH | $871.00 | $1,340.00 | $268.00–$1,098.80 | — | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 IR 36475 RF Ablat Ther 1st Vein | $8,517.60 | $13,104.00 | $2,620.80–$13,104.00 | 37% above | 35% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 IR 36475 RF Ablat Ther 1st Vein | $8,517.60 | $13,104.00 | $2,620.80–$10,745.28 | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN/TISSUE | $837.20 | $1,288.00 | $257.60–$1,288.00 | 8% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, skin/subcu. Tissue | $920.40 | $1,416.00 | $283.20–$1,416.00 | 18% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE TISSUE UP TO 20CM | $920.40 | $1,416.00 | $283.20–$1,416.00 | 18% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN/TISSUE | $837.20 | $1,288.00 | $257.60–$1,056.16 | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE TISSUE UP TO 20CM | $920.40 | $1,416.00 | $283.20–$1,161.12 | — | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement, skin/subcu. Tissue | $920.40 | $1,416.00 | $283.20–$1,161.12 | — | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $510.25 | $785.00 | $157.00–$785.00 | 43% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 O/P Blood Transfusion 0-6 Hrs | $640.90 | $986.00 | $197.20–$986.00 | 29% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion-FFP | $640.90 | $986.00 | $197.20–$986.00 | 29% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion-Packed RBC | $640.90 | $986.00 | $197.20–$986.00 | 29% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion-Platelets | $640.90 | $986.00 | $197.20–$986.00 | 29% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 O/P Blood Transfusion 7-12 Hrs | $843.05 | $1,297.00 | $259.40–$1,297.00 | 6% below | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Given | $1,088.10 | $1,674.00 | $334.80–$1,674.00 | 21% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 O/P Blood Transfusion 13-18 Hrs | $1,088.10 | $1,674.00 | $334.80–$1,674.00 | 21% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 O/P Blood Transfusion 19+ Hrs | $1,502.80 | $2,312.00 | $462.40–$2,312.00 | 67% above | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $510.25 | $785.00 | $157.00–$643.70 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion-FFP | $640.90 | $986.00 | $197.20–$808.52 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 O/P Blood Transfusion 0-6 Hrs | $640.90 | $986.00 | $197.20–$808.52 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion-Platelets | $640.90 | $986.00 | $197.20–$808.52 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion-Packed RBC | $640.90 | $986.00 | $197.20–$808.52 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 O/P Blood Transfusion 7-12 Hrs | $843.05 | $1,297.00 | $259.40–$1,063.54 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 O/P Blood Transfusion 13-18 Hrs | $1,088.10 | $1,674.00 | $334.80–$1,372.68 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Given | $1,088.10 | $1,674.00 | $334.80–$1,372.68 | — | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 O/P Blood Transfusion 19+ Hrs | $1,502.80 | $2,312.00 | $462.40–$1,895.84 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metaneb Treatment | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer # | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI # Treatment | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB # | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neb with Heliox # MHSB | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Completed # | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Updraft Treatment - ER | $246.35 | $379.00 | $75.80–$379.00 | 118% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Humidity # Continuous | $321.10 | $494.00 | $98.80–$494.00 | 185% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol with Heliox Daily Charge | $827.45 | $1,273.00 | $254.60–$1,273.00 | 634% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Completed # | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metaneb Treatment | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Updraft Treatment - ER | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer # | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB # | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neb with Heliox # MHSB | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI # Treatment | $246.35 | $379.00 | $75.80–$310.78 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Humidity # Continuous | $321.10 | $494.00 | $98.80–$405.08 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol with Heliox Daily Charge | $827.45 | $1,273.00 | $254.60–$1,043.86 | — | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 Given | $479.70 | $738.00 | $147.60–$738.00 | 29% below | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Given | $479.70 | $738.00 | $147.60–$605.16 | — | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 ED Critical Care (Face to Face ) Initial 30-74 Min | $1,543.10 | $2,374.00 | $474.80–$2,374.00 | 27% below | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED Critical Care (Face to Face ) Initial 30-74 Min | $1,543.10 | $2,374.00 | $474.80–$1,946.68 | — | 35% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $520.65 | $801.00 | $160.20–$801.00 | 24% below | 35% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY | $520.65 | $801.00 | $160.20–$656.82 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM (EKG)/1 | $182.65 | $281.00 | $56.20–$281.00 | 10% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram (EKG) charge | $182.65 | $281.00 | $56.20–$281.00 | 10% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Charge - ECC | $182.65 | $281.00 | $56.20–$281.00 | 10% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM (EKG) | $182.65 | $281.00 | $56.20–$281.00 | 10% below | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram (EKG) charge | $182.65 | $281.00 | $56.20–$230.42 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM (EKG) | $182.65 | $281.00 | $56.20–$230.42 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM (EKG)/1 | $182.65 | $281.00 | $56.20–$230.42 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Charge - ECC | $182.65 | $281.00 | $56.20–$230.42 | — | 35% |
| Electroconvulsive therapy (ECT), one session CPT 90870 ECT | $958.75 | $1,475.00 | $295.00–$1,475.00 | 25% below | 35% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT | $958.75 | $1,475.00 | $295.00–$1,209.50 | — | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Level 1 (Brief) (1-2) | $182.65 | $281.00 | $56.20–$281.00 | 16% below | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED Level 1 (Brief) (1-2) | $182.65 | $281.00 | $56.20–$230.42 | — | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Level 2 (Limited) (3-5) | $326.95 | $503.00 | $100.60–$503.00 | 22% below | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Level 2 (Limited) (3-5) | $326.95 | $503.00 | $100.60–$412.46 | — | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Level 3 (Intermediate) (6-8) | $536.90 | $826.00 | $165.20–$826.00 | 31% below | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Level 3 (Intermediate) (6-8) | $536.90 | $826.00 | $165.20–$677.32 | — | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Level 4 (Extended) (9-13) | $839.15 | $1,291.00 | $258.20–$1,291.00 | 29% below | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Level 4 (Extended) (9-13) | $839.15 | $1,291.00 | $258.20–$1,058.62 | — | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Level 5 (Comprehensive) (>/=14) | $1,251.25 | $1,925.00 | $385.00–$1,925.00 | 28% below | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Level 5 (Comprehensive) (>/=14) | $1,251.25 | $1,925.00 | $385.00–$1,578.50 | — | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Diagnostic Stress Exercise Treadmill MHSB | $640.25 | $985.00 | $197.00–$985.00 | 16% below | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 DIAGNOSTIC EXERCISE TEST CHG ONLY | $652.60 | $1,004.00 | $200.80–$1,004.00 | 14% below | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Diagnostic Exercise Test | $652.60 | $1,004.00 | $200.80–$1,004.00 | 14% below | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Diagnostic Stress Exercise Treadmill MHSB | $640.25 | $985.00 | $197.00–$807.70 | — | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 DIAGNOSTIC EXERCISE TEST CHG ONLY | $652.60 | $1,004.00 | $200.80–$823.28 | — | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Diagnostic Exercise Test | $652.60 | $1,004.00 | $200.80–$823.28 | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV-ER-1st hour | $234.65 | $361.00 | $72.20–$361.00 | 36% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 O/P Hydration Infusion - 1st. hr | $243.10 | $374.00 | $74.80–$374.00 | 34% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Done | $243.10 | $374.00 | $74.80–$374.00 | 34% below | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV-ER-1st hour | $234.65 | $361.00 | $72.20–$296.02 | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Done | $243.10 | $374.00 | $74.80–$306.68 | — | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 O/P Hydration Infusion - 1st. hr | $243.10 | $374.00 | $74.80–$306.68 | — | 35% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INTL = <1HR | $262.60 | $404.00 | $80.80–$404.00 | 35% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 Infusion Therapy-ER-1st hour | $262.60 | $404.00 | $80.80–$404.00 | 35% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 Given | $262.60 | $404.00 | $80.80–$404.00 | 35% below | 35% |
| IV infusion of a medicine, first hour CPT 96365 O/P Infusion Therapy-1St Hr | $262.60 | $404.00 | $80.80–$404.00 | 35% below | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INTL = <1HR | $262.60 | $404.00 | $80.80–$331.28 | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 O/P Infusion Therapy-1St Hr | $262.60 | $404.00 | $80.80–$331.28 | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Given | $262.60 | $404.00 | $80.80–$331.28 | — | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Infusion Therapy-ER-1st hour | $262.60 | $404.00 | $80.80–$331.28 | — | 35% |
| IV push of a medicine, first drug CPT 96374 IV push, Initial 0-15 mins | $159.25 | $245.00 | $49.00–$245.00 | 25% below | 35% |
| IV push of a medicine, first drug CPT 96374 zzNM ROM IV Inj Radionuclide Diag | $378.95 | $583.00 | $116.60–$583.00 | 79% above | 35% |
| IV push of a medicine, first drug CPT 96374 Intravenous Injection-Ther/Prop/Diag | $378.95 | $583.00 | $116.60–$583.00 | 79% above | 35% |
| IV push of a medicine, first drug CPT 96374 NM MAC IV Inj Radionuclide Diag | $378.95 | $583.00 | $116.60–$583.00 | 79% above | 35% |
| IV push of a medicine, first drug CPT 96374 NM IV Injection Radionuclide Diag | $378.95 | $583.00 | $116.60–$583.00 | 79% above | 35% |
| IV push of a medicine, first drug CPT 96374 Given | $378.95 | $583.00 | $116.60–$583.00 | 79% above | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 IV push, Initial 0-15 mins | $159.25 | $245.00 | $49.00–$200.90 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 NM IV Injection Radionuclide Diag | $378.95 | $583.00 | $116.60–$478.06 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 Intravenous Injection-Ther/Prop/Diag | $378.95 | $583.00 | $116.60–$478.06 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 NM MAC IV Inj Radionuclide Diag | $378.95 | $583.00 | $116.60–$478.06 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 zzNM ROM IV Inj Radionuclide Diag | $378.95 | $583.00 | $116.60–$478.06 | — | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 Given | $378.95 | $583.00 | $116.60–$478.06 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Drug SC/IM-Each Seq Diff Drug | $80.60 | $124.00 | $24.80–$124.00 | 23% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection SQ or IM (non-vaccine) | $80.60 | $124.00 | $24.80–$124.00 | 23% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic/Prophylatic/Diag Inj | $80.60 | $124.00 | $24.80–$124.00 | 23% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Subq/Intramusc Inject-Ther/Prop/Diag | $80.60 | $124.00 | $24.80–$124.00 | 23% below | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Subq/Intramusc Inject-Ther/Prop/Diag | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic/Prophylatic/Diag Inj | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection SQ or IM (non-vaccine) | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Drug SC/IM-Each Seq Diff Drug | $80.60 | $124.00 | $24.80–$101.68 | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 NEUROPSYCHOLOGICAL CONSULT | $303.55 | $467.00 | $93.40–$467.00 | 21% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 NEUROPSYCHOLOGICAL CONSULT | $303.55 | $467.00 | $93.40–$382.94 | — | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES | $256.10 | $394.00 | $78.80–$394.00 | 70% below | 35% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES | $256.10 | $394.00 | $78.80–$323.08 | — | 35% |
| New patient office visit, about 30 minutes CPT 99203 E&M New Pt Level 3 (FAC) | $68.90 | $106.00 | $21.20–$106.00 | 58% below | 35% |
| New patient office visit, about 30 minutes CPT 99203 O/P Visit - Brief (New) | $82.55 | $127.00 | $25.40–$127.00 | 50% below | 35% |
| New patient office visit, about 30 minutes CPT 99203 Wound Clinic Level 3-New | $198.90 | $306.00 | $61.20–$306.00 | 20% above | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 E&M New Pt Level 3 (FAC) | $68.90 | $106.00 | $21.20–$86.92 | — | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 O/P Visit - Brief (New) | $82.55 | $127.00 | $25.40–$104.14 | — | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Wound Clinic Level 3-New | $198.90 | $306.00 | $61.20–$250.92 | — | 35% |
| New patient office visit, about 45 minutes CPT 99204 E&M New Pt Level 4 (FAC) | $115.05 | $177.00 | $35.40–$177.00 | 39% below | 35% |
| New patient office visit, about 45 minutes CPT 99204 WOUND CLINIC LEVEL 4 - NEW | $300.95 | $463.00 | $92.60–$463.00 | 59% above | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 E&M New Pt Level 4 (FAC) | $115.05 | $177.00 | $35.40–$145.14 | — | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WOUND CLINIC LEVEL 4 - NEW | $300.95 | $463.00 | $92.60–$379.66 | — | 35% |
| New patient office visit, about 60 minutes CPT 99205 E&M New Pt Level 5 (FAC) | $214.50 | $330.00 | $66.00–$330.00 | 15% below | 35% |
| New patient office visit, about 60 minutes CPT 99205 WOUND CLINIC LEVEL 5 - NEW | $387.40 | $596.00 | $119.20–$596.00 | 53% above | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 E&M New Pt Level 5 (FAC) | $214.50 | $330.00 | $66.00–$270.60 | — | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WOUND CLINIC LEVEL 5 - NEW | $387.40 | $596.00 | $119.20–$488.72 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M New Pt Level 2 (FAC) | $68.90 | $106.00 | $21.20–$106.00 | 51% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M New Pt Level 1 (FAC) | $68.90 | $106.00 | $21.20–$106.00 | 51% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Wound Clinic Level 2-New | $136.50 | $210.00 | $42.00–$210.00 | 3% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Wound Clinic Level 1-New | $136.50 | $210.00 | $42.00–$210.00 | 3% below | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OT 99201 INITIAL CLINIC EVAL (NEW) | $317.20 | $488.00 | $97.60–$488.00 | 126% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E&M New Pt Level 1 (FAC) | $68.90 | $106.00 | $21.20–$86.92 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E&M New Pt Level 2 (FAC) | $68.90 | $106.00 | $21.20–$86.92 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Wound Clinic Level 2-New | $136.50 | $210.00 | $42.00–$172.20 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Wound Clinic Level 1-New | $136.50 | $210.00 | $42.00–$172.20 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OT 99201 INITIAL CLINIC EVAL (NEW) | $317.20 | $488.00 | $97.60–$400.16 | — | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY | $313.30 | $482.00 | $96.40–$482.00 | 47% above | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCAID) | $313.30 | $482.00 | $96.40–$482.00 | 47% above | 35% |
| Psychotherapy session, 60 minutes CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCARE) | $313.30 | $482.00 | $96.40–$482.00 | 47% above | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY | $313.30 | $482.00 | $96.40–$395.24 | — | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCAID) | $313.30 | $482.00 | $96.40–$395.24 | — | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 INDIVIDUAL PSYCHOTHERAPY (MCARE) | $313.30 | $482.00 | $96.40–$395.24 | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M Established Pt Level 5 (FAC) | $180.05 | $277.00 | $55.40–$277.00 | 20% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CLINIC LEVEL 5 | $242.45 | $373.00 | $74.60–$373.00 | 61% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E&M Established Pt Level 5 (FAC) | $180.05 | $277.00 | $55.40–$227.14 | — | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WOUND CLINIC LEVEL 5 | $242.45 | $373.00 | $74.60–$305.86 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M Established Pt Level 3 (FAC) | $65.00 | $100.00 | $20.00–$100.00 | 26% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 O/P Visit - Brief (Estab) | $82.55 | $127.00 | $25.40–$127.00 | 6% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OT 99213 LYMPHEDEMA FOLLW-UP TREATMENT-3 | $83.85 | $129.00 | $25.80–$129.00 | 5% below | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CLINIC LEVEL 3 | $150.15 | $231.00 | $46.20–$231.00 | 71% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E&M Established Pt Level 3 (FAC) | $65.00 | $100.00 | $20.00–$82.00 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 O/P Visit - Brief (Estab) | $82.55 | $127.00 | $25.40–$104.14 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OT 99213 LYMPHEDEMA FOLLW-UP TREATMENT-3 | $83.85 | $129.00 | $25.80–$105.78 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND CLINIC LEVEL 3 | $150.15 | $231.00 | $46.20–$189.42 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M Established Pt Level 4 (FAC) | $82.55 | $127.00 | $25.40–$127.00 | 26% below | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND CLINIC LEVEL 4 | $195.00 | $300.00 | $60.00–$300.00 | 76% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Peds Oncology Short Stay II | $280.15 | $431.00 | $86.20–$431.00 | 152% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OT 99214 LYMPHEDEMA TREATMENT (60) | $313.30 | $482.00 | $96.40–$482.00 | 182% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OT 99214 LYMPHEDEMA TREATMENT (90) | $472.55 | $727.00 | $145.40–$727.00 | 326% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E&M Established Pt Level 4 (FAC) | $82.55 | $127.00 | $25.40–$104.14 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WOUND CLINIC LEVEL 4 | $195.00 | $300.00 | $60.00–$246.00 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Peds Oncology Short Stay II | $280.15 | $431.00 | $86.20–$353.42 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OT 99214 LYMPHEDEMA TREATMENT (60) | $313.30 | $482.00 | $96.40–$395.24 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OT 99214 LYMPHEDEMA TREATMENT (90) | $472.55 | $727.00 | $145.40–$596.14 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M Established Pt Level 2 (FAC) | $65.00 | $100.00 | $20.00–$100.00 | 26% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WOUND CLINIC LEVEL 2 | $126.10 | $194.00 | $38.80–$194.00 | 145% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PT PEDIATRIC CLINIC | $259.35 | $399.00 | $79.80–$399.00 | 403% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OT 99212 DEVELOP PROGRESS CLINIC | $259.35 | $399.00 | $79.80–$399.00 | 403% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SLP DEVELOPMENTAL PROGRESS CLINIC | $259.35 | $399.00 | $79.80–$399.00 | 403% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E&M Established Pt Level 2 (FAC) | $65.00 | $100.00 | $20.00–$82.00 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WOUND CLINIC LEVEL 2 | $126.10 | $194.00 | $38.80–$159.08 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OT 99212 DEVELOP PROGRESS CLINIC | $259.35 | $399.00 | $79.80–$327.18 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PT PEDIATRIC CLINIC | $259.35 | $399.00 | $79.80–$327.18 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SLP DEVELOPMENTAL PROGRESS CLINIC | $259.35 | $399.00 | $79.80–$327.18 | — | 35% |
| Spirometry (breathing test) CPT 94010 Spirometry | $326.95 | $503.00 | $100.60–$503.00 | 33% above | 35% |
| Spirometry (breathing test) CPT 94010 Pulm Function Screening | $326.95 | $503.00 | $100.60–$503.00 | 33% above | 35% |
| Spirometry (breathing test) inpatient CPT 94010 Pulm Function Screening | $326.95 | $503.00 | $100.60–$412.46 | — | 35% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry | $326.95 | $503.00 | $100.60–$412.46 | — | 35% |
| Spirometry before and after a bronchodilator CPT 94060 Pre and Post Spirometry | $562.25 | $865.00 | $173.00–$865.00 | 4% above | 35% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry Before/After Bronch-Lung | $562.25 | $865.00 | $173.00–$865.00 | 4% above | 35% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pre and Post Spirometry | $562.25 | $865.00 | $173.00–$709.30 | — | 35% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Before/After Bronch-Lung | $562.25 | $865.00 | $173.00–$709.30 | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Done | $111.80 | $172.00 | $34.40–$172.00 | 47% below | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Therapeutic | $111.80 | $172.00 | $34.40–$172.00 | 47% below | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 <200 mL | $111.80 | $172.00 | $34.40–$172.00 | 47% below | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Done | $111.80 | $172.00 | $34.40–$141.04 | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, Therapeutic | $111.80 | $172.00 | $34.40–$141.04 | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 <200 mL | $111.80 | $172.00 | $34.40–$141.04 | — | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 diphtheria/tetanus/pertussis (DTaP) (PED) 15 units-5 units-23 mcg/0.5 mL (Daptacel) Susp | $102.05 | $157.00 | $31.40–$157.00 | 24% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 diphtheria/tetanus/pertussis (DTaP) (PED) 15 units-5 units-23 mcg/0.5 mL (Daptacel) Susp | $102.05 | $157.00 | $31.40–$128.74 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 hepatitis B pediatric vaccine 5 mcg/0.5 mL IM Inj | $95.55 | $147.00 | $29.40–$147.00 | 30% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 hepatitis B pediatric vaccine 5 mcg/0.5 mL IM Inj | $95.55 | $147.00 | $29.40–$120.54 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj | $325.00 | $500.00 | $100.00–$500.00 | 26% above | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella virus vaccine SubQ Inj | $325.00 | $500.00 | $100.00–$410.00 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal groups A, C, W, and Y vaccine - tetanus toxoid conjugate quad 0.5 mL Inj | $586.30 | $902.00 | $180.40–$902.00 | 68% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal groups A, C, W, and Y vaccine - tetanus toxoid conjugate quad 0.5 mL Inj | $586.30 | $902.00 | $180.40–$739.64 | — | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 nirsevimab-alip vaccine PF 50 mg/0.5 mL Inj (weight less than 5 kg) | $1,824.55 | $2,807.00 | $561.40–$2,807.00 | 61% above | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 nirsevimab-alip vaccine PF 50 mg/0.5 mL Inj (weight less than 5 kg) | $1,824.55 | $2,807.00 | $561.40–$2,301.74 | — | 35% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine, chick embryo 2.5 intl units IM Inj (RabAvert) | $1,453.40 | $2,236.00 | $447.20–$2,236.00 | 82% above | 35% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine, human diploid cell 2.5 intl units IM Inj (Imovax) | $1,522.95 | $2,343.00 | $468.60–$2,343.00 | 90% above | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, chick embryo 2.5 intl units IM Inj (RabAvert) | $1,453.40 | $2,236.00 | $447.20–$1,833.52 | — | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine, human diploid cell 2.5 intl units IM Inj (Imovax) | $1,522.95 | $2,343.00 | $468.60–$1,921.26 | — | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria toxoids (Td) adult/adolescent 5 units-2 units/0.5 mL IM Inj 0.5 mL | $129.35 | $199.00 | $39.80–$199.00 | 13% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria toxoids (Td) adult/adolescent 5 units-2 units/0.5 mL IM Inj 0.5 mL | $129.35 | $199.00 | $39.80–$163.18 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertussis (Adacel Tdap) IM Inj 0.5 mL | $167.05 | $257.00 | $51.40–$257.00 | 36% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertussis (Adacel Tdap) IM Inj 0.5 mL | $167.05 | $257.00 | $51.40–$210.74 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RC Immunization Adm 1 Vaccine | $78.65 | $121.00 | $24.20–$121.00 | 28% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin, 1 Vaccine | $78.65 | $121.00 | $24.20–$121.00 | 28% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Done | $78.65 | $121.00 | $24.20–$121.00 | 28% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RC Immunization Adm 1 Vaccine | $78.65 | $121.00 | $24.20–$99.22 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Done | $78.65 | $121.00 | $24.20–$99.22 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin, 1 Vaccine | $78.65 | $121.00 | $24.20–$99.22 | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RC Immunization Adm EA Addl Vac | $54.60 | $84.00 | $16.80–$84.00 | 37% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Each add'l vaccine | $54.60 | $84.00 | $16.80–$84.00 | 37% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin, Ea Addl Vaccine | $54.60 | $84.00 | $16.80–$84.00 | 37% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RC Immunization Adm EA Addl Vac | $54.60 | $84.00 | $16.80–$68.88 | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Each add'l vaccine | $54.60 | $84.00 | $16.80–$68.88 | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin, Ea Addl Vaccine | $54.60 | $84.00 | $16.80–$68.88 | — | 35% |
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.